Narcissistic personality disorder (NPD)

What is Narcissistic personality disorder (NPD)

Narcissistic Personality Disorder (NPD) is a complex mental health condition characterized by patterns of grandiosity, a constant need for admiration, and a lack of empathy. People with NPD often have an exaggerated sense of self-importance and struggle with maintaining healthy relationships due to their manipulative behaviours and emotional detachment.

Where does the term Narcissistic personality disorder come from?

The term narcissism originates from Greek mythology, specifically the story of Narcissus, a beautiful young man who fell in love with his own reflection. This myth laid the foundation for the psychological concept of narcissism, which involves excessive self-love and a lack of empathy for others.

The first modern use of the term narcissism in psychology was to describe it as a sexual perversion where individuals took their own body as a sexual object. Later, the term narcissus-like was used to describe excessive self-admiration.

Over time, narcissism evolved from being considered a perversion to a recognised personality disorder, with Narcissistic personality disorder (NPD) officially classified in psychological literature. The disorder is characterised by grandiosity, a need for admiration, and a lack of empathy.

Diagnostic criteria of Narcissistic personality disorder

NPD is a persistent pattern of delusions of grandeur (in fantasy or behaviour), a need for admiration, and a lack of empathy, starting at early adulthood that can be seen in 5 or more of the following:

1. a grandiose sense of self-importance, for example, exaggerating their success and talents and expecting to be recognised as the best without necessarily having achieved those successes;
2. a fixation with fantasies of infinite success, control, brilliance, beauty, or idyllic love;
3. credence that they are extraordinary and exceptional and can only be understood by, or should connect with, other extraordinary or important people or institutions;
4. a desire for unwarranted admiration;
5. a sense of entitlement;
6. interpersonally oppressive behaviour;
7. no form of empathy;
8. resentment of others or a conviction that others are resentful of them;
9. a display of egotistical and conceited behaviour or attitudes.

A brief discussion of the symptoms of Narcissistic personality disorder

Narcissistic Personality Disorder (NPD) is a mental health condition characterised by a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy. While self-confidence is healthy, NPD goes beyond that, leading to significant difficulties in relationships, work, and overall well-being.

Key symptoms:

1. Exaggerated sense of self-importance:

Individuals with NPD often believe they are superior and unique, expecting recognition without commensurate achievements.

2. Preoccupation with fantasies of success and power:

They frequently dwell on fantasies of unlimited success, beauty, power, or ideal love.

3. Need for excessive admiration:

Validation from others is crucial, and they may seek constant praise or attention.

4. Sense of entitlement:

They expect special treatment and often exploit others to achieve their goals.

5. Interpersonal exploitation:

Relationships may be transactional, with little regard for others’ needs or feelings.

6. Lack of empathy:

A hallmark trait—they struggle to recognize or care about others’ emotions.

7. Envy and arrogance:

They often belittle others and feel envious of their success while exhibiting a condescending attitude.

Despite appearing confident, individuals with NPD may harbour deep-seated insecurities, leading to hypersensitivity to criticism. While the symptoms can be challenging for those around them, understanding the condition can foster empathy and encourage those affected to seek professional support.

A story of Narcissistic personality disorder

Schalk* met a new friend as a student years ago. This new friend was the most incredible human being. They shared everything and met each other on a soulmate level that no mortal would ever understand. Their shared world was filled with intellect, poetry, art, and music. Schalk felt that they were one soul split into two individuals. Fred* was attractive, sensitive, sympathetic, upbeat, intellectual, and simply amazing.

Fred pulled Schalk into a shared world that was from another world. Schalk’s lifelong friends were no longer good enough. They were not on the same level as he was with Fred. They would never be able to understand it. Schalk would spend weekends with Fred in his beautiful home in another incredible world. Fred would tell him about another friendship he had that was so intimate that they sometimes shared a bed. Schalk would not mind even sharing a bed with him, as part of their shared soul. He had never felt closer to anyone than with Fred. Schalk, completely heterosexual, would also not mind sharing his soul and body with Fred.

Fred had a girlfriend who sang like a nightingale. There was an immediate attraction between Schalk and Lanelle*. Fred realised that she was in love with Schalk.

In an incredible act of brotherly love, Fred told Schalk that she was actually in love with him and that Fred gives her to him. Who has ever experienced such closeness and friendship? It really was the most incredible gesture. Unconditional. Heavenly. They hugged each other that evening like no lovers ever could.  Like Schalk had never hugged a girl, not even his mother. Shortly thereafter, Schalk and Lanelle became involved in a relationship with Fred’s permission and blessing.

After their brotherly hug the previous night, Fred called Lanelle the next day and threatened to print pamphlets to tell the entire campus how his girlfriend and best friend had betrayed him. Schalk could not understand how this wonderful friendship had suddenly become twisted. Fred suddenly hated and undermined him. Fred followed the same pattern with his subsequent relationships (you may think that you are to blame for what went wrong between you until you realise that this pattern keeps repeating itself and that you are just the common denominator).

In the meanwhile, Fred has become involved in a relationship with another man. Matters between them also went awry and he exposed this man in the press, exactly as he had threatened Lanelle. The attention the press attracted exposed other skeletons in Fred’s life. Tragically, Fred ended his own life.

Another story of Narcissistic personality disorder

Christine*’s husband, Nicholas*, would always create such an atmosphere when her best friend, Stephanie*, visited her. Stephanie instead made sure that she went home when Christine’s husband came home. Christine was just as tense when he arrived at home. During their marriage, she did not have any real friends left, and she was not allowed to even use the phone.

She eventually had to quit her job and became dependent on him, to such a degree that even after their divorce she had to stay there for a while, despite the fact that she had found a teaching job again.

However, she had to save money in order to afford rent and put down a deposit before she could leave the house. He blackmailed her with their boys (who were everything to her) and said that he would make sure that she would lose them. He made sure that the boys went to a high school where he then put them in the dormitory. He told them all sorts of lies about their mother in order for them to withdraw themselves from her. He wanted to destroy her and he did.

The eldest boy is now 21 years old and experiences severe anxiety attacks. He is also furious with his mother because she never fought for them as her boys and left them to their father’s fate.  He was furious with his mother for that. These were of course all lies that Nicholas told the boys.

Nicholas still believes to this day – and still tells the boys – that Christine will crawl back to him, even after they have been separated for more than 12 years.

• If you are wondering why I am telling you these stories story, you might want to look at the diagnostic criteria again and see how many of the criteria you can identify in the above story.

*Not their real names