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Narcissism: Symptoms, Causes and Treatment

“Idaho Nobility” by Mimi Stuart©

Symptoms of Narcissism

There are degrees of narcissism, ranging from excessive self-importance to full-fledged Narcissistic Personality Disorder (NPD.) For people suffering from NPD, the craving for admiration, status or power is the primary drive in their lives. As a result, they display extreme selfishness, a lack of empathy, and grandiosity.

Narcissists are preoccupied with self-aggrandizement to hone public opinion of their image. They seek power, fame, status, money, or sexual conquests and are often envious of others who have an abundance of these resources. To obtain “narcissistic supply”—adulation, power, fame, etc.—they will exaggerate and misrepresent their talents and accomplishments. Grandiose and arrogant, they demand that others treat them as special or superior.

High-functioning narcissists present themselves well and are socially adept, having worked hard at creating their image. However, in intimate relationships, they frequently display envy, arrogance, entitlement, and cruelty. They protect themselves from criticism, humiliation, and rejection by over-reacting with contempt, outrage, and abuse.

Narcissists use their charm and charisma to attract people into their orbit, but they often end up exploiting them to serve their own needs. Their attitude of superiority and their tendency to blame others for their own misdeeds do not promote mutually-satisfying, long-term loving relationships.

Causes of Narcissism

Healthy narcissism is a stage that very young children need to experience to gain the confidence required to grow up, take care of themselves, and be able to initiate social interactions. Children generally grow out of this phase if they experience adequate mirroring-receiving empathy and approval from one’s caregiver, and idealization—being able to look up to a caregiver as a respected person separate from oneself. If they don’t experience adequate mirroring or idealization, their development may become arrested in the narcissistic stage.

Lack of mirroring occurs in one of the following ways:

1. Approval is erratic or lacking all together. The child is ignored.

2. Admiration is too unrealistic to believe, while realistic feedback is lacking. “You’re the cutest, smartest…”

3. Criticism for bad behavior is excessive. “You are bad, evil, stupid!!”

4. The parents are excessively permissive and overindulge the child, implying a lack of caring. “Sure, have a bowl of candy, more juice, toys, throw your food if you want to, I don’t care.”

Children are deprived of idealization in one of the following ways:

1. The parents are unpredictable, unreliable, or lacking in empathy.

2. The parents are emotionally or physically abusive.

3. The parents have no interest in the child’s needs, but exploit the child to feed their own self-esteem.

When children do not experience mirroring or idealization, their psychological development can be arrested in the narcissistic phase. They do not develop empathy for themselves or others. They feel flawed and unacceptable. They fear rejection and isolation because of their perceived worthlessness.

To cover their feelings of worthlessness, they focus on controlling how others view them by embellishing their image, accomplishments and skills. Their deep shame causes them to develop an artificial self. We all develop an artificial self to some degree, but narcissists identify fully with their artificial self.

They suffer from low self-esteem, although they and those who have fallen under their spell may not believe that they have a problem with self-esteem. People with adequate self-esteem are usually willing to look at themselves with honest self-reflection and consider areas in which they could improve. They have empathy for the flaws and inadequacies in both themselves and others.

Narcissists, however, loathe and conceal their flaws, believing that only perfection and superiority can be displayed. Thus, they view themselves and others with a perspective that swings from over-valuation to repugnance. In their quest for approval and acceptance, they use their charm and charisma. Once dependent on others’ approval, the smallest hint of disapproval can send them into a state of cruel vengeance.

Praise and admiration boost the narcissist’s self-esteem, but only temporarily, because it merely reflects the false self. When faced with criticism or solitude, shadow feelings of worthlessness grow in corresponding proportion to the narcissist’s grandiosity. To fight off this inner doom, the narcissist doubles his or her efforts in pursuit of self glorification. The cycle is never ending and unfulfilling.

Treatments for Narcissism

Narcissists feel ashamed when confronted with a criticism or failure, and may become enraged at the suggestion that they should get treatment. Thus, narcissists are generally not interested in healing. Yet they will seek therapy when they have hit rock bottom or when they are compelled to by the courts or an irate spouse.

There are no known medications to treat narcissistic personality disorder, although there are medications to treat depression and anxiety disorders, which may accompany NPD.

Psychotherapy, or talk therapy, can help a motivated narcissist understand and regulate feelings of distrust, envy, and self-loathing. Generally, psychotherapy, which focuses on strengthening the ego and developing a more realistic self-image, is a long-term endeavor. Cognitive Behavioral Therapy in particular aims at identifying cognitive distortions and false beliefs with more realistic beliefs and replacing harmful behaviors with healthy behaviors.

A new treatment called Cold Therapy has been developed by Sam Vaknin, author of “Malignant Self-love & Narcissism Revisited” and other books about personality disorders. Cold Therapy’s treatment of Narcissistic Personality Disorder, Antisocial Personality Disorders and certain mood disorders is based on two premises: (1) That narcissistic disorders are actually forms of complex post-traumatic conditions, and (2) That narcissists are the outcomes of arrested development and attachment dysfunctions. Consequently, it borrows techniques from child psychology and from treatment modalities used to deal with PTSD.

by Alison Poulsen, PhD

Guest Author Sam Vaknin: Shame Makes the Whole World Go Around – or Only Codependents and Narcissists?

"Raven" by Mimi Stuart©

“Raven” by Mimi Stuart©

GUEST AUTHOR SAM VAKNIN writes:

Lidija Rangelovska advanced the idea that some children subjected to abuse in dysfunctional families objectified, dehumanized, their boundaries breached, and their growth stunted develop intense feelings of shame. They turn out to be codependents or narcissists owing to their genetic makeup and innate character. According to her, children who turned out to be codependents as adults are resilient, while the more fragile narcissists seek to evade shame by concocting and then deploying the False Self.

As Lidija Rangelovska observes, shame motivates “normal” people and those suffering from Cluster B personality disorders differently. It constitutes a threat to the former’s True Self and to the latter’s False Self. Owing to the disparate functionality and psychodynamics of the True and False selves, the ways shame affects behavior and manifests in both populations differ. Additionally, pervasive, constant shame fosters anxiety and even fears or phobias. These can have either an inhibitory effect or, on the contrary, disinhibitory functions (motivate to action.)

The True Self involves an accurate reality test with minimal and marginal cognitive deficits as well as the capacity to empathize on all levels, including and especially the emotional level. People whose True Self is intact, mature, and operational are capable of relating to others deeply (for example, by loving them). Their sense of self-worth is stable and grounded in a true and tested assessment of who they are. Maintaining a distinction between what we really are and what we dream of becoming, knowing our limits, our advantages and faults and having a sense of realistic accomplishments in our life are of paramount importance in the establishment and maintenance of our self-esteem, sense of self-worth and self-confidence.

Shame threatens the True Self by challenging the affected person’s ego-syntony: by forcing her to “feel bad” about something she has said or done. The solution is usually facile and at hand: reverse the situation by apologizing or by making amends.

In contrast, the False Self leads to false assumptions and to a contorted personal narrative, to a fantastic worldview, and to a grandiose, inflated sense of being. The latter is rarely grounded in real achievements or merit. The narcissist’s feeling of entitlement is all-pervasive, demanding and aggressive. It easily deteriorates into the open verbal, psychological and physical abuse of others.

When the patient with the False Self feels shame it is because his grandiosity, the fantastic narrative that underpins his False Self, is challenged, usually – but not necessarily – publicly. There is no easy solution to such a predicament. The situation cannot be reversed and the psychological damage is done. The patient urgently needs to reassert his grandiosity by devaluing or even destroying the frustrating, threatening object, the source of his misery. Another option is to reframe the situation by delusionally ignoring it or recasting it in new terms.

So, while shame motivates normal people to conduct themselves pro-socially and realistically, it pushes the disordered patient in the exact opposite direction: to antisocial or delusional reactions.

Shame is founded on empathy. The normal person empathizes with others. The disordered patient empathizes with himself. But, empathy and shame have little to do with the person with whom we empathize (the empathee). They may simply be the result of conditioning and socialization. In other words, when we hurt someone, we don’t experience his or her pain. We experience our pain. Hurting somebody – hurts US. The reaction of pain is provoked in us by our own actions. We have been taught a learned response: to feel pain when we hurt someone.

We attribute feelings, sensations and experiences to the object of our actions. It is the psychological defence mechanism of projection. Unable to conceive of inflicting pain upon ourselves – we displace the source. It is the other’s pain that we are feeling, we keep telling ourselves, not our own.

Additionally, we have been taught to feel responsible for our fellow beings and to develop guilt and shame when we fail to do so. So, we also experience pain whenever another person claims to be anguished. We feel guilty owing to his or her condition, we feel somehow accountable even if we had nothing to do with the whole affair. We feel ashamed that we haven’t been able to end the other’s agony.

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by Guest Author Sam Vaknin, the author of Malignant Self-love: Narcissism Revisited and After the Rain – How the West Lost the East, as well as many other books and ebooks about topics in psychology, relationships, philosophy, economics, international affairs, and award-winning short fiction.

He is the Editor-in-Chief of Global Politician and served as a columnist for Central Europe Review, PopMatters, eBookWeb, and Bellaonline, and as a United Press International (UPI) Senior Business Correspondent. He was the editor of mental health and Central East Europe categories in The Open Directory and Suite101.

Visit Sam’s Web site.

Read Sam Vaknin’s “Codependence: Issues and Goals in the Treatment of Dependent Personality Disorder.”

Read “Feeling Shame: ‘I’m not worthy to be loved.’”


Guest Author Sam Vaknin: Inner Voices, False Narratives, Narcissism, and Codependence

"Snobberville" by Mimi Stuart © Live the Life you Desire

“Snobberville” by Mimi Stuart ©
Live the Life you Desire

Guest Author Sam Vaknin writes:

The narcissist constructs a narrative of his life that is partly confabulated and whose purpose is to buttress, demonstrate, and prove the veracity of the fantastically grandiose and often impossible claims made by the False Self. This narrative allocates roles to significant others in the narcissist’s personal history. Inevitably, such a narrative is hard to credibly sustain for long: reality intrudes and a yawning abyss opens between the narcissist’s self-imputed divinity and his drab, pedestrian existence and attributes. I call it the Grandiosity Gap. Additionally, meaningful figures around the narcissist often refuse to play the parts allotted to them, rebel, and abandon the narcissist.

The narcissist copes with this painful and ineluctable realization of the divorce between his self-perception and this less than stellar state of affairs by first denying reality, delusionally ignoring and filtering out all inconvenient truths. Then, if this coping strategy fails, the narcissist invents a new narrative, which accommodates and incorporates the very intrusive data that served to undermine the previous, now discarded narrative. He even goes to the extent of denying that he ever had another narrative, except the current, modified one.

The narcissist’s (and the codependent’s) introjects and inner voices (assimilated representations of parents, role models, and significant peers) are mostly negative and sadistic. Rather than provide succour, motivation, and direction, they enhance his underlying ego-dystony (discontent with who he is) and the lability of his sense of self-worth.

Introjects possess a crucial role in the formation of an exegetic (interpretative) framework which allows one to decipher the world, construct a model of reality, of one’s place in it, and, consequently of who one is (self-identity). Overwhelmingly negative introjects – or introjects which are manifestly fake, fallacious, and manipulative – hamper the narcissist’s and codependent’s ability to construct a true and efficacious exegetic (interpretative) framework.

Gradually, the disharmony between one’s perception of the universe and of oneself and reality becomes unbearable and engenders pathological, maladaptive, and dysfunctional attempts to either deny the hurtful discrepancy away (delusions and fantasies); grandiosely compensate for it by eliciting positive external voices to counter the negative, inner ones (narcissism via the False Self and its narcissistic supply); attack it (antisocial/psychopathy); withdraw from the world altogether (schizoid solution); or disappear by merging and fusing with another person (codependence.)

by Sam Vaknin, Author of the comprehensive book on narcissism “Malignant Self-love: Narcissism Revisited.”

Read Sam Vaknin’s “Please Don’t Leave me!” When Your Abuser Becomes Codependent

Read “Symptoms of Narcissism.”

“My parent didn’t care about me.” How we develop Defense Mechanisms (Part II)

"Kiai" by Mimi Stuart ©
Live the Life you Desire

Generally, people experience a parent as either too involved or not involved enough. In the first case, the parent may seem controlling, overwhelming, or hovering. In the second case, a parent may seem indifferent, abandoning, or not present.

It is normal to develop mild defense mechanisms even with good parenting. These defenses are healthy when used consciously. However, they limit our choices when we react unconsciously or in an extreme way.

A child can develop defense mechanisms to the under-involved parent. Abandonment includes not only the indifference of the parent, but also environmental insufficiency, for instance, poverty, prejudice, or a wartime childhood.

Children tend to engage in magical thinking, which says to them that the world around them is a message about them.” If my mother neglects me, or I am poor and never have enough food, I must be unworthy and bad.” There are four typical responses to a sense of lack, the first two of which involve internalizing poor self-esteem.*

1. Self-sabbotage: Patterns of self-sabotage develop as a way to confirm poor self-esteem—that I am not worthy of success, happiness or good things happening. The child feels a certain comfort in the familiarity of continuing to fail.

2. Grandiosity: Some people over-compensate for an unconscious sense of poor self-esteem. They try to prove they are worthwhile by driving an expensive car, having a big house, achieving many milestones, and/or developing an impressive outer appearance. If all one’s effort is spent in these pursuits, little time is left for less showy and more personal fulfillment.

3. Serving the narcissist: A chronic sense of emptiness leads children to serve the narcissistic parents, who are stage-door mothers or hockey-team fathers. Even when the child makes the parent proud, there’s a feeling of lack in the relationship. The parent is simply unable to relate to the child other than to use his or her accomplishments to feed the parent’s narcissism. Even after growing up, the narcissist’s child experiences a sense of living someone else’s life.

4. Neediness: Through an inordinate search for reassurance or pats on the back the needy person seeks to feel worthwhile. The birth of addictions can occur as an attempt to manage anxiety by connection. For instance, excessive materialism, serial relationships, and distraction result from a longing to satiate. The longing never stops as the human spirit is never satisfied in these ways.

While our defense mechanisms originally served to help us survive or thrive in our childhood environment, as adults, reflexive responses disempower us. Once we recognize that a defense mechanism may imprison us, we can begin to think twice before acting and make new choices to live the life we desire.

by Alison Poulsen, PhD

*Reference and recommended reading and seminars: James Hollis, PhD, Author and Senior Jungian Analyst


Read “Family visits: ‘I feel overwhelmed thinking about my family visiting next week.’”

Read “‘My parent was controlling.’ How we develop Defense Mechanisms (Part I)”