For those of you who have allowed your subscription to the American Journal of Psychiatry to lapse or, like me, who engaged in some light napping during Psych 101, let me remind you. NPD is the working abbreviation for Narcissistic Personality Disorder. The “to a T” part you will have to figure out on your own. NPD has been getting some play on the net lately, in fact, a friend of a friend just sent me an interesting piece applying NPD to a current political celebrity. I, of course, would never do that. Consider this, then, just an intellectual inquiry to an interesting, long ignored subject.
First let me deal with the etymology of the term “narcissism”. It is derived from Greek, or Roman or some other mythology of antiquity. Surely you remember that Narcissis was the son of the river god Cephissus and the nymph Liriope. One of the many character flaws of Narcissus was that he refused to return the love of those who loved him. His Nemesis, another god in the making (sound familiar) lured him to a pool of water at which Narcissus became infatuated with his own reflected image. To cut to the chase, he ultimately did the dutch act presumably because he was so enamored of his own beauty. He came to realize that no one would ever love him as much as he loved himself, and he lost the will to live. And as you all know, those who had a greatly exaggerated opinion of themselves came to be known as narcissists, and voila, the Narcissistic Personality Disorder was born. Yes, I know this is a much abbreviated version of the story, but I’m just getting to the important part and I wanted to save the space.
It doesn’t take a lot of research to determine that there exists a fairly well agreed upon definition of NPD. It runs something like this: “NPD is a long-term pattern of abnormal behavior characterized by exaggerated feelings of self-importance, an excessive need for admiration, and a lack of understanding the feelings of others. Dr. Steve Bressert, PhD wrote in a recent article that “the symptoms of narcissistic personality disorder include: grandiose sense of importance, preoccupation with unlimited success, belief that one is special and unique, exploitative of others, lacks empathy, is arrogant…He went on to opine that while the resultant behaviors may have been appropriate for a king in the 16th century, it is generally considered inappropriate for most ordinary people today. Hmm. I’d say that is an overwhelming understatement.
Of course, you know that I would not leave you with only this superficial understanding of the subject. I did the proverbial deep dive. I went directly to the source for all things on the mentally deficient. The well known and much appreciated DSM-5. What? You aren’t familiar with this tome. DSM-5 is the Diagnostic and Statistical Manual of Mental Disorders. I dunno what the 5 is for, but if you’re in the trade and want to figure if the bizarre behavior of your patient has a name, this would be your go-to book. So here it is, from the horses mouth…
“People with a narcissistic personality disorder (NPD) are characterized by their persistent grandiosity, excessive need for admiration, and a disdain and lack of empathy for others…In addition, people with NPD may exhibit fragile egos, an inability to tolerate criticism, and a tendency to belittle others in an attempt to validate their own superiority.” The emphasis is mine.
It goes on, “…individuals with NPD have most or all of the following symptoms:
- Grandiosity with expectations of superior treatment from others
- Fixations on fantasies of power, success, intelligence, attractiveness, etc
- A self-perception of being unique, superior and associated with high-status people and institutions
- Needing constant admiration from others
- Sense of entitlement to special treatment and to obedience from others
- Exploitative of others to achieve persona gain
- Unwilling to empathize with others’ feelings, wishes, or needs
- Intensely envious of others and the belief that others are equally envious of them
- Pompous and arrogant demeanor.
Wow, what a list. I wonder if all symptoms are weighted equally. For example, do you get an 8 for needing constant admiration, but only a 2 for being pompous and arrogant. Maybe you just check the box, if you have, say, more than 6 checked you’re it. I suspect, but don’t know, that like so many things while it may be hard to define precisely, you’ll know it if you see it.
There’s a lot of other stuff in the learned research that is referred to as associated behaviors of NPDers. I wont try to discuss them all but one that that jumped out at me was the assertion that those with NPD “use various strategies to protect the self at the expense of others. They tend to devalue, derogate, insult, blame others, and they often respond to threatening feedback with anger and hostility.” Emphasis also mine.
I spent a lot of time and read what seemed to be a lot of gibberish about causation. Let me give you an example, “Experts tend to apply a biopsychosocial model of causation, meaning that a combination of environmental , social, genetic and neurobiological factors likely play a role.” Huh! I think Roger the artful dodger nailed it when he said, “that ol’ boy, he was born on third base, but thought he hit a triple.” I suspect that we’ll never know, and I’m not sure it matters.
Let me say a few words about megalomania. It wasn’t listed in the research as an “associated behavior, but it seems clear to me that it should be. Simply put, a megalomanic is one who has delusions of grandeur, or who believes that one is or is destined for greatness.
Perhaps my hero Bertrand Russell said it best, “the megalomanic differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history.”
What worries me is if we wind up in the clutches of a megalomaniacal narcissist. A charming power monger who will do anything, who will say anything, who will promise anything to be loved (elected). Hmm. Know anyone who fits this bill…to a T.