How to Deal With Narcissistic Personality Disorder

October 10, 2016

The terms narcissist and narcissistic personality disorder are thrown around rather loosely today. While a touch of self centeredness, need for admiration or difficulty being criticized may seem narcissistic, it doesn’t necessarily warrant a diagnosis of true narcissistic personality disorder. (And here’s an important point to remember: narcissism is not the same as confidence.)

But when traits of being self-centered, egotistical and manipulative are exhibited to the extreme, it can become the basis for the psychological disorder. Like all similar conditions, being diagnosed with narcissist personality disorder means a person must meet a certain diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition.

You can find true narcissists at every level of society. In its more extreme form and used for nefarious reasons, the results of narcissistic personality disorder can be devastating. The combination of an inability to empathize, coupled with  high-level grandiosity can lead to harming others without remorse. Many psychology experts believe Hitler suffered from narcissistic personality disorder, along with many dangerous cult leaders like Jim Jones David Koresh. Polygamist leader Warren Jeffs is believed to be a true narcissist, too. Aside from initially possessing charming traits that draw followers in, these people demanded perfect loyalty from followers, overvalued themselves and devalued those around them.

Those examples of famous narcissists are extreme cases. Chances are, though, you’re dealing with a much less sinister form of narcissism every day. Maybe you encounter this at your own dinner table, where a charming but emotionally unavailable parent or spouse puts you down in order to elevate himself or herself. Perhaps it’s someone in the office or cubicle next to you who makes a habit and big production out of storming into meetings late.

Or your best friend who constantly interrupts you while you’re talking, always turning the conversation back to themselves and rarely listening to what you have to say. Narcissists are known for putting perfectionist-like expectations on others, and then berating others when those expectations aren’t met. Maybe you even see some of these traits in yourself.

In fairytales, you may recognize Cinderella’s stepmother and stepsisters as narcissists. Today, in the real world, some psychologists suggest that Republican presidential candidate Donald Trump shows classic signs of narcissistic personality disorder. Whether or not Trump is a clinical narcissist is one thing. But what we have to realize is that many of us are dealing with narcissistic personalities every day.

Narcissistic personality disorder isn’t just a challenge for the person living with it condition. This disease casts a wide net, negatively impacting people in the narcissist’s life. The words and actions of a true narcissist can cause high stress and leave lasting damage on  parents, siblings, children, other family members, friends and co-workers. That’s why it’s so important to learn how to ID and properly deal with a narcissist. And if you are showing signs and symptoms of narcissism, there are ways you can seek help, too.

Here, former FBI profiler Joe Navarro, author of Dangerous Personalities: An FBI Profiler Shows How to Identify and Protect Yourself from Harmful People, breaks down a narcissist:

“Narcissistic personalities care only for themselves, their needs and their priorities. While you and I appreciate attention, the narcissist craves it and manipulates people and situations to get it. While you and I work hard to be successful, the narcissistic personality connives to succeed and may cheat, lie, embellish the truth or scheme to get ahead, uncaring of how others are affected.”

What Is Narcissistic Personality Disorder?

So what is a narcissist? First, let’s be clear. It goes way beyond someone who loves looking in the mirror. A true narcissist acts in ways that are toxic and dangerous. And this can greatly impact relationships, putting strain on family members, friends and co-workers of a narcissist.

This narcissist definition helps break it down: Narcissistic personality disorder is a mental disorder in which people have an inflated sense of their own importance, a deep need for admiration and a lack of empathy for others. But behind this mask of ultra-confidence lies a fragile self-esteem that’s vulnerable to the slightest criticism, according to the Mayo Clinic. It may be hard for a true narcissist to seek medical help for their condition, though, because mental illness may not fit with the individual’s image of power, image and perfection.

Symptoms of Narcissistic Personality Disorder + Diagnosing the Condition

According to the DSM-5, narcissistic personality disorder is characterized as a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration and lack of empathy, beginning by early adulthood and present in a variety of contexts, indicated by five or more of the following:

Has a grandiose sense of self-importance (for example, exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).

Is preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love.

Believes 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, for example, unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.

Is interpersonally exploitative, for example, takes advantage of others to achieve his or her own ends.

Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.

Is often envious of others or believes that others are envious of him or her.

Shows arrogant, haughty behaviors or attitudes.

But to diagnose narcissistic personality disorder, a psychologist must makes sure other criteria involving personality disorders must be met. Some of these involve an excessive need for admiration or setting personal standards unreasonably high to see oneself as exceptional (or too low based on a sense of entitlement).

To be diagnosed with narcissistic personality disorder, a person also needs to show problems with relationships. This can translate as a lack of empathy or having mostly superficial relationships dominated by a need for personal gain.

Other things mental health professionals look for are antagonisms, grandiosity (feelings of entitlement) and attention-seeking behavior. For someone with true narcissistic personality disorder, these personality impairments can be seen consistently over time and in throughout different situations. Mental health professionals are also instructed to make sure the personality trains aren’t normal based on the person’s developmental stage, social-cultural environment, drug use, medication or medical conditions (such as severe head trauma).

Critics of the DSM-5 methods for diagnosing narcissistic personality disorder say it fails to cover some core psychological features of the disorder, including:

-vulnerable self-esteem

-feelings of inferiority

-emptiness and boredom

-affective reactivity and distress

Depression, anxiety, pain, fear and perfectionism often plague people living with narcissistic personality disorder, too.

And while much as been written about the extrovert-like qualities of a narcissist, scientists now know that subtypes of more introverted narcissists also exist. While they possess many of the qualities of a classical narcissist, they may operate in more subtle ways. For example, some introverted narcissists deal with disagreeable people or situations using passive aggressive methods.

A 1-Question Test for Narcissism?

Testing for narcissism usually involves, among other things, asking a series of 40 questions known as the Narcissistic Personality Inventory. But in a study looking at 2,200 of all ages, scientists recently found they could reliably ID narcissistic people by asking them this exact question:

To what extent do you agree with this statement: “I am a narcissist.” (Note: The word “narcissist” means egotistical, self-focused, and vain.)

Participants rated themselves on a scale of 1 (not very true of me) to 7 (very true of me).

“People who are willing to admit they are more narcissistic than others probably actually are more narcissistic. People who are narcissists are almost proud of the fact. You can ask them directly because they don’t see narcissism as a negative quality — they believe they are superior to other people and are fine with saying that publicly. — Brad Bushman, PhD, study co-author and professor of psychology at The Ohio State University.

Narcissist Definition: Defining Two Different Types

While all narcissists are self-absorbed, lack empathy and are self entitled, thinking they are more important than others, the condition can be further broken down into two categories.

The Grandiose/Overt Narcissist

Grandiose narcissism includes a desire to maintain a pretentious self-image, an exhibitionistic tendency, and a strong need for the admiration of others. They tend to truly confident and are known to be dominant. Self esteem isn’t an issue with this type.

The grandiose type is more likely to be part of what psychologist call “The Dark Trio.” This trio includes narcissism, Machiavellianism (the manipulation and exploitation of others for personal interest, and with no remorse) and psychopathy, a condition characterized by impulsiveness, antisocial behavior, selfishness, callousness and lack of remorse.

The Vulnerable/Covert Narcissist

Vulnerable narcissists tend to be more emotional sensitive and “feel helpless, anxious and victimized when people don’t treat them like royalty,” according to a description by Randi Kreger and Bill Eddy of the High Conflict Institute.

“Vulnerable narcissists appear to be over-compensating for low self-esteem and a deep-seated sense of shame that may date back to early childhood. They developed the behaviors as a coping mechanism to deal with neglect, abuse or a dismissive style of parent-child attachment (meaning the parents never developed a close bond with their child, so he never felt safe and secure in his parents’ love).” — Randi Kreger and Bill Eddy, High Conflict Institute.

Characterized by preoccupation with grandiose fantasies, this type of narcissist fluctuates between feelings of superiority and inferiority and fragile self-confidence. This type of narcissist is plagued by self esteem issues, no matter how perfect their life may seem.

A 2016 study found that vulnerable narcissists are more vulnerable to social media addiction compared to grandiose narcissists and non-narcissists. The study, published in the journal Cyberpsychology, Behavior, and Social Networking, found that social media sites like Facebook and Instagram tend to be “safe” ways for vulnerable narcissists to gain attention by controlling their image and sharing it with a wider audience.

Narcissistic Personality Disorder Causes & Risk Factors

Genetic or Learned? Maybe Both

The exact cause of narcissistic personal disorder is not known. According to Cleveland Clinic, many professionals believe that a combination of biological and genetic factors and individual temperamental patterns. Another possible cause of narcissism involves early life experiences, such as excessive pampering or, on the flip side, harsh or negative parenting.

It’s very common for children and teenagers to display signs of narcissism, but most grow out of this over time and don’t progress into narcissistic personality disorder. The condition does affect males more than females and tends to start emerging during the teenage or early adult years.

The Narcissist’s Brain

Interestingly, in 2013, scientists used MRI brain imaging to show actual brain variations in people who lack empathy, a key feature of narcissistic personality disorder. In the study, researchers studied 34 people, 17 of whom were diagnosed with narcissistic personality disorder. Although people living with this disorder are well able to recognize what other persons feel, think and intent, they display little compassion.

Scientists found that people diagnosed with narcissistic personality disorder exhibited structural abnormalities in the cerebral cortex part of the brain responsible for processing and generating compassion. For people with the disorder, the brain’s external nerve cell layer of the cerebral cortex region was significantly thinner compared to the control group.

“Our data shows that the amount of empathy is directly correlated to the volume of gray brain matter of the corresponding cortical representation in the insular region, and that the patients with narcissism exhibit a structural deficit in exactly this area. Building on this initial structural data, we are currently attempting to use functional imaging to understand better how the brains of patients with narcissistic personality disorder work.” — Dr. Stefan Röpke, lead study author

Your Parents’ Paychecks

Growing up wealthy seems to make people more narcissistic when they take on leadership roles later in life. A study published in 2016 looking at military leaders found that those displaying narcissistic traits were more likely to have grown up in families with higher income levels.

The researchers say growing up among wealth may lead to the false belief that higher-income people are more talented or special than other people. This also may lead to the feeling that the narcissistic leader doesn’t require help, input or ideas from other people. Growing up amongst higher parental income indirectly impaired leadership performance by fostering narcissism, which in turn reduced engagement in important leadership behaviors, the researchers found.

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