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Narcissus, as the Greek legend depicted, fell in love with his own reflection. Narcissistic Personality Disorder (or NPD) is a disabling disorder, which affects every part of the sufferer's life and the lives of those around them. It is classified as a Cluster B Personality Disorder in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition DSM-IV (American Psychiatric Association, 1994), and the syndrome is now believed to be much more than simply 'self-love'.
We all possess specific personality traits, or characteristics, which often develop in adolescence and become 'set' by adulthood. However, when they become rigid or unchanging and begin to impact on everyday functioning they can lead to psychiatric symptoms. Individuals with personality disorders often blame other people for their problems, and this is especially true of people with NPD.
According to the DSM-IV these individuals have an extreme sense of self-importance, so much so that they appear to have lost touch with reality. This has been referred to as a 'Delusion of Grandeur'. They are extremely demanding, expecting to be admired and praised for everything they do. There also appears to be a contradiction at work - they have an inflated sense of self-worth but constantly require others to reaffirm this - they believe that they are unique or 'special' and that everyone else must acknowledge this 'fact'.
Other characteristics that are evident among people with NPD include: lack of empathy or feelings for other people, inability to love others (they can be great 'actors' though!), tendency to envy others for their possessions or abilities, tendency to feel bored and restless a great deal of the time, tendency to idolize people they feel they can get praise or justification for their behavior from yet on the other hand they can just as quickly 'drop' these people if they no longer serve their narcissistic purposes, and the fact that many NPD sufferers tend to be intelligent, manipulative, control-freaks who can be outwardly charming on the surface but cruel and cold should the situation or person not meet their very high expectations.
However, in order for a person to be classified as having NPD they must meet at least 5 of the trait profiles as described in the DSM -IV (summarized below - for further details please see the Manual):
(1) a grandiose sense of self-importance - exaggeration of achievements, expectation that people will see their superiority. Whether they have achieved anything to be praised for or not, is not important.
(2) have fantasies of personal success, power, wealth, intelligence, beauty, or ideal love with a submissive partner.
(3) believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people. Therefore they choose their acquaintances for self-purposes.
(4) must have excessive admiration at all times from other people.
(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations. They tend to be the dominant participant in any relationship.
(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her 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 or her.
(9) shows arrogant, haughty behaviors or attitudes. Tend to be very patronizing.
It should also be noted that if the NPD sufferer does not get his/her 'way' they can become violent - shouting or physically lashing out at the people who dispute their 'world view'. Despite their sense of self-importance (believing that they are 'always right') they are very susceptible to criticism - they are easily offended and often feel mistreated. Other behaviors that are apparent include: temper tantrums, verbal lashing-out, and emotional, physical or sexual abuse of those closest to them, plus an inflated tendency to exaggerate.
Also, because they spend so much time looking for praise they can become quickly depressed or show evidence of addictive behaviors. Alcohol and/or drug abuse tends to co-exist with this disorder. The difficulty for therapists is that many persons with NPD will NOT seek therapy - the narcissist will see any attempt to help them change their behaviors or thoughts as a sign of 'weakness', which they, being so 'perfect' couldn't possibly need. Due to generally high intelligence however they are often aware when people begin to withdraw from them and at times have insight into the fact that something 'might be wrong with them'. When this happens however they tend to justify their actions by blaming other people/circumstances.
NPD, although recognized for many years, it was not fully defined until the late 1980s. More studies are necessary in order to fully understand the disorder because no one really knows how widespread it is. Psychiatrists believe however that the majority of sufferers are male and that 5-7% of the population may suffer at any one time. This figure may be a gross underestimate.
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