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