Symptoms of Narcissistic Personality Disorder
The narcissistic personality disorder is one of the top three most
difficult personality disorders to treat. It is defined as an ongoing
pattern of grandiosity and need for admiration, and a lack of empathy
for others. It should be noted that it is three times more common
in males than females. These individuals have an obvious self love,
and believe they are knowledgeable and indeed expert in a wide variety
of areas. They are usually shocked when they are not praised for
their efforts. These individuals are preoccupied with success and
power. They feel they are gifted and talented. They may make statements
like, “I have a photographic memory,” when in reality
they do not. They rarely admit to a mistake or wrongdoing. They
rarely apologize when the occasion arises. These individuals insist
on having the best of everything. They are grossly defensive, and
unable to look at themselves objectively. They have an inflated
and false sense of entitlement, and lack of sensitivity towards
others. They feel they deserve whatever they want or need. These
individuals are extremely self-absorbed. If they are giving, they
usually give monetarily, and are unable to give emotionally. They
are viewed by others as arrogant and snobbish, act condescendingly
towards healthcare providers and therapists in the assessment phase.
It is also very common for these individuals to act ingratiatingly
and very complimentary in the first session, very similar to traits
found in sociopathic personality disorder. These individuals are
extremely sensitive to criticism, although may not show it outwardly.
When their shortcomings are targeted, however, they may appear extremely
wounded.
Causes of Narcissistic Personality Disorder
There are many theories regarding what causes a narcissistic personality
disorder. Subsequently what you are about to read is one more theory,
based on my experiences in treating many patients with narcissistic
personality disorder. I have found definite commonalities between
individuals from which one can draw conclusions regarding causation.
As such, I believe one of the most common causes is impoverished
self-esteem, occurring at a young age. These individuals often have
a loss of a strong father figure in their lives. If they have not
lost their father figure, then the father has been emotionally absent.
These fathers are usually condescending, critical, and do not empower
their children at a young age. Subsequently, as they grow older
these children overcompensate for their lack of self-esteem, carrying
with them some traits from their fathers such as the emotional distancing,
while inflating their false sense of self worth. Sadly, individuals
with narcissistic personality disorder really never find their true
selves. In therapy, it is extremely difficult because these individuals
are grossly defensive. When targeting a narcissistic personality
disorder and in trying to reflect back to them perceptions of their
loved ones and others around them, they become defensive, digging
their heels into the sand, adamantly believing that it is “everyone
else’s fault.” This author has found that if the narcissist’s
parents are still alive, it can be extremely beneficial to discuss
with them the importance of focusing on some of the issues that
exist, such as the father-son relationship, and some of the voids
in that relationship. This may be of benefit in terms of turning
around some of the symptomatology of the narcissist. The narcissist’s
mother is usually a passive individual who has enabled the pathology
to continue over the years. There may or may not be alcoholism present
in the family.
Treatment of Narcissistic Personality Disorder
Treatment of narcissistic personality disorder takes the form of
one-to-one therapy. Sessions should be a minimum of 45 minutes long.
The patient should not be confronted at the start. It takes awhile
to develop a trusting relationship. Eventually the sessions should
be twice a week.
It is important at some point to move into marital and/or family
sessions, for one-to-one therapy will not long be beneficial.
Medication is of no use. In fact, patients usually adamantly resist
medication. It is not uncommon for these individuals to be referred
to therapy by their employers, especially when increased conflicts
continue in the workplace. Nevertheless, the prognosis is dim. These
patients usually consistently have relationship problems, and therapy
does become stressful and tiresome.
Narcissists DO NOT try to commit suicide. When you love yourself
as much as a narcissist does, suicide is not an option.
|
