Tag Archive | Narcissistic personality disorder

PART II: WHAT HAPPENS WITH CHILDREN WHO WERE RAISED BY A NARCISSIST IN ADULTHOOD?

Family system good or bad influences our personality, the way we see the world and feel about ourselves. Unfortunately being raised by the narcissist parent is a tough spot to be in. You are probably dragging with yourself a very negative perception of you which influences a lot of areas in your life. In this article we will take a look on the hardships that comes from being raised by the Narcissist.

Pain from upbringing
Having to accept that your parent doesn’t love you like other parents love their children is the painful process. You have to grieve the loss of the parent you never had. Really grieve the fact that you didn’t get the love and support you needed. Part of that requires releasing the fantasy that your narcissistic parent can change and eventually give you what you need. They are unable to change. At least not to the extent that they would be able to give you genuine love. Sometimes accepting that can make your relationship with narcissistic parent bearable but there is nothing wrong with cutting all ties with your narcissistic parent.
Also we often forget about the other parent-the not narcissistic one. There is a lot of pain hiding there too. This parent was allowing the abuse to keep happening. He was the silent observer and didn’t protect you the way he should. Usually children defend this parent, because he was the safe haven while growing up. But in therapy after we deal with pain that was cost by narcissistic parent the new pain and anger emerge directed toward the other parent. Why didn’t you do something? Why you haven’t protracted me? “One of the most heart-breaking moments for me as a child was realizing that dad knew what was going on. After a bad beating from mom, he brought me a candy bar.”

Negative self-image
Children of narcissistic parents often wonder if they are really lovable. You distrust and devaluate your inner selves as nothing of value could come from inside. “I feel worthless and unlovable. If anyone shows affection, I know that they only do it because they want something in return.”
You are chronically unsure of themselves, and overly-worried about what others think of them. You feel insecure, because you never experienced unconditional love. “I fight the things I’ve been called almost every day, things like stupid, lazy, fat, drama queen, property, slightly mentally retarded, selfish, paranoid, hypochondriac, and more.”

Underdeveloped identity
Child raised in Narcissistic family is forced to ignore his own needs and desires. The boundaries between mother and child become so blurred. Not only that, the parent was not in tuned with the child and they labeled children’s emotions according to their own. That leaves behind the confusion of who I am, what am I feeling? Also child often don’t know how to read their own body because parent didn’t give the right words to emotions and body sensations. Person who is not connected with his feelings is puzzled by an ache in the heart, palpitations, shortness of breath and a churning in the stomach. They become dissociated from their feelings and bodily sensations and consequently often end up exhausted and ill.
Consequently, you don’t trust your instincts, and have trouble expressing your feelings. You worry that if you assert yourself you will risk losing love. Because you are so used to please others your identity don’t have the opportunity to fully develop. “I sense for a very long time that my body wasn’t my body. It could be abused, or I could be held down and tickled to crying point or made to dance for visitors. I’m still over-sensitive to being grabbed or pulled by anyone.”

Guilt and shame
Another major sign of being raised by narcissists is the constant feelings of guilt and shame. They are coming from inability to meet your parent expectations and being constantly humiliated. You can also experience chronic feelings of emptiness. To avoid this feeling you can escape to hyper sexuality or acting out (in a potentially harmful manner) for attention.

Avoiding error
Child of narcissist tries to avoid error even at a brand new or difficult activity. Some can be deadly afraid to go out of their routine.  Narcissistic parent teaches their child that there is only perfection or failure.  They believe that they should appeared perfect and with no need of help. Consequently they avoid taking chances because of the fear of (parental) judgment. They stay in the security of sameness.

Boundaries
Most likely you have poor interpersonal boundaries and inability to say “no”. People-pleasing is very common behavior. You are deeply afraid to speak up confidently or challenge others. You are going to need to discover boundaries, where you begin and your parent ends, to free your authentic self. When you choose who you want to be, rather than who your parents wanted you to be, you break free from their narcissistic grip.

Noticing the details
Like in Borderline families also child from Narcissistic family becomes attuned to the changes in the environment. “Changes in tone? Check. Micro-shifts in facial expressions? Noted. Gestures that contradict spoken words? Documented.” You had to be “emotion detective” in order to survive your childhood. You can be highly sensitive and intuitive to the needs of others, but you are also constantly on the lookout for what’s about to come. This can lead to taking on other people emotions and not being able to set a healthy boundary in adulthood. “I’m intensely aware of body language, and that comes from the ‘walking on eggshells’ life and trying to anticipate. It’s distressing when people are telling me one thing and their body language is telling another.”

Narcissist becomes Narcissist?
If you were a golden child there is a strong possibility that you will become a narcissist. You can turn out to be self-centered, have the compulsive need to be always right, you are unable to take criticism, demand perfection from others and yourself, you can become hypersensitive and continuous feel mistreated by others and you desperately need to be loved. If you grow up watching your parent exploit others, you can lack a strong moral compass and transfer this behavior to the people around you. “I’m ignorant. You may tell me things, and I will even ask you where you went on holidays, how long did it take you, who was with you – and 2 minutes later I won’t remember a thing. I learnt to block out the screams and nonsense that my mother tells me over and over again, and unfortunately, I now subconsciously do the same to the other people.”
Beside Narcissistic personality disorder, you can also develop other psychological disorder such as Borderline personality disorder, anxiety, depression, addiction or Schizoid personality disorder. “I self harm. During my life it varied, but included things like blade cuts, excessive masturbation, biting lips and gums.”
Beside psychological problems you can develop a bunch of (psycho) somatic issues like migraines, autoimmune disorders, chronic fatigue syndrome, and heart problems. Bottom line is trauma causes all kinds of physical and psychological problems. “I eat. I am morbidly obese. I would gladly trade for one of those addictions that don’t show so prominently, like workaholic or excessive exercising. But this is what I’ve got. I wish I could lay it down.”

(Romantic) relationships
Children from Narcissistic family often have unhealthy relationship. There are several aspect contributing to it:

  • All children are vulnerable in front of their parents but with horrible experiences child in Narcissistic family learns to keep to himself. The child is deeply hurt by the parent who uses his feelings for a personal gain. Consequently you learn that you can’t trust others with what is truly going on inside of you. “I can’t trust anyone. I don’t completely trust my girlfriend, I don’t trust my friends (I always think “Are they going to stab me while I’m asleep? Why does my girlfriend pretend to love me?”) even if there’s no reasons to think that. At work I do everything myself, even if there’s help available. Sometimes that means I’m a bit overloaded.”
    Often you are unable to tolerate your feelings as well. On the other hand children of narcissists have a tendency to overshare in the hopes that someone will see their pain and come rescue them. That normally ends up in another toxic relationship.
  • You are so used to be mistreated in the relationships that you don’t recognized when mistreatment is going on and you don’t know how to stop it.
  • Many are desperate for a love they never received. You can have idealized perception of romantic relationship. Usually the image is created from what you saw in the movies. This can also be one of the ways to avoid intimacy. Meaning that you are looking for something that doesn’t exist. Probably because you are joining for parent love that was never there. Going into the same destructive circle causes re-traumatization but you don’t know how to end vicious circle. “I ended up marrying an emotionally unavailable man. I was married 23 long years. I finally had the courage to leave. With my next relationship, I thought I’d finally found love! I thought I’d finally found my soulmate! I realized, after a year, that he was a covert narcissist of the exhibitionist variety!”
  • You form insecure attachment, mostly avoidant attachment, in which you deal with your fear by shutting people out. “I will never risk depending on anyone ever again!” or anxious attachment, where you chase after love. “Why won’t you pay attention to me!”
  • Some stays in the relationship just for the sake of settling down. Long-term relationships can provide an odd sense of comfort to someone who has always felt alienated. However most of those raised by a Narcissist have an intense fear of commitment, especially when it comes to committing to a person who may actually truly care for you. Commitment to you signifies another person having complete control over you and your emotions. As a result, you tend to defend your freedom whenever you feel it might be challenged and can withdraw when things get too intense. Even staying in long-term relationship that doesn’t work indicates the fear of commitment. “I rather be here and know what to expect than be in healthy relationship where I would need to deal with my fear of closeness.”
  • You have a tendency to become attached to toxic people and chaotic situations in early adulthood in a more intense. Unfortunately you internalized verbal and emotional abuse as a twisted sense of “normal” in childhood, so it’s no wonder that you rationalize toxic behavior in adulthood.
  • You often get into one-sided relationships where you get drained by the other person without getting any benefits in return (=codependency). This endless ‘giving’ is usually rooted in a deeply painful feeling of never being quite enough and having to work hard to receive love.

Being raised by a Narcissist causes a deep wound that takes a lot of time and determination to heal. Basically, you need to put your energy in to mothering yourself. Maybe that means getting re-parented by a therapist, to some extent by romantic partnership, friends or nurturing neighbors. All of these people can become part of your collective parent who gives you love, support, helps you through painful times and reminds you that you are worth it. With time you will internalize this nurturing collective parent that you didn’t have at the time of growing up.

PART I: BEING RAISED BY A NARCISSIST

Narcissism runs on a spectrum, from healthy narcissism to malignant narcissism, with a lot of gray in between. Narcissistic people suffer tremendously from their childhood trauma and this pain is too much for them to carry, so they pretend it’s not there or they keep lashing out on other people to ease their own pain. Narcissism doesn’t have to be absolute. It can show up in little ways and often under the guise of doing “what’s best” for your children. It tends to play out inter-generationally, with narcissistic parents producing either narcissistic or codependent children. Parents who are narcissistic share many traits with parents who have Borderline Personality Disorder. The traits of these two disorders overlap quite a bit. The difference between BPD and NPD is how they use manipulation. BPD is trying to prevent abandonment and NPD is trying to maintain the image of perfection.

Narcissistic trails in parenthood

Possessives
Narcissistic parent can be defined as someone who lives through their children and is possessive towards them. Typically, the narcissistic parent perceives the independence of a child as a threat. As long as you don’t represent a threat to your narcissistic parent, and are making them proud, they are OK towards you, or continue to ignore you. But the moment you become difficult or don’t meet their expectations, you become a problem. It is very hard for them to let their possession go. This typically shows when you get serious romantic partner. Your new girlfriend is viewed as a major threat. “My mum criticized my girlfriend to me when she wasn’t around. She was showing her disapproval through little things, like never included her name on any Christmas cart that she wrote.” In the eyes of some narcissistic parents, no romantic partner is ever good enough for their offspring.

  • “When you support her or don’t oppose her, she has this charming personality that’s very hard to resist. But when you oppose her, you can expect her to throw in every trick she has to make your life miserable.”

Boundaries
Within the realm of narcissistic parenting, personal boundaries are often disregarded with the goal of molding and manipulating the child to satisfy the parents’ expectations. They would go through your private belongings, without a thought, sometimes even using what they found against you. Asking nosy questions without noticing that you are feeling uncomfortable is also very common. You don’t have any truly private space even in the bathroom. Narcissistic parent crosses boundaries in many ways. Verbal and/or physical violent is common in their home.

  • “My mum has given away my property without my consent, sometimes even in front of me. Not to mention she expressed (her) opinions instead of me and make an appointments for me without even consulting me. “
  • “I told my mum she cannot bring her friends to my party but she showed up with them anyway. I couldn’t send them away because she told them they were invited. So, I either have to give in, or be the bad guy to these poor dupes on my doorstep.”
  • I came home from school when I was 15 or so, and found all my drawers dumped out on my bed, and my mother sitting in my desk chair, holding my diary. She was livid. Apparently, I hadn’t put my socks in the drawer right, so she decided to check all my drawers and closet. Seeing that none of my clothing was put away to her standards, she dumped it all out and in the process found and read my diary. That was a bad day. I wore long sleeves for weeks, and had to wear a sweat suit in gym to hide what she did to me.”

Lack of Empathy
Narcissistic parent is incapable to be mindful of the child’s own thoughts and feelings, and validate them as real and important. Only what the parent thinks and feels matters. Some of the most common issues in narcissistic parenting are due to the lack of appropriate, responsible nurturing which ultimately contributes to a child’s dysfunctional patterns. Consequently children feel little or no emotional attachment to their parent.

  • “My mum minimizes, discounts or ignores my opinions and experiences. Even when I talk about the subject that I am an expert on, she choose to demine the information. She never listens to a word that I say.”
  • My mother sees herself as a loving person. Nothing could be more far away from the truth in reality. She is incredibly cold-hearted, rude, ignorant, and callous with an inability to show compassion.

Manipulation
Narcissistic parent use manipulation to mold you the way they want you to be. The most common tactic used by the narcissist are:

  1. Ignoring: They can ignore you for days or weeks when you are not doing the things they want you to do. “When I didn’t do well in school my mum didn’t talk to me until I corrected my mark.” There is also one subtype of Narcissistic parent called “Ignoring Narcissists”. This parents have very little interest in their children. They take notice only when it is necessary. Usually when they need to portrait the perfect family picture or when they need to make sure that their child is taking the path that was chosen for him. “My mum showed interest in me only when it has something to do with school. The moment I tried to talk to her about something else she didn’t really listened.”
  2. Withholding love: Love is given as a conditional reward, rather than the natural expression of healthy parenting. On the other hand, the withholding of love is used as threat and punishment.
  3. Threatening: Narcissistic parent often use your personal information you told them a while against you when you don’t want to follow their direction. Child quickly learns not to share anything with their parents and hides everything from them.
  4. Guilt and shame: Narcissistic parent make you feel guilty and ashamed of yourself if you want to do something different from what they expected. “Ow, you are going to take the trip and I have to stay at home with your dad, how thoughtful of you” or ˝Because you can’t play the piano well, mummy looks like a fool˝.
  5. Being in the middle: Narcissistic parent uses their child to manipulate others-most likely their partner. Children are often expected to deal with adult issues and are put in the middle of disputes. This forces the child to make difficult decisions. Putting the child in the position where he needs to choose between one parent instead of the other leaves profound trauma. “How can I take my father’s side when my mother needs me more?”
    All of this manipulation tactics are preventing you to develop into a healthy individual with strong and clear identity.

Narcissistic rage
Their rage is based on fear. Anything that is threatening to expose their inner feelings of unworthiness needs to be destroyed. “My mom just flipped out when I said I am getting tired of pretending in front of my relatives that I am still studying to be a doctor. She started hitting me and screaming unclear sentences. I didn’t dare to tell my relatives the truth after that.”

Everything is about them
Narcissistic parent take all of the air in the room. Their profound need for attention and praise subverts everyone else’s needs. They turn others to be their listener. They don’t notice their boredom, exhaustion and desire to speak too. They love to show others how “special” they are (grandiosity). They enjoy publically parading what they consider their superior dispositions, be it material possessions, physical appearance, projects and accomplishments, background and membership, contacts in high places, and/or trophy spouse and offspring. They go out of their way to seek ego-boosting attention and flattery.

  • “My mother creates odd occasions at which she can be the center of attention, such as memorials for someone close to her who died long ago, or major celebrations of small personal milestones. She loves to entertain so she can be the life of her own party.”
  • “At the dinner table me, my sisters and my father were talking. My mother suddenly slipped from her chair and collapsed onto the floor, apparently unconscious. Shocked and concerned, we rushed to her side and picked up the phone to call 911, at which time she regained consciousness. The same scenario played out a few more times at the dinner table. If the conversation shifted away from her she would dramatically drop to the floor. We started to ignore her and talked over it. She continued to fall sometimes. She’d lie there for a bit and then pretend to wake up in confusion.”

Maintaining the appearances
They like to present a perfect family image to outsiders. They go to great lengths to ensure that others perceived your family as a loving, successful and enviable. Children are normally aware of this play, but kept silent for fear of wrath from their parent.

  • “I’m in therapy to deal with the effects of being raised by a narcissistic parent. I didn’t even realize until I was pretty well into adulthood that’s what it was. I thought it was me. I thought something was wrong with me. Everyone loves my mom. Everyone talks about how amazing she is, how charming, how much she sacrifices for her family, so I figured that if I was miserable at home it certainly couldn’t have been because of her. The truth is, everyone thinks so highly of her because she has carefully crafted that image and manipulated and lied to maintain it. She has used other people to make herself look better, and hurt others in the process. That’s the truth.”
  • The thing about narcissists that is the absolute worst is that no one else knows what’s going on. They have fooled everyone else because they are master manipulators. Everyone else in my family and extended peer group thinks my mother is this amazing, strong, dedicated woman who has raised two severely challenging children. What’s funny is, as much as I can’t stand my brother, we are a lot alike and have suffered a lot of the same traumas at the hands of my mother. We are both incredibly sensitive souls who have been abused and luckily, I found my way out of it. I moved 3000 miles away from her. My brother was not so fortunate, and depends on her to survive.”
  • She cares excessively about what people think. “What will the neighbors think”, is a sentence that I’ve heard countless times. If you actually have a genuine problem, don’t expect her to care about you, but about how it will appear to others. Keeping up appearances is key, regardless of whether you’re suffering or not.”

Everything is personal
Narcissistic parents take their children’s every feeling or action personally. These parents are easily angered when a child doesn’t agree with them or mirror them. They expect the child to be happy when she is and miserable when she is. If the child is happy when the parent is sad, it is taken as a sign of disloyalty and insensitivity. They are so sensitive to praise and admiration as fuel that it makes them overly sensitive to criticism. So children learn to tiptoe around these emotional minefields, trying not to trigger that anger, or worse, have their parents withdraw love. The child of narcissist parent is never seen as he truly is. Of course, there are moments when child objects to his parent, but even then he feels bad, wrong, and confused.

  • She also makes up ridiculous lies about trivial mistakes. Just to give one example: she once repaired a shirt, but put the button on the wrong side. I pointed this out to her — I wasn’t angry or anything, I thought it was funny, and she made up absolutely silly excuses like: “it just shot through”. She can never do something wrong and thus she will never apologize. I don’t think I’ve ever heard her say “sorry”.

Marginalization
Some narcissistic parents are threatened by their child’s potential, promise, and success, as they challenge the parent’s self-esteem. Consequently, they might make a concerted effort to put the child down, so the parent remains superior. They are nit-picking their child, they are judgmental and critical towards him, they constantly compare him to someone better and reject his success and accomplishments. Whenever someone complimented your achievements, your parent would jump in and shift the attention to themselves. “Yes, she gets it from me. I was always athletic as a child.”

  • “When I got married a few years later, she told me that my wedding was “not for the bride, but actually for her mother”. I made her my Matron of Honor and chose her favorite color for the bridesmaid’s dresses. She bought a dress the same color as mine.”

Grandiosity and Superiority
Many narcissistic parents have a falsely inflated self-image, with a conceited sense about who they are and what they do. Some children of narcissistic parents become the same: “We’re better than they are.” This sense of grandiose entitlement, however, is almost exclusively based on superficial, egotistical, and material trappings. They feel more important because of materialistic things or status they have in the society.

Dependency
Narcissistic person is strongly dependent on others. The dependency can be emotional, physical, or financial. They are trying to make you dependent on them (possessiveness, manipulation), so they can control you. One common tactic to do that is to infantilize you. This can be as direct as making you feel incompetent every time you try something new, or it can be as subtle as always stepping in and offering to do something you can clearly do for themselves. Unfortunately, this behavior rarely stops even after you become an adult. In fact, it can sometimes become worse as the narcissistic parent fears their children’s growing independence and the end of their narcissistic supply.
On the other hand some parents expect their children to take care of them for the rest of their lives.

  • “My mom expects me to support her financially on an on-going basis. She says that she can’t live without me.
  • “Walking into my office, (I managed the number 3 top Allstate office out of 900 agents) not respecting my employees and still undermining me on how I need to go back to school and finish my degree or I will never make it in life. She homeschooled me and deliberately kept me from finishing school in order to keep me locked in her web of abuse. She took me out of school when I was 11 because she was about to have another baby and “homeschooling was a great option!” She had me working two full-time jobs at 16 and I barely had a 9th grade education when I ran away at 17.”
  • “I grew up a text book co-dependent, always looking outside of myself for validation. Since I was solely focused on my mother, I did not develop my own identity – it was given to me by her. My identity was based on my role. I had an “underdeveloped self esteem (no boundaries) combined with an inappropriate caring for others (invading a boundary), and an inappropriate reliance on another’s response (invading a boundary), in a negatively reinforcing loop.”

 

Humiliation
Narcissistic parent berated, demeaned and harassed you on a constant basis. She often latched onto an insecurity of yours and used it to humiliate you. “My mom made fun of my birth mark on my face all the time.” Many of her putdowns are simply by comparison. She’ll talk about how wonderful someone else is or what a wonderful job they did on something you’ve also done. The contrast is left up to you. She’ll spoil your pleasure in something by simply congratulating you for it in an angry, envious voice that conveys how unhappy she is. If you complain about mistreatment by someone else, she will take that person’s side even if she doesn’t know them at all. It is impossible to confront someone over their tone of voice, their demeanor or the way they look at you, but once your narcissistic mother has you trained, she can promise terrible punishment without a word. Being constantly put down or told that you are in a wrong rubs off on you and lowers your self-esteem.

  • “When I was getting more independent 16+ according to my mum all my friends were bad influences, my boyfriend was horrible, my choices of clothing was also too grandma for my age. When I started working she needed a wanted a contract phone so I got one for her. She ran up the bill which I had to pay for over £400.”

Golden child doesn’t shine so bright
Narcissistic parent often choose the favorite child or so called golden child. A golden child can’t do anything wrong, is the smartest and the best at everything they do. This is what the narcissistic parent believes and will enforce in their child. The other child (scapegoat) is seen as the black sheep, and the cause of all issues. Everything the scapegoat does is wrong, not as good as it should be, and they always have to take the blame. The scapegoat stands for everything that is not perfect in the family. The roles of golden child and scapegoat can also switch frequently. Consequently all communication between siblings is superficial and driven by duty, or they may never talk to each other at all.
The narcissist also uses favoritism and gossip to poison her children’s’ relationships. While she may never praise you to your face, she will do that in front of your siblings. The end result is a family in which almost all communication goes through the narcissistic mother. Golden child can become narcissist himself but not necessarily. They can see the favoritism and feel guilty for it.

  • “It didn’t make any sense, my brothers were wonderful humans. They are much more talented than I am. I had very strong feelings of guilt. I watched the people I loved receive the rage. I felt like I should have been able to fix things. My mother would tell me to go to my room and be very, very quiet while she was taking her frustration out on them.”
  • “My brother was and is the Golden Child. He could do no wrong, he was the perfect baby, the perfect child, and when he wrecked 3 cars in a row while in High School, none of those accidents were his fault. I, on the other hand, was a disappointment. I “cried all the time when I was a baby”, my mother had to cut her college education short because I “cried at the daycare that she put me in”, I was “always losing things”, and she couldn’t have a pet “because the cat scratched me.”
  • “He was diagnosed with cancer a few years ago and given two years to live. He has been depressed about this, but not for the reasons you might think. When he cried the most was when he was telling me how sad he was that he wasn’t going to be around for my sister, as she didn’t have a boyfriend yet and she needed to be trained on how to be attractive to other men. He then went on to blame me for not teaching her how to get a boyfriend as I’m her older sister. He especially put me down for not convincing her to get plastic surgery for her face.”

NARCISSISTIC PERSONALITY DISORDER (NPD)

  1. Definition of Narcissistic personality disorder (NPD)

The term narcissism was first used in relation to human psychology by Sigmund Freud in his essay “On Narcissism” after the figure of Narcissus in Greek mythology (Golomb 2003: 18).
The Myth: One day Narcissus was walking in the woods when Echo (mountain nymph) saw him, fell deeply in love, and followed him. Narcissus sensed he was being followed and shouted “Who’s there?”. Echo repeated “Who’s there?” She eventually revealed her identity and attempted to embrace him. He stepped away and told her to leave him alone. She was heartbroken and spent the rest of her life in lonely glens until nothing but an echo sound remained of her. Nemesis, the goddess of revenge, noticed this behavior after learning the story and decided to punish Narcissus. Once, during the summer, getting thirsty after hunting, the goddess lured him to a pool where he leaned upon the water and saw himself in the bloom of youth. Narcissus did not realize it was merely his own reflection and fell deeply in love with it, as if it was somebody else. Unable to leave the allure of his image, he eventually realized that his love could not be reciprocated and he melted away from the fire of passion burning inside him, eventually turning into a gold and white flower (Source: https://en.wikipedia.org/wiki/Narcissus_(mythology))
Narcissism is “a pattern of traits and behaviors which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition.” (Vaknin 2003:18) The narcissist constantly tries to repair his injured self-esteem by adoring and admiring his gilded self. (Golomb 2003: 18)

  • Diagnostic criteria

There is a whole range of narcissistic reactions, styles, and characteristics – from the mild, reactive and transient to the permanent personality disorder. NPD is commonly diagnosed with other personality disorders, such as Histrionic, Borderline, Paranoid, and Antisocial Personality Disorders (Vaknin 2003).
The ICD-10 (International Classification of Mental and Behavioural Disorders) defines NPD as “a personality disorder that fits none of the specific rubrics”. It relegates to the category “F60.8 Other specific personality disorders”, together with eccentric, “haltlose” type, immature,        narcissistic, passive-aggressive and psychoneurotic (ICD-10).
American DSM-IV-TR defines NPD as “an all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation and lack of empathy”.
The DSM specifies nine diagnostic criteria. Five (or more) of these criteria must be met for a diagnosis of NPD.
Proposed Criteria:

  • ‘Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognized as superior without commensurate achievements);
  • Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
  • Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
  • Requires excessive admiration, adulation, attention and affirmation – or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);
  • Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favorable priority treatment;
  • Is “interpersonally exploitative”, i.e., uses others to achieve his or her own goals;
  • Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
  • Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;
  • Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, being “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.’ (Vaknin 2003: 19)

1.1.2. Short comparison with other personal disorders
As mentioned earlier NPD is commonly diagnosed with other personality disorders. In this chapter I will introduced short comparison with four other personality disorder.
Opposite from patients with the Borderline Personality Disorder (BPD), the self-image of the narcissist is stable, he or she is less impulsive, self-destructive and concerned with abandonment issues. Also they are not as clinging as BPD patients (Vaknin 2003). Borderline and narcissistic patients both idealize and devalue others. But there is a different between them. BPD patient alternates between idealization and devaluation. For example, first they will idealize you, you will be the best therapist they ever had, and in the next session they will devaluated you, you will be the worst person they had ever know.  Nevertheless, the borderline patient cares about others. The narcissistic patient is more exploitative. Idealization is connected with expectation to satisfied patient’s grandiose fantasy. The minute expectations are not met, narcissist abandons you and looks for another one who will meet his grandiose fantasies (MacKinnon and others).
In short, on surface functioning of the narcissistic personality is much better than that of the average borderline patient. In general, NPD individuals are more capable of high, sustained achievement and will have more successful work history than the person with Borderline Personality Disorder. Both kinds seek attention, but unlike borderline, who seek nurturing attention, narcissist feel they deserve admiring attention because of their superiority (http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
Histrionic Personality Disorder (HPD) and NPD: Both personality types tend towards the demonstrative, exhibitionistic, dramatic and seductive in their behavior. Contrary to the histrionic patient, the narcissist is achievements-orientated and proud of his or her possessions and accomplishments. Narcissists also rarely display their emotions as histrionics do and they hold the sensitivities and needs of others in contempt. While the characteristic distinguishing feature of Histrionic Personality Disorder is coquettishness, the feature of NPD is grandiosity. Person with HPD is warm, playful, and spontaneous and can be dependent on others. These individuals are capable of love, empathy whereas those with NPD are not (Vaknin 2003; look at http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
While persons with NPD and Antisocial Personality Disorder (ASPD) share tendencies to be tough-minded, glib, superficial, exploitative, and unempathetic, NPD are less impulsive, less aggressive, and less deceitful. All ASPD are assumed to have a narcissistic personality structure, but not all narcissists are ASPD. Unlike a person with ASPD, the person with NPD has not learned to be ruthless or competitively assertive and aggressive when frustrated. A critical distinguishing feature is that in ASPD, there are no feelings of guilt or remorse and as opposed to ASPD, few narcissists are criminals (Vaknin 2003; see http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
Patients suffering from the range of obsessive-compulsive disorders (OCD) are committed to perfection and believe that only they are capable of attaining it. But, as opposed to narcissists, they are self-critical. However, someone with NPD is more likely to believe that he has actually achieved perfection. Shortly, the OCD seeks perfection, the narcissist claims it. The value systems of these two personality types differ as well: person with OCD has deeply held, rigid but genuine moral and socio-political beliefs. In contrast, the person with NPD might exposed such deeply held values but actually lacks any true commitment to them (Vaknin 2003; see http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).

1.1.3. Defense mechanism
Over all narcissists intended to protect true self from hurt and trauma. He creates False Self which is omnipotent, invulnerable, and omniscient, through which he regulates his self (Vaknin 2003). To maintain that state, narcissists develop different defense mechanisms. There are three defense mechanisms that are the most common for narcissists: splitting, graciosity and isolation/distance.
Graciosity: narcissist creates relationships only with people who admire them or who he admires. Consequently he is afraid that others will disappoint him or demand attention for themselves. When attention is turned away from them, they distance themselves and leaves the relationship (Praper 1996: 180).
Distance and isolation: narcissist doesn’t realize that he is hurt and wounded. When they got the feeling that others don’t see them as perfect, feeling of inferiority is awaken in them. They are unable to take criticism and take a distance when this happens (Praper 1996: 180).
Splitting or black and white thinking can be seen as a developmental stage as well as a defense mechanism, which is also common in NPD. Narcissist believe that they need to be admired by others. The ones who don’t admire them are categorized as bad. Their ego is not capable of accepting good and bad objects in one person (Praper 1996, see http://en.wikipedia.org/wiki/Splitting_%28psychology%29#Narcissistic_personality_disorder).

1.1.4. Types of narcissism
We all go through narcissistic developmental stage in our lives. As infants and toddlers we all feel that we are the center of the Universe and it is impossible to imagine that our needs wouldn’t be met (Praper 1996). Here we talk about primary narcissism, where toddler doesn’t separate the mother from himself and he depends on her to satisfy his primary needs (Lasch 1979: 79). Both self and others are viewed immaturely-as idealizations (Vaknin 2003). Gradually toddler gains experiences that everything cannot be the way he wants. He realize that there are obstacles in the world, which brings him little disappointments and make him overcome primary narcissism (Praper 1996).
Secondary or pathological narcissism is a pattern of thinking and behaving in adulthood. It manifests in the chronic pursuit of personal gratification and attention, in social dominance and personal ambition, bragging, insensitivity to others, lack of empathy and/or excessive dependence on others to meet his responsibilities in daily living and thinking (Vaknin 2003). Lasch says that this type of narcissism tries to destroy painful disappointments in childhood and cover the childs rage towards people that hurtled him. (Lasch 1979: 79)
Manfield differentiates the exhibitionist type and cover narcissism, both belonging to secondary narcissism (Praper 1996: 178):
The first type is exhibitionistic type. Children during childhood get a lot of support in their grandiosity but there is no room for individuality and true feelings. This type is common for families with one child. Investment in one child raises grand expectations. The child should be born genius, and should use every opportunity to demonstrate this to others. When not acting as expected, he can be roughly rejected by his parents. Avoiding rejection, he continues to be brilliant, perfect, sweet. He also requires that others treat him as special (Praper 1996: 178).
The second type is the disguised type. The child has experienced that grandiose ideas are unacceptable. He learns to hide any such feeling and behaviors. However, he still develops perfectionism and hypersensitivity to criticism. The need for superiority is suppressed while suffering from feelings of inferiority. The truth is that he in fact doesn’t believe that he is inferior (Praper 1996: 179). The disguised type appears humble and modest, so impressively weak that it isn’t difficult to overlook the hidden grandiose self (Praper 1996: 223).
Also Millon distinguish 4 subtype of secondary narcissism in the following photo:

Table: Narcissistic Personality Subtypes (available at: http://www.millon.net/taxonomy/summary.htm)

  1. Origins of narcissism 

NPD has been considered as pathology of self as formation of pathological development of identity (Praper 1996: 175). Considering the work of Otto Kernberg, narcissism is an ego distortion. Ego functions enable us to observe our self and environment. With narcissism, the ego is unable to develop observations from environment in to cohesive picture of self (look Praper 1996: 176). Kernberg sees narcissism as a defense against feelings of individual anger and abandonment, stemming from the child’s rejection. As a result narcissists are distrustful and incapable of relying on others. Their relationships are marked by jealousy, control, and withdrawal (Žižek 1987: 118-119).
By Kerenberg, pathological narcissism originates from the serious frustrations in separation phase (Praper 1996). Kernberg points out that narcissism is a result of permanently cold parental figures, which express indifference or hostility towards the child. This inadequacy is reflected in their tendency to inflate their self-image (Otway and Vignoles 2006).
Kohut believes that narcissism is a normal aspect of infantile development. The child’s self-grandiosity is supported by mirroring and idealizing relationship between child and parent. If these needs are not met, the child as an adult may appear poorly adapted to adult forms of narcissism (Otway and Vignoles 2006). He also believes that the loss of the object that would allow binding and idealized mirroring force the person to direct fantasy only to himself. Therefore, the NPD is looking for a person who would idealize him. Hoping that through the binding with others, he will achieve the feeling of coherent self. In reality he is looking for mother’s admiration that was not there (Praper 1996, 177). The secondary narcissism happens because the process of archaic infantile narcissism to a healthy adult narcissism is interrupt. (Otway and Vignoles 2006).
By Winnicottu, the reason for narcissism is the lack of empathy and harmony between parent and child. Another reason can be overly intrusive behavior from the parent. Child develops a false self, which protects the true self from intrusion and damage. Therefore, narcissists always offer impeccable false self and protect himself against feelings of inferiority (Praper 1996:177).
Millon’s theory opposes to mentioned theories which believe that negative relationship between child and parent is reason for narcissism. Instead, Millon says that the reason is the excessive attention of parents, over-pampering, forbearance and admiration. Parents show unrealistic judgment of the child’s abilities, thereby increasing children’s self-image, which the environment does not necessarily support. Despite the differences in the theories, all believe that narcissism is a result of dysfunctional childhood experiences. (Otway and Vignoles 2006)

  1. Personal attributes

Main personal characteristics which are normally found in NPD:
Sensitivity to criticism: patients with NPD feel injured, humiliated and empty when criticized. They often react with devaluation, rage, and defiance to any5 real or imagined criticism. They are incapable to tolerate setbacks, disagreement, and criticism. (Vaknin 2003)
In personal relationships narcissist is not capable of attachment to others. He depends only on recognition from others. He doesn’t t trust people because he has pathological fear of over-dependency on others. That’s why he usually have short love relationships that in his mind shouldn’t be too stressful or emotionally demanding (Žižek, 1987). The relationships are typically impaired due to their lack of empathy, disregard for others, exploitativeness, sense of entitlement, and constant need for attention (Vaknin 2003).
Narcissist is unable to enjoy because he connects enjoyment with others. Enjoyments starts when others notice his enjoyment. A narcissist is totally external, which indicates inner emptiness and loss of their identity.
Narcissist is incapable of mourning. They are not able to converting rage, because of the loss, to the mourning. He is only able to forget the lost object, or to determine that in fact he didn’t like them anyway. After that he directs his energy towards new person.
For narcissist, the availability of people is taken for granted. To this type of person you are not a person with feelings, you are a ‘thing’ to feed off and sustain their existence.
Narcissist use manipulation to get what he wants. He knows exactly which manipulative tactic is going to work best in which situation. When he wants something from us he pays attention to us but the moment he doesn’t need us anymore he acts indifferent toward us. Narcissists work within win-lose strategy. They believe their world is positioned to serve their insatiable needs. (Žižek, 1987; Tonia Evans 2008)
Being perfect: narcissist has a fear of failure, for example loneliness and aging. That’s why they take care of their body, trying to stay young  and be under the spotlight-so they won’t get lost in the crowd of average people (Žižek, 1987).  They are either “cerebral” (intelligence or academic achievements) or “somatic” (physique, exercise, physical or sexual prowess and romantic or physical “conquests”) (Vaknin 2003). Which means they are trying to be perfect in physical appearance or in intellectual accomplishments.
Narcissist in society: narcissist sees himself as some kind of an exception. He seems adapted to the social norms but he doesn’t take them seriously. He plays this game just to avoid punishment and be successful in the society. He is convinced that everybody else is doing the same-“everyone is wearing masks, social life is just a game” (Žizek, 1987). A narcissist sees the admired person as “an extension of themselves.” If that person refuses them, they “immediate experience hatred and fear, and devaluate previous Idol” (Lasch 1979: 155-156). A narcissist avoids intimacy and associates only with people who are, like himself-perfect (Praper 1996: 180). Žižek mentions three types of other people, separated by the narcissist:

  1. The ideal-other: they expect approval and recognition, he identified with them
  2. Enemies, who are preventing his narcissistic affirmation, so they must be destroyed
  3. All the rest, the mass of people, ”suckers”: a grey average, which is here only to take advantage off and then reject them (Žižek 1987: 111).

 

  1. Narcissist as a patient

Several different approaches to individual therapy have been tried with NPD patients, ranging from classical psychoanalysis to Gestalt therapy. The emerging consensus is that therapists should set modest goals for treatment with NPD patients. Most of them cannot form a sufficiently deep bond with a therapist to allow healing from early-childhood injuries as a matter of fact they rarely turn to therapy at the first place (Frey, 2010).
“As of 2002, there are no medications that have been developed specifically for the treatment of NPD. Patients with NPD who are also depressed or anxious may be given drugs for relief of those symptoms (Frey, 2010).
Kerenberg noticed that narcissistic patients shows excessive self-centeredness, over dependency on admiration from others, prominence of fantasies of success and grandiosity. They avoid facts that are contrary to their inflated image of themselves. A narcissistic patient due to the pain of isolation protects himself with a position of self-sufficiency. They don’t let people emotionally close (Kerenberg, 2007, 505; Praper 1996:223).
They suffer from inordinate envy, which is conscious and unconscious. They show greediness, exploitative behavior, entitlement, devaluation of others, and incapacity to really depend on others. But ironically they need the admiration of others. They show a remarkable lack of empathy, shallowness in their emotional life and lack of capacity for commitment to relationships and goals. Also their self-esteem is regulated by severe mood swings. They have chronic sense of emptiness and boredom which they try to escape through eating, drug and alcohol use. In addition, their tendency to criticize and devalue their therapists (as well as other authority figures) makes it difficult for therapists to work with them (Kerenberg, 2007, 505, Frey 2010).
Patients with NPD may present typical complications of this disorder, including sexual promiscuity or sexual inhibition, drug dependence and alcoholism, social parasitism, severe (narcissistic type) suicidality and parasuicidality (=their aim is not to die). For instance, a patient with NPD tends to become depressed when his feelings are badly hurt, when his defenses have let him down and when he believes his world is collapsing. When wounded, he is at the greatest risk of acting out, either against himself or others. A patient experiencing a narcissistic rage may become homicidal, particularly if he has a need to seek revenge. Under conditions of severe stress and regression, a narcissist can experience significant paranoid developments and brief psychotic episodes (look Kerenberg, 2007, 505; http://www.lmars.com/n-personality-disorder.htm).
Using Heinz Kohut’s self-psychology model, the goal of therapy is to allow the patient to incorporate the missing self-object functions into his internal psychic structure. This process is called transmuting internalization. In this sense, these patients’ psyches are “under construction” and therapy is their building time. Empathy is being the key for making changes in therapy. Without it, the patient whose self is too weak to tolerate more aggressive interpretation, would not benefit from therapy and in fact may suffer more damage (McLean, 2007).
Therapists can recognize narcissistic patients by contratransfer. By feelings of boredom and emotional desertion. The therapist may become sleepy, absent, experiencing shame. He can react as all-knowing expert on life, competing with all the therapists that client had left earlier. When the client devalues him, he feels inadequacy and helplessness (Praper 1996:223).
“The prognosis for younger persons with narcissistic disorders is hopeful to the extent that the disturbances reflect a simple lack of life experience. The outlook for long-standing NPD, however, is largely negative. Some narcissists are able, particularly as they approach their midlife years, to accept their own limitations and those of others, to resolve their problems with envy, and to accept their own mortality. Most patients with NPD, on the other hand, become increasingly depressed as they grow older.” (Frey 2010)

References