Today's Wednesday • 8 mins read
— By Dr. Sandip Roy.
Narcissism is characterized by the primary goal of establishing and maintaining a grandiose self (Morf & Rhodewalt, 2001). Narcissistic Personality Disorder (NPD) is the diagnosed clinical form of narcissism.
The presence of narcissistic features, such as high self-confidence and grandiose exhibitionism, does not make a Narcissistic Personality Disorder (NPD).
The Diagnostic and Statistical Manual (DSM-5), a trusted manual among mental health professionals, provides a blueprint for understanding this complex disorder.
The DSM-5 Narcissistic Personality Disorder Diagnostic Criteria
Narcissistic Personality Disorder (NPD) is characterized by:
- a pervasive pattern of grandiosity,
- a constant need for admiration, and
- a distinct lack of empathy, beginning in early adulthood and present in a variety of contexts.
NPD is indicated by 5 or more of the following 9 criteria:
- Grandiose sense of self-importance.
- Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
- Believes he or she is special and unique as can only be understood by, or should associate with, other special or high-status people.
- Requires excessive admiration.
- Has a sense of entitlement and unreasonable expectation or especially favorable treatment.
- Is interpersonally exploitative (takes advantage of others).
- Lacks empathy and is unwilling to identify or recognize the feelings and needs of others.
- Is envious of others or believes others are envious of him or her.
- Shows arrogant, haughty behaviors or attitudes.
1. Grandiose sense of self-importance
A narcissist exaggerates their achievements, expecting recognition far beyond their actual merit.
This is like the emperor parading in his ‘new clothes,’ unable to perceive the stark reality of his situation.
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Narcissists live in a bubble of illusion, a fantasy world of their own making, driven by delusions of grandeur and a desperate need for validation.
They seek the spotlight to validate their exaggerated characteristics. They tend to pursue an idealistic concept of success, power, brilliance, beauty, or love, but are remarkably inconsistent in following through on efforts to achieve that ideal.
3. Believes he or she is special and unique as can only be understood by, or should associate with, other special or high-status people
Narcissists perceive themselves as unique and extraordinary, worthy of the company of high-status individuals.
This social snobbery of associating only with those who reflect or enhance their inflated self-image makes them arrogant and obnoxious. This also makes narcissists admire narcissistic dictators.
4. Requires excessive admiration
The need for constant affirmation is a common trait among narcissists. They crave and even demand to be validated for their qualities, decisions, ideas, possessions, and achievements.
If they see the spotlight shift away from them, they often resort to emotional drama and psychological manipulation to regain their focus.
5. Has a sense of entitlement and unreasonable expectations or especially favorable treatment
Narcissists demand preferential treatment wherever they go. This shows up as unreasonable expectations of favorable treatment from others. They demand center stage in your life, avoiding any confrontation with their own flaws, an encounter that could trigger unbearable shame. When they do not get the importance they believe they deserve, it often leads them to get into conflicts and rage.
6. Is interpersonally exploitative (takes advantage of others)
Most narcissists do not have even a few true friends. They prefer an entourage of people they can exploit. They are also reluctant to reveal their vulnerabilities to others, since they fear being exploited themselves.
They lack genuine empathy, which makes their friendships one-sided. Sooner or later, their friends understand their tendency to use others for personal gain, and keep away from them.
7. Lacks empathy and is unwilling to identify or recognize the feelings and needs of others
Empathy and compassion are the lifeblood of human connection, and both are absent in narcissists. The empathy deficit makes it difficult for narcissists to recognize or respond appropriately to others’ feelings and needs, often leaving those close to them emotionally marooned.
8. Is envious of others or believes others are envious of him or her
Narcissists believe others are envious of them. Actually, they are themselves envious of other people’s success and status, and often project these feelings of envy onto others. Worse, when they blame others for their shortcomings and failures, they fail to look into the psychological mirror and recognize themselves.
9. Shows arrogant, haughty behaviors or attitudes
This is an overt display of their grandiosity, often used as a defense mechanism. This haughtiness is common among overt narcissists but can show up in covert narcissists when their self-image is threatened. They wield their arrogance as a shield, deflecting perceived threats to their grandiose self-image.
The Invisible Narcissist: A DSM-5 Blind Spot
“The Devil’s greatest trick was convincing the world he didn’t exist.”
One flaw in the DSM-5’s approach is that it largely focuses on the grandiose or overt subtype of narcissism, leaving the vulnerable or covert narcissist less recognized.
This omission gives the covert narcissist a cloak of diagnostic invisibility.
There have been debates over the years about the classification, subtyping, and criteria of NPD, and how well these capture the various presentations of narcissism.
However, these debates are a normal part of the ongoing scientific discourse aimed at improving our understanding and treatment of mental health disorders.
Transactional Relationships: The Narcissist’s Modus Operandi
On interpreting the DSM-5’s criteria, it becomes evident that a narcissist’s relationships are typically transactional.
For narcissists, relationships are like deals. They forge their friendships after making sure they will get something more out of it, such as more attention or to move up in the world.
You stop being useful to the narcissist when they see you’re questioning their actions or demanding more than you are giving. They will discard you at this point, without much of a hint or explanation.
Only then that you realize how coldhearted they have been since the start of your relationship. They really never cared about your feelings or needs.
Did you know that you can undo their twisted tangle of talks called Narcissistic Word Salad?
Early Intervention: A Controversial Counterpoint
When does narcissism first show up in a person? A debate exists around the onset of NPD.
A consensus in clinical psychology suggests that a diagnosis of a personality disorder should be deferred until at least 18 years of age. This age boundary is considered the last opportunity to reverse the damage inflicted by a traumatic or invalidating childhood.
However, there exists the counterargument that early diagnosis and intervention, when a youth starts showing the first signs of narcissism, may serve as a powerful preventative measure.
A diagnosis not only informs the patient, but it also serves as a guide for future medical and mental health providers, steering the therapeutic course.
The DSM helpfully standardized the NPD diagnostic criteria, so that all over the world, clinicians reach the same diagnosis.
Narcissism & Self-esteem
Self-esteem is a personality trait that emerges from self-evaluation: if we have a high opinion of ourselves (i.e., regarding our abilities, physical appearance, strength, or other characteristics susceptible to evaluation), it is likely that we will have high self-esteem.
Narcissism is a personality trait that shares some content with self-esteem: narcissists have a high opinion of themselves, their worth and abilities. However, narcissism comprises additional personality characteristics: superiority, grandiosity, entitlement, arrogance, and, most importantly, interpersonal antagonism (Ackerman et al., 2011; Weiss et al., 2019). These adverse and malevolent social outcomes are the reasons narcissism is viewed as part of the “dark” personality traits – behavioral dispositions associated with immoral, antisocial, and socially destructive behavior (Paulhus, 2014).
In normal populations, the results from the Narcissistic Personality Inventory test (Emmons, 1984; Raskin & Hall, 1981) often correlate with self-esteem (Rhodewalt & Morf, 1995; Sinha & Krueger, 1998).
Narcissistic people usually think very highly of themselves, but in a way that’s not stable or real; they can quickly feel threatened or insecure.
In studies, being narcissistic (but not just having high self-esteem) made people more likely to act aggressively, especially if someone had upset them before.
Why was “narcissism” removed from the DSM?
The term “narcissism” was never officially a diagnostic category.
The term “Narcissistic Personality Disorder (NPD)” was introduced and recognized as a specific diagnosis in the DSM-III (1980). This was a formalization that established a criterion for clinicians to use in their practice to make a more precise diagnosis of this personality disorder.
Historically, in 1967-68, psychoanalysts Otto Kernberg and Heinz Kohut presented two early theories on narcissism. Kernberg described a “narcissistic personality structure,” proposing three types of narcissism: normal adult narcissism, normal infantile narcissism, and pathological narcissism. Kohut presented the concept of “narcissistic personality disorder,” arguing that narcissism is an essential aspect of normal development.
Final Words
Narcissistic Personality Disorder is a narrative of grandiosity, entitlement, and exploitation.
• • •
√ Also Read: Narcissistic Projection: Learn How To Handle It (With Examples)
√ Please spread the word if you found this helpful.