Narcissistic Personality Disorder (NPD) refers to a disorder in which an individual becomes excessively preoccupied with his or her power, adequacy, vanity and prestige, even at the expense of others (Schulze et al., 2013). In other words, a person with narcissistic personality disorder does not see the mental damage he or she is likely to cause to himself/herself and others. Current statistics indicates that one percent of the entire population is affected by NPD.
Persons who have been diagnosed with NPD have excessive feelings of self-importance. In essence, such individual possess or exhibit a high sense of entitlement, as well as, unrealistic sense of superiority in both behavior and beliefs (Schulze et al., 2013). On one hand, they have a strong desire for admiration, but, unfortunately, they lack empathy.
Diagnosis and Symptoms
According to the DSM-IV-TR, symptoms of NPD include (Millon, 1996):
- Unrealistic high expectations of special treatment;
- Arrogance in attitude and behavior;
- Lack of empathy; such a person cares less about the feelings and desires of others;
- Preoccupation with high hopes and fantasies of massive success, intelligence, power, and attractiveness;
- An NPD patient envies others, and also believes others enemy him or her;
- Such persons expect positive reinforcements, admiration and attention from others;
- Such people expect to be accorded high respect and importance even if they have no superior accomplishments.
In addition, persons with NPD take advantage of others so long they meet their desires. As such, keeping healthy relationships with others is a challenge. This disorder is characterized by an abnormal sense of self-importance, emotional and dramatic behavior, that are similar to borderline anti-social and personality disorders (Siegel, 2006).
Such people are excessively arrogant and are in constant search for power and superiority. On one hand, the characteristics of a person with NPD can be similar to those of a person with a high self-esteem and confidence (Siegel, 2006). However, one is said to have this order, when those traits appears to be pathological. There is an inherent feeling in people with this disorder that they are naturally better than others. In the real sense, such people have a delicate self-esteem, and, in fact, cannot handle criticism. In line with this, they often try to cover up for their fragile and delicate self-esteem and fear of criticism by belittling others in order to validate their superiority.
In addition, their lack of empathy is characterized by inability to rationalize and understand the feelings of others. Such people tend to behave in a manner that will attract attention towards them; they careless about other’s feelings (Siegel, 2006). In children, the grandiose feelings that are a characteristic of NPD patients are seen as part of the development stage. Children have the incapability to between their ideal and actual self. However, by the time they are eight years old, they can differentiate between positive and negative views (Siegel, 2006). On a positive note, people with this disorder can perform well in competitions. For instance, in sport competitions, a narcissistic person believes that he or she is the best, and this can spur them to victory.
Treatment
James Masterson, Stephen Johnson and Heinz Kohut have outlined clinical strategies that ought to be used in the management of patients with NPD (Kernberg, 1970). Various models of therapy have been proposed. A good example is the Schema Therapy that was engineered by Young Jeffrey. This therapy is an umbrella of a host of other psychotherapeutic regimes including cognitive behavioral therapy and psychodynamic therapy (Kernberg, 1970). Unfortunately, people suffering from NPD rarely seek therapy attention because they feel that they are justified to behave in that manner. They have the opinion that they have no problem. In fact, most of the NPD patients do not realize the destruction they are causing to themselves and others as well (Kernberg, 1970). For those who seek assistance, it is normally because of the insistence by their relatives or friends.
However, most do not opt to go for therapy because they fear that their personal inadequacies will be unearthed. This therapy seeks to change behavior patterns of affected persons so that they become emphatic in their daily activities and relationships. In addition, this approach recognizes their unique talents and assists the affected person to use them positively. In other words, the objective is not to dampen their feeling of euphoria and superiority, but it seeks to assist them emphasize with others. Affected persons are expected not to think about their own welfare, but also think about others.
Another approach is temperament change. Skill training in this case is employed to manage anger, impatience and impulsivity. Unfortunately, the success rate of therapy is poor since many patients are defensive, and they tend to resist the therapy (Kernberg, 1970). In addition, medication has registered extremely poor results the management of patients with NPD. Psychoanalytic psychotherapy is the only form of therapy that has recorded convincing results (Kernberg, 1970). It is important for therapists not to quickly distort the patient’s traits; they should take caution and allow for progressive change.
Furthermore, group therapy can be employed. On one hand, group therapy may prove more beneficial than a clinician’s-led therapy because the client is likely to learn from peer influence. On the other hand, it might not succeed because the client might exhibit a sense of egocentrism, socially deviant behavior, isolation or withdrawal. There are mixed reactions among therapists with respect to the use of group therapy. Those who second it believe that the group therapy helps NPD patients explore boundaries, increase self-awareness, develop trust and accept feedback (Kernberg, 1970). Most importantly, relationship therapists stress on the use of four interpersonal skills namely conflict/problem resolution, discussion, empathy, and effective expression (Kernberg, 1970).
In conclusion, this paper has discussed the key underpinnings of NPD. In essence, NPD takes center stage when an individual becomes excessively preoccupied with his or her power, adequacy, vanity and prestige, even at the expense of others. NPD patients NPD take advantage of others so long they meet their desires; keeping healthy relationships with others is a challenge. Such people are excessively arrogant, and are in constant search for power and superiority; they tend to behave in a manner that will attract attention towards them; they careless about other’s feelings. Unfortunately, people suffering from NPD rarely seek therapy attention because they feel that they are justified to behave in that manner. They have the opinion that they have no problem. Medications and other forms of therapy have shown poor results. Psychoanalytic psychotherapy is the only form of therapy that has recorded convincing results. It is important for therapists not to quickly distort the patient’s traits; they should take caution and allow for progressive change.
References
Kernberg, O.F. (1970). Factors in the psychoanalytic treatment of narcissistic personalities. Journal of the American Psychoanalytic Association, 18(51–85), p. 56.
Millon, T. (1996). Disorders of Personality: DSM-IV-TM and Beyond. New York: John Wiley and Sons.
Schulze, K. et al. (2013). Gray matter abnormalities in patients with narcissistic personality disorder. J Psychiatr Res. 47(10), 1363-9.
Siegel, J.P. (2006). Dyadic splitting in partner relational disorders. Journal of Family Psychology, 20 (3), 418–422.
