Love Thyself but not too much Narcissistic Personality Disorder

On Monday, I posted about the normal-ish side of narcissism. It's considered a continuous personality trait, which means some of us have less, some more, but we all fall somewhere along the continuum. Today, I'm going to talk about folks who fall on one of the extreme ends of that spectrum--those with narcissistic personality disorder.

If you read my quick-and-dirty guide to personality disorders, you'll remember that narcissistic personality disorder falls into Cluster B: those marked by a high degree of drama and emotionality. According to the DSM-IV, narcissistic personality disorder is a pervasive pattern of grandiosity and need for admiration as evidenced by at least five of the following symptoms:

1. grandiose sense of self-importance (for example, expects to be recognized as superior without achievements to match)
2. preoccupied with fantasies of unlimited success, power, beauty, or ideal love
3. believes he/she is unique and special, and should only associated with people of higher status
4. requires excessive admiration
5. takes advantage of others to achieve his/her own ends
6. lacks empathy: is unwilling to recognize the feelings and needs of others
7. is envious of others and believes others are envious of him/her
8. shows arrogant, haughty behaviors and attitudes

To be considered a disorder, these symptoms have to manifest across situations and settings, MUST cause clinically significant distress (in this case ... usually for others) in one or more important areas of functioning, and can't be better accounted for by another mental disorder (bipolar disorder, for example, as individuals in a manic state can sometimes be quite grandiose). Narcissistic personality disorder can, however, be diagnosed along with a primary psychiatric disorder such as depression or substance dependence.

Risk factors for this disorder include things like learning manipulative behaviors from parents, unpredictable or unreliable caregiving, lack of affection and praise as a child, and being neglected or abused. If you learn early on that vulnerability is unacceptable, you might grow a pretty thick emotional shell, thick enough to keep you from recognizing and empathizing with others. However--remember my post about multifinality? Lots of people experience these things and don't turn out to have this disorder.



There are plenty of individuals with narcissistic personality disorder depicted in movies/television. How about this guy?

Dr. Christian Troy of Nip/Tuck via fanpop.com

Christian Troy was a pretty classic case. As far as I can recall. I believe he might have exhibited every single symptom in the DSM-IV criteria, and there was no doubt his behaviors caused a clinically significant amount of distress, both for himself and for many others. He showed the classic pattern of strong first impression that deteriorates quickly once you get to know him a bit, and short-term relationships as the norm.

Can you think of other movie or book characters who have this disorder? What tips you off? And how about real life? Have you ever had someone like this in your life? Do you recognize any of these qualities in yourself?

This week for the Sisterhood of the Traveling Blog, Lydia answers the question "If you’re querying now, or have in the past, how do you develop patience to wait for responses?" Go see what she has to say!