Narcissistic personality disorder

Narcissistic personality disorder: description

When people present themselves in a very self-loving way, always looking for mistakes from others instead of themselves, the term “narcissism” quickly falls. But what is a narcissist? People with a narcissistic personality have an extreme need for attention, appreciation and admiration. Often they stand out through arrogance and self-realization. They can not stand criticism and failure can plunge them into serious crises. Narcissistic individuals, however, have difficulty empathizing with other people. They often behave condescendingly toward others. Dealing with narcissists is therefore very challenging.

Again and again there are discussions about whether our society is becoming increasingly narcissistic. Are people only focused on their success and perfect self-expression? There is no clear answer. Narcissism, however, is a phenomenon that has long occupied people. Even in Greek mythology one finds Narcissus – a youth who falls in love with his own reflection and rejects the love of all others.

It is important to distinguish between narcissism and a true narcissistic personality disorder. Narcissists are often very ambitious. They are therefore also in leadership positions and can lead a very successful life. However, when narcissism is strong and leads to suffering for the person and his environment, narcissism becomes pathological (pathological narcissism). The transition from personality trait to disruption is fluid. Although there is much discussion in the society about narcissism, narcissistic personality disorder is still poorly understood.

Narcissistic personality disorder: how many are affected?

About one percent of the population suffer from narcissistic personality disorder. Men get the diagnosis more often than women. Most sufferers seek treatment for other mental illnesses. Often they suffer from depression, other personality disorders, somatoform disorders (physical ailments without organic cause), fears, eating disorders or addiction problems.

Types of Narcissistic Personality Disorder

According to a study by Russ and colleagues (2008), Narcissistic Personality Disorder can be divided into three types:

• terrific-malignant narcissism
• vulnerable-fragile narcissism
• exhibitionistic narcissism with a high level of function

Narcissistic personality disorder: terrific malignant type

People of the grandiose malignant or malignant type can become a danger to society. Malignant narcissism is a combination of narcissism, aggression, paranoia and antisocial behavior. A devilish mixture that can move people to extremely cruel acts. Stalin and Hitler, for example, are referred to as malignant narcissists. They are convinced of their greatness. If they do not feel valued by others, they will revenge themselves without remorse. The rejection does not have to be real. Through their paranoid tendency, they quickly see enemies in their fellow human beings.

Narcissistic personality disorder: vulnerable-fragile type

The vulnerable-fragile narcissism initially seems atypical, as it is characterized by depressed mood, anxiety and shame. Therefore, this form is also called “hidden narcissism”. People of this type are very sensitive to criticism and failures. They have great difficulty translating into others. Those affected seek more therapeutic help than the other types because of depression and other mental symptoms.

Narcissistic personality disorder: exhibitionistic type

The exhibitionist type publishes its grandeur in public. As a result, he draws the attention he needs. This type can adapt well in our competitive world and be very successful. His appearance is very self-confident. To others, these people behave arrogantly and coolly. This form is also called “open narcissism”.

But people with a narcissistic personality disorder can also be very self-confident and grandiose in a moment, and sooner or later show signs of depression and anxiety. It is therefore conceivable that the different types are facets of one and the same disorder. Research is still in its infancy.

Narcissistic personality disorder: symptoms

Personality disorder is when people show a certain pattern of behavior, thinking, and feelings that are very different from the expectations of the sociocultural environment. These inflexible personality traits lead to suffering and impairment in the social, professional or other areas.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), at least five of the following symptoms must be present for the diagnosis of Narcissistic Personality Disorder:

The affected

• have an exaggerated sense of their own importance
• have fantasies of limitless success, power, beauty or ideal love
• believe to be special and unique and to be understood only by special or respected persons
• expect from others excessive admiration
• expect others to treat them more favorably and automatically respond to their expectations
• use others to achieve their own goals
• have little empathy; do not want to empathize with others
• They often feel envy for others or believe others are jealous of them
• behave arrogantly and arrogantly

However, the narcissism symptoms are not always so clear. Some do not show their arrogance openly. The signs are only recognizable if you look very closely.

Experts have long assumed that narcissistic personality disorder is associated with high self-esteem. However, recent studies show that the self-esteem of those affected is low. They disguise their self-worth doubts by their autocratic self-representation. There can be no talk of self-love. Rather, people with a narcissistic personality disorder suffer from inner emptiness and are very dependent on the recognition of others. Upgrading one’s self or devaluing others is an attempt to overcome negative emotions. An insult, such as the separation of the partner can cause vindictiveness, but also cause depression to suicide.

Narcissistic personality disorder: causes and risk factors

Narcissistic personality disorder arises from an interaction of various factors. According to recent twin studies, genes have a greater impact on narcissistic personality disorder than on other personality disorders. But the environmental influences also play an important role.

Narcissistic personality disorder: environmental factors

Many experts see the roots of narcissism in childhood. However, the theories about the origin vary widely and currently there are no reliable findings. There is only agreement that the narcissistic disorder is due to adverse interactions with caregivers.

The leading researcher in Narcissistic Personality Disorder, Otto Kernberg, assumes that emotionally cold or latent aggressive parents promote an exaggerated self-expression. Children who receive little recognition overcome this violation of self-esteem by focusing on achievements they are praised for (for example, school achievements). Other researchers suggest that children who have no boundaries from their parents can develop an unrealistic and perfectionist self-image. Both parenting styles are ultimately a neglect of the child’s needs. Children need security and love, but also borders. For a healthy development, they also need to learn how to deal with disappointment, the ability to back off and empathize with the feelings of others.

Narcissistic personality disorder: examinations and diagnosis

To diagnose narcissistic personality disorder, a psychiatrist or psychotherapist should be consulted. The therapist can make a diagnosis based on specific questions based on the diagnostic criteria. The diagnosis is also used to distinguish other personality disorders, such as the histrionic personality disorder, which is characterized by egocentric and theatrical behavior, or a borderline disorder. If possible, the therapist will also ask close family members how they are experiencing the victim. The following questions could be asked by the therapist to diagnose Narcissistic Personality Disorder:

1. Do you feel like you are doing great things in your life?
2. Do you often get the impression that others do not recognize your grandeur?
3. Do you find it exhausting to deal with the feelings and interests of other people?

The diagnosis of narcissistic personality disorder is often felt by those affected as an attack on their person. A good explanation of the background of the diagnosis is therefore of great importance. The diagnosis should not condemn the person concerned, but help him to better understand himself and his environment. This understanding is often very relieving, both for those affected and their relatives.

Narcissistic personality disorder: treatment

Narcissistic people have no insight that their own behavior creates problems. They are – at least superficially – convinced of the greatness of their self and seek the fault of the other people. When narcissists seek treatment, it is usually due to an additional mental disorder, such as depression, alcohol or drug addiction. Psychotherapeutic procedures are used to treat narcissistic personality disorder.

Narcissistic personality disorder: relationship building

An essential component of a successful narcissism therapy is a trusting relationship between the person concerned and the therapist. Narcissistic individuals often find it very difficult to get involved with the therapist. The admission of needing help is felt by narcissists as a defeat and threat to their self-image. Often, they first evaluate the therapist to maintain their superiority. It may take some time for the person to be willing to trust and work with the therapist.

Narcissistic personality disorder: empathy

The therapist helps the sufferer to better understand his behaviors and feelings. Narcissistic behaviors are often an attempt to compensate for negative emotions. However, arrogance and arrogance do not go well with fellow human beings. In order to improve the relationship with other people, the affected person must work on his empathy ability, so that he can empathize with others better. The therapist develops new behavioral strategies with the client, which contribute to a better interaction with other people.

Narcissistic Personality Disorder: Realistic Claims

The mental health of people with a narcissistic personality disorder is especially at risk if their excessive demands are not met. Any offense is a threat to your self. An important measure in therapy is therefore to question the claims and set goals that are actually achievable.

Narcissistic personality disorder: therapy and healing

Relatives hope that the therapist can cure narcissism. Although today, unlike in the past, it is no longer assumed that narcissistic personality disorder can not be changed. But unlike a disease, a personality disorder is inherent in the personality itself. In the true sense, therefore, one can not expect narcissism to be curable. In about half of the people, the symptoms are reduced but – thanks to a therapy – within two years.

The therapeutic goal is not to turn the narcissist into another human being. Rather, the therapy is an offer to those affected to change with the help of the therapist’s extreme behavior and ways of thinking and to improve his own life. The therapeutic goals are developed by the therapist together with the person concerned. Ultimately, therapy is about reducing ailments.

Narcissistic personality disorder: partnership

Partnering with someone who has a narcissistic personality disorder is a big challenge. For narcissists, the world is practically just about them. To put oneself into the partner (or other people) is not one of her strengths.

For a working partnership, it is not only important that the narcissist be treated by a therapist. The partner should also seek professional help to learn more about how to deal properly with a narcissist.

Read more in the article Narcissistic Personality Disorder: Partnership.

Narcissistic personality disorder: course and prognosis

A favorable prognosis have persons who have success experiences and good relationship experiences make. The better the self-perception becomes, the easier it becomes to recognize and process the narcissistic traits themselves. For sufferers who can not get involved with the therapist because of their arrogance, have many failures in life and abuse drugs or alcohol, the prognosis is worse.

The Narcissistic personality disorder also brings with it an increased risk of suicide. When one’s own greatness is shaken, a deep offense sets in. As a result, some sufferers take their own lives.