Narcissistic personality disorder (NPD) is a personality disorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive need for admiration and a delusional sense of status, diminished ability or unwillingness to empathize with others’ feelings, and interpersonally exploitative behavior. Narcissistic personality disorder is one of the sub-types of the broader category known as personality disorders. It is often comorbid with other mental disorders and associated with significant functional impairment and psychosocial disability.
Overview on narcissist
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) describes NPD as possessing at least five of the following nine criteria.
- A grandiose sense of self-importance
- Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- Believing that they are “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
- Requiring excessive admiration
- A sense of entitlement (unreasonable expectations of especially favorable treatment or automatic compliance with their expectations)
- Being interpersonally exploitative (taking advantage of others to achieve their own ends)
- Lacking empathy (unwilling to recognize or identify with the feelings and needs of others)
- Often being envious of others or believing that others are envious of them
- Showing arrogant, haughty behaviors or attitudes.
Narcissistic personality disorder usually develops either in youth or in early adulthood. True symptoms of NPD are pervasive, apparent in varied social situations, and are rigidly consistent over time. Severe symptoms of NPD can significantly impair the person’s mental capabilities to develop meaningful human relationships, such as friendship, kinship, and marriage. Generally, the symptoms of NPD also impair the person’s psychological abilities to function socially, either at work or at school, or within important societal settings. The DSM-5 indicates that, in order to qualify as symptomatic of NPD, the person’s manifested personality traits must substantially differ from social norms.
Signs of narcissism
What are the symptoms of narcissistic personality disorder?
- Sense of self-importance.
- Preoccupation with power, beauty, or success.
- Entitled.
- Can only be around people who are important or special.
- Interpersonally exploitative for their own gain.
- Arrogant.
- Lack empathy.
- Must be admired.
Symptoms include an excessive need for admiration, disregard for others’ feelings, an inability to handle any criticism and a sense of entitlement.
Management
Treatment for NPD is primarily psychotherapeutic; there is no clear evidence that psychopharmacological treatment is effective for NPD, although it can prove useful for treating comorbid disorders. Psychotherapeutic treatment falls into two general categories: psychoanalytic/psychodynamic and cognitive behavioral. Psychoanalytic therapies include transference focused psychotherapy, mentalization-based treatment and metacognitive psychotherapy. Cognitive behavioral therapies include cognitive behavioral therapy, schema therapy and dialectical behavior therapy. Formats also include group therapy and couples therapy. The specific choice of treatment varies based on individual presentations.
Management of narcissistic personality disorder has not been well studied, however many treatments tailored to NPD exist. Therapy is complicated by the lack of treatment-seeking behavior in people with NPD, despite mental distress. Additionally, people with narcissistic personality disorder have decreased life satisfaction and lower qualities of life, irrespective of diagnosis. People with NPD often present with comorbid mental disorders, complicating diagnosis and treatment. NPD is rarely the primary reason for which people seek mental health treatment. When people with NPD enter treatment (psychologic or psychiatric), they often express seeking relief from a comorbid mental disorder, including major depressive disorder, a substance use disorder (drug addiction), or bipolar disorder.
Question: Can a narcissist be a good person?
Narcissists can sometimes be helpful and caring. However, more often than not, they only pretend to have these qualities. Moreover, even when they act giving and helping, they are not motivated by empathy because they severely lack it, and as a result, their help is often not very productive.