Psych Series #6

Psych Series #6: Narcissistic Personality Disorder

Ever feel as though you are better than others? Do you fantasize about your own power, success, or attractiveness? Do you have trouble keeping healthy relationships? You may be experiencing symptoms of Narcissistic Personality Disorder.

Personality disorders involve personality traits that can cause an individual to feel and behave in a socially distressing ways. These traits can also limit a person's ability to function in a healthy way in relationships, at work, at school, and in other areas of his/her life. Personality disorders are categorized into three clusters:

• Cluster A: Odd or eccentric behavior (i.e. Schizoid, Paranoid, or Schizotypal Disorders)

• Cluster B: Dramatic, emotional or erratic behavior (i.e. Antisocial, Borderline, or Narcissistic Disorders)

• Cluster C: Anxious, fearful behavior (i.e. Avoidant, Dependent, or Obsessive-Compulsive Disorders)

Narcissistic Personality Disorder as a mental health diagnosis first appeared in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). According to the DSM-IV-TR, this disorder occurs in approximately 2 to 16 percent of the "clinical population" and less than 1 percent of the "general population" (APA, 2000). Narcissistic Personality Disorder is more frequently diagnosed in men than women.

Signs & Symptoms

• Lack of humility

• Grandiose sense of self-importance
  

• Exaggeration achievements and talents

• Lack of empathy; unwilling to recognize or identify with the feelings and needs of others

• Fragile sense of self-esteem

• Appear "tough-minded" or "unemotional"

• Envy; being envious of others; believing others are envious of him/her

• Difficulty maintaining healthy relationships

• Sense of entitlement; unreasonable expectation of favorable treatment or automatic compliance with his/her expectations

• Arrogant, haughty behaviors or attitudes

• Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love

• Interpersonal exploitation; takes advantages of others to achieve his/her own ends

• Easily hurt or rejected

• Set unrealistic goals.

Clinical Picture

• "Individuals with narcissistic disorder appear to lack humility, being overly self-centered and exploiting others to fulfill their own desires. They often do not conceive of their behavior as being inappropriate or objectionable. Because they view themselves as 'superior' beings, they believe they are entitled to special rights and privileges (Townsend, 2003)."

• "Though often grounded in grandiose distortions of reality, their mood is usually optimistic, relaxed, cheerful, and carefree. This mood can easily change, however, as a result of their fragile self-esteem. If they do not meet self-expectations, do not receive positive feedback they expect from others, or draw criticism from others, they may respond with rage, shame, humiliation, or dejection (Townsend, 2003)."

Risk Factors

• Overindulgence and overvaluation by parents (i.e. parent living vicariously through child)
  

• Unpredictable or unreliable care-giving from parents

• Severe emotional abuse in childhood

• Being praised for perceived exceptional looks or talents by adults

• Learning manipulative behaviors from parents

• Excessive admiration that is not balanced with realistic feedback

Treatments

• Cognitive Behavioral Therapy - helps identify unhealthy, negative beliefs/behaviors and replace them with healthy positive ones

• Family Therapy - therapy sessions involving the entire family exploring conflicts, communication, and problem-solving to assist with relationship issues

• Group Therapy - therapy sessions with a group of people with similar conditions; helps with better relating to others; good way to learn how to listen to others, learn about their feelings, and offer support.

If any of these signs/symptoms/definitions sound familiar, you can find assistance or more information through your primary care provider, local mental health clinic, or on-line at mayoclinic.com.

Wishing you all peace, love, and happiness this year!