Wednesday, July 13, 2011

Love Thyself (but not too much): Narcissistic Personality Disorder

On Monday, I posted about the normal-ish side of narcissism. It's considered a continuous personality trait, which means some of us have less, some more, but we all fall somewhere along the continuum. Today, I'm going to talk about folks who fall on one of the extreme ends of that spectrum--those with narcissistic personality disorder.

If you read my quick-and-dirty guide to personality disorders, you'll remember that narcissistic personality disorder falls into Cluster B: those marked by a high degree of drama and emotionality. According to the DSM-IV, narcissistic personality disorder is a pervasive pattern of grandiosity and need for admiration as evidenced by at least five of the following symptoms:
  1. grandiose sense of self-importance (for example, expects to be recognized as superior without achievements to match)
  2. preoccupied with fantasies of unlimited success, power, beauty, or ideal love
  3. believes he/she is unique and special, and should only associated with people of higher status
  4. requires excessive admiration
  5. takes advantage of others to achieve his/her own ends
  6. lacks empathy: is unwilling to recognize the feelings and needs of others
  7. is envious of others and believes others are envious of him/her
  8. shows arrogant, haughty behaviors and attitudes

To be considered a disorder, these symptoms have to manifest across situations and settings, MUST cause clinically significant distress (in this case ... usually for others) in one or more important areas of functioning, and can't be better accounted for by another mental disorder (bipolar disorder, for example, as individuals in a manic state can sometimes be quite grandiose). Narcissistic personality disorder can, however, be diagnosed along with a primary psychiatric disorder such as depression or substance dependence.

Risk factors for this disorder include things like learning manipulative behaviors from parents, unpredictable or unreliable caregiving, lack of affection and praise as a child, and being neglected or abused. If you learn early on that vulnerability is unacceptable, you might grow a pretty thick emotional shell, thick enough to keep you from recognizing and empathizing with others. However--remember my post about multifinality? Lots of people experience these things and don't turn out to have this disorder.

There are plenty of individuals with narcissistic personality disorder depicted in movies/television. How about this guy?
Dr. Christian Troy of Nip/Tuck via fanpop.com

Christian Troy was a pretty classic case. As far as I can recall. I believe he might have exhibited every single symptom in the DSM-IV criteria, and there was no doubt his behaviors caused a clinically significant amount of distress, both for himself and for many others. He showed the classic pattern of strong first impression that deteriorates quickly once you get to know him a bit, and short-term relationships as the norm.

Can you think of other movie or book characters who have this disorder? What tips you off? And how about real life? Have you ever had someone like this in your life? Do you recognize any of these qualities in yourself?

This week for the Sisterhood of the Traveling Blog, Lydia answers the question "If you’re querying now, or have in the past, how do you develop patience to wait for responses?" Go see what she has to say!


20 comments:

  1. Great post, as always. The first thing I thought of was the character Erica Kane of "All My Children," and then realized any number of soap characters would fit this criteria. Such a person is not someone I would like within my group of family/friends; but as an entertaining character in fiction? Perfect!

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  2. I once had a roommate who exhibited many of these traits and to top it off, was a pathological liar (she lied constantly, about things that she knew we knew she was lying about - once she lied about knowing a person that we had both been friends with for years). Plus she had some hoarding tendencies. By the end of a year she couldn't walk on the floor of her room, and she allowed her cats to poop on the floor in the common living room and then didn't clean it up for weeks. It is EXHAUSTING to be friends with someone like that, not to mention to live with them.

    (PS - now she's at medical school!)

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  3. Cool- Ive been looking forward to this one! I've suspected my younger sister might have NPD for a long time. (But doesn't everyone think their siblings are selfish? lol) Unfortunately in her case, she's a bit on the extreme side of the spectrum. I'd love to hear about sibling order of birth and personality. Is there really a 'middle child syndrome'? :)

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  4. I can't think of anyone I know who fits this description. Maybe close, but more like annoyingly normal than clinically. My 11 yo shows tendencies towards this, but that as to do with his AS.

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  5. I have only met one person who meets all of these requirements, and she's a hot mess. She has been her entire life. I don't thinks she ever got help. Her poor kids!

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  6. Yes, I've known at least one person with this disorder. Extremely high functioning and intelligent, went to acrobatic lengths to stay on top. Achieved great success in business-no big surprise, right? I think this person's big trick was an actual ability to empathize when it served him, but he fits at least six of those other characteristics. Soap operas (day or night) seem like the perfect place to find these people!

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  7. Wow. One person in real life comes to mind immediately. I'm trying to cut this person out of my life because they really hurt me, (we're definitely talking significant distress) but it's HARD.

    And, ah, Christian Troy. I miss Nip/Tuck, I loved that show :)

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  8. I can think of a few people who show some of those traits (in the extreme) -- but not all of them. And at least one of them has been diagnosed as bipolar, so I think her behavior falls under that umbrella.

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  9. It seems to me that someone suffering from this disorder (can we say they're suffering? LOL) wouldn't ever realize it. It would feel completely natural, right? I suppose that's true all around though with mental illness. Most cases anyway.

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  10. Oh, ick yes. Christian was definitely certifiable. He made my skin crawl. Great post! You must be amazing at writing characters w/all of your insights into the human psyche. :)

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  11. Hahaha! Great example of a character with NPD. Nice post!

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  12. Definitely knew one, also a compulsive if not pathological liar. Manipulative. Passive aggressive. Ooh! Hope you tackle that one at some point! Great post!

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  13. That nip/tuck guy is perfect. I think a lot of monarchs of the past were probably narcissistic...something about being told they were god-like. :)

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  14. eeks! i've never seen nip-tuck! the whole concept of cosmetic surgery gives me the heebie-jeebies!
    *shivers*

    now,i have a question. i know a couple gals (they don't know each other) who seem incapable of seeing any flaws in themselves or the actions they take, even when there is all kinds of evidence that they are doing something wrong. they search for any way to spin blame, and see themselves as the victims in all things. even if there is noone against them. i don't really think it's so much paranoia... but i wonder if it's some kind of off-shoot of narcissism. where they can't realize their own flaws... there self-image is incompatible with having flaws... does that make sense? or would that be something else completely?
    i'm just trying to understand them. :)

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  15. Oh boy, have I known people with this. At least they really seem to have it. It's funny because I was just discussing this disorder with a friend of mine. I guess one of her friends was actually diagnosed. and that led me to think about someone else I know that sounded just like that.

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  16. OOOOH...The MC in AMERICAN PSYCHO scared me to death with his narcissism (and some other stuff). Of course, I run into people every day who think the world of themselves. Or that the world should think of only them. I just let them go on their merry ways. :)

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  17. I've known some people with these personality traits, although thankfully not ALL of them. It seems like the more symptoms one person has, the less fun they are to be around. It gets old really fast!

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  18. Wonderful post! One of my cp's read a couple chapters of the ya I'm working on. She immediately didn't like the mc. She didn't know that was how she was supposed to feel about him. He's like Christian, but younger...

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  19. One of my X's pretty much was the poster boy of narcissism. So amusing recognising those traits as I read your post.

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