Narcissistic Personality Disorder (NPD) is a type of personality disorder that you might be familiar with due to the media coverage it gets, or hearing people refer to others as a narcassist, but it is important to remember it is a complex mental health condition that is both incredibly difficult for the person and the people in their lives. A person who has been diagnosed with Narcissistic Personaility Disorder appears to others as someone who has an inflated sense of self-importance, a constant need for admiration, and no understanding of their impact on others, due to a lack of empathy. But these traits, while difficult for others, stem from a deep lack of confidence or shame, you might even have come across the term narcissistic wound to describe this. While the term ‘narcissist’ is often thrown around casually, NPD is a serious and diagnosable personality disorder that affects roughly 1% of the population. In Ireland and the UK, awareness of personality disorders, including NPD, is growing. However, it can still be challenging to recognise, both for individuals and their families, who may struggle to understand the root of the behaviour. This guide explores the key traits of NPD, its impact on relationships, how it can be diagnosed, and the available treatments.
Symptoms of NPD
Individuals with NPD often display a consistent pattern of grandiosity, entitlement, and a need for admiration. These traits may surface in various areas of life, from personal relationships to professional settings. Below are some common features:
- Grandiosity and Inflated Self-Importance: Individuals with NPD may overestimate their achievements and talents, often speaking about themselves in an exaggerated manner. They might expect others to recognise them as superior, even when their accomplishments do not warrant it. It can very hard if not impossible for the person to recognise this in themselves, but if you have been in close contact with someone with Narcassistic Personality Disorder, you will recognise it. For example, Bet spent 10 years getting qualified in her job, before setting up her business which became successful, her partner, even though his involvement in the business was small and came after her 10 years of study, took full credit for the success of her business, and saw his role as much more than it was, and was unable to see her achievement. On the flip side, years later when her business was not doing well, he blamed her; this example shows how the person with NPD can overestimated their role in achievements, and distance themselves or blame others when things go wrong.
- Need for Excessive Admiration: Narcissists thrive on admiration and validation from others. They often seek constant praise and can become upset or angry if they do not receive it.
- Lack of Empathy: A hallmark of NPD is the inability to empathise with others. Narcissists often fail to recognise or care about the feelings and needs of those around them.
- Sense of Entitlement: Individuals with NPD often believe that they deserve special treatment or unquestioned compliance from others. They may become angry or frustrated when they do not receive preferential treatment.
- Exploitativeness in Relationships: Narcissists tend to use others to achieve their own ends, often without considering the consequences for those they exploit.
- Arrogant or Haughty Behaviours: A narcissist may exhibit condescending behaviour towards others, viewing those they perceive as inferior with disdain.
While these behaviours may seem extreme, it’s important to remember that people with NPD are often deeply insecure and struggle with issues related to self-worth. It this this understanding that can make it difficult to leave a relationship with someone who is a narcassist, as if you even see a glimmer of their devalued view of self, compassion, as it was in my case, makes people stay.
Causes of NPD
The development of NPD is likely influenced by a combination of genetic, environmental, and cultural factors:
- Childhood and Environmental Factors: A lack of empathy from caregivers or an overabundance of praise and admiration during childhood may contribute to the development of NPD. A child who is constantly told they are special or superior may develop unrealistic expectations of themselves and others.
- Genetic and Biological Factors: Research suggests that some individuals may have a genetic predisposition towards developing NPD. Brain imaging studies also suggest that those with NPD may have structural differences in areas of the brain involved in empathy and emotional regulation .
- Cultural Influences: In Western cultures, particularly those that place high value on individual achievement and self-promotion, narcissistic traits can be more pronounced. The rise of social media has also been linked to an increase in narcissistic behaviours .
How NPD Affects Relationships
Narcissistic Personality Disorder can have a devastating effect on personal and professional relationships.
- Romantic Relationships: In romantic settings, a person with NPD may initially idealise their partner, only to later devalue and discard them. The relationship may be characterised by emotional abuse, manipulation, and gaslighting. For instance, a partner may be blamed for the narcissist’s faults or made to feel as though they can never meet expectations.
- Family Dynamics: Within a family, NPD can cause significant strain. Parents with NPD may be controlling and manipulative, creating an emotionally unhealthy environment for children. Children of narcissistic parents often report feeling invalidated and used as extensions of their parent’s own desires.
- Workplace and Social Interactions: In professional environments, those with NPD may struggle with teamwork or respecting the authority of others. Their need for dominance and admiration can lead to conflicts with colleagues and supervisors.
Diagnosing Narcissistic Personality Disorder
NPD is diagnosed based on criteria from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). To receive a diagnosis, individuals must display at least five of the following traits: grandiosity, preoccupation with fantasies of power or beauty, a belief in being ‘special’, a need for excessive admiration, a sense of entitlement, exploitative behaviour, lack of empathy, envy, and arrogant behaviours .
Seeking Help: In Ireland and the UK, a diagnosis of NPD is typically made by a clinical psychologist or psychiatrist. Professionals such as those in the British Psychological Society or the Irish Association for Counselling and Psychotherapy can offer assessments.
Treatment
Treating NPD is challenging, as individuals with the disorder often resist seeking help. However, with the right therapeutic approach, significant improvement can be made.
- Cognitive Behavioural Therapy (CBT): This approach helps individuals identify and change their distorted thinking patterns. It can be useful for managing the grandiosity and entitlement often seen in NPD . Read more on CBT.
- Psychodynamic Therapy: This longer-term therapy explores unconscious conflicts and unresolved childhood experiences. It can help the individual develop healthier relationships and better understand their emotions . Read more on psychodynamic therapy.
- Dialectical Behaviour Therapy (DBT): DBT, which focuses on managing intense emotions, can be particularly effective when treating comorbid conditions such as Borderline Personality Disorder that may overlap with NPD. You can read more about DBT here.
- Family Therapy: Family members affected by a loved one’s NPD can benefit from therapy that helps them set boundaries and navigate their relationship healthily. In the UK, family therapy services such as those offered by Relate can be helpful . Read more on family therapy.
How to Set Boundaries and Protect Yourself
If you are in a relationship with someone with NPD, setting healthy boundaries is essential. Learn to recognise signs of emotional manipulation, and consider seeking support from a therapist. In Ireland, the Irish Council for Psychotherapy offers resources and referrals for individuals affected by personality disorders .
Narcissistic Personality Disorder is a deeply complex and often misunderstood condition. However, with proper diagnosis and treatment, individuals with NPD can learn to manage their symptoms and build healthier relationships. It is important to approach NPD with compassion, recognising that those who suffer from it are often struggling with deep emotional pain.
Frequently Asked Questions (FAQs)
Can someone with NPD change?
Yes, though treatment is often difficult, individuals with NPD can change with consistent therapy.
Is NPD more common in men or women?
Research suggests that NPD is slightly more common in men, but it can affect anyone.
How can I protect myself from a narcissist?
Establish clear boundaries, seek support from trusted friends, family, or a therapist, and recognise when a relationship is causing you harm.
What is the difference between narcissism and NPD?
Healthy narcissism involves self-confidence and positive self-regard, while NPD is a pathological condition that causes significant distress and dysfunction.
References:
- Livesley, W. J. (2018). A Handbook on Personality Disorders. UK: Cambridge University Press.
- Twenge, J. M., & Campbell, W. K. (2009). The Narcissism Epidemic: Living in the Age of Entitlement. New York: Free Press.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Beck, A. T. (1979). Cognitive Therapy and the Emotional Disorders. New York: Penguin Books.
- Bateman, A., & Fonagy, P. (2004). Psychotherapy for Borderline Personality Disorder: Mentalisation-Based Treatment. Oxford: Oxford University Press.
- British Psychological Society. (2022). Personality Disorders – NPD [online]. Available at: www.bps.org.uk
- Bergman, S. (2020). Narcissism and Social Media: A Growing Issue. Journal of Social Psychology, 58(3), pp. 234-246.
- Irish Council for Psychotherapy. (2023). Available at: www.psychotherapycouncil.ie