Narcissistic Personality Disorder: Symptoms, Causes, Diagnose and Treatment

Before we plunge into the many details of the above mentioned psychological personality disorder let us first understand some basic topics related to it.

What is a personality disorder?

According to Robert A.Baron[i], personality disorders are the disorders involving extreme and inflexible personality traits that are distressing to the persons who have them or cause them problems in school, at work, or in interpersonal relations.

The American Psychiatric Association (APA) has defined personality disorder to be a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.

There are 10 specific types of personality disorders. Common to all is a long term pattern of behaviour and inner experience that differs from what is expected. Without proper treatment, the behaviour is inflexible and long lasting.

What is Narcissism?

Narcissism refers to excessive interest in or admiration of oneself and one’s physical appearance. It comes from the Greek myth of young Narcissus who fell in love with his own image reflected in water. Narcissus is the pursuit of gratification from vanity or egoistic admiration of one’s idealized self image and attributes.

What is Narcissism in Psychology?

In the field of Psychology, narcissism refers to extreme selfishness, with grandiose views of one’s own talents and a craving admiration for the same. This concept was introduced in psychology by Sigmund Freud, the father of Psychology.

A Guide for Narcissistic Personality Disorder (NPD) 

What is Narcissistic Personality Disorder (NPD) ?

Narcissistic personality disorder (NPD) is a personality disorder with a long term pattern of abnormal behaviour characterised by exaggerated feelings of self importance, excessive need for admiration by others, pervasive pattern of grandiosity in fantasy or behaviour and a lack of empathy. It is classified within the cluster B by the Diagnostic and Statistical Manual of Mental Disorder (DSM IV), as having dramatic, emotional and erratic behaviour. The term came into use in the year 1968.

Signs and symptoms of NPD

People suffering from this disorder are characterised by persistent grandiosity, excessive need for admiration and a personal disdain and lack of empathy for others. Persons with NPD may show a distorted sense of superiority and seek to control power over others. They value themselves over others to the extent that they openly disregard the feelings and wishes of others, and expect themselves to be treated as superior.

The DSM V indicates some of the symptoms:

• Grandiosity with expectation of superior treatment from others.
• Fantasy of power, attractiveness, talents etc.
• Needing continual admiration from others.
• Unwilling to empathize with the feelings of others.
• Arrogant behaviour.
• Envious behaviour towards others.

True symptoms of NPD are pervasive, rigid and remain consistent over time. The symptoms must be severe enough to impair the person’s capabilities to develop healthy human relationships. The traits manifested by the person must differ from cultural norms in order to qualify as symptoms of NPD.

People with NPD may exaggerate their skills and competencies. The sense of superiority may cause them to monopolize conversations and become impatient when others talk about themselves. They are prone to feelings of shame, humiliation due to their hypersensitivity. The defence mechanisms at work here are denial, idealization and devaluation.

Causes of NPD

Social, environmental and genetic factors play a key role in forming a narcissistic personality. NPD is heritable if the person is having a family history of the disorder. It can also develop from an impaired attachment to the parents. This can make the child believe to be unwanted and unimportant due to lack of personality. Extreme parenthood may also contribute to this disorder. Oversensitive temperament, excessive praise or criticism in childhood, overindulgence by parents or family members, severe emotional abuse during childhood, manipulative behaviours etc. are certain factors which may develop NPD.

Treatment of NPD

Narcissistic Personality Disorder is rarely the primary reason for people to seek treatment. It is typically prompted by difficulty in seeking relief from other disorders such as depression, bi-polar disorder etc. Further digging into the problem may let the disorder come to surface. The treatment of NPD is centred around Psychotherapy. It is a procedure in which people with mental disorder interact with a trained psychotherapist who helps them change certain behaviours, thoughts or emotions so that they feel and function better. Contemporary treatments involve transference focused, metacognitive and schema focused therapies. Transference involves intense emotional feelings of love or hate towards the analyst on the part of the patient undergoing psychoanalysis. This helps to change the patient’s feelings towards others. Metacognitive therapy is a psychological talking therapy. It first discovers what the patient believes about his/her own thoughts and show them how those thoughts lead to unhelpful responses and provide alternative ways to them. Group treatment has benefits as receiving peer feedback may be more acceptable to the patient rather than that of the therapist’s. It let’s them explore boundaries, develop trust, increase selfawareness and accept feedback. Relationship therapy is most effective when both partners cooperatively participate.

No medication is indicated for treating NPD but may be used to treat co occurring mental conditions or symptoms associated with it such as depression, anxiety etc.

In addition to treatment, certain self coping strategies can be helpful for people having a personality disorder such as learning about the condition, getting active, getting routine medical care, get a support group, avoid alcohol, try stress management etc.

Narcissistic personality disorder is just another personality disorder. It is not a joke nor a stigma. Proper care and support can help the person overcome this problem and restore back to normal life. Proper psychological treatment and full family and peer support is essential to deal with it and any other mental disorder. Hope and self belief are necessary for any patient suffering from any mental disorder to stay strong and overcome it. It should be a duty of each and every individual to support the person and not stigmatize him/her. Such positive behaviour may help them to cure faster and also drop suicidal rates around us, occurring as a result of neglect and shaming the people suffering.