In recent years, people have been using the word “narcissistic” more and more. Whether it’s people referring to selfie culture or the word being used to describe a particular person’s actions, it seems everywhere you turn someone else is being called a narcissist. When depicted in media, narcissists usually range from the cold, arrogant character with little regard for other people’s feelings to the manipulative character who only keeps people around to use them before discarding them. Examples of the former include Meryl Streep’s character Miranda Priestly in The Devil Wears Prada or Dr. Gregory House played by Hugh Laurie in House. Examples of the latter include Regina George, played by Rachel McAdams, in Mean Girls and James Gandolfini’s character Tony Soprano in The Sopranos. Yet recently, people with Narcissistic personality disorder, like many with personality disorders, have been pushing back against this stigma. While these media portrayals often show narcissists as being uncaring towards others, in real life, many actually suffer from low self-esteem which drives them towards the need for constant admiration. Yet there are also many people who suffer from abuse from relationships with narcissistic people, whether it’s a partner, a friend, or a parent. So what exactly is Narcissistic personality disorder and does the portrayal in the media capture it correctly, or only add to a stigma?
The term narcissist comes from the Greek myth of Narcissus, a man who became so enamored by his own reflection that he died rather than having to leave it to get food and water before being turned into the Narcissus flower. The first description of Narcissistic personality disorder came from psychoanalyst Robert Waelder in 1925, though the name for the disorder would not be coined until 1968 by Heinz Kohut. Most people display some level of narcissistic traits. We all want to feel important, and many people believe they deserve better than their current lot in life. However, only one percent of people show high enough levels of narcissism for it to be considered Narcissistic personality disorder. In order to be formally diagnosed with Narcissistic personality disorder, someone has to display five or more of the following symptoms.
1. Have a grandiose sense of self-importance.
2. Preoccupied by fantasies such as those of unlimited success, brilliance, beauty, power, or ideal love.
3. Believe they are special or unique and can only be understood by and associate with people of a certain standing.
4. Require excessive admiration.
5. Have a sense of entitlement.
6. Manipulates others to achieve their own gains.
7. Lacks empathy.
8. Often envious of others or believes others are envious of them.
9. Display arrogant and haughty behaviors or attitudes.
While the DSM-V does not officially recognize any subtypes of Narcissistic personality disorder, various studies have been done that break down the disorder into subtypes. While you can find different subcategories depending on what resources you draw on, there are two many subtypes of narcissism: grandiose and vulnerable. When most people think of a narcissist, they tend to conjure up the mental image of a grandiose narcissist. Generally seen as arrogant, cocky, and on top of the world, grandiose narcissists believe they are entitled to things in the world and are not afraid to manipulate people to get it due to their decreased empathy. Vulnerable narcissists on the other hand tend to have very low self-esteem and tend to be more anxious and resentful than grandiose. More likely to be defensive and lash out at people for critiques, they’re more obvious about needing validation and often play the victim in order to achieve this.
While everyone who has Narcissistic personality disorder can be labeled a narcissist, not everyone who is a narcissist has Narcissistic personality disorder. In order to have Narcissistic personality disorder, a patient has to meet the criteria, (having five or more symptoms listed in the DSM-V) and, like every disorder, be diagnosed by a trained and licensed therapist. The reason that so few people end up diagnosed with this disorder is due to one of the key symptoms of this disorder: people with narcissistic traits rarely believe they are the ones at fault. If there is an issue, due to the grandiose sense of importance, the belief that they are “special”, or the sense of entitlement, people with narcissistic tendencies are less likely to believe the source of the problem may stem from themselves and therefore do not seek out therapy or help. Unfortunately, due to this, Narcissistic personality disorder is extremely under-studied. While it is believed that around one percent of people will be affected by Narcissistic personality disorder during their lifetime, the cause of this disorder is not known. Some theories link it to childhood trauma while other people believe it’s genetic. Either way, it begins to appear in early adulthood. When people with Narcissistic personality disorder do end up in therapy, it is generally due to other aspects of their life such as substance abuse or other mental illnesses. While there are no current medications to treat Narcissistic personality disorder, psychotherapy or talk therapy has been shown to help someone suffering from the disorder to develop new, healthier behaviors. If you or someone you know is suffering from Narcissistic personality disorder, please consider reaching out to a trained therapist in order to get diagnosed and begin treatment. While there is no “cure”, like with any personality disorder, learning how to deal with and manage the symptoms can lead to a happier, healthier life and more stable relationships.
