Understanding Narcissistic Personality Disorder

Pathological narcissism pervades every facet of the personality, every behavior, every cognition, and every emotion. This makes it difficult to treat. Add to this the narcissist's unthinking and deeply-ingrained resistance to authority figures, such as therapists--and healing, or even mere behavior modification, are rendered unattainable.

Pathological narcissism is often co-morbid with mood disorders, compulsive rituals, substance abuse, paraphilias, or reckless behavior patterns. Many narcissists are also anti-social. Lacking empathy and convinced of their own magnificence, they feel that they are above social conventions and the law. Some of these concomitant problems are amenable to a combination of medication and talk therapy. Not so the core defense mechanisms of the narcissist.

The narcissist is both victimizer and victim. The essence of the narcissistic disorder is a breakdown of internal communication. The narcissist invents and nurtures a false self intended to elicit attention--positive or negative--from others and thus to fill his innermost void. He is so engrossed in securing narcissistic supply from his sources by putting on an energy-sapping show - that he fails to materialize his potential, to have mature, adult relationships, to feel, and, in general, to enjoy life.

To the narcissist, other people are never more than potential sources of supply with a useful "shelf life". The narcissist invariably ends up cruelly devaluing and discarding them, like dysfunctional objects. Little wonder that the narcissist - haughty, abrasive, exploitive, manipulative, untruthful - is universally held in contempt, derided, hated, persecuted, and cast out. But we should never forget that he pays a dear price for something which, essentially, is beyond his full control--i.e., for his illness."

Upbringing and Narcissism

There are no authoritative studies to back a genetic predisposition to pathological narcissism--nor the oft-heard claim that it is the outcome of abuse. But anecdotal evidence, case studies, and the investigation of population in outpatient clinics and so on--reveals a correlation between abuse in early childhood and infancy and the emergence of pathological narcissism as a defense mechanism.

There are many forms of abuse. The most well-known and frequently discussed include incest, molestation, beatings, constant berating, terrorizing, abandonment, arbitrary punishment, capricious and unstable parental behavior and environment, authoritarian, emotionless, rigid and hierarchical home regime and so on.

But more pernicious are the subtle and socially-acceptable forms of abuse--such as doting, smothering, treating the child as an extension of the parent, forcing the child to realize the parents' unfulfilled dreams and unrealized wishes, putting the child on constant display maintaining unrealistic expectations of him and so on. These modes of abuse permeate the tenuous self-boundaries formed by the child and teach him that he is loved because of what he accomplishes rather than due to who he is.

Treating Narcissism

Every aspect of the personality is pervaded by pathological narcissism. It colors the narcissist's behavior, cognition, and emotional landscape. This ubiquity renders it virtually untreatable. Additionally, the narcissist develops deep-set resistance to authority figures, such as therapists. His attitude to treatment is conflictual, competitive, and hostile. When he fails to co-opt the therapist into upholding his grandiose self-image, the narcissist devalues and discards both the treatment and the mental health practitioner administering it.

Mood disorders, compulsive rituals, substance abuse, paraphilias, reckless, or anti-social behavior patterns often accompany pathological narcissism (they are co-morbid). While some of these coexistent problems can be ameliorated through a combination of medication and talk therapy--not so the core defense mechanisms of the narcissist.

Sam Vaknin is the author of Malignant Self Love: Narcissism Revisited. His Web site "Malignant Self Love - Narcissism Revisited" is an Open Directory Cool Site and a Psych-UK recommended Site.

Sam is not a mental health professional, although he is certified in psychological counseling techniques. He is the editor of Mental Health Disorders categories in the Open Directory Project and on Mentalhelp.net. He maintains websites about the Narcissistic Personality Disorder (NPD) and about relationships with abusive narcissists.

Sam is also the editor of the Narcissistic Personality Disorder topic in Suite 101, the moderator of the Narcissistic Abuse List and other mailing lists (c. 3900 members).