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The topic of personality disorders can be controversial and challenging to understand. This article aims to provide an overview and offer advice on treating narcissistic personality disorder.
What is narcissism?
Narcissism is a personality syndrome characterized by an exaggerated sense of self-importance, a need for excessive admiration, and a lack of empathy for other people. People with narcissistic personality disorder may have difficulty dealing with criticism and may become angry or resentful when they do not receive the admiration they feel they deserve. They may also exaggerate their own achievements and talents, expecting to be treated as superior without corresponding achievements.
The diagnosis is rooted in psychodynamic theories of personality development but is now a separate diagnosis in the DSM (the American Diagnostic Manual used in psychiatry).
Narcissism exists on a spectrum, from mild narcissistic traits to full-blown narcissistic personality disorder. The diagnosis is made in specialist psychiatry after a personality assessment.
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What is a personality disorder?
Personality disorders, or personality syndromes, are psychological conditions that affect an individual’s thoughts, feelings and behaviours in a way that often differs significantly from societal norms and expectations.
As people with personality disorders may have difficulty relating to others, this can lead to problems in both personal and professional relationships.
What causes narcissism?
Narcissism, particularly in the case of Narcissistic Personality Disorder (NPS), is thought to be caused by a combination of genetic, biological, psychological and environmental factors.
There is no clear genetic link, but genes can have an impact. Biological factors are not fully understood. Past experiences growing up and in the family are important. These can include excessive admiration by parents or, conversely, neglect or emotional abuse. Both of these extremes can contribute to an unhealthy self-image and relational patterns.
Childhood trauma can also contribute, as well as other psychological factors such as self-esteem and insecurity, which narcissism tries to hide. There are several factors at play.
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How common is personality disorder?
According to an article in Psychopathology Journal, it is difficult to give exact figures, as many people with personality disorders go undiagnosed and untreated, but it is estimated that around 7% of the South African population suffers from a personality disorder.
Symptoms of narcissism
The symptoms of narcissism, especially in the case of narcissistic personality disorder (NPS), include several behaviours and attitudes. It is important to note that not everyone who exhibits narcissistic traits has a fully developed personality disorder. Here are some common symptoms:
- Excessive sense of self-importance: The person may exaggerate their achievements and talents, expecting to be recognized as superior even without the corresponding merits.
- Fantasies of unlimited success, power, brilliance, beauty or ideal love: The person may have unrealistic visions of success, power or perfection.
- Believe they are “special” and unique: The person may believe that they can only be understood by, or should associate with, other special or high-status people (or institutions).
- Requires excessive admiration: There is often a need for excessive attention and admiration.
- Has a sense of entitlement: The person often expects unreasonable favours and concessions from others.
- Exploits others: The person may use others to achieve their own goals.
- Lacks empathy: The person often has difficulty recognizing or identifying with the feelings and needs of others.
- Is jealous of others or believes others are jealous of them: There may be a belief that others are jealous of them, or the person may be jealous of others.
- Displays arrogant and haughty behaviour or attitudes: The person may have an inflated self-image and behave in a superior manner.
It is important to remember that these symptoms must be long-lasting and significantly affect the person’s social, work or other important areas of life to be considered part of a narcissistic personality disorder. Furthermore, it is important that diagnosis and treatment are done by a trained psychologist or psychiatrist.
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Gender differences in narcissism
There are some gender differences in narcissism, especially in the frequency, expression and type of narcissistic traits. Men generally have more narcissistic traits but this does not mean that women cannot have them too. Men may be more likely to show arrogance or assertiveness, while women may show more subtle forms of narcissism, such as excessive concern for their appearance or charm. There are theories of ‘covert narcissism’ (hidden, less obvious narcissism), which can involve feelings of inferiority and hypersensitivity to criticism, but this form is not a formal diagnosis.
It is important to note that these differences are generalizations and individual variations are large. In addition, cultural, social and environmental factors influence how narcissistic traits are expressed and experienced. The diagnosis and assessment of narcissistic personality disorder should always be made by a licensed professional, taking into account the individual’s unique circumstances and background.
Assessment of personality disorders
Personality disorders are usually diagnosed in specialist psychiatry through a personality assessment. This involves taking an initial medical history to review the background of the symptoms and completing assessment forms. This is followed by a structured diagnostic interview and an interview with family members to see how the symptoms manifest themselves in different areas. You will often see both a doctor and a psychologist, and the assessment may also include a blood test to rule out an underlying medical cause.
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12 FAQs about Narcissism
What is personality disorder?
A personality disorder is an enduring pattern of behaviour, worldview and inner experience markedly different from what is expected of those around you. This is because personality disorders can affect one’s ability to relate to others and function effectively in everyday life.
Is narcissism a type of personality disorder?
Yes, narcissistic personality disorder is one of several types. Individuals with narcissism have an exaggerated sense of self-importance and a lack of empathy towards other people.
How is a psychopath different from other personality syndromes?
A psychopath often shows a lack of conscience and empathy and can manipulate others without any sense of guilt or remorse. It is an extreme form of antisocial personality disorder, which is another personality syndrome, and it requires professional evaluation and treatment.
How is narcissism diagnosed?
Diagnosis of narcissism is usually carried out by a psychiatrist or psychologist and involves a detailed diagnostic interview and family interview.
What treatment options are available for personality disorders?
Treatment can vary depending on the type of disorder and the unique needs of the individual, but usually involves a combination of psychotherapy and, if necessary, medication.
How can I help someone close to me who has a personality disorder?
The most important step is to encourage the person to seek professional help. You can also offer emotional support but remember that you are not a substitute for qualified care.
Is there any way to prevent personality disorders?
Personality disorders are largely caused by environmental influences during childhood, so there are things you can do to prevent unhealthy personality development if you have children. Personality disorder mainly manifests itself in adulthood, so consult a child psychologist if necessary, or an adult psychiatrist if you think you may have a personality disorder as a parent.
Can you force someone to go to therapy?
No, you cannot force someone to go to therapy. It is rarely a good idea to force someone into therapy. A person needs to understand that they need to work on themselves. Therapists rarely see people with the above personality syndromes in the therapy room. These people usually believe that they do not need to go to therapy.
How common is personality disorder?
It is unclear, but one estimate is that around 10% of the population suffers from personality disorders.
Is it more common among men or women?
Men generally have more narcissistic traits, but there are also more non-formal forms of covert narcissism, which there are theories that women may have more of.
What causes narcissism?
Narcissism, particularly in the case of Narcissistic Personality Disorder (NPS), is thought to be caused by a combination of genetic, biological, psychological and environmental factors.
When can narcissism be diagnosed?
Narcissism usually manifests itself in adulthood, as childhood and adolescence are still largely responsible for shaping one’s personality.
Where can I go if I or someone I know has symptoms of narcissism?
To get a diagnosis, you should contact your healthcare centre to get a referral to a specialist psychiatrist. For milder problems, you can go for treatment via Lavendla. Narcissism can be treated,
Treatment of narcissistic personality disorder
The treatment of narcissism, especially narcissistic personality disorder (NPS), can be longer but it is possible to get better. There is no specific medicine that cures NPS, so psychotherapy is the main method of treatment. Treatment goals often include helping the individual to understand their feelings and behaviours better, develop healthier relationships, and manage any co-occurring mental illness. There are different treatment approaches that can be helpful:
Psychodynamic Therapy: This approach focuses on exploring underlying, unconscious conflicts that may underlie narcissistic behaviours. The therapist helps the individual to understand and process these conflicts.
Cognitive behavioural therapy (CBT): CBT can help individuals identify and change destructive thought patterns and behaviours. This may include working to challenge excessive self-centeredness or learning to recognize and respect the needs and feelings of others.
Schema-focused therapy: This form of therapy combines elements from several different therapeutic schools and focuses on identifying and changing deeply rooted patterns or schemas that have governed the individual’s behaviour since childhood.
Group therapy: Group therapy can be particularly beneficial as it provides a social context where the individual can learn empathy and receive feedback from others in a safe environment.
Medication: While there is no specific medication for NPS, medications such as antidepressants or anti-anxiety drugs may be prescribed to address co-occurring mental health issues.
Family therapy: Because narcissistic behaviour can deeply affect family relationships, family therapy can be useful in addressing these dynamics and promoting healthier interactions.
It is important to remember that individuals with narcissistic personality disorder often do not seek treatment because they do not see their own behaviours as problematic. This can make engagement and progress in therapy particularly challenging. Longevity and patience are essential in treatment, and progress can be gradual. In addition, it is important that therapy is adapted to the individual’s specific needs and situation, often by a psychologist or psychiatrist with experience in personality disorders.
Advice for people who know someone with a personality disorder
Living with someone with a personality disorder can be a difficult experience and can affect you greatly.
- Be careful with boundaries: It is important to set clear boundaries to protect yourself and your psychological well-being.
- Seek professional help: Diagnosing or treating someone is not your job. Let this be handled by healthcare providers.
- Try not to judge: A personality syndrome is a medical diagnosis, not a character flaw. It does not always excuse a person’s behaviour but can explain it.
- Be aware of your needs: Take care of yourself and seek support from friends, family or a professional therapist or psychologist.
