Narcissism produces a distorted self-image, an oversized ego, and a presumption of superiority not based on any real-world accomplishments. Narcissists reveal their feelings about themselves and others through their actions, which are often manipulative and self-centered. Despite the depth of feeling narcissism generates, and the deep-seated insecurity it compensates for, people diagnosed with severe narcissism (narcissistic personality disorder) can learn to manage their symptoms and reduce the disorder’s influence over their lives.
Facts about Narcissistic Personality Disorder
There are multiple qualities that allow mental health professionals to identify narcissism, and when those characteristics manifest on a daily basis and cause significant life disruptions narcissistic personality disorder (NPD) may be diagnosed.
People with NPD usually experience a host of life complications as a result of their personality distortions. These include troubled and chaotic interpersonal relationships, turbulent work and/or educational histories, financial difficulties, encounters with the legal system, and co-occurring mental health or substance abuse conditions.
According to statistics obtained during the 2004-2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC II):
- 2 percent of American adults suffer from narcissistic personality disorder.
- NPD is present in about 7.7 percent of men and 4.8 percent of women.
- The highest incidence of NPD is among young adults age 20-25, 9.4 percent of whom suffer from the disorder.
- 6 percent of NPD sufferers had a co-occurring substance use disorder at some point in their lives.
- 40 percent of NPD sufferers also experienced a co-occurring anxiety disorder.
- 6 percent of people with NPD have had a co-occurring mood disorder.
There is no cure for narcissistic personality disorder. However, with long-term psychotherapy, people with NPD can learn to manage their symptoms and control the effects of their narcissistic tendencies.
Narcissistic Personality Disorder Characteristics
Narcissistic behavior and attitudes are common among human beings. But only a small percentage of those who exhibit narcissistic characteristics will meet the diagnostic criteria for narcissistic personality disorder, the clinical term for chronic narcissism that impacts every facet of a person’s life.
The distinctive characteristics of narcissistic personality disorder include:
Lack of empathy
People with NPD cannot relate to or understand the suffering of others, especially when they’re the ones responsible for the pain. If confronted with the truth about how their behavior has caused harm, narcissists will react with denial or confusion, asserting their innocence while demonstrating no real sympathy or compassion.
Research suggests that the inability of narcissists to empathize is based more on habit than lack of potential. With the help of intensive mental health treatment, NPD patients can learn to broaden their perspectives, until they begin to comprehend the feelings and experiences of loved ones and other companions.
Exaggerated sense of self-importance
Narcissists believe they’re destined to accomplish great things, and if they haven’t done so already it is only a matter of time (they think) until their talents are acknowledged and success achieved. When great results are slow to come they will not adjust their expectations, but will instead blame others for holding them back.
To receive validation for their illusions, narcissists are not above lying about their histories of achievement. They feel justified in doing so, since they’re convinced they will actually do those things someday.
Feelings of entitlement
People with narcissistic characteristics expect to be pampered, coddled, waited on, or otherwise taken care of by everyone they encounter. When that doesn’t happen they react with moral outrage, seeing it as a sign of disrespect.
Narcissists don’t believe they deserve special treatment because of their accomplishments—they believe it is their birthright, based on their natural status as superior beings.
Selfishness in relationships
People with narcissistic personality disorder frequently mistreat, manipulate, or abuse the people close to them to get what they want. They see nothing wrong with doing so, since they always put themselves first and do not consider the needs of others to be as important as their own.
Narcissists don’t exploit others because they have bad feelings about them. In fact, there is nothing personal about their actions. They use others only when they believe it is necessary to help them achieve their goals.
Enviousness and suspicion of other people’s motivations
People with narcissistic personality disorder envy the accomplishments and exalted status of others they consider successful. This betrays their inner insecurities, which persist despite their apparent self-assurance.
NPD sufferers also believe others are envious of them, dismissing criticism of their behavior as driven by envy or jealousy. In general, narcissists see bad intentions everywhere, and they are cynical toward those who profess to be motivated by compassion or ethics.
A need for excessive praise and attention
This is another trait that suggests narcissists aren’t as secure as they seem. Despite their professed beliefs in their own superiority, they need constant validation and reinforcement to support their high opinions of themselves. They believe they’re entitled to such treatment because of their superior talents and abilities, but if praise doesn’t come it leaves them feeling anxious and depressed.
When companions fail to express their gratitude or admiration, people with NPD take great offense and feel underappreciated. Unfortunately for their loved ones, narcissists are almost never satisfied with the amount of attention they receive and constantly believe they deserve more.
Arrogant and judgmental in attitude
NPD sufferers tend to see the world in simplistic, extreme terms. They see themselves as supreme and their rivals or enemies (whoever they might be) as inferior and deserving of rejection or criticism.
Their arrogance is a natural reflection of their assumed superiority, and they judge others as a way to elevate themselves. Some who are included in their inner circles are treated better, but narcissists are easily disillusioned by others and frequently reject people they once embraced.
Insistence on associating only with other special people
In line with their belief in their own power and importance, narcissists prefer to associate only with those they consider to be nearly equal in stature. Being in the presence of people who are accomplished and respected helps bolster their sense of superiority and worthiness.
Unfortunately for NPD sufferers, the people they admire often don’t share those feelings. When narcissists are rejected by those with status it can cause a crisis of confidence, although the narcissist will try to repress rather than acknowledge those feelings.
Preoccupied by fantasies of great achievements, power, or recognition
Narcissists believe it is their destiny to be fabulously successful, in every area of life. When the success they expect is slow to come they may retreat into a fantasy world, where they are praised and admired and acknowledged as special by everyone.
From the narcissist’s perspective, these fantasies seem achievable and realistic, possibly even preordained. But as time passes and their fantasies don’t come true, they may become bitter and begin taking out their frustrations on family and friends. Rather than facing the truth about their limitations, they look for scapegoats to blame for their failures.
Feelings of inferiority, insecurity, and low self-esteem, and an extreme need for the approval of others
It is important to recognize the split nature of narcissistic personality disorder. The narcissist’s apparently sincere belief in their own superiority is actually a coping mechanism that helps shield them from their deep-seated insecurities and poor self-esteem.
This is why narcissists are so desperate to be acknowledged and praised by other people. They rely on that reinforcement to silence their inner voices, which seek to undermine their self-confidence and cast doubt on their true worthiness.
What is a Malignant Narcissist?
The most destructive forms of narcissistic behavior are exhibited by the malignant narcissist, who suffers from NPD but also shows symptoms of antisocial personality disorder (sadism, paranoia, aggressiveness, etc.).
A malignant narcissist will demonstrate the typical characteristics, but with an added edge or intensity that can poison their relationships with other people. They will mistreat, abuse, or manipulate others continuously if it helps them get what they want, which explains why they struggle to maintain any relationships for an extended period of time.
Malignant narcissists have enough polish and charisma to cover their real motivations on most occasions. When their true nature is finally exposed, family members and friends are often shocked and bewildered by what they discover.
Malignant narcissists frequently cause great emotional or physical harm to others, to the point where they may be labeled sociopaths or psychopaths. But ultimately narcissism is their real problem, and without therapeutic intervention their malicious behavior may continue indefinitely.
Can Narcissism Be Treated?
There has long been a belief that personality is ingrained and that personality disorders cannot be successfully treated.
But this is untrue. The traits of personality disorders are tendencies that can be overcome, with residential and long-term outpatient therapy that helps sufferers identify the faulty thinking patterns that underlie them.
In the case of narcissistic personality disorder, childhood exposures to neglectful, abusive, or overindulgent parenting are usually implicated in the condition’s onset. This gives therapists and patients an opening to probe more deeply into the underlying causes of narcissistic thinking and behavioral patterns, and once these issues are addressed the healing process can begin in earnest.
Individual, group, and family and couples therapy can help NPD sufferers come to terms with their disorder. Guided by trained therapists, they will analyze how their narcissistic assumptions and attitudes have damaged their relationships and prevented them from reaching their full life potential. As NPD sufferers learn more about the sources of their false beliefs and delusions, their behavior should gradually lose potency.
When co-occurring substance abuse or mental health problems have been diagnosed, inpatient recovery programs that treat the symptoms of each condition simultaneously are by far the best option. Regardless of the circumstances, people with narcissistic personality disorder should begin their recovery in a residential treatment center, where intensive therapy in a fully supportive setting can be provided.
The road to recovery from narcissistic personality disorder is a long one. But with a patient, dedicated approach to healing, NPD sufferers can see dramatic improvements in their symptoms and in their overall quality of life.