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What is Narcissism
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Written by Sam Vaknin
What is Narcissism?
A pattern of traits and behaviours which signify infatuation and obsession
with one's self to the exclusion of all others and the egotistic and ruthless
pursuit of one's gratification, dominance and ambition.
- Most narcissists (50-75%, according to the DSM IV-TR) are men.
- The Narcissistic Personality Disorder (NPD) is one of a
"family" of personality disorders (known as "Cluster B"). Other members of
Cluster B are Borderline PD, Antisocial PD and Histrionic PD.
- NPD is often diagnosed with other mental health disorders ("co-morbidity")
- or with substance abuse and impulsive and reckless behaviors ("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.
- Narcissistic Supply is outside attention - usually positive (adulation,
affirmation, fame, celebrity) - used by the narcissist to regulate his labile
sense of self-worth.
- 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 romantic or physical "conquests").
- Narcissists are either "classic" - see definition below - or they are
"compensatory", or "inverted" - see definitions here: "The Inverted Narcissist".
- The classic narcissist is self-confident, the compensatory narcissist
covers up in his haughty behaviour for a deep-seated deficit in self-esteem,
and the inverted type is a co-dependent who caters to the emotional needs of a
classic narcissist.
- NPD is treated in talk therapy (psychodynamic or cognitive-behavioural).
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.
The American Psychiatric Association, based in Washington D.C., USA,
publishes the Diagnostic and Statistical Manual of Mental Disorders,
fourth edition, Text Revision (DSM-IV-TR), 2000.
Click here to
read the DSM-IV-TR diagnostic criteria for the Narcissistic
Personality Disorder.
The international equivalent of the DSM is the ICD-10, Classification of
Mental and Behavioural Disorders, published by the World Health Organization in
Geneva (1992).
Click here
to read the ICD-10 diagnostic criteria for the Narcissistic
Personality Disorder.
The DSM defines NPD as "an all-pervasive pattern of grandiosity (in
fantasy or behavior), need for admiration or adulation and lack of empathy,
usually beginning by early adulthood and present in various
contexts."
The ICD regards NPD as "a personality disorder that fits none of the
specific rubrics." It relegates it to the category "Other Specific
Personality Disorders" together with the eccentric, "haltlose",
immature, passive-aggressive, and psychoneurotic personality disorders and
types.
The DSM specifies nine
diagnostic criteria. For NPD to be diagnosed, five (or more) of these
criteria must be met.
(In the text below, I have proposed modifications to the language of these
criteria to incorporate current knowledge about this disorder. My modifications
appear in bold italics.)
(My amendments do not constitute a part of the text of the DSM-IV-TR,
nor is the American Psychiatric Association (APA) associated with them in any
way.)
Click here
to download a bibliography
of the studies and research regarding the Narcissistic Personality Disorder
(NPD) on which I based my proposed revisions.
Proposed Amended Criteria for the Narcissistic Personality
Disorder
- Feels grandiose and self-important (e.g., exaggerates accomplishments,
talents, skills, contacts, and personality traits to the point of
lying, demands to be recognized as superior
without commensurate achievements);
- 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;
- 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);
- Requires excessive admiration, adulation, attention and affirmation
- or, failing that, wishes to be feared and to be notorious (Narcissistic
Supply);
- Feels entitled. Demands automatic and full compliance
with his or her unreasonable expectations for special and
favourable priority treatment;
- Is "interpersonally exploitative", i.e., uses others to
achieve his or her own ends;
- Devoid of empathy. Is unable or unwilling to
identify with, acknowledge, or accept the
feelings, needs, preferences, priorities, and choices of
others;
- Constantly envious of others and seeks to hurt or destroy the
objects of his or her frustration. Suffers from persecutory
(paranoid) delusions as he or she believes that they feel the same
about him or her and are likely to act similarly;
- Behaves arrogantly and haughtily. Feels superior, omnipotent,
omniscient, invincible, immune, "above the law", and omnipresent (magical
thinking). Rages when frustrated, contradicted, or confronted by
people he or she considers inferior to him or her and unworthy.
Author Bio Sam Vaknin ( http://samvak.tripod.com ) is the
author of Malignant Self Love - Narcissism Revisited and After the Rain - How
the West Lost the East. He served as a columnist for Central Europe Review,
PopMatters, and eBookWeb , and Bellaonline, and as a United Press International
(UPI) Senior Business Correspondent. He is the the editor of mental health and
Central East Europe categories in The Open Directory and
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