1.How can I identify someone with narcissistic Personality Disorder?
All of us have narcissistic TRAITS. Some of us even develop a narcissistic PERSONALITY, or a narcissistic STYLE. Moreover, narcissism is a SPECTRUM of behaviors - from the healthy to the utterly pathological (a condition known as the Narcissistic Personality Disorder, or NPD).
The Diagnostic and Statistical Manual (DSM) IV-TR uses this language to describe the malignant narcissist:
“An all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts.”
So, what matters is that these characteristics, often found in healthy people, appear jointly and not separately or intermittently and that they are all-pervasive (invade, penetrate, and mould every aspect, nook, and cranny of the personality):
1… That grandiose fantasies are abundantly discernible;
2… That grandiose (often ridiculous) behaviors are present;
3… That there is an over-riding need for admiration and adulation or attention (“narcissistic supply”);
4… That the person lacks empathy (regards other people as two dimensional cartoon figures and abstractions, unable to “stand in their shoes”);
5… That these traits and behaviors begin, at the latest, in early adolescence;
6… That the narcissistic behaviors pervade all the social and emotional interactions of the narcissist.
- By having this disorder can a person with NPD live a productive lifestyle? Why or Why not?
Is pathological narcissism a blessing or a malediction?
The answer is: it depends. Healthy narcissism is a mature, balanced love of oneself coupled with a stable sense of self-worth and self-esteem. Healthy narcissism implies knowledge of one’s boundaries and a proportionate and realistic appraisal of one’s achievements and traits.
Pathological narcissism is wrongly described as too much healthy narcissism (or too much self-esteem). These are two absolutely unrelated phenomena which, regrettably, came to bear the same title. Confusing pathological narcissism with self- esteem betrays a fundamental ignorance of both.
Pathological narcissism involves an impaired, dysfunctional, immature (True) Self coupled with a compensatory fiction (the False Self). The sick narcissist’s sense of self-worth and self-esteem derive entirely from audience feedback. The narcissist has no self-esteem or self-worth of his own (no such ego functions). In the absence of observers, the narcissist shrivels to non-existence and feels dead. Hence the narcissist’s preying habits in his constant pursuit of Narcissistic Supply. Pathological narcissism is an addictive behavior.
Still, dysfunctions are reactions to abnormal environments and situations (e.g., abuse, trauma, smothering, etc.).
Paradoxically, his dysfunction allows the narcissist to function. It compensates for lacks and deficiencies by exaggerating tendencies and traits. It is like the tactile sense of a blind person. In short: pathological narcissism is a result of over-sensitivity, the repression of overwhelming memories and experiences, and the suppression of inordinately strong negative feelings (e.g., hurt, envy, anger, or humiliation).
That the narcissist functions at all - is because of his pathology and thanks to it. The alternative is complete decompensation and integration.
In time, the narcissist learns how to leverage his pathology, how to use it to his advantage, how to deploy it in order to maximize benefits and utilities - in other words, how to transform his curse into a blessing.
Narcissists are obsessed by delusions of fantastic grandeur and superiority. As a result they are very competitive. They are strongly compelled - where others are merely motivated. They are driven, relentless, tireless, and ruthless. They often make it to the top. But even when they do not - they strive and fight and learn and climb and create and think and devise and design and conspire. Faced with a challenge - they are likely to do better than non-narcissists.
Yet, we often find that narcissists abandon their efforts in mid-stream, give up, vanish, lose interest, devalue former pursuits, fail, or slump. Why is that?
Narcissists are prone to self-defeating and self-destructive behaviors.
The Self-Punishing, Guilt-Purging Behaviors
These are intended to inflict punishment on the narcissist and thus instantly relieve him of his overwhelming anxiety.
This is very reminiscent of a compulsive-ritualistic behavior. The narcissist feels guilty. It could be an “ancient” guilt, a “sexual” guilt (Freud), or a “social” guilt. In early life, the narcissist internalized and introjected the voices of meaningful and authoritative others - parents, role models, peers - that consistently and convincingly judged him to be no good, blameworthy, deserving of punishment or retaliation, or corrupt.
The narcissist’s life is thus transformed into an on-going trial. The constancy of this trial, the never adjourning tribunal is the punishment. It is a Kafkaesque “trial”: meaningless, undecipherable, never-ending, leading to no verdict, subject to mysterious and fluid laws and presided over by capricious judges.
Such a narcissist masochistically frustrates his deepest desires and drives, obstructs his own efforts, alienates his friends and sponsors, provokes figures in authority to punish, demote, or ignore him, actively seeks and solicits disappointment, failure, or mistreatment and relishes them, incites anger or rejection, bypasses or rejects opportunities, or engages in excessive self-sacrifice.
In their book “Personality Disorders in Modern Life”, Theodore Millon and Roger Davis, describe the diagnosis of “Masochistic or Self-Defeating Personality Disorder”, found in the appendix of the DSM III-R but excluded from the DSM IV. While the narcissist is rarely a full-fledged masochist, many a narcissist exhibit some of the traits of this personality disorder.
The Extracting Behaviors
People with Personality Disorders (PDs) are very afraid of real, mature, intimacy. Intimacy is formed not only within a couple, but also in a workplace, in a neighborhood, with friends, while collaborating on a project. Intimacy is another word for emotional involvement, which is the result of interactions in constant and predictable (safe) propinquity.
PDs interpret intimacy as counter-dependence, emotional strangulation, the snuffing of freedom, a kind of death in installments. They are terrorized by it. To avoid it, their self-destructive and self-defeating acts are intended to dismantle the very foundation of a successful relationship, a career, a project, or a friendship. Narcissists feel elated and relieved after they unshackle these “chains”. They feel they broke a siege, that they are liberated, free at last.
The Relief of Being Abandoned
The Default Behaviors
We are all, to some degree, inertial, afraid of new situations, new opportunities, new challenges, new circumstances and new demands. Being healthy, being successful, getting married, becoming a mother, or someone’s boss - often entail abrupt breaks with the past. Some self-defeating behaviors are intended to preserve the past, to restore it, to protect it from the winds of change, to self-deceptively skirt promising opportunities while seeming to embrace them.
Moreover, to the narcissist, a challenge, or even a guaranteed eventual triumph, are meaningless in the absence of onlookers. The narcissist needs an audience to applaud, affirm, recoil, approve, admire, adore, fear, or even detest him. He craves the attention and depends on the Narcissistic Supply only others can provide. The narcissist derives sustenance only from the outside - his emotional innards are hollow and moribund.
The narcissist’s enhanced performance is predicated on the existence of a challenge (real or imaginary) and of an audience. Baumeister usefully re-affirmed this linkage, known to theoreticians since Freud.
The Narcissist as a Failure and a Loser
Three traits conspire to render the narcissist a failure and a loser: his sense of entitlement, his haughtiness and innate conviction of his own superiority, and his aversion to routine.
The narcissist’s sense of entitlement encourages his indolence. He firmly believes that he should be spoon-fed and that accomplishments and honors should be handed to him on a silver platter, without any commensurate effort on his part. His mere existence justifies such exceptional treatment. Many narcissists are under-qualified and lack skills because they can’t be bothered with the minutia of obtaining an academic degree, professional training, or exams.
The narcissist’s arrogance and belief that he is superior to others, whom he typically holds in contempt - in other words: the narcissist’s grandiose fantasies - hamper his ability to function in society. The cumulative outcomes of this social dysfunction gradually transform him into a recluse and an outcast. He is shunned by colleagues, employers, neighbors, erstwhile friends, and, finally, even by long-suffering family members who tire of his tirades and rants.
Unable to work in a team, to compromise, to give credit where due, and to strive towards long-term goals, the narcissist - skilled and gifted as he may be - finds himself unemployed and unemployable, his bad reputation preceding him.
Even when offered a job or a business opportunity, the narcissist recoils, bolts, and obstructs each and every stage of the negotiations or the transaction.
But this passive-aggressive (negativistic and masochistic) conduct has nothing to do with the narcissist’s aforementioned indolence. The narcissist is not afraid of some forms of hard work. He invests inordinate amounts of energy, forethought, planning, zest, and sweat in securing narcissistic supply, for instance.
The narcissist’s sabotage of new employment or business prospects is owing to his abhorrence of routine. Narcissists feel trapped, shackled, and enslaved by the quotidian, by the repetitive tasks that are inevitably involved in fulfilling one’s assignments. They hate the methodical, step-by-step, long-term, approach. Possessed of magical thinking, they’d rather wait for miracles to happen. Jobs, business deals, and teamwork require perseverance and tolerance of boredom which the narcissist sorely lacks.
Life forces most narcissists into the hard slog of a steady job (or succession of jobs). Such “unfortunate” narcissists, coerced into a framework they resent, are likely to act out and erupt in a series of self-destructive and self-defeating acts (see above).
But there are other narcissists, the “luckier” ones, those who can afford not to work. They laze about, indulge themselves in a variety of idle and trivial pursuits, seek entertainment and thrills wherever and whenever they can, and while their lives away, at once content and bitter: content with their lifestyle and the minimum demands it imposes on them and bitter because they haven’t achieved more, they haven’t reached the pinnacle or their profession, they haven’t become as rich or famous or powerful as they deserve to be.
We all have a scenario of our life. We invent, adopt, are led by and measure ourselves against our personal narratives. These are, normally, commensurate with our personal histories, our predilections, our abilities, limitations, and our skills. We are not likely to invent a narrative which is wildly out of synch with our selves.
We rarely judge ourselves by a narrative which is not somehow correlated to what we can reasonably expect to achieve. In other words, we are not likely to frustrate and punish ourselves knowingly. As we grow older, our narrative changes. Parts of it are realized and this increases our self-confidence, sense of self-worth and self-esteem and makes us feel fulfilled, satisfied, and at peace with ourselves.
The narcissist differs from normal people in that his is a HIGHLY unrealistic personal narrative. This choice could be imposed and inculcated by a sadistic and hateful Primary Object (a narcissistic, domineering mother, for instance) - or it could be the product of the narcissist’s own tortured psyche. Instead of realistic expectations of himself, the narcissist has grandiose fantasies. The latter cannot be effectively pursued. They are elusive, ever receding targets.
This constant failure (the Grandiosity Gap) leads to dysphorias (bouts of sadness) and to losses. Observed from the outside, the narcissist is perceived to be odd, prone to illusions and self-delusions and, therefore, lacking in judgement.
The dysphorias - the bitter fruits of the narcissist’s impossible demands of himself - are painful. Gradually the narcissist learns to avoid them by eschewing a structured narrative altogether. Life’s disappointments and setbacks condition him to understand that his specific “brand” of unrealistic narrative inevitably leads to frustration, sadness and agony and is a form of self-punishment (inflicted on him by his sadistic, rigid Superego).
This incessant punishment serves another purpose: to support and confirm the negative judgement meted out by the narcissist’s Primary Objects (usually, by his parents or caregivers) in his early childhood (now, an inseparable part of his Superego).
The narcissist’s mother, for instance, may have consistently insisted that the narcissist is bad, rotten, or useless. Surely, she could not have been wrong, goes the narcissist’s internal dialog. Even raising the possibility that she may have been wrong proves her right! The narcissist feels compelled to validate her verdict by making sure that he indeed BECOMES bad, rotten and useless.
Yet, no human being - however deformed - can live without a narrative. The narcissist develops circular, ad-hoc, circumstantial, and fantastic “life-stories” (the Contingent Narratives). Their role is to avoid confrontation with (the often disappointing and disillusioning) reality. He thus reduces the number of dysphorias and their strength, though he usually fails to avoid the Narcissistic Cycle (see FAQ 43).
The narcissist pays a heavy price for accommodating his dysfunctional narratives:
Emptiness, existential loneliness (he shares no common psychic ground with other humans), sadness, drifting, emotional absence, emotional platitude, mechanisation/robotisation (lack of anima, excess persona in Jung’s terms) and meaninglessness. This fuels his envy and the resulting rage and amplifies the EIPM (Emotional Involvement Preventive Measures) - see Chapter Eight of the Essay.
The narcissist develop a “Zu Leicht - Zu Schwer” (“Too Easy - Too difficult”) syndrome:
On the one hand, the narcissist’s life is unbearably difficult. The few real achievements he does have should normally have mitigated this perceived harshness. But, in order to preserve his sense of omnipotence, he is forced to “downgrade” these accomplishments by labelling them as “too easy”.
The narcissist cannot admit that he had toiled to achieve something and, with this confession, shatter his grandiose False Self. He must belittle every achievement of his and make it appear to be a routine triviality. This is intended to support the dreamland quality of his fragmented personality. But it also prevents him from deriving the psychological benefits which usually accrue to goal attainment: an enhancement of self-confidence, a more realistic self-assessment of one’s capabilities and abilities, a strengthening sense of self-worth.
The narcissist is doomed to roam a circular labyrinth. When he does achieve something - he demotes it in order to enhance his own sense of omnipotence, perfection, and brilliance. When he fails, he dares not face reality. He escapes to the land of no narratives where life is nothing but a meaningless wasteland. The narcissist whiles his life away.
But what is it like being a narcissist?
The narcissist is often anxious. It is usually unconscious, like a nagging pain, a permanence, like being immersed in a gelatinous liquid, trapped and helpless, or as the DSM puts it, narcissism is “all-pervasive”. Still, these anxieties are never diffuse. The narcissist worries about specific people, or possible events, or more or less plausible scenarios. He seems to constantly conjure up some reason or another to be worried or offended.
Positive past experiences do not ameliorate this preoccupation. The narcissist believes that the world is hostile, a cruelly arbitrary, ominously contrarian, contrivingly cunning and indifferently crushing place. The narcissist simply “knows” it will all end badly and for no good reason. Life is too good to be true and too bad to endure. Civilization is an ideal and the deviations from it are what we call “history”. The narcissist is incurably pessimistic, an ignoramus by choice and incorrigibly blind to any evidence to the contrary.
Underneath all this, there is a Generalised Anxiety. The narcissist fears life and what people do to each other. He fears his fear and what it does to him. He knows that he is a participant in a game whose rules he will never master and in which his very existence is at stake. He trusts no one, believes in nothing, knows only two certainties: evil exists and life is meaningless. He is convinced that no one cares.
This existential angst that permeates his every cell is atavistic and irrational. It has no name or likeness. It is like the monsters in every child’s bedroom with the lights turned off. But being the rationalising and intellectualising creatures that cerebral narcissists are - they instantly label this unease, explain it away, analyse it and attempt to predict its onset.
They attribute this poisonous presence to some external cause. They set it in a pattern, embed it in a context, transform it into a link in the great chain of being. Hence, they transform diffuse anxiety into focused worries. Worries are known and measurable quantities. They have reasons which can be tackled and eliminated. They have a beginning and an end. They are linked to names, to places, faces and to people. Worries are human.
Thus, the narcissist transforms his demons into compulsive notations in his real or mental diary: check this, do that, apply preventive measures, do not allow, pursue, attack, avoid. The narcissist ritualizes both his discomfort and his attempts to cope with it.
But such excessive worrying - whose sole intent is to convert irrational anxiety into the mundane and tangible - is the stuff of paranoia.
For what is paranoia if not the attribution of inner disintegration to external persecution, the assignment of malevolent agents from the outside to the figments of turmoil inside? The paranoid seeks to alleviate his own voiding by irrationally clinging to rationality. Things are so bad, he says, mainly to himself, because I am a victim, because “they” are after me and I am hunted by the juggernaut of state, or by the Freemasons, or by the Jews, or by the neighbourhood librarian. This is the path that leads from the cloud of anxiety, through the lamp-posts of worry to the consuming darkness of paranoia.
Paranoia is a defence against anxiety and against aggression. In the paranoid state, the latter is projected outwards, upon imaginary others, the instruments of one’s crucifixion.
Anxiety is also a defence against aggressive impulses. Therefore, anxiety and paranoia are sisters, the latter merely a focused form of the former. The mentally disordered defend against their own aggressive propensities by either being anxious or by becoming paranoid.
Yet, aggression has numerous guises, not only anxiety and paranoia. One of its favourite disguises is boredom. Like its relation, depression, boredom is aggression directed inwards. It threatens to drown the bored person in a primordial soup of inaction and energy depletion. It is anhedonic (pleasure depriving) and dysphoric (leads to profound sadness). But it is also threatening, perhaps because it is so reminiscent of death.
Not surprisingly, the narcissist is most worried when bored. The narcissist is aggressive. He channels his aggression and internalises it. He experiences his bottled wrath as boredom.
When the narcissist is bored, he feels threatened by his ennui in a vague, mysterious way. Anxiety ensues. He rushes to construct an intellectual edifice to accommodate all these primitive emotions and their transubstantiations. He identifies reasons, causes, effects and possibilities in the outer world. He builds scenarios. He spins narratives. As a result, he feels no more anxiety. He has identified the enemy (or so he thinks). And now, instead of being anxious, he is simply worried. Or paranoid.
The narcissist often strikes people as “laid back” - or, less charitably: lazy, parasitic, spoiled, and self-indulgent. But, as usual with narcissists, appearances deceive. Narcissists are either compulsively driven over-achievers - or chronic under-achieving wastrels. Most of them fail to make full and productive use of their potential and capacities. Many avoid even the now standard paths of an academic degree, a career, or family life.
The disparity between the accomplishments of the narcissist and his grandiose fantasies and inflated self image - the Grandiosity Gap - is staggering and, in the long run, unsustainable. It imposes onerous exigencies on the narcissist’s grasp of reality and on his meagre social skills. It pushes him either to reclusion or to a frenzy of “acquisitions” - cars, women, wealth, power.
Yet, no matter how successful the narcissist is - many of them end up being abject failures - the Grandiosity Gap can never be bridged. The narcissist’s False Self is so unrealistic and his Superego so sadistic that there is nothing the narcissist can do to extricate himself from the Kafkaesque trial that is his life.
The narcissist is a slave to his own inertia. Some narcissists are forever accelerating on the way to ever higher peaks and ever greener pastures. Others succumb to numbing routines, the expenditure of minimal energy, and to preying on the vulnerable. But either way, the narcissist’s life is out of control, at the mercy of pitiless inner voices and internal forces.
Narcissists are one-state machines, programmed to extract Narcissistic Supply from others. To do so, they develop early on a set of immutable routines. This propensity for repetition, inability to change and rigidity confine the narcissist, stunt his development, and limit his horizons. Add to this his overpowering sense of entitlement, his visceral fear of failure, and his invariable need to both feel unique and be perceived as such - and one often ends up with a recipe for inaction.
The under-achieving narcissist dodges challenges, eludes tests, shirks competition, sidesteps expectations, ducks responsibilities, evades authority - because he is afraid to fail and because doing something everyone else does endangers his sense of uniqueness. Hence the narcissist’s apparent “laziness” and “parasitism”. His sense of entitlement - with no commensurate accomplishments or investment - irritates his social milieu. People tend to regard such narcissists as “spoiled brats”.
In specious contrast, the over-achieving narcissist seeks challenges and risks, provokes competition, embellishes expectations, aggressively bids for responsibilities and authority and seems to be possessed with an eerie self-confidence. People tend to regard such specimen as “entrepreneurial”, “daring”, “visionary”, or “tyrannical”. Yet, these narcissists too are mortified by potential failure, driven by a strong conviction of entitlement, and strive to be unique and be perceived as such.
Their hyperactivity is merely the flip side of the under-achiever’s inactivity: it is as fallacious and as empty and as doomed to miscarriage and disgrace. It is often sterile or illusory, all smoke and mirrors rather than substance. The precarious “achievements” of such narcissists invariably unravel. They often act outside the law or social norms. Their industriousness, workaholism, ambition, and commitment are intended to disguise their essential inability to produce and build. Theirs is a whistle in the dark, a pretension, a Potemkin life, all make-belief and thunder.
- Can you provide me with some clear, precise background information for Narcissistic Personality Disorder?
Pathological narcissism is a life-long pattern of traits and behaviours which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition.
As distinct from healthy narcissism which we all possess, pathological narcissism is maladaptive, rigid, persisting, and causes significant distress, and functional impairment.
Pathological narcissism was first described in detail by Freud in his essay “On Narcissism” (1915). Other major contributors to the study of narcissism are: Melanie Klein, Karen Horney, Franz Kohut, Otto Kernberg, Theodore Millon, Elsa Roningstam, Gunderson, and Robert Hare.
What is Narcissistic Personality Disorder (NPD)?
The Narcissistic Personality Disorder (NPD) (formerly known as megalomania or, colloquially, as egotism) is a form of pathological narcissism. It is a Cluster B (dramatic, emotional, or erratic) personality disorder. Other Cluster B personality disorders are the Borderline Personality Disorder (BPD), the Antisocial Personality Disorder (APD), and the Histrionic Personality Disorder (HPD). The Narcissistic Personality Disorder (NPD) first appeared as a mental health diagnosis in the DSM III-TR (Diagnostic and Statistical Manual) in 1980.
The ICD-10, the International Classification of Diseases, published by the World Health Organisation in Geneva  regards the Narcissistic Personality Disorder (NPD) as “a personality disorder that fits none of the specific rubrics”. It relegates it to the category “Other Specific Personality Disorders” together with the eccentric, “haltlose”, immature, passive-aggressive, and psychoneurotic personality disorders and types.
The American Psychiatric Association, based in Washington D.C., USA, publishes the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Text Revision (DSM-IV-TR)  where it provides the diagnostic criteria for the Narcissistic Personality Disorder (301.81, p. 717).
The DSM-IV-TR defines Narcissistic Personality Disorder (NPD) as “an all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts”, such as family life and work.
The DSM specifies nine diagnostic criteria. Five (or more) of these criteria must be met for a diagnosis of Narcissistic Personality Disorder (NPD) to be rendered.
[In the text below, I have proposed modifications to the language of these criteria to incorporate current knowledge about this disorder. My modifications appear in bold italics.]
[My amendments do not constitute a part of the text of the DSM-IV-TR, nor is the American Psychiatric Association (APA) associated with them in any way.]
[Click here to download a bibliography of the studies and research regarding the Narcissistic Personality Disorder (NPD) on which I based my proposed revisions.]
Proposed Amended Criteria for the Narcissistic Personality Disorder
a… Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognised as superior without commensurate achievements);
a… Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
a… Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
a… Requires excessive admiration, adulation, attention and affirmation - or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);
a… Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favourable priority treatment;
a… Is “interpersonally exploitative”, i.e., uses others to achieve his or her own ends;
a… Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
a… Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;
a… Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.
Prevalence and Age and Gender Features
According to the DSM IV-TR, between 2% and 16% of the population in clinical settings (between 0.5-1% of the general population) are diagnosed with Narcissistic Personality Disorder (NPD). Most narcissists (50-75%, according to the DSM-IV-TR) are men.
We must carefully distinguish between the narcissistic traits of adolescents - narcissism is an integral part of their healthy personal development - and the full-fledge disorder. Adolescence is about self-definition, differentiation, separation from one’s parents, and individuation. These inevitably involve narcissistic assertiveness which is not to be conflated or confused with Narcissistic Personality Disorder (NPD).
“The lifetime prevalence rate of NPD is approximately 0.5-1 percent; however, the estimated prevalence in clinical settings is approximately 2-16 percent. Almost 75 percent of individuals diagnosed with NPD are male (APA, DSM IV-TR 2000).”
From the Abstract of Psychotherapeutic Assessment and Treatment of Narcissistic Personality Disorder By Robert C. Schwartz,Ph.D., DAPA and Shannon D. Smith, Ph.D., DAPA (American Psychotherapy Association, Article #3004 Annals July/August 2002)
Narcissistic Personality Disorder (NPD) is exacerbated by the onset of aging and the physical, mental, and occupational restrictions it imposes.
In certain situations, such as under constant public scrutiny and exposure, a transient and reactive form of the Narcissistic Personality Disorder (NPD) has been observed by Robert Milman and labelled “Acquired Situational Narcissism”.
There is only scant research regarding the Narcissistic Personality Disorder (NPD), but studies have not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to it.
Comorbidity and Differential Diagnoses
Narcissistic Personality Disorder (NPD) is often diagnosed with other mental health disorders (“co-morbidity”), such as mood disorders, eating disorders, and substance-related disorders. Patients with Narcissistic Personality Disorder (NPD) are frequently abusive and prone to impulsive and reckless behaviours (“dual diagnosis”).
Narcissistic Personality Disorder (NPD) is commonly diagnosed with other personality disorders, such as the Histrionic, Borderline, Paranoid, and Antisocial Personality Disorders.
The personal style of those suffering from the Narcissistic Personality Disorder (NPD) should be distinguished from the personal styles of patients with other Cluster B Personality Disorders. The narcissist is grandiose, the histrionic coquettish, the antisocial (psychopath) callous, and the borderline needy.
As opposed to patients with the Borderline Personality Disorder, the self-image of the narcissist is stable, he or she are less impulsive and less self-defeating or self-destructive and less concerned with abandonment issues (not as clinging).
Contrary to the histrionic patient, the narcissist is achievements-orientated and proud of his or her possessions and accomplishments. Narcissists also rarely display their emotions as histrionics do and they hold the sensitivities and needs of others in contempt.
According to the DSM-IV-TR, both narcissists and psychopaths are “tough-minded, glib, superficial, exploitative, and unempathic”. But narcissists are less impulsive, less aggressive, and less deceitful. Psychopaths rarely seek narcissistic supply. As opposed to psychopaths, few narcissists are criminals.
Patients suffering from the range of obsessive-compulsive disorders are committed to perfection and believe that only they are capable of attaining it. But, as opposed to narcissists, they are self-critical and far more aware of their own deficiencies, flaws, and shortcomings.
Clinical Features of the Narcissistic Personality Disorder
The onset of pathological narcissism is in infancy, childhood and early adolescence. It is commonly attributed to childhood abuse and trauma inflicted by parents, authority figures, or even peers. Pathological narcissism is a defense mechanism intended to deflect hurt and trauma from the victim’s “True Self” into a “False Self” which is omnipotent, invulnerable, and omniscient. The narcissist uses the False Self to regulate his or her labile sense of self-worth by extracting from his environment narcissistic supply (any form of attention, both positive and negative).
There is a whole range of narcissistic reactions, styles, and personalities - from the mild, reactive and transient to the permanent personality disorder.
Patients with Narcissistic Personality Disorder (NPD) feel injured, humiliated and empty when criticized. They often react with disdain (devaluation), rage, and defiance to any slight, real or imagined. To avoid such situations, some patients with Narcissistic Personality Disorder (NPD) socially withdraw and feign false modesty and humility to mask their underlying grandiosity. Dysthymic and depressive disorders are common reactions to isolation and feelings of shame and inadequacy.
The interpersonal relationships of patients with Narcissistic Personality Disorder (NPD) are typically impaired due to their lack of empathy, disregard for others, exploitativeness, sense of entitlement, and constant need for attention (narcissistic supply).
Though often ambitious and capable, inability to tolerate setbacks, disagreement, and criticism make it difficult for patients with Narcissistic Personality Disorder (NPD) to work in a team or to maintain long-term professional achievements. The narcissist’s fantastic grandiosity, frequently coupled with a hypomanic mood, is typically incommensurate with his or her real accomplishments (the “grandiosity gap”).
Patients with Narcissistic Personality Disorder (NPD) are either “cerebral” (derive their Narcissistic Supply from their intelligence or academic achievements) or “somatic” (derive their Narcissistic Supply from their physique, exercise, physical or sexual prowess and romantic or physical “conquests”).
Patients with Narcissistic Personality Disorder (NPD) are either “classic” (meet five of the nine diagnostic criteria included in the DSM), or they are “compensatory” (their narcissism compensates for deep-set feelings of inferiority and lack of self-worth).
Some narcissists are covert, or inverted narcissists. As codependents, they derive their narcissistic supply from their relationships with classic narcissists.
Treatment and Prognosis
The common treatment for patients with Narcissistic Personality Disorder (NPD) is talk therapy (mainly psychodynamic psychotherapy or cognitive-behavioural treatment modalities). Talk therapy is used to modify the narcissist’s antisocial, interpersonally exploitative, and dysfunctional behaviors, often with some success. Medication is prescribed to control and ameliorate attendant conditions such as mood disorders or obsessive-compulsive disorders.
The prognosis for an adult suffering from the Narcissistic Personality Disorder (NPD) is poor, though his adaptation to life and to others can improve with treatment.
a… Goldman, Howard H., Review of General Psychiatry, fourth edition, 1995. Prentice-Hall International, London.
b… Gelder, Michael, Gath, Dennis, Mayou, Richard, Cowen, Philip (eds.), Oxford Textbook of Psychiatry, third edition, 1996, reprinted 2000. Oxford University Press, Oxford.
c… Vaknin, Sam, Malignant Self Love - Narcissism Revisited, eighth revised impression, 1999-2006. Narcissus Publications, Prague and Skopje.
4. what are the symptoms of NPD?
Perhaps the most immediately evident trait of patients with Narcissistic Personality Disorder (NPD) is their vulnerability to criticism and disagreement. Subject to negative input, real or imagined, even to a mild rebuke, a constructive suggestion, or an offer to help, they feel injured, humiliated and empty and they react with disdain (devaluation), rage, and defiance.
From my book “Malignant Self Love - Narcissism Revisited”:
“To avoid such intolerable pain, some patients with Narcissistic Personality Disorder (NPD) socially withdraw and feign false modesty and humility to mask their underlying grandiosity. Dysthymic and depressive disorders are common reactions to isolation and feelings of shame and inadequacy.”
Due to their lack of empathy, disregard for others, exploitativeness, sense of entitlement, and constant need for attention (narcissistic supply), narcissists are rarely able to maintain functional and healthy interpersonal relationships.
Many narcissists are over-achievers and ambitious. Some of them are even talented and skilled. But they are incapable of team work because they cannot tolerate setbacks. They are easily frustrated and demoralized and are unable to cope with disagreement and criticism. Though some narcissists have meteoric and inspiring careers, in the long-run, all of them find it difficult to maintain long-term professional achievements and the respect and appreciation of their peers. The narcissist’s fantastic grandiosity, frequently coupled with a hypomanic mood, is typically incommensurate with his or her real accomplishments (the “grandiosity gap”).
There are many types of narcissists: the paranoid, the depressive, the phallic, and so on.
An important distinction is between cerebral and somatic narcissists. The cerebrals derive their Narcissistic Supply from their intelligence or academic achievements and the somatics derive their Narcissistic Supply from their physique, exercise, physical or sexual prowess and romantic or physical “conquests”.
Another crucial division within the ranks of patients with Narcissistic Personality Disorder (NPD) is between the classic variety (those who meet five of the nine diagnostic criteria included in the DSM), and the compensatory kind (their narcissism compensates for deep-set feelings of inferiority and lack of self-worth).
Some narcissists are covert, or inverted narcissists. As codependents, they derive their narcissistic supply from their relationships with classic narcissists.
- What made you interested in doing research about NPD?
I suffer from NPD.
You can learn more about me and my work here:
http://malignantselflove.tripod.com/archive01.html (scroll down to section
titled “Sam Vaknin, NPD”)
http://www.suite101.com/articles.cfm/npd (my journal)
http://malignantselflove.tripod.com/sipurim.html (short fiction)
- What is the definition in your own words Narcissistic Personality Disorder?
Please see response to question # 3.
- when dealing with a person with NPD, what procedures do you take?
How to Cope with Narcissistic and Psychopathic Abusers
- How do you courage family members to deal with a person with this disorder?
See response to question number 7 above.
- How do people with NPD perform on their jobs?
The narcissist naturally gravitates towards those professions which guarantee the abundant and uninterrupted provision of Narcissistic Supply. He seeks to interact with people from a position of authority, advantage, or superiority. He thus elicits their automatic admiration, adulation, and affirmation - or, failing that, their fear and obedience.
Several vocations meet these requirements: teaching, the clergy, show business, corporate management, the medical professions, the military, law enforcement agencies, politics, and sports. It is safe to predict that narcissists would be over-represented in these occupations.
The cerebral narcissist is likely to emphasize his intellectual prowess and accomplishments (real and imaginary) in an attempt to solicit supply from awe-struck students, devoted parishioners, admiring voters, obsequious subordinates, or dependent patients. His somatic counterpart derives his sense of self-worth from body building, athletic achievements, tests of resilience or endurance, and sexual conquests.
The narcissistic medical doctor or mental health professional and his patients, the narcissistic guide, teacher, or mentor and his students, the narcissistic leader, guru, pundit, or psychic and his followers or admirers, and the narcissistic business tycoon, boss, or employer and his underlings - all are instances of Pathological Narcissistic Spaces.
This is a worrisome state of affairs. Narcissists are liars. They misrepresent their credentials, knowledge, talents, skills, and achievements. A narcissist medical doctor would rather let patients die than expose his ignorance. A narcissistic therapist often traumatizes his clients with his acting out, rage, exploitativeness, and lack of empathy. Narcissistic businessmen bring ruin on their firms and employees.
Moreover, even when all is “well”, the narcissist’s relationship with his sycophants is abusive. He perceives others as objects, mere instruments of gratification, dispensable and interchangeable. An addict, the narcissist tends to pursue an ever-larger dose of adoration, and an ever-bigger fix of attention, while gradually losing what’s left of his moral constraints.
When his sources become weary, rebellious, tired, bored, disgusted, repelled, or plainly amused by the narcissist’s incessant dependence, his childish craving for attention, his exaggerated or even paranoid fears which lead to obsessive-compulsive behaviours, and his “drama queen” temper tantrums - he resorts to emotional extortion, straight blackmail, abuse, or misuse of his authority, and criminal or antisocial conduct. If these fail, the narcissist devalues and discards the very people he so idealized and cherished only a short while before.
As opposed to their “normal” colleagues or peers, narcissists in authority lack empathy and ethical standards. Thus, they are prone to immorally, cynically, callously and consistently abuse their position. Their socialisation process - usually the product of problematic early relationships with Primary Objects (parents, or caregivers) - is often perturbed and results in social dysfunctioning.
Nor is the narcissist deterred by possible punishment or regards himself subject to Man-made laws. His sense of entitlement coupled with the conviction of his own superiority lead him to believe in his invincibility, invulnerability, immunity, and divinity. The narcissist holds human edicts, rules, and regulations in disdain and human penalties in disdain. He regards human needs and emotions as weaknesses to be predatorily exploited.
I, for instance, being a narcissist myself, can’t hold a job or even run my own business for very long. People - co-workers, clients, suppliers - complain that I create a “bad atmosphere”, that I am a “difficult person”, that they have to walk on brittle eggshells lest I explode, humiliate them, expose their errors and their weaknesses, or simply walk away.
At the workplace, I connive and collude and spread malicious gossip and complain and grumble and insult profusely and make everyone utterly miserable. I project my fears and foibles unto others. I impose my paranoid set of mind. I am full with ideas of reference - convinced that people are talking about me, conspiring against me, berating me behind my back, out to get me.
I have caused the disintegration of teams and dreams and firms too many to enumerate. Like a ghost, like a poison, I permeated everything, destabilizing, provoking, sowing fear and doubt and mutual suspicion, leading inexorably to recriminations and internecine fighting.
Yet, I have done none of this intentionally or with deliberation. These are the unwanted and inadvertent outcomes of my disorder. My grandiose fantasies make me undertake tasks far beyond my capabilities - and then flunk them spectacularly. My sense of entitlement - never commensurate with my achievements - breeds in me a deep-seated conviction of deprivation and discrimination and a wrathful attitude towards those who will not kowtow and instantaneously cater to my inflated needs. My paranoia paints the world in the penumbral hues of suspicion and intrigue.
There is no way to appease me or to stop me. I am the terminator - ever in flux, ever evasive, omnipresent, and all- pervasive. I am the shadow on the wall, the whisper behind the water cooler, the muffled smirking in the corner. I am the traitorous employee, the snitch, the industrial spy, the venomous co-worker, the malicious on-looker. I desert the sinking ship first.
Despite my grandiose self-image, I constantly feel like a cheat. I know that the self people perceive is my FALSE Self. I know that I am false and vain and prone to modulation by the vicissitudes of my Narcissistic Supply. I realize how frivolous, how ephemeral, how unreal I am. In an effort to cover up for these shortcomings I lie and I exaggerate. I dent my credibility and risk my reputation daily in my struggle to sustain a figment of my own pathology. I crush and violently demean any doubter of my skills, any questioner of my qualifications, any threat - perceived or real - to my facade.
The perpetrators of the recent spate of financial frauds in the USA acted with callous disregard for both their employees and shareholders - not to mention other stakeholders. Psychologists have often remote-diagnosed them as “malignant, pathological narcissists”.
Narcissists are driven by the need to uphold and maintain a false self - a concocted, grandiose, and demanding psychological construct typical of the narcissistic personality disorder. The false self is projected to the world in order to garner “narcissistic supply” - adulation, admiration, or even notoriety and infamy. Any kind of attention is usually deemed by narcissists to be preferable to obscurity.
The false self is suffused with fantasies of perfection, grandeur, brilliance, infallibility, immunity, significance, omnipotence, omnipresence, and omniscience. To be a narcissist is to be convinced of a great, inevitable personal destiny. The narcissist is preoccupied with ideal love, the construction of brilliant, revolutionary scientific theories, the composition or authoring or painting of the greatest work of art, the founding of a new school of thought, the attainment of fabulous wealth, the reshaping of a nation or a conglomerate, and so on. The narcissist never sets realistic goals to himself. He is forever preoccupied with fantasies of uniqueness, record breaking, or breathtaking achievements. His verbosity reflects this propensity.
Reality is, naturally, quite different and this gives rise to a “grandiosity gap”. The demands of the false self are never satisfied by the narcissist’s accomplishments, standing, wealth, clout, sexual prowess, or knowledge. The narcissist’s grandiosity and sense of entitlement are equally incommensurate with his achievements.
To bridge the grandiosity gap, the malignant (pathological) narcissist resorts to shortcuts. These very often lead to fraud.
The narcissist cares only about appearances. What matters to him are the facade of wealth and its attendant social status and narcissistic supply. Witness the travestied extravagance of Tyco’s Denis Kozlowski. Media attention only exacerbates the narcissist’s addiction and makes it incumbent on him to go to ever-wilder extremes to secure uninterrupted supply from this source.
The narcissist lacks empathy - the ability to put himself in other people’s shoes. He does not recognize boundaries - personal, corporate, or legal. Everything and everyone are to him mere instruments, extensions, objects unconditionally and uncomplainingly available in his pursuit of narcissistic gratification.
This makes the narcissist perniciously exploitative. He uses, abuses, devalues, and discards even his nearest and dearest in the most chilling manner. The narcissist is utility- driven, obsessed with his overwhelming need to reduce his anxiety and regulate his labile sense of self-worth by securing a constant supply of his drug - attention. American executives acted without compunction when they raided their employees’ pension funds - as did Robert Maxwell a generation earlier in Britain.
The narcissist is convinced of his superiority - cerebral or physical. To his mind, he is a Gulliver hamstrung by a horde of narrow-minded and envious Lilliputians. The dotcom “new economy” was infested with “visionaries” with a contemptuous attitude towards the mundane: profits, business cycles, conservative economists, doubtful journalists, and cautious analysts.
Yet, deep inside, the narcissist is painfully aware of his addiction to others - their attention, admiration, applause, and affirmation. He despises himself for being thus dependent. He hates people the same way a drug addict hates his pusher. He wishes to “put them in their place”, humiliate them, demonstrate to them how inadequate and imperfect they are in comparison to his regal self and how little he craves or needs them.
The narcissist regards himself as one would an expensive present, a gift to his company, to his family, to his neighbours, to his colleagues, to his country. This firm conviction of his inflated importance makes him feel entitled to special treatment, special favors, special outcomes, concessions, subservience, immediate gratification, obsequiousness, and lenience. It also makes him feel immune to mortal laws and somehow divinely protected and insulated from the inevitable consequences of his deeds and misdeeds.
The self-destructive narcissist plays the role of the “bad guy” (or “bad girl”). But even this is within the traditional social roles cartoonishly exaggerated by the narcissist to attract attention. Men are likely to emphasise intellect, power, aggression, money, or social status. Narcissistic women are likely to emphasise body, looks, charm, sexuality, feminine “traits”, homemaking, children and childrearing.
Punishing the wayward narcissist is a veritable catch-22.
A jail term is useless as a deterrent if it only serves to focus attention on the narcissist. Being infamous is second best to being famous - and far preferable to being ignored. The only way to effectively punish a narcissist is to withhold narcissistic supply from him and thus to prevent him from becoming a notorious celebrity.
Given a sufficient amount of media exposure, book contracts, talk shows, lectures, and public attention - the narcissist may even consider the whole grisly affair to be emotionally rewarding. To the narcissist, freedom, wealth, social status, family, vocation - are all means to an end. And the end is attention. If he can secure attention by being the big bad wolf - the narcissist unhesitatingly transforms himself into one. Lord Archer, for instance, seems to be positively basking in the media circus provoked by his prison diaries.
The narcissist does not victimise, plunder, terrorise and abuse others in a cold, calculating manner. He does so offhandedly, as a manifestation of his genuine character. To be truly “guilty” one needs to intend, to deliberate, to contemplate one’s choices and then to choose one’s acts. The narcissist does none of these.
Thus, punishment breeds in him surprise, hurt and seething anger. The narcissist is stunned by society’s insistence that he should be held accountable for his deeds and penalized accordingly. He feels wronged, baffled, injured, the victim of bias, discrimination and injustice. He rebels and rages.
Depending upon the pervasiveness of his magical thinking, the narcissist may feel besieged by overwhelming powers, forces cosmic and intrinsically ominous. He may develop compulsive rites to fend off this “bad”, unwarranted, persecutory influences.
The narcissist, very much the infantile outcome of stunted personal development, engages in magical thinking. He feels omnipotent, that there is nothing he couldn’t do or achieve if only he sets his mind to it. He feels omniscient - he rarely admits to ignorance and regards his intuitions and intellect as founts of objective data.
Thus, narcissists are haughtily convinced that introspection is a more important and more efficient (not to mention easier to accomplish) method of obtaining knowledge than the systematic study of outside sources of information in accordance with strict and tedious curricula. Narcissists are “inspired” and they despise hamstrung technocrats.
To some extent, they feel omnipresent because they are either famous or about to become famous or because their product is selling or is being manufactured globally. Deeply immersed in their delusions of grandeur, they firmly believe that their acts have - or will have - a great influence not only on their firm, but on their country, or even on Mankind. Having mastered the manipulation of their human environment - they are convinced that they will always “get away with it”. They develop hubris and a false sense of immunity.
Narcissistic immunity is the (erroneous) feeling, harboured by the narcissist, that he is impervious to the consequences of his actions, that he will never be effected by the results of his own decisions, opinions, beliefs, deeds and misdeeds, acts, inaction, or membership of certain groups, that he is above reproach and punishment, that, magically, he is protected and will miraculously be saved at the last moment. Hence the audacity, simplicity, and transparency of some of the fraud and corporate looting in the 1990’s. Narcissists rarely bother to cover their traces, so great is their disdain and conviction that they are above mortal laws and wherewithal.
What are the sources of this unrealistic appraisal of situations and events?
The false self is a childish response to abuse and trauma. Abuse is not limited to sexual molestation or beatings. Smothering, doting, pampering, over-indulgence, treating the child as an extension of the parent, not respecting the child’s boundaries, and burdening the child with excessive expectations are also forms of abuse.
The child reacts by constructing false self that is possessed of everything it needs in order to prevail: unlimited and instantaneously available Harry Potter-like powers and wisdom. The false self, this Superman, is indifferent to abuse and punishment. This way, the child’s true self is shielded from the toddler’s harsh reality.
This artificial, maladaptive separation between a vulnerable (but not punishable) true self and a punishable (but invulnerable) false self is an effective mechanism. It isolates the child from the unjust, capricious, emotionally dangerous world that he occupies. But, at the same time, it fosters in him a false sense of “nothing can happen to me, because I am not here, I am not available to be punished, hence I am immune to punishment”.
The comfort of false immunity is also yielded by the narcissist’s sense of entitlement. In his grandiose delusions, the narcissist is sui generis, a gift to humanity, a precious, fragile, object. Moreover, the narcissist is convinced both that this uniqueness is immediately discernible - and that it gives him special rights. The narcissist feels that he is protected by some cosmological law pertaining to “endangered species”.
He is convinced that his future contribution to others - his firm, his country, humanity - should and does exempt him from the mundane: daily chores, boring jobs, recurrent tasks, personal exertion, orderly investment of resources and efforts, laws and regulations, social conventions, and so on.
The narcissist is entitled to a “special treatment”: high living standards, constant and immediate catering to his needs, the eradication of any friction with the humdrum and the routine, an all-engulfing absolution of his sins, fast track privileges (to higher education, or in his encounters with bureaucracies, for instance). Punishment, trusts the narcissist, is for ordinary people, where no great loss to humanity is involved.
Narcissists are possessed of inordinate abilities to charm, to convince, to seduce, and to persuade. Many of them are gifted orators and intellectually endowed. Many of them work in in politics, the media, fashion, show business, the arts, medicine, or business, and serve as religious leaders.
By virtue of their standing in the community, their charisma, or their ability to find the willing scapegoats, they do get exempted many times. Having recurrently “got away with it” - they develop a theory of personal immunity, founded upon some kind of societal and even cosmic “order” in which certain people are above punishment.
But there is a fourth, simpler, explanation. The narcissist lacks self-awareness. Divorced from his true self, unable to empathise (to understand what it is like to be someone else), unwilling to constrain his actions to cater to the feelings and needs of others - the narcissist is in a constant dreamlike state.
To the narcissist, his life is unreal, like watching an autonomously unfolding movie. The narcissist is a mere spectator, mildly interested, greatly entertained at times. He does not “own” his actions. He, therefore, cannot understand why he should be punished and when he is, he feels grossly wronged.
So convinced is the narcissist that he is destined to great things - that he refuses to accept setbacks, failures and punishments. He regards them as temporary, as the outcomes of someone else’s errors, as part of the future mythology of his rise to power/brilliance/wealth/ideal love, etc. Being punished is a diversion of his precious energy and resources from the all-important task of fulfilling his mission in life.
The narcissist is pathologically envious of people and believes that they are equally envious of him. He is paranoid, on guard, ready to fend off an imminent attack. A punishment to the narcissist is a major surprise and a nuisance but it also validates his suspicion that he is being persecuted. It proves to him that strong forces are arrayed against him.
He tells himself that people, envious of his achievements and humiliated by them, are out to get him. He constitutes a threat to the accepted order. When required to pay for his misdeeds, the narcissist is always disdainful and bitter and feels misunderstood by his inferiors.
Cooked books, corporate fraud, bending the (GAAP or other) rules, sweeping problems under the carpet, over-promising, making grandiose claims (the “vision thing”) - are hallmarks of a narcissist in action. When social cues and norms encourage such behaviour rather than inhibit it - in other words, when such behaviour elicits abundant narcissistic supply - the pattern is reinforced and become entrenched and rigid. Even when circumstances change, the narcissist finds it difficult to adapt, shed his routines, and replace them with new ones. He is trapped in his past success. He becomes a swindler.
But pathological narcissism is not an isolated phenomenon. It is embedded in our contemporary culture. The West’s is a narcissistic civilization. It upholds narcissistic values and penalizes alternative value-systems. From an early age, children are taught to avoid self-criticism, to deceive themselves regarding their capacities and attainments, to feel entitled, and to exploit others.
As Lilian Katz observed in her important paper, “Distinctions between Self-Esteem and Narcissism: Implications for Practice”, published by the Educational Resources Information Center, the line between enhancing self-esteem and fostering narcissism is often blurred by educators and parents.
Both Christopher Lasch in “The Culture of Narcissism” and Theodore Millon in his books about personality disorders, singled out American society as narcissistic. Litigiousness may be the flip side of an inane sense of entitlement. Consumerism is built on this common and communal lie of “I can do anything I want and possess everything I desire if I only apply myself to it” and on the pathological envy it fosters.
Not surprisingly, narcissistic disorders are more common among men than among women. This may be because narcissism conforms to masculine social mores and to the prevailing ethos of capitalism. Ambition, achievements, hierarchy, ruthlessness, drive - are both social values and narcissistic male traits. Social thinkers like the aforementioned Lasch speculated that modern American culture - a self-centred one - increases the rate of incidence of the narcissistic personality disorder.
Otto Kernberg, a notable scholar of personality disorders, confirmed Lasch’s intuition: “Society can make serious psychological abnormalities, which already exist in some percentage of the population, seem to be at least superficially appropriate.”
In their book “Personality Disorders in Modern Life”, Theodore Millon and Roger Davis state, as a matter of fact, that pathological narcissism was once the preserve of “the royal and the wealthy” and that it “seems to have gained prominence only in the late twentieth century”. Narcissism, according to them, may be associated with “higher levels of Maslow’s hierarchy of needs … Individuals in less advantaged nations … are too busy trying (to survive) … to be arrogant and grandiose”.
They - like Lasch before them - attribute pathological narcissism to “a society that stresses individualism and self-gratification at the expense of community, namely the United States.” They assert that the disorder is more prevalent among certain professions with “star power” or respect. “In an individualistic culture, the narcissist is ‘God’s gift to the world’. In a collectivist society, the narcissist is 'God’s gift to the collective.”
Millon quotes Warren and Caponi’s “The Role of Culture in the Development of Narcissistic Personality Disorders in America, Japan and Denmark”:
“Individualistic narcissistic structures of self-regard (in individualistic societies) … are rather self-contained and independent … (In collectivist cultures) narcissistic configurations of the we-self … denote self-esteem derived from strong identification with the reputation and honor of the family, groups, and others in hierarchical relationships.”
Still, there are malignant narcissists among subsistence farmers in Africa, nomads in the Sinai desert, day laborers in east Europe, and intellectuals and socialites in Manhattan. Malignant narcissism is all-pervasive and independent of culture and society. It is true, though, that the way pathological narcissism manifests and is experienced is dependent on the particulars of societies and cultures.
In some cultures, it is encouraged, in others suppressed. In some societies it is channeled against minorities - in others it is tainted with paranoia. In collectivist societies, it may be projected onto the collective, in individualistic societies, it is an individual’s trait.
Yet, can families, organizations, ethnic groups, churches, and even whole nations be safely described as “narcissistic” or “pathologically self-absorbed”? Can we talk about a “corporate culture of narcissism”?
Human collectives - states, firms, households, institutions, political parties, cliques, bands - acquire a life and a character all their own. The longer the association or affiliation of the members, the more cohesive and conformist the inner dynamics of the group, the more persecutory or numerous its enemies, competitors, or adversaries, the more intensive the physical and emotional experiences of the individuals it is comprised of, the stronger the bonds of locale, language, and history - the more rigorous might an assertion of a common pathology be.
Such an all-pervasive and extensive pathology manifests itself in the behavior of each and every member. It is a defining - though often imp