What is Narcissistic Personality Disorder – An In-depth Analysis

Narcissistic Personality Disorder (NPD) is a mental health condition that manifests as an inflated sense of self-importance, lack of empathy, and a great need for admiration.

This disorder involves a pattern of self-centered, arrogant thinking and behavior, often resulting in problematic relationships and interactions. In this post we will seek to understand what narcissistic personality disorder is exactly, and the implications for the person who has this condition and the people around them.

narcissistic personality disorder diagnosis

The Psychiatric Definition and Diagnostic Criteria for Narcissistic Personality Disorder

A good place to start when trying to understand what narcissistic personality disorder is, are the diagnostic criteria for Narcissistic Personality Disorder (NPD). These are defined by the American Psychiatric Association in their Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

According to the DSM-5, a person must meet five or more of the following symptoms to be diagnosed with NPD:

  1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
  2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
  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 (or institutions).
  4. Requires excessive admiration.
  5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
  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 others are envious of him or her.
  9. Shows arrogant, haughty behaviors or attitudes.

In addition to these criteria, some studies suggest there may be subtypes of Narcissistic Personality Disorder.

For instance, some patients may exhibit more characteristics of grandiosity, while others may display more vulnerability or sensitivity.

These subtypes may require different therapeutic approaches.

narcissistic personality disorder

Development of Narcissistic Personality Disorder

The development of Narcissistic Personality Disorder (NPD) is a complex process that involves a combination of genetic, environmental, social, and psychological factors.

It’s important to note that while we can identify common factors associated with the development of NPD, the exact cause remains unknown, and it can vary greatly from person to person.

Genetic Factors

There’s evidence to suggest that personality disorders such as NPD may have a genetic component.

This means that if a person has a close family member, such as a parent or sibling, with NPD, they may be more likely to develop the disorder themselves.

Environmental Factors

The environment in which a person grows up can play a significant role in the development of NPD.

For example, children who are excessively pampered or whose parents have high expectations and push them to excel at all costs may be at risk.

On the other hand, children who experience neglect, abuse, or extreme criticism may also develop NPD as a coping mechanism.

Social Factors

Societal and cultural influences can contribute to the development of NPD. Living in a society that values individual success and achievement above all else can foster narcissistic traits.

Psychological Factors

Certain personality and temperamental traits may predispose a person to develop NPD. These can include a low tolerance for frustration, a tendency to be competitive and ambitious, and a disposition towards aggression.

The development of NPD typically begins in early childhood or adolescence and continues into adulthood. It’s often a gradual process that becomes more apparent as the individual ages. However, the severity and expression of symptoms can vary widely among individuals with the disorder.

Understanding the Behavioral Patterns of Narcissistic Personality Disorder

Narcissistic Personality Disorder significantly influences a person’s thoughts, behaviors, and their interactions with others.

Here are some common behaviors associated with Narcissistic Personality Disorder, along with practical examples:


Grandiose Sense of Self-importance

Individuals with Narcissistic Personality Disorder often have an inflated sense of their own importance.

They may exaggerate their achievements or talents and expect recognition even when it is not deserved.

For example, they may insist on having the best of everything – the best car, house, or job, even if these claims are not based in reality.

Preoccupation with Power, Beauty, or Success

People with this disorder are often preoccupied with fantasies about success, power, beauty, or the perfect mate.

They may spend an excessive amount of time fantasizing about achieving power or success, or they might be overly focused on their physical appearance.

Sense of Entitlement

Those with Narcissistic Personality Disorder typically have a sense of entitlement and unreasonable expectations of favorable treatment.

They may expect others to go out of their way to help them or may expect special treatment because of their perceived superior status.

Manipulative Tendencies

They may use others to achieve their own ends. They can be manipulative and ignore the wants and needs of others.

For instance, they might take credit for someone else’s work or disregard the feelings of others if it benefits them.

Lack of Empathy

One of the most characteristic behaviors of people with NPD is their lack of empathy. They often have difficulty recognizing the desires and feelings of others.

This can manifest as dismissiveness towards others’ feelings, or an inability to understand why someone would be upset by their actions.

Need for Constant Attention and Admiration

Narcissists have a deep need for admiration and attention. They require constant praise and validation.

As a result they constantly try to steer conversations back to themselves or become upset if they are not the center of attention.

What is the Impact of Narcissistic Personality Disorder?

Narcissistic Personality Disorder can have a profound impact on both individuals with the disorder and those around them.

The effects can be wide-ranging, touching every aspect of a person’s life, from relationships to work performance and overall mental health.


Personal Impact

On a personal level, individuals with NPD often struggle with maintaining healthy relationships.

Their excessive need for admiration and lack of empathy can cause significant distress in their interpersonal interactions.

They also find it difficult to understand or appreciate the perspective of others, leading to conflicts and strained relationships.

Furthermore, individuals with Narcissistic Personality Disorder are often dissatisfied with their lives. Despite their outward display of confidence and superiority, they have a fragile self-esteem and are extremely sensitive to criticism.

This can result in feelings of unhappiness, emptiness, and in severe cases, depression.

Impact on Relationships

In relationships, the partner or family members of an individual with NPD may feel manipulated, neglected, or abused due to the individual’s self-centered behavior and lack of empathy.

This can lead to a cycle of conflict and resentment, making it challenging to maintain a healthy and supportive relationship.

Workplace Impact

In the workplace, individuals with NPD can create a hostile environment due to their desire for power and recognition.

They may take credit for others’ work, belittle colleagues, or become argumentative when their ideas are challenged. This can lead to decreased morale and productivity within the team.

Mental Health Impact

NPD also has potential implications for a person’s mental health.

The constant need for validation and fear of criticism can trigger anxiety and depressive symptoms. In some cases, individuals with NPD may also have co-occurring mental health conditions such as substance abuse disorders.

How to Deal with a Person Who Has Narcissistic Personality Disorder

Interacting with a person who has Narcissistic Personality Disorder (NPD) can be challenging. Their behavior patterns, such as a lack of empathy, excessive need for admiration, and sense of entitlement, can create difficulties in maintaining a healthy relationship.

Here are some strategies that may help:

Set Boundaries

It’s crucial to set clear boundaries to protect your wellbeing. This could mean limiting the time you spend together or specifying what behaviors you will not tolerate. Be firm and consistent with these boundaries, despite attempts to cross them.

Maintain Your Self-esteem

People with NPD often belittle others to elevate themselves. It’s important to remember that their comments reflect their disorder, not your worth. Surround yourself with positive influences and engage in activities that boost your self-esteem.

Avoid Arguments

Engaging in arguments with a person who has NPD can be counterproductive, as they may twist the situation to make themselves appear superior or as the victim. Instead, try to remain calm and composed, and avoid getting drawn into their manipulative tactics.

Practice Empathy, But Don’t Enable

While it’s important to understand that NPD is a mental health condition that affects behavior, this doesn’t mean enabling harmful actions. You can empathize with their struggles without excusing negative behavior.

Seek Support

Dealing with a person with NPD can be emotionally draining. Seek support from trusted friends, family, or a mental health professional. Joining a support group can also provide valuable insights from others who have had similar experiences.

Encourage Treatment

If the person with NPD is open to it, encourage them to seek treatment. Therapy can help individuals with NPD understand their behavior and learn healthier ways to interact with others.

Treatment Option for Narcissistic Personality Disorder

Treatment for Narcissistic Personality Disorder primarily involves psychotherapy, also known as talk therapy.

This form of treatment helps individuals with NPD gain a greater understanding of their behaviors, feelings, and how they affect others.

It can also assist them in developing healthier self-esteem and relating to others in a more positive, rewarding way.

Several types of therapy have been found effective in treating NPD:

Psychotherapy: This form of therapy can help people with NPD become more aware of their narcissistic tendencies and how they impact others. It can also help them begin to understand and regulate their emotions.

Cognitive Behavioral Therapy (CBT): CBT is often used to treat Narcissistic Personality Disorder. Through multiple sessions of CBT, sufferers can learn to replace grandiose and distorted thoughts with more realistic and positive ones. It helps the individual identify harmful behavioral patterns and develop strategies to change them.

Gestalt Therapy: This form of therapy emphasizes personal responsibility and focuses on the individual’s experience in the present moment. It can aid individuals with NPD in gaining a better understanding of themselves and their relationships.

Schema Therapy: Schema therapy combines elements of cognitive, behavioral, and psychodynamic therapies. It’s designed to help individuals recognize and change negative patterns of thinking and behavior.

In some cases, medication may be used to treat co-occurring mental health conditions, such as depression or anxiety, which can make therapy more manageable. However, there are currently no FDA-approved medications specifically for the treatment of NPD.

Group, family, and couples therapy can also be beneficial, providing opportunities for individuals with NPD to learn and practice new skills in a safe and supportive environment.

While treatment for NPD can be challenging, with the right help and support, individuals with this disorder can make significant improvements in their lives.

Final Thoughts on Narcissistic Personality Disorder

In conclusion, dealing with a person with Narcissistic Personality Disorder (NPD) requires patience, understanding, and strategic interaction.

Key tactics include setting clear boundaries and adhering to them consistently, maintaining your self-esteem in the face of potential belittlement, and avoiding getting drawn into arguments or power struggles.

While empathy is important, it’s crucial not to enable harmful behaviors. Seeking support from trusted individuals or professionals can provide emotional relief and practical advice.

Remember, your mental wellbeing is paramount, and it’s essential to take care of yourself first. Navigating relationships with individuals with NPD can be challenging, but with the right tools and support, it is manageable.

Frequently Asked Questions about Narcissism

Frequently Asked Questions about Narcissistic Personality Disorder

What is Narcissistic Personality Disorder?

Narcissistic Personality Disorder is a mental disorder characterized by an inflated sense of self-importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others.

What are the symptoms of Narcissistic Personality Disorder?

The symptoms of Narcissistic Personality Disorder include having an exaggerated sense of self-importance, expecting to be recognized as superior without achievements that warrant it, exaggerating talents or achievements, being preoccupied with fantasies about success, power, brilliance, beauty, or the perfect mate, and being unwilling or unable to recognize the needs and feelings of others.

What causes Narcissistic Personality Disorder?

The exact cause of NPD is unknown. However, it’s believed to involve a combination of genetic and environmental factors. It’s also thought that NPD may be linked to mismatches in parent-child relationships with either excessive pampering or excessive criticism.

How is Narcissistic Personality Disorder diagnosed?

NPD is diagnosed based on a psychological evaluation that includes specific criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This includes patterns of grandiosity, need for admiration, and lack of empathy.

How does Narcissistic Personality Disorder affect relationships?

Individuals with NPD often have difficulty maintaining healthy relationships due to their lack of empathy and their need for admiration. They may struggle to understand the perspective of others, which can lead to conflicts and strained relationships.

Is Narcissistic Personality Disorder common?

Estimates suggest that up to 6% of people may have NPD, with rates higher in men than in women. However, many people show some narcissistic traits without having full-blown NPD.

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