An Assessment of Narcissistic Personality Disorder Essay Example

of Echo but her sad, pleading voice. Narcissus thought the image in the water was real and pined away with desire, eventually transforming into the flower that bears his name. He gazed into a pool of water and ironically fell in love with and became obsessed with his own reflection.Narcissus thought the image in the water was real and pined away with desire, eventually transforming into the flower that bears his name (Millon & Davis, 2000). Like Narcissus, the narcissist seems to be unaware of the intensity of his or her own self-love and how it affects the lives of others. Regardless, it is the primary sense of insufficiency that is the actual problem of the narcissist—the grandiosity is just a front used to mask profound feelings of inadequacy.

The DSM-IV (2000) lists nine features of diagnostic criteria for Narcissistic Personality Disorder.It must begin by early adulthood and present, in a range of conditions, as specified by five or more of the following: 1. Grandiose sense of self-importance; 2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love; 3. Believes he is ‘special’ and unique and can only be understood by, or should be associated with, other special or high status people (or institutions); 4. Requires excessive admiration; 5.

Has a sense of entitlement—unreasonable expectations of especially favorable treatment or of automatic compliance with his expectations; 6.Is interpersonally exploitive—takes advantage of others to achieve his own ends; 7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others; 8. Is often envious of others or believes that others are envious of him; 9. Shows arrogant, haughty

behaviors or attitudes. The process of distinguishing between two or more disorders with similar or overlapping signs and symptoms is called differential diagnosis.

In order to do this, the differences in the characteristic features of disorders must be found.The differential diagnosis of Narcissistic Personality Disorder includes other Personality Disorders, Obsessive-Compulsive Personality Disorder, mania or hypomania, and personality change caused by a general medical condition (Abel et al. , 2001). Narcissistic Personality Disorder is distinguished by thoughts and actions that show a sense of uniqueness, often engaged with lack of understanding for others, who may be used as items rather than as fellow human beings with feelings and needs. Narcissists are intolerably arrogant and superior; they are so full of themselves that they get lost in fantasies of having fearsome owers, infinite riches, superior brilliance, unlimited success, fame, etc. They may try to solely identify themselves solely with important people or prestigious institutions.

Not only do they believe they are better than everyone else, but they also hold others in contempt for being “inferior” or even just average (Millon & Davis, 2000). They seem to believe that the people who are given the “honor” of socializing with them should, in exchange for that honor, anticipate their every need, and be given unreasonable, special priority treatment. Narcissists are envious of anyone who is more successful than they are.The attitude of entitlement leads to exploitation of others, resulting in little, if any, guilt or remorse (Abel et al.

, 2001). Narcissists are extremely sensitive to personal criticism, yet they themselves are extremely critical of other people. Interpersonal relationships are usually hurt due to these personality traits. To have

a relatively smooth relationship with a narcissist, one must keep a distance, both physically and emotionally, from these self-absorbed people—once the narcissist knows someone is emotionally attached to them, they expect to be able to use them any way they choose to.Eventually, everyone around the narcissist is bound to become a victim.

People are sucked up, voluntarily or involuntarily, into the turbulence that constitutes his life. Narcissists are often spiteful and unforgiving. Often they stalk and harass those they are angry with or against in any way. So while it is possible to get along with narcissists, but it is probably not worth bothering with in the end.

The prognosis is variable. Milder forms of the disorder may actually improve with time, maturity, and events such as enjoyable jobs or marriages.Unfortunately, the more severe forms are associated with both occupational and interpersonal failure. These failures may then intensify the symptoms, causing the situation to only get worse (DSM-IV, 2000). Due to the lack of studies, what causes Narcissistic Personality Disorder is difficult to determine with certainty.

Several schools of thought have come up with possible causes that can be divided into environmental and/or biological causes. Many psychologists and psychoanalysts believe the causes of Narcissistic Personality Disorder are rooted in childhood.It is said that “Narcissism breeds Narcissism”, meaning that the parents of a now-adult narcissist also had or still have the disorder themselves. In Narcissistic Personality Disorder, parents tend to be over-demanding and very judgmental. They see their child as an extension of themselves who must be talented or special in some way; they do not see the child as its own person, but as a

reflection of themselves. It seems as if nothing the child does will ever be good enough (Vaknin, 1996).

However, researchers have also found evidence supporting just the opposite.Over-indulgent parents who provide indiscriminate praise and parents who do not set limits as to what is appropriate in their child’s behavior can also produce narcissists. Inconsistency appears to be the message here—if a child does not know where to turn for guidance or how to behave properly, they do not know what is reality and what is fantasy (Vaknin, 1996). For any solid answers, though, further studies as to whether such a childhood environment is specific to Narcissistic Personality Disorder or not will be vital.

A genetic cause is believed by some scientists. These researchers think that Narcissistic Personality Disorder is passed via a high-frequency recessive gene. In lay terms, this means that both parents have the recessive gene; in other words, both parents have the recessive gene. The likelihood for their children to develop the disorder increases. Like the childhood environment, further research needs to be carried out with this theory. Well-controlled studies of Narcissistic Personality Disorder have not been completed.

Estimates are that the prevalence for the general population is below 1%. In the clinical population, mainly outpatient settings, the prevalence is much higher, ranging from 2% to 16%. Prevention for this disorder is unknown because the exact cause is not known (Abel et al. , 2001). Males make up 75% of those diagnosed as narcissists. Female and male narcissists differ in two ways: the manifestation of their narcissism, and the way they react to treatment (Vaknin, 1996).

Women concentrate on their bodies in manifestation.They show off

and take advantage of their sexuality, their physical charms, and their socially and culturally determined femininity. Men are likely to emphasize intellect, power, money, aggression, or social status. Women are more prone to turn to treatment because in general, women are more likely to acknowledge their psychological problems and they are more likely to ask for or seek help. But, while men may be less liable to reveal or bare their problems, it does not necessarily mean that they are less likely to acknowledge it to themselves.The key rule of narcissism cannot be forgotten: the narcissist uses anything available to him to obtain the “Narcissistic Supply” (Vaknin, 1996).

Forms of this supply are adoration, admiration, approval, attention, etc. As long as the narcissist gets attention, positive or negative, and if they can manipulate or influence others, again, positively or negatively, it constitutes narcissistic supply. The ideal source (person) of this supply is adequately intelligent and gullible, reasonably but not overly submissive, inferior, available (but not outstanding), interchangeable, not manipulative, and undemanding.The narcissist will often lose interest suddenly in a source of supply; this happens for several reasons. For example, the narcissist would not want to belong to a club that will accept him as a member. Or, the narcissist resents his dependence on the supply, so he will begin devaluing that object of dependence to get rid of his discord.

And then sometimes narcissists just get tired of their sources—this usually happens when he gets used to the source and its stimulating effects wear off, or a better source becomes available (Vaknin, 1996).Old sources of narcissistic supply are sought out when the narcissist has absolutely

no other sources at his disposal, recycled and used in desperate situations. As long as he can provoke emotions in someone, old or new source, friend or foe, that person is a supplier for a narcissist, regardless of which emotions. The narcissist rarely feels sorry for what he does to his victims (Vaknin, 1996).

The narcissist hates love—however and wherever shown (Vaknin, 1996). Loving someone means knowing that person intimately.The narcissist likes to think that he is so unique that no one can ever really value him; he believes that he is above mere human understanding and empathy; he is one of a kind in his mind. To say to him, “I love you” means to disagree with this feeling, to try to pull him to the lowest common denominator, disturbing his sense of rareness, thus provoking in him uncontrollable rage.

Since the narcissist knows that he is a phony, he therefore assumes that the person who claims to love him is either lying or a dependent, unsophisticated individual, incapable of recognizing the truth.The narcissist cannot accept the possibility that he has chosen either a liar or an imbecile for a companion. The Narcissistic Personality Disorder is possibly the most unbearable of the Personality Disorders. Their vast unawareness, their certainty that they have supreme intellect and celebrity, and their degradation of the “simple” humans who occupy the planet make narcissists unbearable as family members, partners, coworkers, and acquaintances. They are noted for their sense of entitlement and successive lack of compassion concerning others.

This makes close relationships virtually unattainable, as others are seen not as partners or peers, but as appendages of the narcissist’s ego. Often

narcissists make a good first impression, but others quickly consider them egotistical and conceited. They are also very thin-skinned to assumed slights and often seek a close circle of admirers who will adore them (Millon & Davis, 2000). Narcissists share outer similarities with histrionic, antisocial, paranoid, and sadistic personalities. They experience less anxiety disorders than some other personalities, but still may develop social phobias and obsessions.

They may also experience of depression. A common problem is substance abuse; it is a way to numb their awareness of events that infringe on their sense of self-worth. Narcissists substitute imagination and dreams for reality; their past, present, and future are adorned by these dreams, all adding to their brilliance (Millon & Davis, 2000). Over time, milder forms of the disorder may improve with time and maturity, but without thorough and lengthy treatment, the prognosis is very poor for the narcissist.