Personality Disorders 101: Narcissistic PD

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The term “Narcissism” comes from the Greek myth of Narkissos, a demigod with renowned beauty. Although everybody noticed Narkissos’ beauty, he scorned and rejected everyone who loved him. Eventually Nemesis, the goddess of revenge, led Narkissos to a pool of water, where he fell in love with the image in the water. When Narkissos realised the image was himself, and understood that he could never love anyone else in the same way, he died.

Psychologists first used the word narcissism to mean vanity and admiration of the self. Now, people often call an arrogant or over-confident person a narcissist. But the disorder covers far more areas than vanity or confidence. The DSM-5 describes Narcissistic PD as a pattern of having an unrealistic sense of greatness or uniqueness (grandiosity),a need for admiration, and a lack of empathy. The person needs to have at least 5 of the following criteria:

  • They have a grandiose sense of self-importance. They exaggerate their achievements and talents, and expect to be recognized as superior without reason.
  • They are preoccupied with fantasies of unlimited success, power, brilliance, or beauty, or ideal love
  • They believe they are “special” and unique, and can only be understood by other special or high-status people
  • They require excessive admiration
  • They have a sense of entitlement. They expect especially favourable treatment or automatic obedience to their expectations
  • They take advantage of others to achieve his or her own goals
  • They lack empathy, and are unwilling to recognize or identify others’ feelings and needs.
  • They are envious of others, and believing others are envious of them
  • They are arrogant and haughty to others.

The general PD criteria mentioned in the first post must also apply.  “A person needs to have a collection of unusual behaviours and traits which affect a large portion of their everyday life. Those behaviours and traits must start before early adulthood. They need to cause negative consequences for the person, who should be upset by or annoyed at those behaviours.”

One explanation for NPD is that narcissists experience childhood circumstances which force them to view themselves as flawed and unlovable. This painful belief activates defence mechanisms, which protect the child by reworking their feelings of difference into a safer form. If someone with NPD grew up feeling unloved, they might unconsciously rework that feeling into the counter-belief that people didn’t understand their greatness enough to love them. This would influence their worldview into adulthood, so the person would believe they were better than others or deserved different treatment to others.

As this theory relies on an unconscious process and unconscious beliefs, there is no way to prove it correct or incorrect. However, one study which analysed how psychiatrists would describe their patients seemed to find three subtypes of NPD. Clients with one subtype named fragile narcissism matched the theory; they seemed to use grandiosity as a defense mechanism, and they would feel intensely inadequate and angry if their defense failed.

NPD in media is often shown by arrogance, shallowness and cruelty, through unsympathetic characters; many fictional supervillians display elements of NPD. However, there are positive portrayals of characters focused on a good cause. In the Iron Man films, Iron Man fits multiple NPD critera. He is irresponsible, reckless, entitled and self-important, and other heroes find him difficult to get along with. However, everything he does is ultimately to save others.

Beyond these initial traits its hard to conclusively say if Iron Man would fit NPD. Tony Stark does seem to believe he is special and unique, but he is a superhero. Stark does have a sense of entitlement, but he did temporarily establish world peace. As the unimaginably wealthy CEO of an influential company, he holds so much success, power and brilliance that the fantasy criteria cannot really apply. His pre-existing alcoholism may also be masking or exaggerating the symptoms we see.

Another caveat here that Iron Man 3 shows Stark experiencing realistically complex distress after the events of the first two films. He does not fit any diagnosis in a textbook way. Instead, like a real person experiencing traumatic events without support, he shows a jumble of symptoms which belong to multiple conditions and which influence each other over time.

Although the recommended treatment for NPD is management through therapy, talk therapy is often unsuccessful, as a person with NPD would be likely to interpret any disagreement as the therapist’s fault. Someone with NPD may also abandon therapy if the therapist tries to contest their self-image and expectations.

Psychological Criticisms of NPD

A previous post mentioned that NPD, HPD and BPD all share diagnostic traits. While NPD doesn’t have any intentionally gender-based criteria, 75% of people diagnosed with it are male. This suggests diagnostic traits may be biased towards male expressions of narcissism, while female expressions of narcissism are either unnoticed or interpreted as other disorders like HPD or BPD.

As with HPD, people with NPD generally don’t believe they have any issues. Other people are more likely to feel distress than the person themselves; someone with NPD is unlikely to seek help apart from after an ultimatum from a partner or superior.

Finally, higher-than-average narcissism is often found in successful CEOs and business leaders, who keep pushing their business forward due to traits like self-importance. This is usually rewarded by media coverage, despite the negative consequences for employees. The lifestyles and fame associated with Western business leaders and celebrities are examples of how high narcissism can be expected, or even viewed as beneficial: business is expected to be cutthroat and a CEO is expected to keep their business ahead of the competition. Similarly, celebrities can expect to be “famous for being famous”; to recvieve attention and fame directly proportional to their percieved entitlement to it. These situations show where a society can make distinguishing between adaptive and dysfunctional behaviour very difficult.

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