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Narcissistic Personality Disorder


Neurotic Solution: Narcissistic Type
Self-Confident Personality Type



Perspectives q.v.





The Disease Perspective

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pg. 661) describes Narcissistic Personality Disorder as a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
  • has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements);

  • is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love;

  • believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions);

  • requires excessive admiration;

  • has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations;

  • is interpersonally exploitive, i.e., takes advantage of others to achieve his or her own ends;

  • lacks empathy: is unwilling to recognize or identify with the feelings and needs of others;

  • is often envious of others or believes that others are envious of him or her;

  • shows arrogant, haughty behaviors or attitudes.




The Dimensional Perspective

Here is a hypothetical profile, in terms of the five-factor model of personality, for Narcissistic Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306) (Cf. Compensatory Narcissistic):



High Neuroticism
Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.

High Extraversion
Excessive talking, leading to inappropriate self-disclosure and social friction; inability to spend time alone; attention seeking and overly dramatic expression of emotions; reckless excitement seeking; inappropriate attempts to dominate and control others.

Low Openness
Difficulty adapting to social or personal change; low tolerance or understanding of different points of view or lifestyles; emotional blandness and inability to understand and verbalize own feelings; alexythymia; constricted range of interests; insensitivity to art and beauty; excessive conformity to authority.

Low Agreeableness
Cynicism and paranoid thinking; inability to trust even friends or family; quarrelsomeness; too ready to pick fights; exploitive and manipulative; lying; rude and inconsiderate manner alienates friends, limits social support; lack of respect for social conventions can lead to troubles with the law; inflated and grandiose sense of self; arrogance.

Low Conscientiousness
Underachievement: not fulfilling intellectual or artistic potential; poor academic performance relative to ability; disregard of rules and responsibilities can lead to trouble with the law; unable to discipline self (e.g., stick to diet, exercise plan) even when required for medical reasons; personal and occupational aimlessness.




Character Weaknesses and Vices


Pride, vanity, vainglory, superbia, superiority, hubris, overbearingness, haughtiness, separateness, insensitivity, self-importance, egoism, ego-centricity, wrath, arrogance, malice, hypocrisy, skepticism, ignorance.



Psychiatric*

  • exploitive
  • grandiose
  • feels unique
  • preoccupied with success
  • feels entitled
  • seeks admiration
  • unempathic
  • envious
  • hypersensitive to criticism


Know Your Major Weaknesses

narcissistic.boss - Google Search


* Derived from Michael Stone's (pg. 22) list of the "personality traits" of DSM-III-R Narcissistic Personality Disorder.





The Behavior Perspective





The Life Story Perspective



Childhood

 

Universal Character Disorder   Antisocial


A Christian Approach to Character Disorder

Narcissistic character disorder is a type of "solution" to the problem of anxiety; that is, it is a strategy to alleviate anxiety. The objects of desire and pleasure listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 49-50) are limited goods pridefully turned to for security when we fail to trust God. They are analogous to Karen Horney's "neurotic needs."

Karen Horney: Intrapsychic Strategies of Defense

The Expansive Solution

Narcissistic type

"Even when we deeply value ourselves, the anxiety built into finitude will tempt us to find our source of security in some strategy rather than a trust in God" (Cooper, pg. 163).


Idols

"According to Ellis, emotional and behavioral difficulties occur when humans take simple preferences (desire for love, approval, success) and turn them into dire needs" (Source).

Compulsive Attachments

 Compulsive Aversions
  • being admired
  • aggrandizement
  • being special
  • being unique
  • status
  • superior image
  • superiority
  • special favors
  • favorable treatment
  • prestige
  • dispensations
  • privileges
  • prerogatives
  • acknowledgment of superiority by others
  • being above the rules
  • glory
  • wealth
  • position
  • power
  • success
  • ambition
  • competitiveness
  • being scorned
  • being criticized
  • being seen as common
  • being ordinary
  • being seen as inferior
  • failure
  • others not according them admiration and respect



Cognitive Effects

Basic Belief: I am special. [Strategy]: Self-aggrandizement (Beck, Freeman & associates, pg. 26).

The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney, pg. 32).

Compulsive beliefs and attitudes are idols, too.

In Cognitive Therapy of Personality Disorders, Aaron T. Beck, Arthur Freeman, and associates (1990) list typical beliefs associated with each specific personality disorder. According to my view, the beliefs and attitudes rationalize and reinforce the idealized image and the compulsive attachments and aversions. They are analogous to Karen Horney's "shoulds" and "neurotic claims." Here are the typical beliefs that they have listed (pp. 361-362) for Narcissistic Personality Disorder:

  • I am a very special person.
  • Since I am so superior, I am entitled to special treatment and privileges.
  • I don't have to be bound by the rules that apply to other people.
  • It is very important to get recognition, praise, and admiration.
  • If others don't respect my status, they should be punished.
  • Other people should satisfy my needs.
  • Other people should recognize how special I am.
  • It's intolerable if I'm not accorded my due respect or don't get what I'm entitled to.
  • Other people don't deserve the admiration or riches that they get.
  • People have no right to criticize me.
  • No one's needs should interfere with my own.
  • Since I am so talented, people should go out of their way to promote my career.
  • Only people as brilliant as I am understand me.
  • I have every reason to expect grand things.


Beck's Cognitive Therapy for Personality Disorders







American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington: Author.

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed., text revision. Washington: Author.

Beck, Aaron T. and Freeman, Arthur M. and Associates (1990). Cognitive Therapy of Personality Disorders. New York : Guilford Press.

Beck, Aaron T. and Freeman, Arthur M. and Associates (2003). Cognitive Therapy of Personality Disorders, 2nd ed. New York : Guilford Press.

Cooper, Terry D. (2003). Sin, Pride, and Self-Acceptance: The Problem of Identity in Theology and Psychology. Downers Grove, IL: InterVarsity Press.

Gunderson, John G. and Philips, Katherine A. (1995). Personality Disorders. Comprehensive Textbook of Psychiatry/VI, Vol. 2. Eds. Harold I. Kaplan and Benjamin J. Sadock. Baltimore: Williams & Wilkins.

McCrae, Robert R. (1994). "A Reformulation of Axis II: Personality and Personality-Related Problems." Costa, Paul T., Jr., Widiger, Thomas A., editors. Personality Disorders and the Five-Factor Model of Personality. Washington, D.C.: The American Psychological Association.

(1989). Personality Disorders: Narcissistic Personality Disorder. Treatments of Psychiatric Disorders, Vol. 3. American Psychiatric Association. Task Force on Treatments of Psychiatric Disorders. Washington, DC : American Psychiatric Association.

Stone, Michael H. (1993). Abnormalities of personality: within and beyond the realm of treatment. New York: W.W. Norton.

Tamney, Joseph B. (2002). The Resilience of Conservative Religion. New York: Cambridge UP.



Sigmund Freud and Wilhelm Reich

In a 1931 paper, "Libidinal Types," Sigmund Freud described the narcissistic personality:

The characteristics of the third type, justly called the narcissistic, are in the main negatively described. There is no tension between ego and super-ego - indeed, starting from this type one would hardly have arrived at the notion of a super-ego; there is no preponderance of erotic needs; the main interest is focused on self-preservation; the type is independent and not easily overawed. The ego has a considerable amount of aggression available, one manifestation of this being a proneness to activity; where love is in question, loving is preferred to being loved. People of this type impress others as being 'personalities'; it is on them that their fellow-men are specially likely to lean; they readily assume the role of leader, give a fresh stimulus to cultural development or breakdown existing conditions.

Wilhelm Reich first described the "phallic-narcissistic character" in 1926, and later included the description in Character Analysis.

Even in outward appearance, the phallic-narcissistic character differs from the compulsive and the hysterical character. While the compulsive character is predominantly inhibited, self-controlled and depressive, and while the hysterical character is nervous, agile, apprehensive and labile, the typical phallic-narcissistic character is self-confident, often arrogant, elastic, vigorous and often impressive. The more neurotic the inner mechanism, the more obtrusive are those modes of behavior. As to bodily type, they belong most frequently to Kretschmer's athletic type. The facial expression usually shows hard, sharp masculine features, but often also feminine, girl-like features in spite of athletic habitus. Everyday behavior is never crawling as in passive-feminine characters but usually haughty, either cold and reserved or derisively aggressive, or "bristly," as one of these patients put it. In behavior toward the object, the love object included, the narcissistic element always dominates over the object-libidinal, and there is always an admixture of more or less disguised sadistic traits.

Such individuals usually anticipate any expected attack with an attack on their part. Their aggression is very often expressed not so much in what they say or do as in the manner in which they say or do things. Particularly to people who do not have their own aggression at their disposal they appear as aggressive and provocative. The outspoken types tend to achieve leading positions in life and resent subordination unless they can - as in the army or other hierarchic organizations - compensate for the necessity of subordination by exerting domination over others who find themselves on lower rungs of the ladder. If their vanity is hurt, they react either with cold reserve, deep depression or lively aggression. In contrast to other characters, their narcissism expresses itself not in an infantile manner but in exaggerated display of self-confidence, dignity and superiority, in spite of the fact that the basis of their character is no less infantile than that of others.

Freud, Sigmund (1931). Libidinal Types. Collected Papers, Vol. 5, 1959). New York: Basic Books.

Reich, Wilhelm (1949). Character Analysis, 3rd ed. New York: Farrar, Straus, & Giroux.



Narcissistic and Compensatory Narcissistic Personality Disorders differentiated

In a chapter of Disorders of Narcissism : Diagnostic, Clinical, and Empirical Implications, "DSM Narcissistic Personality Disorder: historical reflections and future directions," Theodore Millon differentiates Narcissistic from Compensatory Narcissistic Personality Disorder:

Reich (1933/1949) captured the essential qualities of what here is termed the elitist narcissistic person when he described the "phallic-narcissist" character as a self-assured, arrogant, and energetic person "often impressive in his bearing.., and.., ill-suited to subordinate positions among the rank and file" (p. 217). As with the compensatory narcissistic person, the elitist narcissistic person is more taken with an inflated self-image than with his or her actual self. Both narcissistic types create a facade that bears minimal resemblance to the actual person. However, the compensatory narcissistic person knows at some level that he or she is in fact a fraud, whereas the elitist narcissistic person is deeply convinced of his or her superior self-image, albeit one that is grounded on few realistic achievements. To elitist narcissistic persons, it is the appearance of things that is perceived as objective reality; an inflated self-image is their intrinsic substance. Only when these illusory elements to self-worth are seriously undermined will the individual be able to recognize, perhaps even to acknowledge, his or her deeper shortcomings.


Narcissistic Personality Disorder: links

 Personality Disorders





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