Narcissistic Personality Disorder (NPD)

What is healthy narcissism?

In its healthiest form narcissism is a confident attitude in yourself where you are aware of and accept your strengths and weaknesses. These make up your good traits and your bad traits. You have a realistic view of yourself and are driven to achieve success or a position in life that is comparable to your abilities. You see the people around you as separate human beings and you have a set of ideals that you are aware are not those of others.

Healthy narcissism is a channel through which people ensure they receive that which they need and want to survive or be happy without consistently harming or disrespecting others.

Everybody has narcissistic traits to some degree. We all have wants and needs that we would like to be fulfilled. As children we all go through normal narcissistic stages during early development and teenage years. Sometimes narcissism plays a bigger part in our lives as we try to ensure our needs are met – nobody’s perfect there will be times when our narcissism becomes a problem.

When is narcissism a problem?

It becomes a problem when someone has a persistently unrealistic image of themselves and those they interact with. It is a belief in themselves that is so inflated there is little chance that they or anyone else will ever be able to meet their needs in full or consistently. Unhealthy narcissism is distressing for all concerned.

Normally when needs and wants are not met bouts of frustration ensue, this can readily be seen when a young child has been told “No”. In this case it is often normal behaviour for a very young child to show their frustration by shouting, crying and even hitting the person who has denied them what they wanted/needed. The child doesn’t understand that they are not automatically entitled to everything they want, that sometimes it’s not always appropriate and that they are separate from other people who can’t or won’t always meet their needs.

There are healthy ways for adults to deal with varying degrees of frustration and normally individuals are capable of doing so swiftly with minimal disturbance to others. People with strong narcissistic tendencies tend to overreact to periods of frustration (outside of normal levels of stress) when their needs are not met or when they feel they have been criticised, in the same way that children do.

Narcissism is unhealthy when a person’s entire behaviour, be it fair or foul, is geared towards ensuring others meet their needs and justify their belief in their inflated self image. This self image is a “false self” and it can be extremely pleasant, charming and intoxicating covering a multitude of insecurities and bad traits.

Most people like to feel that they are liked by others, that people care about them or see them as special and worthwhile but it’s not normally an everyday way of life. Most people do not purposefully seek out special attention or consistently take action to extract people’s emotions from them just to make themselves feel good but this is what narcissistic people do.

People who consistently behave in this way, interacting with others for the sole purpose of bolstering their inflated self image may suffer from Narcissistic Personality Disorder (NPD).

What is the criterion for NPD?

Not everyone who has narcissistic tendencies has NPD. It is not easy for an ordinary person to tell the difference between someone who has strong narcissistic traits and a person with full blown NPD. It is a condition that can only be diagnosed by a mental health professional and even they can make errors in their diagnosis.

The European diagnostic criterion for NPD is not clearly laid out. In America, The Diagnostic and Statistical Manual of Mental Health Disorders – Fourth Edition (DSM-IV) sets out the criteria for NPD where sufferers exhibit:

“Behaviour or a fantasy of grandiosity, a lack of empathy and a need to be admired by others. As indicated by at least five of the following:

  1. Grandiose sense of self-importance.
  2. Fantasies of and preoccupied with beauty, brilliance, ideal love, power, or unlimited success.
  3. A belief of being special and unique and can only be understood or a need to associate with people of high status.
  4. A need for excessive admiration.
  5. An unreasonable expectation of being treated with favour or excepting an automatic compliance to her / his wishes.
  6. Will use others to achieve her / his goals.
  7. Lacks empathy.
  8. Believes others are envious of her / him or is envious of others.
  9. Contemptuous or haughty attitudes / behaviours.”

Often NPD doesn’t stand alone. Suffers of NPD may suffer from elements of other personality disorders. This is due mainly to the fact that it is not possible to define an exact set of criteria for each personality disorder which will apply to all cases. Personality disorders are a relatively new field of research and it is likely the criteria used to define specific disorders will change over time.

Most sufferers diagnosed with NPD are men.

Why do people suffer with NPD? >