Narcissistic Personality Disorder – Causes, Symptoms, Test, Treatment

What Does “Narcissism” Mean?

Narcissism can be defined as showing great interest in getting admired by others for one’s talent or physical features even when they are not present in reality. In psychological point of view, narcissistic people are extremely self centered without caring for others and they often crave for admiration from others. They are often arrogant and show no sympathy or empathy for other’s feelings and they exhibit this character to identify themselves from others.

Personality Disorder

A person is said to have personality disorder if his/her behavior and inner feelings differ from the society. There are certain norms set for each society and whenever a person behaves in different way that is not accepted as “normal” he/she is said to have problems in personality. This kind of enduring pattern can be seen in interpersonal functions and the behavior is not consistent in nature. It typically causes significant diStress to others at home, school and office.

The onset of any personality disorder begins during adolescence or sometimes in early adulthood. People affected with narcissistic personality disorder are self centric and crave for admiration and attention from the society. They believe them to be special and superior to others and live in an inflated feeling and thinking high. A person with NPD has very low self esteem and cannot tolerate even mild criticism. It is difficult for any spouse/partner to live with them since they show no empathy for anyone except him/her. NPD people have trouble in making and sustaining any relationships and have problems in school or workplace.

They often crave for special attention and favors since they strongly believe that they deserve it. No relationship can satisfy and fulfill them and it is difficult for any person to be happy with them. They have the feeling of getting primary importance even with strangers they meet. They show disdainful and snobbish behavior and are often complaining about other’s rudeness. People with NPD are highly sensitive and react wildly for even small criticism.

What Are The Warning Signs To Identify NPD?

People with NPD have the following signs ranging from mild to severe.

They are self centric and have inflated feelings of their appearance and talents.

They expect to be admired constantly even for silly things.

Though they have not done anything great, still they wish to be treated as special and superior.

It becomes a habit for them to exaggerate their talents and achievements in front of others.

NPD people have a tendency to think about their power, success and beauty and they often get involved with these thoughts.

They consider themselves as superior and would like to talk with famous and powerful people around them.

While indulging in conversation they are always dominant and demean and under-value other people, since they believe others to be inferior.

It is usual for them to expect unique favors and immediate compliance from others.

They are likely to take advantage of feelings of others.

NPD people just don’t bother and care about others and they may not even fulfill their basic needs even for spouse and children.

They have tendency to be jealous of others.

They have considerable difficulty in handling criticism since they are highly sensitive.

While talking with others they are mostly arrogant and have a tendency to boast about their pride.

They get short tempered and become impatient if they are not treated as special.

A person with NPD cannot sustain relationship since they have zero tolerance and they seldom respect their partner’s feelings.

It is quite common for them to have interpersonal problems in life.

They are more likely to act with emotional outburst since they have problem in controlling emotions.

It is difficult for them to deal with stress and it is not easy for them to change their behavior since they believe that they are right.

In the inner mind they have feelings of shame and insecurity.

What Are Marked Features Of People With NPD?

Feelings Of Grandiose An interesting feature of NPD is the affected person would have the feeling of grandeur although he/she is not. The affected person shall have an unrealistic feeling of pride and superiority. They always consider them to be “special” and demands special treatment. Since they believe they are more than average they would like to move with rich and affluent people. Though they have done nothing to recognize them as “special” still they believe and think big about their talents, appearance and achievements.

Living In An Imaginary WorldPeople with narcissistic personality have magical thinking and live in an imaginary world deceiving themselves and the society. They constantly tell some fantasy stories to backup their unlimited potential, success and achievements. In reality they are filled with feelings of guilt, shame and inferiority. To fill up the space of emptiness they build up success and brilliance in their path that are exactly opposite to what they really possess. If anyone tries to condemn their power and success stories they tend to react defensively and even go the extent of violence and anger. In other words, they cannot tolerate anybody to overpower their imaginary world. For this reason even trained psychotherapist can have difficult times with such clients.

Crave For Attention and Admiration A person with NPD would constantly need support and encouragement from the people around him/her. They are very choosy in maintaining relationships and move with people who cater to their needs of constant admiration. A husband with Narcissistic personality seeks attention and appreciation from his spouse repeatedly and never would try to understand her talents. Their ego demands constant admiration and they don’t care for anybody’s feelings. In case the spouse confronts/tries to point out his inability he would suspect that she is betraying him.

Outrage and Aggression Narcissist person expect special kind of treatment and wants everyone dear and near to adhere to their wish. You will be ridiculed as useless if you ever try to refuse their wishes. And if you are expecting some favor or appreciation from them, you should be ready to face outrageous behavior from them. For this reason even the close relation faces challenge living with them.

Lack Of Empathy NPD people do not care for other’s feelings since they live in their own world filled with fantasies and power. They will do anything to take advantage of others for fulfilling their needs. A narcissistic person would never think about his family and how is he affecting their lives. At any cost they want to satisfy their needs without bothering what impact it would have on others.

A person is said to have NPD if he/she has some of the above mentioned characters at least for a year or more. Often narcissistic personality begins during early adolescence and becomes full-fledged when the person becomes an adult. For reasons unknown, men are more in number than women affected with NPD. The symptoms of NPD reduce in intensity with age and only very few symptoms are present when the person is of 50 years.

Narcissistic Personality Disorder Tests

Any psychiatrist or psychologist can detect NPD based on the symptoms and behavior of the affected person. There are no concrete tests to assess the intensity of narcissism. People with NPD generally do not admit that they have some problem and seldom seek any treatment.

It is for the family and friends to detect that something is wrong with their personality and bring them to a trained psychologist. In many cases, even close relations would suspect some issue only when their relationship at workplace gets significantly damaged. Several sessions of psychotherapy is needed to treat a person with NPD.

What Factors Cause NPD?

• Exact cause of NPD is not clearly known. Since it deals with personality in the developmental stage, it is more complex and difficult to understand it in the initial stages.
• Genetics play a role in determining the shape of a person’s personality and you are likely to develop NPD if your parents have had such trait.
• Environmental factors can also cause NPD if a person grows in disturbed childhood atmosphere either with over criticism or excess of appreciation.
• Many professionals believe that a combination of factors like psychological, genetic, and biological factors can cause NPD.
• A neglected child or abused child can develop narcissistic personality later and similarly improper parenting style can trigger such behavior in children.

Consequence of NPD

To begin with a person with narcissistic personality have significant problem in sustaining relationship both at home and workplace.

The person can face serious problems in adjusting to school environment or at office.

People with NPD are constantly complaining and never compromise.

They may develop Depression, Anxiety and other psychological problems.

It is easy for them to get addicted to alcohol and other substance.

Treatment

Psychotherapy is the only available method of treating narcissistic personality disorder. It might take long time for the affected person to accept his/her behavioral problem. Psychiatrists can prescribe some medications to manage anxiety and uncontrolled anger.

Stage 1: AcceptanceFirst stage is the most vulnerable one in the method of treating NPD. It is very difficult for the NPD person to accept that something is wrong. Since they live in a fantasy world and think superior of themselves it is hard to convince them even for the psychotherapist.

A person with NPD may feel insecure if someone disturbs his “self” importance. It may create a feeling of panic and quickly he may feel that his world is being shattered. For this reason the affected person may find fault about the psychotherapist and may develop disregard for him/her. The frightened person would try to dominate the doctor/therapist by his arrogance and mock at him and may even comment his/her inability to treat him.

An expert psychotherapist would first convey her feelings of respect and admit the person’s importance. Only then would the patient be able to connect with the therapist/doctor. Initial support should be given by the health care professional to the patient so that he feels comfortable and confident. This would help in easing out the pressure in the mind of the patient.

Stage 2: Confrontation The psychotherapist should establish rapport with the client affected with NPD. Slowly he would enlighten the client’s vulnerabilities. This phase involves step by step confrontation and several arguments in repeated sessions. The client would be enabled to increase his self confidence which is very much needed to understand the situation. Therapist would set small realistic goals to the client supporting him in every possible manner to achieve it. The client would slowly emerge out of fantasy world reducing his shame and guilt feeling to face the real life. Self image of the client is reinforced in every session by the therapist to rebuild his character and personality.

Finally the therapist would explain to him/her the implication of the disorder and the consequences of his behavior on his family and office. In this stage medications are supplemented to manage anger and depressive signs.

Stage 3: Reconstructing Personality The patient can continue with sessions for individual therapy combined with cognitive behavioral approach. Once the symptoms of grandiose and self importance are reduced, the client will be helped to rebuild his personality with life skill training program.

For some clients, family therapy would produce the desired outcome wherein the close relatives of the client would be made to understand the client’s weakness and ego. It takes several weeks or months for the patient to reconstruct his personality which is realistic and acceptable. Hidden talents of the client is exposed and used creatively and a sense of self worth is inculcated on the client.

In most of the cases continuous presence to the therapy sessions will help the client to recover fully. Only in severe cases of NPD in-patient treatment is given to cope with impulsive and self destructive behavior. The period of treatment varies with the intensity of disorder and symptoms. Early intervention of diagnoses can help the patient to recover quickly.

Can NPD Be Prevented?

Since NPD is a kind of personality disorder where changes in thoughts, behavior and emotions happen inside, nothing can be done to prevent it. The family can intervene to offer support and start treatment as soon the initial symptoms of excessive self importance and grandiose begin. Individual therapy can be given to talk and interact with the society in healthy ways. The patient can be trained with effective ways of dealing with conflict and ego weakness.