Narcissistic Personality Disorder (NPD). By Theresa Lowry-Lehnen. Lecturer of Psychology
Narcissistic Personality Disorder (NPD)
Published on: Mar 3, 2016
Transcripts - Narcissistic Personality Disorder (NPD). By Theresa Lowry-Lehnen. Lecturer of Psychology
Narcissistic Personality Disorder (NPD)
RGN, BSc (Hon’s) Specialist Nurse Practitioner, PGCC, Dip Counselling, Dip Advanced
Psychotherapy, BSc (Hon’s) Clinical Science, PGCE (QTS), H.dip Ed, MEd,
MHS accredited (Level 9) Emotional Intelligence (Assessor)
Narcissistic personality disorder (NPD), is a disorder in which the individual
has a distorted self image, unstable and intense emotions, is overly
preoccupied with vanity, prestige, power and personal adequacy, lacks
empathy, and has an exaggerated sense of superiority. NPD is closely
associated with egocentrism - a personality characteristic in which people see
themselves and their interests and opinions as the only ones that really
People with narcissistic personality disorder are not interested in the feelings of
others - they lack empathy; they are unable to feel or appreciate feelings which are
not their own.
The term comes from a character in Greek mythology, called Narcissus who saw his
reflection in a pool of water and fell in love with it.
Narcissistic personality disorder belongs to a group of conditions known as dramatic
personality disorders. Afflicted people have very unstable and intense emotions
and a distorted image of "self". This seeming abnormal love of self, an excessive
sense of importance and superiority, combined with a preoccupation with success
and power do not, in fact, reflect real self-confidence. The individual has a deep
sense of insecurity. His or her self-esteem is extremely fragile. It is common for
people with narcissistic personality disorders to set unrealistic goals.
A study carried out by the National Institute on Alcohol Abuse and Alcoholism and
published in the Journal of Clinical Psychiatry (2012) found that 7.7% of men and
4.8% of women develop narcissistic personality disorder (NDP) during their lifetime.
The researchers also found that NPD rates are much higher among black men and
women, Hispanic women, younger adults, and people who either never married or
became divorced, widowed or separated.
Signs and symptoms
Self-centred and boastful
Seek constant attention and admiration
Consider themselves better than others
Exaggerate their talents and achievements
Believe that they are entitled to special treatment
Are easily hurt but may not show it
Set unrealistic goals
May take advantage of others to achieve their goals.
Other common traits of narcissistic personality disorder include the following:
Preoccupation with fantasies that focus on unlimited success, power, intelligence,
beauty, or love
Belief that he or she is "special" and unique, and can only be understood by other
Expectation that others will automatically go along with what he or she wants
Inability to recognize or identify with the feelings, needs, and viewpoints of others
Envy of others or a belief that others are envious of him or her
Hypersensitivity to insults (real or imagined), criticism, or defeat, possibly reacting
with rage, shame, and humiliation
Arrogant behaviour and/or attitude
The exact cause of narcissistic personality disorder is not known. However, many
mental health professionals believe it results from a combination of factors that may
include biological vulnerabilities, social interactions with early caregivers, and
psychological factors that involve temperament and the ability to manage stresses.
Some researchers believe that narcissistic personality disorder may be more likely to
develop when children experience parenting styles that are excessively pampering,
or when parents have a need for their children to be talented or special in order to
maintain their own self-esteem. On the other end of the spectrum, narcissistic
personality disorder might develop as the result of neglect or abuse and trauma
inflicted by parents or other authority figures during childhood. The disorder usually
is evident by adolescence or early adulthood when personality traits have become
Diagnosing narcissistic personality disorder
Personality, by definition, involves stable traits that develop over time. If physical
symptoms are present, a doctor may undertake a medical history and physical exam.
There are no lab tests that diagnose personality disorders, but if someone has
experienced a change from their usual personality, a doctor may order diagnostic
tests, such as neuro-imaging or blood tests, to rule out a neurological or other
physical illness as the cause of a change in personality.
If the doctor finds no physical reason for the symptoms, he or she would likely refer
the person to a psychiatrist or psychologist, health care professionals who are
specially trained to diagnose and treat mental illnesses. Psychiatrists and
psychologists use specially designed interview and assessment tools to evaluate a
person for a personality disorder.
There are several different types of personality disorders, some of them overlap, and
it is possible to be diagnosed with more than one type.
NPD diagnosis follows the criteria in the Diagnostic and Statistical Manual of Mental
Disorders, (DSM) published by the APA (American Psychiatric Association).
The following must be present for a diagnosis of Narcissistic Personality Disorder:
The patient's idea and importance of self is exaggerated
Fantasies about beauty, success and power over-dominate the patient's thoughts
Patients think they are special, and relate only to other "special" people
They need to be admired all the time
They believe they are entitled to most things
They manipulate and take advantage of other people
They lack empathy - the ability to feel and recognize the feelings of and needs of
They envy other people
Their behaviour comes across as arrogant.
The latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes
some changes in how personality disorders are diagnosed. "(DSM-5) moves from
the multi-axial system to a new assessment that removes the arbitrary boundaries
between personality disorder and other mental health disorders."
There is no effective, known cure for NPD. Psychotherapy is often recommended -
this is a type of counseling which aims to help the individual learn how to positively
relate to other people. Psychotherapy may help the patient better understand what
their problems are, which may bring about a change in their attitudes, resulting in
Psychotherapy may involve CBT (cognitive behavioural therapy), family therapy or
group therapy. CBT helps the patient identify negative beliefs and behaviours, and to
replace them with healthy and positive ones. Psychotherapy aims to help patients
build up their self-esteem and acquire realistic expectations of themselves and other
For some of the more distressing aspects associated with NPD, the doctor may
prescribe medication example, an anti-depressant.
The prognosis depends on the severity of the disorder and the degree to which
people who seek treatment recognize problems within themselves and desire to
change aspects of their personality that may be maladaptive.
A person with untreated NPD has a higher chance of substance abuse (including
drugs and/or alcohol),depression, problems with relationships, difficulties at work or
school, and suicidal behaviours or thoughts.
A recent study found that males with narcissistic personality disorder have higher
levels of cortisol in their blood. Cortisol is a stress hormone. Even those without
much stress in their lives have higher levels. High blood cortisol is linked to a greater
risk of developing cardiovascular problems.
Living with somebody who has NPD
Family members of somebody with NPD describe the sufferer as controlling,
egotistical and forever dissatisfied with what anybody around them does. No matter
what happens, the narcissist will blame others and make them feel guilty for all their
problems. They are described as having short fuses, losing their tempers at the
slightest provocation, or turning their backs and giving people the "silent treatment".
Some can be physically and sexually abusive. The emotional and physical damage
caused by somebody with NPD can be severe. Learning how to become more
confident and assertive can help protect those living with somebody with NPD from