“Narcissist” is a bit of a buzz word at the moment, often used to described somebody’s ex-partner or a picky boss. However, having narcissistic traits is different from having Narcissist Personality Disorder (NPD). True NPD can be diagnosed and treated; yet people with the disorder often don’t have the recognition of their difficulties. The latest Diagnostic and Statistical Manual of Mental Disorders (DSM) lists the primary symptoms of a person with NPD as:
- Having a grandiose sense of self-importance. Exaggerates achievements and talents and expects to be recognized as superior without commensurate achievements.
- Preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love.
- Believing that they are special and unique and can only be understood by or should associate with, other special or high-status people.
- Requiring excessive admiration.
- Having a sense of entitlement.
- Being interpersonally exploitive.
- Lacking in empathy.
- Often envious of others or believes that others are envious of them.
- Showing arrogant, haughty behaviours and attitudes.
A person who has a diagnosable disorder will have at least 5 of these behaviours and this will cause difficulties within their relationships and friendships. The behaviours are chronic, that is for the long term, and are severe. People with NPD consider themselves to be superior, yet they have a very poor sense of self and low self-esteem. Hence, they exaggerate their achievements and exploit others to protect themselves from being humiliated or ashamed. True NPD is often developed in childhood when a parent or parents are either excessively critical or excessively flattering of the child. There are mixed opinions about how prevalent the disorder is; ranging between 1 and 5%.
Most people have some traits of the above, but are unlikely to have a diagnosable personality disorder. Consider the traits to be on a spectrum with people perhaps having more or less of one trait or exhibiting a trait in certain situations. For instance; when drinking alcohol such traits within a person may be more evident. Sometimes partners struggle with communication, and the escalation into an argument or covert control might look like narcissism. In these cases people might be considered self-centred or obnoxious. They may hurt others with their actions, but are generally aware that this is the case, and can be encouraged to change their ways. If you are dealing with someone who is self-centred or obnoxious in this way, it is important to speak assertively and to be kind to yourself. This is not to say that people with NPD cannot improve their ways; they can benefit from psychotherapy which helps to raise insight, see the patterns in their behaviour, learn new behaviours, set more appropriate and realistic goals, recognising their limitations, and address their fragile sense of self in a safe and supportive way. This is of course, if they truly want to change; and they may not, given that they often have limited insight into their difficulties, their behaviours often mean they get what they want, and they lack empathy for others who are hurt in the process. If you are in a relationship or friendship with someone whose behaviours mimic the above, whether NPD or not, it might be wise to assess whether or not your relationship is happy and nurturing.