BY SIMONE J. SMITH
“Narcissism.” The word rolls off our tongues with alarming frequency these days. It’s become the trendy diagnosis, a label slapped on anyone who seems a bit too confident, a bit too self-absorbed, but are we truly understanding the nuances of narcissistic personality disorder (NPD), or are we simply using it as a catch-all for anyone who rubs us the wrong way?
This week, I delve deeper. I will explore the fine line between healthy self-esteem and the dangerous territory of self-importance. I attended a lecture by renowned psychologist Igor Weinberg, PhD, and he provided invaluable insights, breaking down the complexities of NPD while challenging the stigma that shrouds this disorder.
Dr. Weinberg addressed critical questions: How do we distinguish between genuine confidence and the inflated ego characteristic of NPD? What are the real-world impacts of these differing self-perceptions, and most importantly, how can we navigate relationships with individuals who may be struggling with this disorder?
I took the time to meticulously research the questions posed by other attendees at Dr. Weinberg’s lecture; today, I will be providing valuable answers and guidance for those who suspect a loved one may be grappling with NPD. Join me as we shed light on this often-misunderstood condition and gain a deeper understanding of ourselves and those around us.
Narcissism refers to feelings and attitudes towards one’s own self. It is the core of self-esteem and emotions, which influence the way one perceives and relates to others.
One thing that needs to be cleared up is that we all have some narcissistic tendencies. Normal narcissism involves a healthy, positive sense of self-worth and self-regard with self-acceptance, curiosity, and compassion, including pride and enjoyment. Interpersonally, healthy narcissism motivates regard and connection with others, as well as reciprocal sharing with genuine interest in others’ thoughts and feelings, (i.e., commitment and empathy). It promotes an ability to handle challenging situations; to tolerate both criticism and defeats, as well as self-conscious emotions, such as shame, envy, humiliation, frustration, and guilt.
Then, there is an unhealthy narcissism, which is what many of you have come here to understand. Pathological narcissism differs from normal, healthy, or exaggerated narcissism foremost because of fluctuating, or dysregulated self-esteem and emotions. People struggling with pathological narcissism make considerable efforts to enhance themselves to protect and support a special, or amplified, but at the same time, fragile or negative sense of self. They strive to avoid threats and inferiority caused by adverse feelings and experiences, especially reflecting upon the self. Interpersonal closeness and intimacy are usually impaired due to compromised genuine interest in others’ experiences, or reactions, except when it is important for one’s own concerns or gains.
Self-centeredness and the need for personal benefits are additional predominant features. Empathy, including attention to and ability to identify with others’ feelings and needs, is impaired and accompanied by misjudgments of own influence on others. When the level of pathological narcissism is less severe, triggered in certain situations, or limited to a set of specific character features (something that I personally deal with), it is referred to as narcissistic pathology, or narcissistic traits.
The diagnostic term NPD refers to a stable long-term personality functioning that meets the DSM-5 section II, or III criteria for NPD or any other comprehensive diagnostic description. Just to bring everyone up to speed, The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is a comprehensive guide used by mental health professionals to diagnose mental disorders.
According to the DSM-5 section II, striking characteristics of NPD include: self-enhancement and self-centeredness, with interpersonal insensitivity and critical, competitive, or provocative behavior, along with compromised ability for commitment, collaboration, closeness, and mutuality.
The manual also speaks to the fact that NPD has a genetic origin with inherited hypersensitivity, low frustration tolerance, compromised emotion tolerance, and regulation. Early interactions between child and caregivers are influenced by overprotection, leniency, and overvaluation, or alternatively by: inconsistency, dismissiveness, and unreliability.
Both clinical and empirical studies have confirmed that: emotional distress, interpersonal vulnerability, a sense of inadequacy, need for control, avoidance, and fear, pain, shame, and anxiety are important facets of narcissistic personality functioning.
For some patients, the possibility of confirming narcissistic pathology, or receiving the NPD diagnosis when starting treatment can be extremely challenging and evoke deep shame and hopelessness. Others may have deeply rooted negative experiences or trauma that caused the development of narcissistic pathological functioning, and it may take significant time of building alliance and trust until those can be accessible to process in psychotherapy.
A flexible, nonjudgmental, collaborative, and exploratory treatment approach, adjusted to the individual patient’s: functioning, motivation, and degree of self-awareness and self-reflective ability, is strongly recommended. It is necessary to balance patients’ urges to reject and devalue the therapist and drop out of treatment with efforts to encourage and support them to face, explore, and reflect upon their own experiences and behavior.
There is so much to be said about this topic, but for my readers remember that you are not alone. Dealing with someone who has NPD can be incredibly challenging. Prioritize your own well-being. Establish and maintain healthy boundaries. Seek support from friends, family, or a therapist. Educate yourself about NPD to better understand the dynamics at play. Focus on self-care and nurture your own needs. Remember, you deserve to be treated with respect and dignity.
REFERENCES:
https://www.mcleanhospital.org/video/dbt-skills-value-validation
https://www.mcleanhospital.org/video/narcissistic-personality-disorder
https://www.mcleanhospital.org/npd-provider-guide
https://www.mcleanhospital.org/video/it-self-esteem-or-self-importance-exploring-narcissistic-personality-disorder?hsCtaTracking=af60afa0-8d6d-458d-8bbf-88225a8eb3fe%7C89619a95-df79-420f-a553-ecdec8643fbd