In depth review on narcissistic personality disorder

This research newspaper will explore a particular personality disorder called narcissistic. Classification, causes, characteristics, role of childhood, development theory, self-destructive patterns, treatment (remedy & drugs). The major issues in this term job were: discovering the consequences of Narcissistic Personality Disorder on everyday attributions (evaluating the attributional style of individuals with Narcissistic Personality Disorder), examining whether or not narcissistic individuals display more day to day variability and extremity in their emotions than less narcissistic individuals, if there are dissimilarities in self-conceptions between narcissists and other individuals that mediate or modest such affective reactivity, if this emotional reactivity relates to general mood or to more specific self-related impact, if these affective reactions are linked to specific types of events

The reason for this paper is to discuss the general characteristics and treatment of Narcissistic Personality Disorder (NPD). The paper commences with some historical information regarding the condition. Diagnostic conditions and prevalence rates are also provided. This is followed by a brief review of counseling and therapy strategies and techniques for treating NPD.

A personality disorder can be an long lasting patter of interior experience and patterns that deviates markedly from the goals of the individual;s culture, is pervasive and inflexible, has an onset in adolescence or early on adulthood, is stalbe over tiem, and causes distress or impairment (pg. 685 DSM). There are currently ten personality disorders recognized by the DSM, which paper will discuss narcissistic personality disorder. People often confuse narcissistic to be packed with one's self applied, but it has a more intricate side. It'll present an assessment of the literature on borderline personality disorder, a treatment plan for an individual with the disorder, and discuss the therapeutic alliance between a patient with borderline personality disorder and his/her therapist. An estimation of the prevalence of personality disorders in a community inhabitants is from two percent to 14 percent (Linehan Oldham, & Silk, 1995; Hubbard, Saathoff, Bernardo, & Barnett, 1995; Coreeli, 1998).

Development of Narcissistic

A narcissitic person thinks the globe revolves around them. These are inconsiderate people who are not kind. Another phrase for narcissim is a conceited selfish person. The word narcissim was coined by Sigmund Freud. There is a Greek myth about a man Narcissus. He was very self-absorbed and fell in love with his own representation in drinking water.

Narcissistic Personality Disorder (NPD) bases itself on the personality trait of narcissism. According to the Mayo Medical center, NPD is a mental disorder where people have an inflated sense of their own importance and a profound dependence on admiration. Individuals who have problems with NPD believe that everyone is inferior compared to them and do not care about other people's feelings. They might need constant attention and exaggerate their accomplishments and talents; however, even though individuals who have NPD appear to be very conceited and self-absorbed, they don't handle criticism very well. They are very vulnerable to it and react to it with fury and embarrassment.

As stated in lecture, people with severe personality disorders are at risky for hypochondriasis, alcoholic beverages and drug abuse, and violent and home destructive habit. The three main symptoms of NPD explained in the training video are: "the narcissist has grandiose fantasies with an exaggeration of achievements and their put in place the entire world, " "extreme selfishness and self-centeredness with insufficient empathy for others and a feeling of entitlement, " and "overly delicate to criticism or any obstacle to their fake self-image. " They do not worry what they do, so long as these are benefitted. They don't connect their activities with consequences. They assume that they can do whatever they need and nobody can tell them otherwise. This simple fact may provide as a inspiration to commit criminal offenses. If regulations says a person cannot take action, the narcissist believes it does not connect with him/her.

Criteria for Narcissistic Personality Disorder

Has a grandiose sense of self-importance (e. g. , exaggerates accomplishments and talents, needs to be recognized as superior without commensurate accomplishments)

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

Believes that he / she is "special" and unique and can only be realized by, or should relate with, other special or high position people (or institutions)

Requires excessive admiration

Has a feeling of entitlement, i. e. , unreasonable anticipations of especially advantageous treatment or computerized compliance with his or her expectations

Is interpersonally exploitative, i. e. , needs advantage of others to achieve his or her own ends

Lacks empathy: is unwilling to identify or identify with the emotions and needs of others

Is often envious of others or is convinced that others are envious of him or her

Shows arrogant, haughty manners or attitudes

Causes of Narcissism

Medical data exhibiting early mistreatment of individuals from physical, sexual, or mental have negative effects on brain development. Brain influx abnormalities were within histories of such early traumas and were at double the rate compared to non-abused patients. The left area of EEG also demonstrated abnormalities and diminishing development of the kept hemisphere. The MRI proved the left hippocampus of abused patients was much smaller in comparison to non-abused. Studies also showed, that abused children showed deficits of verbal storage. These alterations can raise the risk of despair and many other disorders, including Narcissistic Personality Disorder.

Investigations on verbal abuse also show increase dangers for personality disorders. Offspring who experienced maternal verbal misuse were three times more likely to possess borderline, narcissist, obsessive compulsive, and paranoid personality disorders, during adolescence or early on adulthood. These organizations continued to be significant. Also which confirmed the disorders to be elevated in adulthood.

There may be a link, between Obsessive Compulsive Disorders and Narcissist Disorders. Thus being truly a superficial function, to hold to the self-object. Causing lack of the connection would experience loss of self.

ADHD may also be from the narcissistic disorder. Children who have problems with ADHD are unlikely to develop the connection necessary. Thus the narcissistic disorder occurs, credited to regression or adaptation. Another hypothesis could be the linkage of autistic disorders to Narcissism.


Most narcissists reject the theory they are mentally disturbed. The particular level or amount of Narcissism can improve, but rarely will an individual suffering from the condition be cured due to prolonged, irreplaceable and essential mental investment in their disorder. Narcissists are attached to one thing their disorder.

Treatment of narcissist revolves around the transference of romantic relationship. The analyst remains silent and unseen, there to pay attention, echo and interpret the actions of the Narcissist. The therapist remains emphatic to the needs of his patient by becoming a mirror for the Narcissistic to confront his / her alter ego. According to Grunberger, "the patient should enjoy complete narcissistic freedom in the sense that he should be the one active party. The analyst does not have any real life of his own in relation to the analyzed, " the analyst does not have to be good or bad or even exist at all. Research is not dialogue; it is just a monologue for just two voices, one speaking and the other echoing, repeating, clarifying, and interpreting effectively. According to Grunberger, the analyst must continue to be a faithful and untarnished mirror.

Once the therapeutic relationship is made, the narcissist mirror transference and self-object transference emerge. This is only going to happen when the therapist provides a strong sense of validation to the narcissist allowing the narcissist to recall his damaged child. The amount of reflecting back again to the wounded child will depend on the three types described previously. The merger transference will understand the therapist to be always a virtual extension of them. In the event the therapist should just a bit vary from the needs or opinions of the narcissist, the patient will react by withdrawing. Under the second type, the narcissist perceives the therapist to be individual but alike. It is necessary that the narcissist view the therapist as just like me and become maintained. The 3rd type the therapist must be able to bolster the narcissist's insecure do it yourself. Thus really the only affinity for the narcissist is to reveal his or her grandiosity.

Utilizing the transference permits the narcissist to recover his / her low self-esteem and restate the ruined grandiosity. To treat the false do it yourself, the therapist must take benefit of the narcissist's emotional express. Making the narcissist concentration toward his / her inner feelings at that time. Another procedure could be hands-off type. By allowing the narcissist take control of the trainings in therapy. It is up to the therapist to recognize the narcissist harm and discover the reason for injury. After the injury is discovered the therapist must explore the issue with out threatening the narcissist.

NPD in the DSM-V

Christian Perspective

A Brief History of Narcissism

In 1898, Ellis first used the term narcissism with regards to mindset phenomena when he summarize a special status of auto-erotism where sexual emotions become consumed in self admiration. Freud later included the term into his psychoanalytic theory in his 1914 article 'On Narcissism'. Freud considered narcissism a erotic perversion affecting a pathological intimate love of one's own body. These two ideas cite developmental problems in child years as causal factors resulting in the development of Narcissistic disorder, while others suggest that contemporary society as a whole causes the disorder. Since that time several other subconscious theories have attemptedto clarify and treat the disorder. However, the psychodynamic perspective of Narcissism supplies the most comprehensive reason of the disorder.

The Psychodynamic View of Narcissism

Two overlapping institutions of thought dominate the psychodynamic style of Narcissism: the self-psychology institution represented by Kohut and the thing relations' school represented by Kernberg. Kohut advises narcissism is a component of everyone's psyche that we are born with the disorder. Kernberg argues that narcissism presents a fixation in ones of the developmental times of child years.

The Self Mindset School

Heinz Kohut thought that narcissism was a natural and normal development from labor and birth to adult. In which a healthy normal person, can transform his / her baby narcissism into adult narcissism. "Transmuting internalization" is a term he used to spell it out the process in which a child transforming into a grown-up would face various challenges causing into some frustration. Having maximum frustrations leads the person to develop a solid internal composition or a strong sense of ones self. This is utilized to pay for the lack of external composition or support from others, thus if the narcissist procedure for transmuting is obstructed. Due to a level of aggravation that exceeds the optimal frustration, in which the person experiences. He or she will be stuck in the infantile level, displaying many characteristics of omnipotent and invulnerable child.

The Objects Relationships School

Otto Kernberg's views of narcissism are based on Mahler's theory of parting. Consisting of someone process of separation, from infancy to early on childhood. The producing child gains a stable self-concept by understanding two major stages, normal autism and symbiosis, along with four other sub stages: differentiation, rehearsing, rapprochement, and consolidation of separation-individuation. Kernberg argues that an individual struggles to successfully grasp the rapprochement sub stage and becomes set as of this level. At get older 10 to 14 weeks begins the development stage, in which the child discovers to walk. This capacity, gives a totally new perspective for the child thus giving a feeling of grandiosity and omnipotence, which resembles a narcissist action. At age group 14 to two years the child enters in the rapprochement sub period finding that he or she has restrictions of what they might do. If the kid is severely frustrated they adjust by refusing or as a result returning to the exercising sub phase. This may be his / her security omnipotence and invulnerability.

The Development of Problems

The development of problems occurs when narcissistic attributes become exaggerated in an individual's personality. Through the first eighteen a few months of life an infant will get narcissistic defences. The infant is able to experience being the guts of these mother's world and an oneness with the mother develops. Being the center of the mother's world makes the kid feel powerful and omnipotent plus they know no boundaries to their world. However, a mental health transformation near the end of the eighteen-month period triggers the disintegration of the child's oneness with the mother to take place. When this separation period starts the activities of the kid determines the development of the ego and the starting point of NPD. These experience encompass the mother's capacity to be reactive and hypersensitive to the needs of the kid through the first eighteen a few months. Also, significant in the develop of the ego is the limitations and implications the parents provide between two and ten and the amount of mistreatment or trauma the kid receives during the first seven years of life. This maltreatment does not actually have to come from injury induced by parents. Expert information or peers can even be the culprits. A pattern of grandiosity, high dependence on admiration, entitlement, and lack of empathy will be the chief components in the diagnosis of NPD. These behaviours commence in early adulthood. A narcissistic specific is unable to trust, depends on others, and thus advances numerous, superficial associations to extract tributes from others. Because a narcissistic person has a changing morality--always ready to shift values to gain favour --any romantic relationship with a narcissist has difficulty. Their tendency is to create friendships or passionate associations with only those that can boost their self-esteem or improve their purposes. A narcissistic person has a simple sense of inferiority. Under this inferiority is a preoccupation with fantasies of spectacular achievement and an aimless orientation toward superficial passions. The narcissist uses others to assist them in virtually any tasks they suppose and will frequently take credit for work which others have done. The narcissistic individual may be more successful at their chosen field of work than a few of the other personality disorders because their narcissism is beneficial in their career especially if their work provides narcissistic supply. However, typically they should never be able to escort their pursuits long enough to completely develop any long-term jobs if these assignments are completed they may not be of the best quality.

Narcissists will over inflate their own accomplishments, are boastful, and pretentious. Although he or she may impress others with knowledge and decisiveness, a narcissistic person's information bottom part is often limited to trivia. Lying is an essential parts of the narcissist's behaviour and almost all their self-reports are unreliable. Their cognition is impaired to the extent that they often times misconstrue other's talk and actions. They may actually think that someone respects or adores them although this is a dream which is available only in your brain of the narcissist. Their ideas are seldom original and they choose to price whoever in those days they feel can be an authority. The narcissist's quotations may not be accurate from what the chosen specialist at the time meant. People apart from the narcissist may wonder why the narcissist chosen that individual as an specialist because no true validation may are present that the person the narcissist picks is an specialist. They expect special treatment from others such as not ready in range or being the guts of attention and are mystified when they actually no get what they want. They be prepared to get whatever they need no matter what it means to others. In addition they feel that they can only be realized by people of high status and they often assign special, gifted, or unique attributes that are not factual to the people with whom they connect. They will insist they have the best doctor, lawyer or attorney, etc. , available, and will assign accomplishments compared to that individual to prove their validity. If a person disappoints them, however, they frequently will negate the credentials of these that disappoint them. A narcissistic specific has a fragile sense of self applied. To fortify their sense of do it yourself they rely upon other's admiration and constant attention. They expect other's to covet their belongings and they're constantly seeking compliments. A narcissistic injury occurs when someone defeats or criticizes the narcissistic individual. The narcissist might not show it outwardly, but they are haunted by criticisms and defeats. They commence to feel unfilled, degraded, and humiliated and can handle retaliating with narcissistic trend. Their reactions constitute contempt or defiant disorders.

The purpose of this newspaper is to go over the overall characteristics and treatment of Narcissistic Personality Disorder (NPD). The newspaper begins with some historical information regarding the condition. Diagnostic criteria and prevalence rates are also provided. This is followed by a short review of counselling and therapy strategies and approaches for dealing with NPD.

NPD: Background, Diagnostic Criteria and Prevalence

According to Pervin (1990), the roots of emotional thought regarding NPD can be found in Freud's early writings on narcissism. In this respect, Pervin states that Freud characterized narcissism in five ways. We were holding as: (1) a sexual perversion in which one's own body was used as a intimate subject; (2) a level of libido development; (3) a type of object choice where the sexual object is chosen because of having characteristics much like one's own; (4) a type of object-relationship in which libidinal cathexis is withdrawn from exterior things and redirected toward the self or parts of home; and (5) a constituent of self-esteem related to the ego ideal.

The Narcissist's View of Others

Just as the average person becomes narcissistic because that is what the environment

'needed' him or her to be, so does indeed the narcissist view others not as these are, but as what

he or she needs those to be. Others are thus perceived to exist only in relation to the

narcissist's needs. The word object relations thus assumes a special interpretation with the

narcissist. "We live objects to him, also to the extent that we are narcissistic, others

are things to us. He doesn't really see and notice and feel who we are and, to the extent

that our company is narcissistic, we do not necessarily see and notice and feel the true existence of others.

They, we, are things. . . I am not real. You aren't real. You are an thing to me. I am

an object for you" (Johnson, 1987; P. 48). It really is clear than that the narcissist maintains

the infantile illusion to be merged to the thing. At a subconscious level he or she

experiences complications in differentiating the self from others. It is the extent of this

inability to tell apart personal restrictions which determines the severity of the

narcissistic disorder (Johnson, 1987).

Levels of Narcissism

The most extreme form of narcissism requires the conception that no parting exists

between the home and the object. The object is viewed as an expansion of the home, in the

sense that the narcissist considers others to be a merged part of him or her. Usually, the

objects which the narcissist selects to merge with represent that aspect of the narcissist's

personality about which emotions of inferiority are recognized. For instance when a narcissist

feels unattractive he or she will seek to merge with someone who is perceived by the

narcissist to be attractive. At a marginally higher level is accessible the narcissist who

acknowledges the separateness of the object, however, the narcissist views the thing as similar to himself or herself in the sense that they show a similar subconscious makeup.

In result the narcissist perceives the object as 'just like me'. The best evolved

narcissistic personality perceives the object to be both different and psychologically

different, but is unable to appreciate the object as a distinctive and independent person. The

object is thus perceived as useful only to the scope of its ability to aggrandize the false

self (Manfield, 1992).

Types of narcissism

Pending the identified needs of the environment a narcissist can form in one of two

directions. The average person whose environment helps his or her grandiosity, and

demands that he or she become more than possible will develop to be an exhibitionistic

narcissist. This individual is informed 'you are superior to others', but at the same time

his or her personal feelings are ignored. Thus, to restore his or her feelings of adequacy

the growing specific will attempt to coerce the surroundings into assisting his or her

grandiose boasts of superiority and efficiency. On the other hand, if the environment

feels threatened by the individual's grandiosity it will attempt to reduce the individual

from expressing this grandiosity. Such an individual learns to keep the grandiosity

hidden from others, and can develop to be a wardrobe narcissist. The closet narcissist will

thus only show you his or her thoughts of grandiosity when he or she is convinced that such

revelations will be safe (Manfield, 1992). Like most personality disorders, narcissism occurs to different degrees in various people and can disclose itself in lots of ways. Many highly successful individuals may screen personality traits that could be considered Narcissistic. So, a tiny amount of narcissism might be beneficial. For instance, a lot of today's business market leaders and politicians exhibit many of the qualities associated with Narcissism. However, increased Narcissistic behavior can result in insatiability and catastrophe.

A narcissist can develop in another of two directions. One of them is the exhibitionist narcissist where the environment supports his / her grandiosity but emotions are ignored where she or he continues the cycle thus, trying to revive his / her feelings. This would include the need for attention or attention-seeking practices like dealing with charity, voluntary, not-for-profit sector. In most case they are women who want to demonstrate to the globe they are wonderful, kind, caring, compassionate person. Different ways could be playing up a personal injury or fabricating hate offences. Another example would be Munchausen symptoms. It really is usually a mother, who intentionally harms her child in the purpose, of getting attention from the medical personnel. Sometimes the narcissist will continue to work as a nurse or in nursing homes causing death to some and being not found.

The second type of narcissist is the closet narcissist where the individual suppress himself from expressing this grandiosity. This narcissist will only reveal his / her feelings of grandiosity when such revelations will be safe rather than in public. This could mean having a relationship with someone merely to satisfy his needs. He or she would resort to gender. Narcissist associates would be looked at his or her objects, much less desire. In this case it is aspect of conquest and must transition partners frequently. Some narcissists like complicated situations such as virgins, married women or men, the more difficult the get the better. A narcissist might appear to loose interest in sex and in every his sexual partners. The regularity would dwindle to a few times weekly to some times annually. A Narcissist might avoid his spouse and pursue athletics, politics or volunteering for anything but sex in order to punish her or him for something, or just because they feel confined to him or her or has lost their freedom.

There are three degrees of Narcissism. The extreme level in which there is no separation between the self and the object. The object sometimes appears as an extension of narcissist. An example could be when a narcissist considers himself as unattractive, he would seek someone appealing to fill the need as one. Level two is when a narcissist acknowledges the parting of the thing, but nonetheless views the thing as very much like him or her, posting the same mental health make-up. Level three is when the narcissist perceives both individual and emotional difference but struggles to appreciate the object as a separate person.

Narcissistic Defense Mechanisms

Narcissistic defenses can be found to some extent in all people, but are especially

pervasive in narcissists. These defenses are used to safeguard the narcissist from

experiencing the feelings of the narcissistic personal injury. The best pervasive defense system is the grandiose protection. Its function is to revive the narcissist's

inflated notion of himself or herself. Typically the defense is employed when someone

punctures the narcissist's grandiosity by saying something which interferes with the

narcissist's inflated view of himself or herself. The narcissist will experience a

narcissistic injury similar compared to that experienced in years as a child and will respond by expanding

his or her grandiosity, thus repairing his or her wounded self notion. Devaluation is

another common security which is employed in similar situations. When wounded or

disappointed the narcissist can answer by devaluing the 'offending' person. Devaluation

thus restores the wounded ego by providing the narcissist with a feeling of superiority

over the offender. There are two other defense mechanisms which the narcissist uses.

The self-sufficiency security is used to keep the narcissist psychologically isolated from

others. By keeping himself or herself emotionally isolated the narcissist's grandiosity

can continue to exist unchallenged. Finally, the manic protection is employed when feelings

of worthlessness commence to surface. To avoid experiencing these emotions the narcissist

will attempt to occupy himself or herself with various activities, so that he / she has no

time still left to feel the emotions (Manfield, 1992).


No subject which approach is utilized in the explanation and treatment of narcissism

it is important to recognize that the narcissistic individual is a complicated and multifaceted

human being. Deep inside narcissistic individuals experience tremendous pain and

suffering, for which they try to compensate for by the projection of the grandiose

front. These folks are not persona disordered. They can be people tortured by

narcissistic injury and crippled by developmental arrests in working which rob them

of the richness of life they deserve. Individual suffering from Narcissistic Personality Disorder usually overestimate their talents and inflate their achievements. They appear boastful and pretentious underestimating and devaluing the achievements and fulfillment of others. Narcissists sometimes fraudulently claim to have qualifications or experiences, which they don't possess.

Fragile self-esteem is another issue for the narcissist. The necessity for constant attention, admiration, matches, along with superior entitlement, and expecting others to defer to them help their fragile self-esteem. Greed another characteristic, expecting to receive rather than give and using any means around them for progression, to include intimate relations.

Narcissist lack of sensitivity has difficulty in spotting the needs and feelings of others. They may be dismissive, contemptuous and impatient when others share or discuss concerns or problems. To conclude the narcissist is oblivious to the hurtfulness of these remarks or action, arrogant, disdainful and patronizing frame of mind, showing envy, emotional coldness and insufficient interest and is quick to blame and criticize others when their needs and anticipations are not satisfied.

In today's modern culture Narcissism is all around us. From the time we awake to enough time we drift off. The children of today tend to be more self-centered then years previously. Could the parents be spoiling them too much? Thus giving them, everything they need, devoid of some degree of frustrations, could possibly lead to narcissistic action. We see it on tv and think it is normal. Tv shows, of men and women endeavoring to be beautiful and the center of attention, like the Neglect America Pageant. Another show, Survivor, where there is merely one person standing by the end. Other factors, can include material items such as automobiles, houses, that must be grander then others, shows object relations to narcissism. Eventually narcissism may be a part of everyday life rather than certainly be a disorder in the years to come.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Model, Content material Revision. Washington, DC: North american Psychiatric Association, 2000.

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