What Is Narcissistic Personality Disorder?

A narcissistic personality disorder is characterized by a long-standing pattern of grandiose behaviour, an overwhelming need for admiration and usually a complete lack of empathy toward others. 

Narcissists are part of the dark triad, alongside psychopath, sociopaths, (I like to separate these two conditions) plus Machiavellian. They are equally capable of being serial killers. Of course, their portrayal in the media is taken to the extreme but you need to treat them with care and protect yourself.

Narcissists In Relationships.

If you are in a relationship with one, my advice is to leave as quickly and safely as possible. Like psychopaths and sociopaths they will use and abuse you. Then when you are no longer of use they move on to someone else. It is highly likely you have suffered domestic violence at their hands. They will push any boundaries you had in place so subtly you won’t even realize it. They are extremely charming people until they have you where they want you.

People with this disorder often believe they are of primary importance in everybody’s life. Believing they are special and everyone thinks they are unique. They exploit others and take recognition for other’s work. They are arrogant and easily jealous of others, especially if they receive the praise or attention the narcissist believes is theirs.

People with a narcissistic personality disorder often display snobbish, disdainful, or patronizing attitudes. This pattern of behaviour can be linked back to their teen or early adulthood years. But you have to remember it is perfectly normal for children to have some narcissism as a means of survival. Someone can be a narcissist and not have the disorder. They may be self-absorbed and hypercompetitive, but not to the extent that it disrupts their daily life.

Symptoms of Narcissistic Personality Disorder.

In order for a person to be diagnosed with a narcissistic personality disorder (NPD) they must meet five or more of the following symptoms:

1. Has a grandiose sense of self-importance. Exaggerates achievements and talents. Expects to be recognized as superior. Requires one significant other in their life to put down and  blame for any mistake they make.
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believes that they are “special” and unique and can only be understood by/or should associate with other special or high-status people (and/or institutions).
4. Requires excessive admiration. They require at least one significant other in their life to do this.
5. Has a very strong sense of entitlement. Unreasonable expectations of  favourable treatment or automatic compliance with their expectations. With a significant other they may place all the debts in their name and all the assets in their own name.
6. Is exploitative of others. Takes advantage of others to achieve their own ends including taking credit for others work. In a personal relationship, they will con the other person out of their money. Or if in long-term relationship control all income leaving their partner and any children without any income.
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 them.
9. Regularly shows arrogant, haughty behaviours or attitudes.
10. Lies and manipulates to get what they want.

Many professionals use the Narcissistic Personality Inventory. A list of 40 questions that measure things such as how much attention and power someone craves. A narcissistic personality disorder is more prevalent in males than females and is thought to occur in around 6 per cent of the general population.

Like most personality disorders, NPD typically will decrease in intensity with age. With many people experiencing few of the most extreme symptoms by the time they are in their 40s or 50s. But they will probably have added an addiction or other mental health illnesses by then.

How Is NPD Diagnosed?

Because personality disorders are described as long-standing and enduring patterns of behaviour, they are most often diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence because a child or teen is under constant development.

Personality disorders such as NPD are diagnosed by a psychologist or psychiatrist. Who compares their symptoms to the NPD Inventory a list of 40 questions designed specifically to diagnose NPD. Plus they will take a complete a life history from the patient but also from family members.

Causes Of NPD.

There is no laboratory, blood, or genetic tests that are used to diagnose a personality disorder. Researchers don’t know what causes NPD. There are many theories, however, most professionals think it is likely due to:

1. biological and genetic factors,
2. social factors (such as how a person interacts in their early development with their family/friends/other children),
3. plus psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress).

This suggests that no single factor is responsible but it is a complex combination.  

Treatment of Narcissistic Personality Disorder.

People with narcissism generally try to sustain an image of perfection and personal invincibility for themselves and attempt to project that impression on to others as well. As a result many people with this disorder don’t seek out treatment.

In fact it is more likely for their family and friends to seek help instead. Some people may be referred for treatment for other conditions such as addictions or other mental health issues and their NPD may be diagnosed then as a result. Others, who do seek treatment, do so when their coping resources are stretched too thin to deal with stress or other life events.

The goal of therapy.

Treatment of narcissistic personality disorder typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder. There is no cure, but therapy can help. The goal is to build up the person’s poor self-esteem and have more realistic expectations of others.

Medications may also be prescribed to help with specific troubling and debilitating symptoms surrounding other conditions. Like other combinations of mental illnesses, treatment should be individualised and each condition treated as standalone disorders. 

Other forms of therapy include group therapy and hospitalization for severe NDP if necessary. Group therapy (as an outpatient) can provide external structuring, which can control destructive behaviour in spite of ego weakness. In groups, the therapist is less authoritative and less threatening to the patient’s grandiosity. The intensity of the emotional experience is lessened, and regression is more controlled. Creating a better setting for confrontation and clarification.

The hospitalization of patients with severe NLP may occur for those who are quite impulsive or self-destructive, or who have poor reality-testing. This is the result of additional symptoms from a co-existing mental disorder that is overlaid on the personality disorder. In general, hospitalizations should be brief and the treatment specific to the particular symptom involved.

Sometimes long-term residential treatment is needed, for those who have poor motivation for outpatient treatment, fragile object or social relationships, chronic destructive acting-out behaviours, and/or chaotic life-style. An inpatient program can offer an intensive environment, which includes individual psychotherapy, family involvement, and a specialized residential environment.

What Signs Might Your Recognise In Someone With NPD?

All of the above is all very good but let’s get practical here, so what you might see in someone with NPD

1. Think about himself most of the time and talk about himself a lot
2. Crave attention and admiration
3. Exaggerate his talents and achievements
4. Take credit for other people’s work (especially if he’s the boss or he can bully another colleague into accepting this situation)
5. Believe he’s special
6. Set unrealistic goals
7. Have wide, fast mood swings
8. Have a hard time taking others’ feelings seriously
9. Strive to win, whatever it takes
10. Fantasize about unlimited success, money, and power
11. Have an addiction (very common for them to abuse alcohol in particular)

Othe signs you may notice.

Someone like this may appear to have high self-esteem. But in reality, they have a deep sense of insecurity underneath that grand exterior. He wants others to be envious, but he’s the jealous one. He’s competitive and threatened by others’ achievements.

His relationships are often stormy and short-lived. That isn’t to say that they can’t maintain a long-term relationship. But the other person will have issues themselves such as co-dependency and there may be a history of domestic violence also.

He leaves a trail of hurt feelings in his wake. They are easily hurt, but either choose to not show it or overreact in rage. He can’t stand criticism, makes excuses and refuses to take responsibility for his flaws, mistakes and failures often blaming someone else if he can. They sees themself as a natural leader who can easily sway others. He doesn’t listen and often interrupts. It’s a one-way street — all take no give. It’s proven that most people are drawn to narcissists and find them attractive, charismatic, and exciting. (I talk about “he” here but narcissists can be female also.)

How Can You Protect Yourself?

As there is no known cure for narcissism, awareness of what they are and how they behave is your best defence. As I’ve said just like psychopaths they will take advantage of you and leave you when they have everything they need from you. Often leaving a wake of debts in your name (if you have been in a relationship) behind, along with emotional and perhaps physical injuries to be fixed.

If you are in a relationship with them (family member or partner)

I would recommend leaving them as soon as you realise what they are and cutting your losses. You cannot fix them.

Yes, they will turn nasty if you try to leave before they are done with you. So please put in place a safety plan first. You may need a protection/safety order as they will not take no for an answer at first. It isn’t unheard of for people to actually move home and county, or even country, to get away from these people.

If you have set up healthy boundaries you are unlikely to attract such an individual in the first place. But even if you have left this kind of relationship it is never too late to seek help. So find a therapist and begin setting these boundaries up.

Going to court against a narcissist (partner or family member)

1. Be very prepared, I would advise you to engage a solicitor. But also to have everything in place and get all the documentation you need before you let the narcissist know about the solicitor or court details.
2. Talk to Women’s Aid (Ireland, UK), Refuge or Men’s Aid (for men in Ireland), if you need to first. All offer court accompaniment service.
3. Get a safety/protection order in pace. Call the police if they violet this and keep calling.
4. Document everything they do and say.
5. Stick to any custody orders, don’t cave into any charm they might turn on.
6. Don’t be surprised, if you have kids, that they try to use them against you or threaten to take them. Document everything and leave it to your solicitor.
7. Report violations of maintenance orders (will always happen).
8. Never give them the benefit of the doubt, trust your gut.
9. Don’t lose it in front of a judge, let your solicitor deal with the narcissist.
10. Be prepared to get therapy for your sake but also for the kid’s sake, you could have PTSD.

Working with a narcissist.

If you work with a narcissist then look for another job but don’t advertise this fact. Again go as quietly as possible because they will make your life hell if they think losing you will be detrimental to their careers.

What you might expect to see (they will use one or more of the following tactics):

1. They are eager to give their opinion. Even unsolicited, and he believes he is smarter and more insightful than anyone.
2. She likes to lecture but doesn’t like to listen.
3. He sees himself as more important, influential than anyone, has more accomplishments and will exaggerate them to everyone who will listen.
4. He believes he is destined for the highest positions in the company. With his charisma and drive, his achievements may actually match his ambition. But it will probably be on the back of other’s hard work.
5. You may find yourself drawn in and end up admiring him, a person you’d like to submit to and serve.
6. He may manipulate you by making you feel good about yourself. Appearing to admire your work and value your contributions highly. But his goal is to make you feel the same way about him so he can use you. When you have no further use, you are out.
7. She may humiliate her colleagues. Using contempt she will belittle your work and ridiculing you at meetings.
8. She may become threatening when she wants something from you.
9. He will make you doubt yourself and your value to your employer. Slowly your confidence will be eroded.
10. They can also be vindictive and they will try to destroy you once you become their target. You may not even realise what you did or you have challenged her in some way. She’ll attempt to trash your reputation with your employers or co-workers. She will sabotage your work. If she is your boss, she may fire you and also try to ruin your chances of future employment.

How to cope with the narcissist at work: 

1. Ignore her “helpful” suggestions, offer polite thanks and move on.
2. Don’t bother challenging her it will only escalate things and make you an enemy you don’t need. You will feel tempted especially when they act superior. But a direct challenge will only escalate her brutal assault on your personality and work.
3. Like with any other colleague be open to her views. You can still do it your way, but she could have a valid point.
4. It also helps to have a sense of humour and a very strong belief in your own self-worth. If you don’t, get therapy and work on building your healthy boundaries.
5. Be careful not to give too much. He won’t feel grateful and will do nothing to advance your own career.
6. Don’t be swayed by flattery or excessive admiration.
7. Watch how she treats other people who can’t advance her career or who may be her rivals.
8. You might want to transfer to a different department or look for another job before the damage to your psyche and your reputation has gone too far.
9. You may need to go legal. They know how to disguise their true nature from people other than their victims. So you will need hard evidence. Document everything: proof of your work; toxic emails and other communications; get witness statements from your co-workers.

Work With Me.

Remember you are allowed to ask for support. No one is an island. In fact I would strongly advice you make sure you create a positive support system before you start to make any changes in your life. One part of that positive support system is working a therapist.

If you need extra support then you can also work with me. We all struggle with stress and overwhelm from time to time. If you find this has become a problem for you and you’d like some support then schedule an appointment with me.