Understanding Narcissistic Personality Disorder

Narcissistic Personality Disorder (NPD) is one of the most difficult and frustrating mental disorders to experience or treat.  Its name comes from the Greek myth about Narcissus, a handsome young man who saw his reflection in a pool of water and fell in love with it. We all have known individuals who seem to be snobbish, self-important, or patronizing with others.  In its extreme, such behaviors may be symptomatic of a narcissistic personality.

For all their feelings of superiority, individuals with NPD have great difficulty with relationships and managing life’s everyday problems.  Friends and loved ones also find it difficult to cope with the selfish and grandiose behaviors that are a hallmark of the disorder.

The Nature of Narcissistic Personality Disorder

NPD is a condition characterized by an overwhelming need for attention and admiration, a heightened sense of self-importance, and a lack of empathy toward others. Ironically, for all their boastful and entitled behavior, individuals with narcissistic personality disorder have problems with self-esteem. Their self-importance hides a deep, underlying sense of insecurity.

NPD is classified as a “dramatic” personality disorder, characterized by a distorted sense of self and unstable, intense emotions. Typical symptoms include:

  • Exaggerated sense of self-importance;
  • Preoccupation with fantasies of power, success, beauty, etc.;
  • Belief that one is unique or special;
  • Need for excessive admiration from others;
  • Strong sense of entitlement; e.g., demands for favorable treatment;
  • Exploitative behavior, such as taking advantage of others to achieve one’s own goals;
  • Lack of empathy or ability to identify with others’ needs or feelings;
  • Feelings of envy or belief that others are envious of them;
  • Regular displays of haughty or arrogant behavior.

To be diagnosed with the disorder, an individual must meet at least five of these symptoms.

NPD is believed to occur in over 6 per cent of the general population. It usually emerges in late adolescence or early adulthood and is more common in males than females.  Its cause is unknown, but most professionals subscribe to a bio-psychosocial view, believing that a combination of biological, genetic, psychological, and environmental factors lead to the disorder.  Early interactions with family; e.g., lack of affection or over-indulgence, may partially shape narcissistic behaviors. There is also a somewhat increased risk for the disorder in children of those with NPD.

Coping with Narcissistic Personality Disorder

NPD symptoms tend to peak in early adulthood. By middle age, many people experience fewer intense symptoms. But waiting out the progression of the disorder is not an ideal solution for individuals or their families.

Although there is no known cure for NPD, individuals can respond successfully to long-term psychotherapy. The most beneficial therapies for patients include:

  • Cognitive behavioral therapy, to identify negative, unhealthy beliefs and replace them with healthier ones;
  • Family therapy, to explore interpersonal conflicts and communication problems and better manage family relationships;
  • Group therapy, to facilitate communication with patients with similar conditions and promote listening skills and support for others.

Personality traits are difficult to alter, so the therapeutic process can take several years.  Short-term goals focus on reducing such damaging effects of NPD as substance abuse, depression, and shame. Long-term, therapy strives to reshape the individual’s personality and develop a more realistic self-image.

Family members may also need assistance in coping with the effects of the disorder. Suggestions for loved ones include the following:

  • Learn about the disorder. Understanding the nature of narcissistic personality disorder can make it less mysterious and frustrating.
  • Adjust your own mind-set. You may need to change your own way of dealing with the person, as it is not likely they will make changes for you.
  • Have realistic expectations.  Don’t ask for more than a loved one with NPD can give.
  • Avoid emotional dependence.  Don’t try to constantly please a loved one with NPD. Be aware of your own self-worth.
  • Set clear boundaries.  Don’t be afraid to say no, or to cut unproductive conversations short.
  • Practice effective communication.  When talking to someone with NPD, suggestions are more effective than requests.  Offer praise when warranted. (Remember that people with NPD have poor feelings of self-worth deep inside.)
  • Rely on a support system. Opening up to others will help you be more objective and reduce your emotional reliance on the person with NPD. Formal support can also be obtained through counseling and family support groups.

Understanding and dealing with NPD can be frustrating to all parties.  But with proper treatment and support, the disorder can be managed, as individuals learn to function more effectively and become more emotionally stable.

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