What Is Narcissistic Personality Disorder?

The term “narcissistic” is often used to describe someone who is conceited or self-centered. All of us must have a certain degree of healthy narcissism in order to have self confidence and to have concern for our own well being. Narcissistic as an adjective is not the same as Narcissistic Personality Disorder (NPD). The difference with someone who has NPD is that the condition has a profound negative impact on nearly all their relationships and interferes with most aspects of their life.

Perhaps the reason you are seeking information about Narcissistic Personality Disorder is because there is someone in your life who is terribly difficult to get along with. It seems that no matter what approach you take, you are simply unable to make things work with this person. It could be that you are dealing with a person who suffers from NPD.

Symptoms

The following is the list of symptoms given in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), which is the standard that mental health professionals use to diagnose patients.

• has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
• is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
• 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)
• requires excessive admiration
• has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
• is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
• lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
• is often envious of others or believes that others are envious of him or her
• shows arrogant, haughty behaviors or attitudes

An official diagnosis can be made only by a mental health professional. This list of symptoms may help to determine whether a person with a difficult personality may actually have NPD. Typically, 5 of the 9 symptoms must be present.

Looking at the list of symptoms, it can be hard to tell if a person fits the description. At first, I only felt like a few of the symptoms described the difficult person in my life. However, after reading a lot more about the symptoms and gaining a better understanding of them, I came to see that nearly all of them applied. To help you better understand how these symptoms could describe the NPD person in your life, I’ll try to describe each one a little better.

Has a grandiose sense of self-importance

The classic description of an NPD individual includes the word “grandiose”. This means that they exaggerate the value of their achievements, the scope of their experience, the importance of their position, even the humor (or terror or seriousness, etc.)  of their stories about everyday encounters. For example:

-A person who supervises one or two people at work might introduce himself as a manager or executive.
-A woman who likes to bargain shop may exaggerate to her friends how much money she saves.
-A person who has taken photography classes may tell others she is a professional photographer.
- When someone mentions being friends with an individual, an NPD person might comment that they know the same individual better, or have been friends with them longer.
- An NPD person relating a story may use dramatic storytelling skills to make the story bigger than life.

While many types of people exaggerate sometimes, the NPD individual tends to exaggerate nearly all the time. They seem to be able to time their grandiose statements to come immediately after a statement someone else may have made about their own achievements/experience/qualifications, thereby making themselves appear better - a kind of “one-up” syndrome.

Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

An NPD person seems to fantasize about grand opportunities worthy of their perceived greatness - a perfect lover, a high position in business, an important recognition, or a deserved high salary. They seem assured that they are entitled to high position and respect, amazing friendships and ideal romance. This fantasizing is what often leads directly to the constant conflict you will experience with an NPD person. As their spouse, friend or co-worker, the NPD person idealizes YOU. You are their perfect match, their best friend, their dream companion. They have incredibly high expectations of your time, loyalty and capacity to give them everything they need in terms of love, support and validation. You will never be able to meet their unrealistic expectations and the NPD person in your life will constantly feel disappointed in you.

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)

An NPD individual likes to set herself/himself apart from “average” people by appearing to be better than their peers. They do this with their grandiose statements designed to elevate your perception of them. They may create the illusion of being from an elite family or they may claim to have above average taste or style. They insist on top notch treatment at restaurants or from the administration at their child’s school. They can be known for leaving customer service personnel in tears after an incident at the store or over the phone because an NPD person is one customer who is always right. They like to make others feel like it is a special thing to be included in their privileged circle of close friends, and can decide on a whim that certain individuals are “out” of the circle. Individuals who challenge the NPD person’s special status or disagree with them are quickly dropped from the NPD person’s good graces.

Requires excessive admiration

Sufferers of NPD typically lack self esteem. They put on a false front of being special or even better than most people, but they need to know that other believe the charade. They want to hear people tell them that they are beautiful, intelligent or kind. An NPD person will often ask what you think of their idea, or their outfit, or their home because they need to hear you affirm that they are good and wonderful. They want to be received with hugs and enthusiasm when they enter a room, and fussed over when it is time for them to depart. They become frustrated when they cannot elicit the compliments they seek from you. They can even become injured if an idea or suggestion of theirs is not accepted because that could be viewed as a rejection of their superior intellect and ability – like an anti-compliment.

An NPD person is difficult in a disagreement because it is critical that they maintain the façade of perfection that they have created. So acknowledging mistakes or apologizing doesn’t serve their interests. For them, that would be like admitting to being flawed and imperfect.

Has a sense of entitlement , i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

An NPD person might claim to be a “rules person” – someone who supports and upholds laws and regulations. However, in practice, NPD individuals are “exception to the rule” people. They believe in rules that apply to everyone else. They usually find some reason why they should not have to comply with certain rules or be restricted by policies because they are a special case. They want to go to the front of the line. They like special attention from doctors. They expect discounts and freebies. An NPD person reacts with anger and indignation when they are denied special treatment.

Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

Individuals with NPD will push you to the limit of your capacity to give. They intrude on others’ time and kindness while seeming unaware that their expectations are far beyond what should be expected of any one individual to give. Individuals with NPD often try to appear as victims in need of help, or they use pretended authority or superiority to push people to give to them. When the NPD person asks too much, they put you in a sort of trap. Your only choices are to comply with the NPD person’s demands at great personal expense (in time, money, dignity, etc.), or you refuse their demands and risk incurring rage on the part of the NPD person and appearing to be insensitive or selfish.

An NPD person may also exploit businesses or institutions to extract as much as they possibly can. He/she may claim to have disliked food at a restaurant to avoid having to pay for it. They may demand more than they are entitled to when returning something at a store or take a handful (or four) of free samples when they are meant to take one. They typically know how to “work the system”, whether it’s the welfare system, the healthcare system or any other system.

Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

A lack of empathy is the hallmark of an NPD person. This means that they cannot discern what others are feeling. They know on an intellectual level that other people have emotions and feelings, but they cannot feel them. They can’t internalize the sadness that a callous remark from them might invoke. They cannot feel the joy that you feel when you tell them the best news ever. It’s why we call NPD a disorder. Narcissists have a real disability when it comes to relating to others on an emotional level. Their own feelings are the only ones that matter to them, so it’s easy for them to ride roughshod over your feelings. They are not very good at deciphering the meaning of what is being said because they only hear the words, not the emotion. Sarcasm is a dangerous thing when speaking with a narcissist because they won’t pick up on the sarcasm part of what you say. They could take something the wrong way and end up feeling hurt and angry after a perfectly ordinary conversation.  Some narcissists become good at reacting appropriately to your emotions because they have learned what is expected of a human being in certain situations. That is why it can be hard to see this lack of empathy at first. You may think the NPD person in your life is empathizing with you, but try to think of a time when they have shed a tear with you in your moment of joy. See if you can remember their face falling, reflecting your anguish when you are hurting. Most likely, they only look blankly at you while you try to describe your feelings. A hug or verbal expression of comfort may be forthcoming, but it’s only because they know that is what they are supposed to do, not because they actually feel sorry for you.

Is often envious of others or believes that others are envious of him or her

Individuals with NPD believe they deserve all the good things that happen to others around them. It is difficult for them to feel happy for someone else who has had good fortune of some kind because individuals with NPD can’t get past the feeling of envy. They may seek to acquire all the same things their friends have – even going as far as purchasing the same brand and style of a specific object. They, in turn, assume that all people are likewise envious of them in everything from their house or their clothing to their friends, their job or even their children.

Shows arrogant, haughty behaviors or attitudes

Arrogance is fairly easy to spot in narcissists. They tend to brag about themselves and can appear snobbish or patronizing. They may make fun of others opinions or appearance (even if they actually admire them). They can react to threats against their superiority – known as narcissistic injury - by lashing out or making condescending remarks. Sometimes NPD people mask their arrogance and react to narcissistic injury in a more subtle way by appearing to be unaffected by the threat or minimizing the criticism to appear to be “above it”.

Causes of Narcissistic Personality Disorder

Doctors and researchers are uncertain what causes NPD. However, there are some things that NPD people have in common relating to their upbringing, which may be contributing factors to the development of the disorder. NPD sufferers seem to fall into one of two groups. 

1) One possible cause of NPD is that they were raised in an environment where they were overly praised and catered to by their parents or others. They may have been lavished with compliments for every little thing and told how wonderful they are so often that they grow up to believe they are indeed better than their peers. However, as they get older and start to feel that perhaps they are not able to live up to the standard of perfection, they continue to maintain the facade of perfection so that no one will see through to the insecurity that they feel on the inside. 

2) Another possible cause of NPD is that the person experienced trauma or neglect in some form as a child. Perhaps their parents were emotionally uninvolved, or they experienced the loss of a parent or a divorce for which they were not able to properly grieve. Maybe they were forced to grieve alone and had to carry on as if they were fine. They learn to create the illusion that they are fine on the outside while they are crumbling on the inside. Maintaining this false front becomes a way of life as they reach adulthood, and by then they are used to covering up their true self and creating something much better to present to the world.

Either way, the NPD person has feelings of worthlessness and self loathing that are unconscious. All their efforts are focused on building and maintaining the false front - the illusion of perfection - and keeping their feelings of insecurity repressed. The motivation for all their controlling behavior is the fear that their façade might crack and expose their true character in all its insecure, ordinary nakedness. Their only source of self esteem is the positive feedback, also known as Narcissistic supply, that they extract from the people around them.