Narcissistic Personality Disorder

This essay will explore a particular personality disorder called narcissistic. From this research, the reader will learn the definition, causes, types and levels as well treatment from a science and Christian perspective. Also, this paper will discover the issues behind diagnosing narcissistic personality and reason some would like to exclude Narcissistic from the personality disorder group.

Definition of Narcissistic

Hey! Look at me! I am better than you. I accomplish 2 degrees in four years. I work for a top notch firm.

I only associated with those on my level which you not. You are beneath me and I will not waste my time speaking with someone like you. The statements listed above are examples of a person with Narcissistic personality disorder. The purpose of this paper is to discuss the general definition and treatment of Narcissistic Personality Disorder (NPD). This research paper will begin will the definition then leading into the history of narcissism. Also, included will be the criteria for which one will need to meet in order to be diagnosed with this mental illness.

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Before defining narcissistic, we will define personality disorder which “is an enduring patter of inner experience and behavior that deviates markedly from the expectations of the individuals culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment” (DSM, 2000, pg. 685 DSM). People’s thoughts, emotions, and our attitude toward things are all part of our personality. Most people with a healthy personality trait are easily able to get along with their peers or the people around them.

There are currently ten personality disorders recognized by the DSM, and this paper will discuss narcissistic personality disorder. People often confuse narcissistic as being full of one’s self, but it has a more complex side. After getting background of NPD, we will explore is there a spiritual or Christian alternative for treatment or should it be combined with psychology to provide the optimal outcome?

Development of Narcissistic

A narcissistic person thinks the world revolves around them. They are inconsiderate people who are not kind or nice. Others word for narcissism are selfish, conceited, or snobbish person. The word narcissism was used by Kohut, Kernberg, and Sigmund Freud. There is a Greek myth about a man Narcissus. He was very self-absorbed and fell in love with himself. Narcissistic Personality Disorder (NPD) bases itself on the personality trait of narcissism. People that suffer this mental disorder have a need for admiration and exaggerated sense of their importance. A narcissistic person sees everyone else as poor or second compared to themselves (Dimaggio & et al., 2008). They require constant attention and much recognition of their achievements and talent; even though people who have NPD appear to be egotistic, they do not handle criticism very well. They are very susceptible to it and react to it with viciousness and humiliation.

People are inclined to become alcohol and drug abuse, violent, and hypochondriasis. They do not care what they do, as long as they are reaping the benefits. They do not connect their actions with consequences. They believe that they can do whatever they want and no one can tell them otherwise. This fact may serve as a motivation to commit crime. If the law says a person cannot do something, the narcissist believes it does not apply to him/her. Problems will occur when narcissistic traits become exaggerated in an individual’s personality. During the infant stage, mothers are infatuated with their baby. The baby is provided with narcissistic tendencies when it is only about them and no one else. The infant is the center of attention for the mother as well as the rest of the family making the child feel powerful and almighty. The child will have a big ego, but once the infant cross into the toddler stages, the center of attention changes causing the child to feel separated from all the love and attention. With this ego the child will develop narcissistic trends. The parent should provide limits and consequences to the child’s actions and do not baby him or her all the time. For Freud, these are the oral and anal stages of life when personality problems can develop (Corey, 2009, pg. 67).

A pattern of excessive need for admiration and lack of empathy are characteristics of NPD that begins to in young adulthood. Those suffering from NPD are unable to develop healthy relationships that would allow them to depend on others, trust others, or truly love someone. Narcissistic people can only formed relationships with those that can put them up on a pedestal and enhance their beauty/accomplishments. Their tendency is to form friendships or romantic relationships with only those that can enhance their self-esteem or advance their purposes. The goal is to impress others with their knowledge, beauty, or wealthy. They become boastful about themselves. Most narcissists are liars. They lie about their lives and often unreliable. They expect special treatment, to have their way, and be the center of attention. A narcissistic person tends to mock someone who holds some type of power. They want to have the same level of admiration if not more than the person in control. They had no idea what a healthy sense of self is because their sense self is depend upon other’s praise, attention, and compliments. A narcissistic injury occurs when someone defeats or criticizes the narcissistic individual (Miller, 1992). It may not portray on their face at the time of the injury, but they dislike criticism and defeat. They begin to feel outrage, embarrassment, and humiliation. The narcissistic person will attempt to get back at a person that injuries them.

Causes of Narcissism

Definite causes behind narcissism have yet been discovered. Some causes from research have been genetics, self-reflection, and cultural factors (Simopoulos, 1988). Also, data have concluded that “children who do not experience the opportunity to differentiate, and those who lack the opportunity to idealize others while also taking pride in themselves, may later suffer from narcissistic” (Corey, pg.83). Children need to be able to identity with other children their age. They should know who to feel empathy for a child that has less rather than judge and think they have it better. This will teach character and help them be grateful and thankful for what they do have. The Mayo Clinic has suggested social and psychological factors. Social factors include how one would interact with family and friend at an early age. Do they believe they are better, richer, pretty, or smarter than others? Psychological factors include the development of a person disposition and how one deal with stress. There is no single cause for NPD. There are a group of factors that can contribute to narcissistic personality disorder.

Criteria for Narcissistic Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorder (2000) states a pervasive patter of grandiosity, need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

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

Other personality disorder can be confused with NPD. The personality disorders have certain similarities. Histrionic, Antisocial, and Borderline Personality Disorders are cold, superficial, and indifferent toward others (DSM-IV, 2000). When diagnosing one must take into consideration all of the personality disorder and go by the conditions measured in the DSM to provide an accurate diagnose.

View of Narcissism

Heinz Kohut believed that narcissism was normal development from birth to adult. Kohut suggest that everyone has been guilty of being selfish, conceited, and stuck up at some point of time in their life. In which a healthy normal person, would be able to transform his or her infant narcissism into adult narcissism. “Transmuting internalization” is a term he used to describe the process in which an infant transforming into an adult would encounter various challenges resulting into some frustration. Having optimal frustrations leads the person to develop a strong internal structure or a strong sense of one’s self. This is used to compensate for the lack of external structure or support from others, thus if the narcissist process of transmuting is obstructed. Due to a level of frustration that exceeds the optimal frustration, in which the person experiences. He or she will be stuck in the infantile level, displaying many characteristics of omnipotent and invulnerable child.

Otto Kernberg’s views of narcissism are based on Mahler’s theory of separation. Consisting of an individual process of separation, from infancy to early childhood. The developing child gains a stable self-concept by mastering two major phases, normal autism and symbiosis, along with four other sub phases: differentiation, practicing, rapprochement, and consolidation of separation-individuation. Kernberg argues that an individual is unable to successfully master the rapprochement sub phase and becomes fixed at this level. At age 10 to 14 months begins the development stage, in which the child learns to walk. This ability, gives a whole new perspective for the child thus giving a sense of grandiosity and omnipotence, which resembles a narcissist behavior. At age 14 to 24 months the child enters in the rapprochement sub phase finding that he or she has limits of what he or she can do. If the child is severely frustrated they adapt by refusing or consequently returning to the practicing sub phase. This will be his or her security omnipotence and invulnerability.

Treatment

Many narcissists do not believe they are mentally ill. Many people do not seek help for narcissism. They come to treatment for a different mental disorder. It is unlikely that a person can be cured from narcissism, but their way of thinking about themselves can be modify. The counselor can become a mirror for the client. This would allow the client to see their way of thinking, actions, deeds, and misuse of affection from others. The client can confront their super ego with the help of the counselor. The ideal treatment is to talk with the client about their self-perception. The counselor can repeat to the client their narcissistic views. The client can transfer their narcissism to the counselor by recalling events that injured them. Once the counselor uncovers the injuries, they can explore what happen and the causes behind their behaviors. Also, the counselor can allow the client to keep their narcissistic way of thinking in session. Then once the therapeutic relationship has been established, the counselor can refute and provide explanations for their need of admiration.

Therapy Types

Psychoanalytic therapy originated from Sigmund Freud. Psychoanalytic theory view of human nature is determinism. The narcissistic person should want to determine what has caused them to have an egotistical personality. Clients are unaware of the conditions that cause their conduct and feelings. With the help of the counselor, clients will be able to turn the unconscious into consciousness. The structure of personality view is made up of three structures which are the id, the ego, and the superego. This theory also discusses the ego defense mechanisms that are very important. Everyone uses these mechanisms to some extent in their lives to alleviate stress. The defense mechanisms are: repression, denial, reaction formation, projection, displacement, rationalization, sublimation, regression, introjections, identification, and compensation (Corey, 2009, 67).

The goals of this theory are to make the unconscious conscious and strengthen the ego. The counselor function is to help the client gain the freedom to live, to assist clients in achieving self-awareness, honesty and effective personal relationships. They also help the client deal with anxiety and gain control over impulsive and irrational behavior. The client does most of the work in this therapy and it is long-term treatment.

Family systems therapy is “represented by a variety of theories and approaches, all of which focus on the relational aspects of human problems” (Cory, 2009, p. 458). People seek each other’s attention, approval, and support and react to each other’s needs, expectations, and distress. This will affect how adults manage their relationships, for good or bad, represents a continuance of patterns developed in early family life. Bowen hypothesized that “within families, anxiety about separation and loss, or too much togetherness and intensity, was handled in predictable ways: by conflict, by adaptation and reciprocal functioning, by triangling, and by cut-off” (p. 238). Leaders in society who give orders and do not allow individuals to be personal responsibility will be participating in handicapping the person to remain dependent. The family of the narcissistic person can help clear up their distorted image of themselves. The behavior had to be learned or pass down from someone else, therefore it would be helpful it the client had a support system to him or her identify a healthy sense of self.

NPD in the DSM-V

Should Narcissistic Personality Disorder be included on the DSM-V? It seems like narcissistic personality is just a big headed person wanting to be more self-absorbed. In my opinion, the researchers have valid points about not including NPD on the DSM-V. It is rarely diagnosed with prevalence as low as 2% (Campbell, Miller, Widiger, 2010). There is not enough research done on Narcissistic personality disorder. According to Ronningstan (2011), the propose for the DSM 5 will four components which are four general diagnostic criteria for personality disorder; five levels of self and interpersonal personality functioning, five major personality disorder types and 37 personality traits facets organized under six personality trait domains (pg. 251). Researchers have suggest that there is a need to cover different narcissim variants (Campbell, Miller, Widiger, 2010, pg. 643).

Test Use

The Narcissistic Personality Inventory (NPI) is the most widely used measure of narcissism in social psychological research. Although several versions of the NPI have been proposed in the literature, a forty-item forced-choice version (Raskin & Terry, 1988) is the one most commonly employed in current research. The NPI is based on the DSM-III clinical criteria for narcissistic personality disorder (NPD), although it was designed to measure these features in the general population. Thus, the NPI is often said to measure “normal” or “subclinical” (borderline) narcissism (i.e., in people who score very high on the NPI do not necessarily meet criteria for diagnosis with NPD).

Biblical Perspective

Christian counseling relies on, and fully expects, the Holy Spirit to intervene and cause supernatural change in the life of the client (Clinton & Ohlschalger). Client must have will power to love and serve God. Clinton & Ohlschalger develop the TRUTH process to use during session T stands for a trigger event. This could represent something has happen to the client as a child that brought on a narcissistic personality. R stands for reckless thinking. The client’s thinking is wrong. One should not think of themselves as better than other people or big-headed. U stands for unhealthy response. How the client treat their relationships or how they come off towards their family ruins their relationship. T stands for truthful thinking. Biblical thinking should change the narcissistic person perception of themselves. If they replace their thinking with thoughts of God, they will become less conceited. H stands for healthy response. A person can respond differently about their achievements and accomplishments. They would not flaunt it or over exaggerate about themselves. Instead they would be considerate of other feelings and take constructive criticism. This process would replace the boastful way the narcissistic person thinks. Truth therapy would allow the person see their true identity the way God made them. God makes not mistakes about the development of his people.

In bible there are scriptures about people that are boastful. Capps (2009) thinks God had NPD. His reason being God had a need for admiration and lack of empathy and is evident in the first several chapters of Genesis (pg. 199). He believes God was selfish to make man in his own image (Gen.1:26-27). God looked out and saw that the things he made were great. His intentions were not to be boastful, but to acknowledge his great work for mankind. According to KJV, James 4:16 states but now you boast in your arrogance. All such boasting is evil. Also there is Jeremiah 9:23, Ephesians 2:8-9 and Psalms 94:4. Capps (2009) belief is God was showing off by healing the sick and raising the dead. God does not like boastful people. God preach the gospel as well as allow his actions to speak for themselves. People should not tell others what they can do but allow others to see their work. Instead of being stuck on self, one should be stuck on being a servant for God. God is not concern with the outer appearance but with the heart and whether his will is being done. Philippians 2:3 states let nothing be done through strife or vainglory; but in lowliness of mind let each esteem other better than themselves (KJV). Narcissism should not have a place in a Christian’s life.

For those who are turning to Christ to help provide healing and answers, should repent and commit their lives to Christ. They should not worry about material things or accomplishments. Blessed are the meek; for they shall inherit the earth (Matthew 5: 5, KJV). God will reward those that are humble and submissive to his word. Humility does not envy what others has, but celebrate with others when they received their blessings. Narcissist seeks to please only himself, whereas a meek man seeks to please others. Narcissism is putting one’s need above all else including God. The desire of the devil is to get God’s children out of his will and into the sinful world. Narcissism is sinful thinking. James makes this point in James 4:8, draw nigh to God, and he will draw nigh to you. Cleanse your hands, ye sinners; and purify your hearts, ye double minded. We are called double minded because our mind is not on God but on worldly possessions. Once the narcissist has cleansed their mind, the Holy Spirit can dwell with him. The Holy Spirit can provide clear and uncorrupted thoughts focused on Godly ways of living rather than lying and being boastful about one’s self. One suffering from narcissistic should know even though their mind is on vain things, God will never leave you nor forsake you. A person can always count on Jesus no matter the situation or circumstances. This should cause one to rejoice!

Conclusion

Narcissistic is a hard disorder to diagnose and find proper research. There are different approaches to treat narcissism. It depends on the severity of which the person has narcissistic personality disorder. In reality, even though the person seems big head, he/she is really hurting inside because they do not know how to have a proper relationship. The mental disorder has hindered their personality developmental and deprives them of their normal personality. People suffering from Narcissistic Personality Disorder usually overemphasize their abilities and boost their accomplishments. They appear boastful and pretentious underestimating and devaluing the achievement and accomplishment of others. Narcissists sometimes fraudulently claim to have qualifications or experiences, which they don’t have. Narcissistic people have self-esteem issues. The need for constant attention, admiration, complements, along with superior entitlement, and expecting others to defer to them help their fragile self-esteem. Narcissist lack of sensitivity has difficulty in recognizing the needs and feelings of others. To conclude the narcissist is oblivious to the hurtfulness of their remarks or behavior, arrogant, disdainful and patronizing attitude, showing envy, emotional coldness and lack of interest and is quick to blame and criticize others when their needs and expectations are not met. In today’s society Narcissism is all around us. From the time we awake to the time we fall asleep. The children of today are more self-centered then generations ago. Could the parents be spoiling them too much? Thus by giving them, everything they want, without some level of frustrations, could possibly lead to narcissistic behavior. Eventually narcissism may be a part of everyday life and not be considered a disorder in the years to come.