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Narcissistic Personality Disorder
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Posted on Thu, Oct 06, 2005 14:46

FROM THE WEB

What is a personality disorder?

[from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994, commonly referred to as DSM-IV, of the American Psychiatric Association. European countries use the diagnostic criteria of the World Health Organization.]

An enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.

A personality disorder is a pattern of deviant or abnormal behavior that the person doesn't change even though it causes emotional upsets and trouble with other people at work and in personal relationships. It is not limited to episodes of mental illness, and it is not caused by drug or alcohol use, head injury, or illness. There are about a dozen different behavior patterns classified as personality disorders by DSM-IV. All the personality disorders show up as deviations from normal in one or more of the following:
(1) cognition -- i.e., perception, thinking, and interpretation of oneself, other people, and events;
(2) affectivity -- i.e., emotional responses (range, intensity, lability, appropriateness);
(3) interpersonal functions;
(4) impulsivity.

Narcissistic Personality Disorder

While grandiosity is the diagnostic hallmark of pathological narcissism, there is research evidence that pathological narcissism occurs in two forms, (a) a grandiose state of mind in young adults that can be corrected by life experiences, and (b) the stable disorder described in DSM-IV, which is defined less by grandiosity than by severely disturbed interpersonal relations.
The preferred theory seems to be that narcissism is caused by very early affective deprivation, yet the clinical material tends to describe narcissists as unwilling rather than unable, thus treating narcissistic behaviors as volitional -- that is, narcissism is termed a personality disorder, but it tends to be discussed as a character disorder. This distinction is important to prognosis and treatment possibilities. If NPD is caused by infantile damage and consequent developmental short-circuits, it probably represents an irremediable condition. On the other hand, if narcissism is a behavior pattern that's learned, then there is some hope, however tenuous, that it's a behavior pattern that can be unlearned. The clinical literature on NPD is highly theoretical, abstract, and general, with sparse case material, suggesting that clinical writers have little experience with narcissism in the flesh. There are several reasons for this to be so:
-- The incidence of NPD is estimated at 1% in the general population, though I haven't been able to discover the basis of this estimate.
-- Narcissists rarely enter treatment and, once in treatment, progress very slowly. We're talking about two or more years of frequent sessions before the narcissist can acknowledge even that the therapist is sometimes helpful. It's difficult to keep narcissists in treatment long enough for improvement to be made -- and few people, narcissists or not, have the motivation or the money to pursue treatment that produces so little so late.
-- Because of the influence of third-party payers (insurance companies), there has been a strong trend towards short-term therapy that concentrates on ameliorating acute troubles, such as depression, rather than delving into underlying chronic problems. Narcissists are very reluctant to open up and trust, so it's possible that their NPD is not even recognized by therapists in short-term treatment. Purely anecdotal evidence from correspondents and from observations of people I know indicates that selective serotonin-reuptake inhibitors, such as Prozac, aggravate narcissists' grandiosity and lack of social inhibition. It has also been suggested that self-help literature about bolstering self-esteem and getting what you want out of life or that encourages the feeling of victimization has aggravating effects on NPD thinking and behavior.
-- Most clinical writers seem unaware that narcissists' self-reports are unreliable. This is troubling, considering that lying is the most common complaint about narcissists and that, in many instances, defects of empathy lead narcissists to wildly inaccurate misinterpretations of other people's speech and actions, so that they may believe that they are liked and respected despite a history of callous and exploitative personal interactions.

[from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994, commonly referred to as DSM-IV, of the American Psychiatric Association. European countries use the diagnostic criteria of the World Health Organization.]

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy.[jma: NPD first appeared in DSM-III in 1980; before that time there had been no formal diagnostic description. Additionally, there is considerable overlap between personality disorders and clinicians tend to diagnose mixes of two or more. Grandiosity is a special case, but lack of empathy and exploitative interpersonal relations are not unique to NPD, nor is the need to be seen as special or unique. The differential diagnosis of NPD is made on the absence of specific gross behaviors. Borderline Personality Disorder has several conspicuous similarities to NPD, but BPD is characterized by self-injury and threatened or attempted suicide, whereas narcissists are rarely self-harming in this way. BPD may include psychotic breaks, and these are uncharacteristic of NPD but not unknown. The need for constant attention is also found in Histrionic Personality Disorder, but HPD and BPD are both strongly oriented towards relationships, whereas NPD is characterized by aloofness and avoidance of intimacy. Grandiosity is unique to NPD among personality disorders, but it is found in other psychiatric illnesses. Psychopaths display pathological narcissism, including grandiosity, but psychopathy is differentiated from NPD by psychopaths' willingness to use physical violence to get what they want, whereas narcissists rarely commit crimes; the narcissists I've known personally are, in fact, averse to physical contact with others, though they will occasionally strike out in an impulse of rage. It has been found that court-ordered psychotherapy for psychopaths actually increases their recidivism rate; apparently treatment teaches psychopaths new ways to exploit other people. Bipolar illness also contains strong elements of grandiosity. See more on grandiosity and empathy and its lack below.]The disorder begins by early adulthood and is indicated by at least five of the following:

Translation: Narcissistic Personality Disorder (NPD) is a pattern of self-centered or egotistical behavior that shows up in thinking and behavior in a lot of different situations and activities. People with NPD won't (or can't) change their behavior even when it causes problems at work or when other people complain about the way they act, or when their behavior causes a lot of emotional distress to others (or themselves? none of my narcissists ever admit to being distressed by their own behavior -- they always blame other people for any problems). This pattern of self-centered or egotistical behavior is not caused by current drug or alcohol use, head injury, acute psychotic episodes, or any other illness, but has been going on steadily at least since adolescence or early adulthood.
NPD interferes with people's functioning in their occupations and in their relationships:
Mild impairment when self-centered or egotistical behavior results in occasional minor problems, but the person is generally doing pretty well.
Moderate impairment when self-centered or egotistical behavior results in: (a) missing days from work, household duties, or school, (b) significant performance problems as a wage-earner, homemaker, or student, (c) frequently avoiding or alienating friends, (d) significant risk of harming self or others (frequent suicidal preoccupation; often neglecting family, or frequently abusing others or committing criminal acts).
Severe impairment when self-centered or egotistical behavior results in: (a) staying in bed all day, (b) totally alienating all friends and family, (c) severe risk of harming self or others (failing to maintain personal hygiene; persistent danger of suicide, abuse, or crime).

1. An exaggerated sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

Translation: Grandiosity is the hallmark of narcissism. So what is grandiose?

The simplest everyday way that narcissists show their exaggerated sense of self-importance is by talking about family, work, life in general as if there is nobody else in the picture. Whatever they may be doing, in their own view, they are the star, and they give the impression that they are bearing heroic responsibility for their family or department or company, that they have to take care of everything because their spouses or co-workers are undependable, uncooperative, or otherwise unfit. They ignore or denigrate the abilities and contributions of others and complain that they receive no help at all; they may inspire your sympathy or admiration for their stoicism in the face of hardship or unstinting self-sacrifice for the good of (undeserving) others. But this everyday grandiosity is an aspect of narcissism that you may never catch on to unless you visit the narcissist's home or workplace and see for yourself that others are involved and are pulling their share of the load and, more often than not, are also pulling the narcissist's share as well. An example is the older woman who told me with a sigh that she knew she hadn't been a perfect mother but she just never had any help at all -- and s...



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Posted on Thu, Aug 16, 2012 17:51

Before my last 2 1/2 yr relationship I never new anything about a real Narc, but here I am over a yr after he took EVERYTHING from me and I am just now learning to live again and maybe trust someone again.I allowed this person to do the things he did because I WAS in love he wasn't. I hope that I will now be able to reconize the signs I could not before. Be very careful, I was blindsided after the passing of my husband of 31 yrs, this man swept me off my feet when I was the most vunerable to allowing something like him to take over my life. I thank god for the strengh to get past all that. Please everyone pay attention to who you let into your lives. Do Not dismiss even the littlest warning sign it could me your life.



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Posted on Sun, Sep 21, 2008 09:27

I was raised by someone afflicted with this disorder, and it was never her that had a problem lol I did all the time in councelling for her. It was horrible. The social worker would ask for her to come in and see him and she would break down into dramatic tears. I've had to break off total contact with her to heal.



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Posted on Sun, Aug 17, 2008 00:56

I will not visit the forums very often, but I hope you folks will keep some of the important personality disorder threads alive because it is really important to know about some of these people and how they can disrupt your lives.



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Posted on Sun, Jul 06, 2008 00:09

I think the importance of this discussion pertains to the website because people are looking for meaningful relationships. A relationship with a narcissist proves very difficult. First of all, should you provoke narcissistic injury, your partner will not be able to handle the criticism as it does not fit their self-image. As a result, they will become overly defensive and very punitive. Their reaction to the "crime" will be way out of context and overly harsh for the offense. This will cause emotional injury and one of the only ways to get back into the narcissist good graces is to take all the blame and mirror the image that they need, all positive, to keep themselves intact. They lack empathy for others, and are not able to look at the others point of view which is one of the reasons you walk on eggshells and risk abandonment for minor infractions according to "normal" people.



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Posted on Tue, Oct 23, 2007 02:43

you are brilliant. thank you for sharing all this.



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Posted on Sun, May 06, 2007 09:24

illumin8me write:
Sam Vakin's Malignant Self Love is the best book on the subject. He, himself, is a "recovered" NPD and has devoted a lot of time to helping those who are and who are involved with or were involved with. A very tedious, draining, exhausting affair I just ended. Will never be the same.

Re:




I tried to date one also and your description "tedious, draining, exhausting" applied to my case also. I never knew anyone who had so many demands, and I also never knew that there could be so many things wrong with me. That is when I started reading about the narcissistic. I am sure glad I escaped intact, but I can see how they could destroy many people, especially people that stand in their way.



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Posted on Sun, Jan 28, 2007 18:02

Sam Vakin's Malignant Self Love is the best book on the subject. He, himself, is a "recovered" NPD and has devoted a lot of time to helping those who are and who are involved with or were involved with. A very tedious, draining, exhausting affair I just ended. Will never be the same.

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Posted on Fri, Jan 26, 2007 22:04

Hi there 4 W's

I was actually reading a 'Paper' in this regard the other day.

I always just thought it intense vanity but is actually a real mental illness.

I was reading it after one of my close friends had been 'dumped' by her boyfriend.

He projected many of the traits mentioned in the 'Paper' and after my friend read it, she found it so much easier to deal with the break-up.

It would seem that it is usually attached to another mental illness and therefore, often difficult to diagnose because of this duality of illnesses.

I think CBT may help but would take a lot of work and of course, it would all be about changing thoughts.

Obviously a big problem is for the sufferer to recognise and acknowledge their illness.



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Posted on Wed, Oct 04, 2006 02:40

Kinda like a drug to them. This is all about SELF CONTROL thats it. period



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Posted on Wed, Oct 04, 2006 02:34

Cause im your mississippi princess im your california queen. i'll stay alive just to follow you home

love,
haven



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Posted on Sun, Aug 27, 2006 08:57

Mr. 1234,
Thanks for the NPD post..I have been dealing with one a work, a male, and it gets very tiring very quickly..administration can't find a way to fire him despite all the ammo I've given them..now he is going to school to get his Master's in Social Work and he will be much worse when he returns to work..I speculate that on any given dating website that there are many people with mental illness and disorders...all behavior is goal oriented and some may have their goals met on these dating sites.......thanks for the posting....it's refreshing to get the intellectual stimulation!



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Posted on Tue, Aug 22, 2006 10:39

Thank you so much for the insight into this behavior. I would like to forward the title of a wonderful book I read that allowed me to become stronger after a two-year relationship with a diagnosed Narcissist--"The Manipulative Man", by Dorothy McCoy, Ed.D. This book will give any of you the ability to see manipulative behaviors as well as give you inner strength. Knowledge really is power.



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Posted on Mon, Jun 26, 2006 16:26

Narcisstics are found in a variety of mental problems...neurosis, psychosis, etc...the DSM is a good introduction bible, but it has the tendency to be heterogenous in it's statements, i.e., too much standardized statements...so it has to be taken with a critical mind...The foundation of understanding (in a different approach) narcissism is first fragility of the self...for a variety of reasons also here...(abuse, traumas, etc), then it only depends what the person does with it...As for all disorders, there is a simple (but very few know that) thing to awknowledge: what the person wants to do with the issue: continuing to hurt others/oneself with it...or taking care of it...Only when the trauma has been too much, resilience is not anymore possible...but still...we can hope..because there are still researches to find new ways of cure...called in a way: the limits of cure...(i.e.: beyound the limits...i



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Posted on Thu, Jun 22, 2006 19:14

ClassyTxLady write:
That's what I had heard, also. Kind of like a 12-step program ... you have to realize there is a problem before you can begin to change!

My observations are that a narcissistic loves being that way and that it isn't a problem for them at all. -- It's just a problem for everyone that knows them or that has to deal with them in any way.



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Posted on Fri, Mar 10, 2006 21:04

That's what I had heard, also. Kind of like a 12-step program ... you have to realize there is a problem before you can begin to change!



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Posted on Fri, Mar 10, 2006 19:49

ClassyTxLady write:
WWWwwwwwww's -

Do you believe NPD is treatable/curable?

I have been told by a professional in the area that it is not treatable and probably not curable. I have never known one that even wanted to change.

wwww



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Posted on Thu, Feb 23, 2006 21:22

WWWwwwwwww's -

Do you believe NPD is treatable/curable?



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Posted on Wed, Feb 15, 2006 22:49

Glad you enjoyed the info. I really think everyone needs to study personality disorders and many are treatable if one becomes aware.



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Posted on Thu, Feb 02, 2006 16:49

wwwwwwwwwwwwwwwww -

This is my first post, so if you don't mind I just HAVE to say:

Excellent article & extremely important information for everyone out there to be aware! I just wish I had known such a "condition" existed before I met my ex! He is a textbook case of a "Cerebral Narcissist" ... and the havoc he created, as well as the chaos he seemingly THRIVED on, were amazing! He was misdiagnosed as Bi-Polar ... the diagnosis never did quite fit ... and the meds never helped ... so when a friend turned me onto a book call "Malignant Self-Love" - OH, what an eye-opener!!! I saw my life, there in print! (SOOOOO thankful I was strong enough and wise enough to walk away...)

Anyway - thank you for putting the info out there ... you have performed a GREAT public service!

  


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