What Is Narcissism?
Narcissistic personality disorder (NPD), or narcissism, is a personality disorder characterized by a sense of grandiosity, the need for attention and admiration, superficial interpersonal relationships, and a lack of empathy. It often accompanies other psychiatric disorders and can be difficult to treat.
What Are the Symptoms of Narcissism and Narcissistic Behavior?
Symptoms — called core features — of narcissistic personality disorder (narcissism) include:
- Exaggerated sense of self-importance
- Feeling superior to others and that one deserves special treatment
- Feelings are often accompanied by fantasies of unlimited success, brilliance, power, beauty, or love
- Excessive need for admiration
- Must be the center of attention
- Often monopolize conversations
- Patients feel slighted, mistreated, depleted, and enraged when ignored
- Superficial and exploitative relationships
- Relationships are based on surface attributes and not the unique qualities of others
- People are only valued only to the extent they are viewed as beneficial
- Lack of empathy
- Severely limited or totally lacking ability to care about the emotional needs or experiences of others, even loved ones
- Identity disturbance
- Sense of self is highly superficial, extremely rigid, and often fragile
- Self-stability depends on maintaining the view that one is exceptional
- Grandiose sense of self is easily threatened
- Patients retreat from or deny realities that challenge grandiosity
- Difficulty with attachment and dependency
- Relies on feedback from the environment
- Relationships only exist to shore up positive self-image
- Interactions are superficial
- Intimacy is avoided
- Chronic feelings of emptiness and boredom
- When attention and praise are not available, patients feel empty, bored, depressed, or restless
- Vulnerability to life transitions
- Difficulty maintaining reality-based personal and professional goals over time
- Compromises required by school, jobs, and relationships may feel unbearable
- Young adults may have a “failure to launch”
- Narcissistic personality disorder is also a significant risk factor for suicide and suicidal attempts.
How Is Narcissism Diagnosed?
Narcissistic personality disorder (narcissism) is diagnosed using The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. A person must meet five of nine of the following traits for a diagnosis of narcissistic personality disorder.
- A grandiose sense of self-importance
- Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- The belief that he or she is “special” and unique and can only be understood by or should associate with, other special or high-status people or institutions
- Requires excessive admiration
- Has a sense of entitlement
- Is interpersonally exploitative — takes advantage of others
- Lacks empathy
- Envies others or believes others are envious of him or her
- Shows arrogant, haughty behaviors and attitudes
Can Narcissism Be Treated?
Treatment for narcissistic personality disorder (narcissism) can be difficult but therapy can often help. Types of therapy include:
- Supportive psychotherapy that uses both psychodynamic and cognitive behavioral techniques, often combined with psychopharmacologic management
- Structured psychotherapies
- Mentalization-based therapy
- Patients are taught to self-reflect
- Transference-focused psychotherapy
- Identifies patient’s treatment goals and established a treatment contract between therapist and patient
- Schema-focused psychotherapy
- Uses cognitive-behavioral therapy, attachment theory, and psychodynamic therapy to treat negative perceptions of self, others, and of one’s place in the world that are established in early life
- Dialectical behavioral therapy
- A form of cognitive behavioral therapy (CBT) that combines individual therapy with group treatment, has core principles of acceptance and change
- Mentalization-based therapy
Medications may also be used to treat narcissistic personality disorder, particularly in patients who have severe symptoms and may be a risk to self or others, and patients who have other, treatable psychiatric conditions.
Medications that may be used to treat narcissistic personality disorder include:
- Mood stabilizers
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