WHAT IS NPD (
Narcissistic Personality Disorder)?
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. Five (or more) of the following criteria must be met:
(1) Feels
grandiose and
self-importance (e.g.,
exaggerates achievements and talents to the point of lying, demands to be recognized as superior without
commensurate achievements)
(2) 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
(3) 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)
(4) Requires excessive admiration, adulation, attention and
affirmation - or, failing that, wishes to be feared and to be
notorious (narcissistic supply).
(5) Feels entitled. Expects unreasonable or special and favourable
priority treatment. Demands automatic and full compliance with his or her expectations
(6) Is "
interpersonally exploitative", i.e., uses others to achieve his or her own ends
(7) Devoid of
empathy. Is unable or unwilling to identify with or acknowledge the feelings and needs of others
(8) Constantly
envious of others or believes that they feel the same about him or her
(9)
Arrogant,
haughty behaviours or attitudes coupled with rage when frustrated,
contradicted, or
confronted.
The language in the criteria above is based on or summarized from:
American Psychiatric Association. (1994).
Diagnostic and statistical manual of mental disorders, fourth edition (
DSM IV). Washington, DC:
American Psychiatric Association.
Sam Vaknin. (1999). Malignant Self Love - Narcissism Revisited, first edition. Prague and Skopje: Narcissus Publication.
Most
narcissists (75%) are men.
NPD (=the
Narcissistic Personality Disorder) is one of a "family" of personality disorders (formerly known as "Cluster B").
Other members:
Borderline PD,
Antisocial PD and
Histrionic PD.
NPD is often diagnosed with other mental health disorders ("
co-morbidity") - or with
substance abuse, or impulsive and reckless behaviours ("dual diagnosis").
NPD is new (1980) mental health category in the
Diagnostic and Statistics Manual (
DSM).
There is only scant research regarding
narcissism.
But what there is has not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to NPD.
It is estimated that 0.7-1% of the general population suffer from NPD.
Pathological narcissism was first described in detail by
Freud. Other major contributors are: Klein, Horney, Kohut, Kernberg, Millon, Roningstam, Gunderson, Hare.
The onset of 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.
There is a whole range of narcissistic reactions -
from the mild, reactive and transient to the permanent personality disorder.
Narcissists 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 "conquests").
Narcissists are either "Classic" - see definition below -
or they are "Compensatory", or "Inverted".
NPD is treated in
talk therapy (psychodynamic or
cognitive-behavioral).
The prognosis for an adult narcissist is poor, though his adaptation to life and to others can improve with treatment.
Medication is applied to side-effects and behaviours (such as mood or affect disorders and obsession-compulsion) -
usually with some success.