Narcissistic Personality Disorder
Narcissistic Personality Disorder

The Story of Narcissus
In ancient Greek mythology, a proud hunter named Narcissus was known for his handsomeness. Narcissus was drawn to anything beautiful and thrived on admiration. He also had disdain for people who loved him. Some of his loved ones committed suicide as a way of proving their unrelenting devotion to his striking appearance.
The Sadness of Echo
Narcissus broke the heart of the wood nymph Echo, who loved him, but he did not care. She then spent the rest of her sad days wandering the woods until all that remained was only her echo sound.
Nemesis Enacts Her Revenge
The goddess of revenge, Nemesis, then retaliated for Echo’s heartbreak. She lured Narcissus to a pool where he saw his reflection in the water. Not realizing he was gazing at himself, he fell in love with the image and could not pull away. Narcissus then realized it was a love that could not be returned. As a result, his fiery passion caused him to melt away until all that was left was a narcissus flower.
Narcissistic Personality Disorder Defined
Narcissistic personality disorder (NPD) is a recognized personality disorder. NPD is listed in the DSM-5, a manual of mental disorders published by the American Psychiatric Association (APA). Narcissistic personality disorder is defined as a disorder that displays:
• A pattern of appearing or trying to appear more valuable than is the case
• A need for admiration
• A lack of empathy
Narcissistic personality disorder is a mental condition where individuals have an inflated sense of their importance. They also have a deep-seated need for lots of attention and admiration from those around them. People with narcissistic personality disorder have troubled relationships and a lack of empathy for others. They display bravado to the world but secretly struggle with self-esteem, which is frequently shattered with the slightest criticism. People with this type of disorder suffer greatly; having trouble with jobs, relationships, and social interactions. There is no such thing as constructive criticism for a sufferer of narcissistic personality disorder; even the most friendly advice will crush their self-esteem.
Symptoms
Excessive Sense of Self-Importance
NPD sufferers feel an exaggerated sense of how important and unique they are. They also set hard to reach goals in front of others to emphasize how “special” they are so others approve of them.
Lack of Empathy
Not being able to recognize or identify with the feelings and needs of others is a major sign of narcissistic personality disorder.
Reactions to Others
People with NPD can tune in to the reactions of others, but only if they perceive them as being relevant to themselves.
Defensiveness
The defenses that people with narcissistic personality disorder throw up around them often put strains on personal relationships. These defenses often lead to isolation. Narcissists need support, love, and respect from others to maintain their inflated self-image. Thus, when their actions alienate others, they suffer immensely. Feelings of isolation and abandonment can result. Slight criticisms that others regard as harmless provoke narcissists to react, often to their detriment.
Side Effects
Despite an inflated sense of importance and self-confidence, there are unfortunate consequences to having narcissistic personality disorder.
Sensitivity
People with narcissistic personality disorder have extremely fragile self-esteem. They are easily injured when they meet with criticism or defeat.
Shame
People with narcissistic personality disorder may also experience higher levels of shame and humiliation from emotional instability.
Depression
A common symptom of narcissistic personality disorder is depression due to the perception of emotional injury from others and social isolation.
Narcissistic Personality Disorder Checklist
The following is a comprehensive list of narcissistic personality disorder behaviors and characteristics. Don’t be concerned if you can relate to a few of them. People with narcissistic personality disorder consistently display most of these items at different levels of severity. People with narcissistic personality disorder can:
- Possess an overstated sense of self-importance
- Display a sense of entitlement
- Exaggerate their talents and achievements
- Need constant, excessive admiration
- Believe in their superiority, so they can only socialize with special people that are their equals
- Have expectations of special favors
- Have expectations of people complying with their wishes without question
- Expect recognition as being superior or special without the achievements that would call for these conclusions
- Have a preoccupation with power, success, beauty, or the perfect partner
- Dominate conversations
- Look down or insult people they perceive as “unequal” or inferior
- Be unable or unwilling to recognize or identify with the needs and feelings of others
- Take advantage of others to get what they want
- Come across as arrogant, self-centered, cocky, stuck-up, and pretentious
- Show envy and feel others envy them
- Believe they must have the best of everything
People with narcissistic personality disorder can also have problems dealing with anything perceived as disapproval or fault-finding. In response, they can:
• Quickly feel slighted at things others consider harmless
• Belittle others to make themselves appear more accomplished
• Have a hard time controlling their emotions and behavior
• React impatiently or angrily when special treatment doesn’t happen
• Experience serious personal problems
• Feel moody and depressed because they are not “perfect”
• Strike back with extreme anger, rage, or contempt to prove they are superior to others
• Have major problems dealing with stress and change
• Secretly harbor feelings of shame, insecurity, humiliation, and vulnerability
Causes of Narcissistic Personality Disorder
Statistics

Connection Between NPD and Addiction

Substance Use
The connection between substance use and narcissistic personality disorder can be from:
• People with NPD attempting to restore or maintain an inflated sense of self-importance.
• When narcissistic personality disorder sufferers encounter unavoidable limitations, they get depressed. Substance use could be a defensive reaction against the effects of depression.
• Aging that affects one’s appearance can also cause people with NPD to become defensive.
• The social isolation NPD sufferers experience can lead to substance abuse or dependence.
These factors can lead someone with narcissistic personality disorder to self-medicate. Using substances can make them feel like they can maintain a sense of superiority and invincibility. However, substance abuse frequently worsens mental health. Self-medication may also be related to blocking out feelings of sadness, depression, and guilt that come from not measuring up to impossibly high standards of perfection.
People with NPD may not want to believe that anything could be wrong, so they don’t see any need for treatment. If they do seek treatment, it probably won’t be for NPD symptoms. It is more likely they will seek treatment for drug or alcohol use, depression, or another mental health problem. Treatment for addiction or other mental health problems may fail if NPD is not recognized and part of the treatment plan because when the patient perceives insults to their self-esteem, it becomes hard to accept and follow through with treatment.
If you:
• Recognize aspects of your personality are related to NPD
• Are abusing drugs or alcohol
• Have overwhelming feelings of sadness, isolation, or anxiety
Then consider talking to a doctor or mental health provider you trust. Getting the right treatment can help make your life easier to handle, more rewarding, and more enjoyable.
Treatment Options
Psychotherapy is “talk therapy.” Therapy takes places within a client-therapist relationship built on trust. A competent therapist recognizes it is not enough to imagine what feelings a person with NPD has. Rather, they can feel what the client feels in a certain situation. This understanding helps the client develop healthier ways of thinking and behaving.
Why Talk Therapy Works
Supportive psychotherapy builds a strong alliance between the client and counselor. The empathy the client receives from the therapist can help fill the void of empathy the client has. Positive experiences happening between client and counselor encourages the client to develop empathy as well.
People with NPD have persistent patterns of disturbed thinking. For example, they abnormally perceive themselves or others. They may have extreme reactions to others. They can experience social isolation and personal relationship problems.
CBT addresses these many issues by changing beliefs and behaviors that are harmful. CBT does this by using:
Cognitive Restructuring:
Helps the client recognize thinking that leads to negative consequences
Behavior Changes:
Helps change behaviors that lead to negative experiences, relationship problems, and isolation.
Exposure:
Over time, the client is exposed to fearful situations to learn how to become less sensitive.
Education:
The therapist provides education and information related to the mental health issues the client experiences.
Skills Training:
Social skills are learned and practiced by the client through role-playing sessions.
Why CBT Works:
Clients with NPD get a better understanding of their behavior that bothers others. They also learn to identify how they act affects the quality of their relationships. Clients learn how to change their improper understandings and beliefs. This helps them become better adjusted and live more fulfilling lives.
While there are no specific drugs for NPD treatment, there are medications that can help relieve some symptoms.
Why Medication Works
Medications can help relieve symptoms related to anxiety and depression. These drugs can help put NPD sufferers in better frames of mind to work on other NPD issues.
Recognizing and Treating Narcissistic Personality Disorder

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