Narcissistic Personality Disorder

Synonyms in a broader sense

• Infatuation
• Self-love
• Selfishness
• egoism

definition

In Greek mythology, the figure of "Narcissus" was the son of the river god Kephisos. This young man once disdained the love of a nymph. Thereupon he was cursed by the goddess Aphrodite. It was his fate to fall madly in love with his reflection. According to legend, he died when a leaf mixed up his reflection on the surface of the water.

The narcissistic personality disorder (see also personality disorder) is characterized above all by a clear tendency to overestimate oneself and one's own abilities, by a very limited ability to empathize with other people and by an extreme sensitivity to criticism from other people.

Note: Healthy Narcissism

At this point it is important to distinguish it from the "healthy narcissism". For a balanced psyche it is not only important but also necessary to be able to assess yourself as special and unique and to be able to describe your own achievements as "great".

Epidemiology

It is estimated that the incidence of narcissistic personality disorder in the normal population is around 0.3%. In psychiatric patients, the incidence is around 1%.

The above Numbers are estimates. From my personal and clinical experience, the incidence of this condition is significantly higher.

diagnosis

Every diagnosis that is made in this country has to be “encrypted” if one wants to make it professionally and not simply from the gut. This means that there are systems in which all diseases known to medicine are more or less well recorded. So a doctor can't just go and distribute diagnoses unless certain criteria are met that the encryption system requires. If the criteria are not met, the diagnosis cannot be made.

The research uses the system of the DSM - IV (Diagnostic and Statistical Manual of Mental Disorders) from the American area. Here the descriptions of the symptoms of the disease are actually more precise. In order to be able to make the diagnosis, precisely defined criteria must be met

Diagnostic criteria according to DSM IV (the onset of the disorder is in early adulthood and at least 5 criteria must be present).

1. has a great feeling of his own importance (exaggerates his own achievements and talents, expects to be recognized as superior without corresponding achievements)
2. is deeply absorbed by fantasies of limitless success, power, splendor, beauty or ideal love
3. believes to be “special” and unique of himself and to be understood by other, special or respected persons (or institutions) or to be able to only associate with them
4. calls for undue admiration
5. displays a sense of entitlement, i.e. exaggerated expectations of particularly preferred treatment or automatic response to one's own expectations
6. is exploitative in interpersonal relationships, i.e. takes advantage of others to achieve its own goals
7. Shows a lack of empathy (sensitivity): unwilling to recognize or identify with the feelings and needs of others
8. is often jealous of others or believes others are jealous of him
9. shows arrogant, arrogant behavior or attitudes

This behavior pattern must be permanent and noticeable in various areas (relationships, work, family, friends, etc.) of life. To make the diagnosis, the person concerned must suffer from their deviant behavior.

Symptoms

The actual term "narcissistic" refers first of all to personal overconfidence. In the clinical picture of narcissistic personality disorder, on the other hand, the problem area lies primarily in the interpersonal relationships between the patient and his environment. He often presents himself with the typical characteristics of a lack of empathy for other people, fear of criticism and faulty social behavior.

In particular, excessive self-presentation and highlighting one's own size lead to regular confrontations with other people. If they now try, e.g. To assess the performance of the patient more realistically or not want to and cannot understand the overvaluation, the narcissist feels a real threat to his personality and thus justifies an intensification of his behavior.

Example: narcissism

A colleague in the office repeatedly presents himself in the canteen with the fact that he can talk to 20 customers a day. The title “Employee of the Year” is almost certain to him. When asked by a colleague whether he knew that some of his customers had complained about him, this colleague blocks this and only says that everyone around him wanted to make themselves important in order to rob him of the fame he deserved.

At this point we would like to refer to our page, on which we have listed and commented on some practical examples of "applied narcissism". These examples were kindly made available to us free of charge by some (usually) unknown guest authors.

Comorbidity

The narcissistic personality disorder can be combined with each other Personality disorder occur. Most often it is linked to the so-called histrionic (hysterical / Hystory) Personality disorder. (Case in point: the behavior of an actress whose new film was torn up by the specialist critics.)

Often the constant "Fight against the world " even symptoms of a real one depression develop.

causes

One of the main theories (Millon and Davis 1996) regarding the development of pathological narcissism is that the parenting style of the parents is seen as very decisive. If a wrong model is set by the parents (one or both parents themselves narcissistic), the child can be wrongly shaped very early on.

"Wrong promotion" can also influence the development of a narcissistic disorder. Parents who teach their children from an early age that they are “better than others” distort the actual perception of their own achievements early on. Often enough, these children become outsiders because of their strange parents and the even stranger beliefs they have been taught. This in turn causes the children to hear from their parents that the other children are jealous that you are better than them.

This further promotes the development of intolerance and misperception of oneself. This leads to permanent conflicts with the environment, which in turn can take a depressive or aggressive course.

Note: Extreme narcissism

In the worst case, extreme narcissistic disorder can result in suicide (“Nobody loves me, nobody understands me ... now I'll show you!). Many of the worst and worst violent crimes also occur out of a narcissistic insult ("If I can't have them, nobody should have them")

Another theory based on Kernberg (1976) states that narcissistic personality disorder is directly related to borderline personality disorder. In his opinion, borderline disorder is the more severe form of narcissistic disorder. According to Kernberg, this has better "defense mechanisms" so that e.g. the emotional fluctuations do not break through as strongly as with the borderline disorder.

therapy

The form of therapy of choice is the psychotherapy There are different starting points:

1. Behavior Therapy:
   Behavioral therapy works primarily on the patient's deficits in dealing with other people. It focuses on the necessary empathy, the right social interaction and the fear of negative evaluation. Here come e.g. Role play and video recordings are used.
   
2. Depth psychological therapy:
   In depth psychology it is primarily about confronting the patient with his defense mechanisms and working on them (e.g. "Why do you have to overestimate yourself?" How do you feel about feelings such as anger, envy and aggression?).
   
3. Advice and coaching:
   So-called coaching, i.e. very practical tips in dealing with other people and in dealing with special problems, is an effective treatment option for narcissism. (However, this does not apply to all mental disorders!).

If, as mentioned above, depression develops, it may be medication With Antidepressants displayed.