I had a neighbor once. He had five children with different women and a revolving doorway of partners. Charming, easily bored and yes…he never seemed to really listen. He had enormous energy, and people were drawn to that energy. He didn’t seem to sleep much or have any down time. He loved attention, and was quick to fight or verbally counter punch, if anyone was not admiring him. He worked three jobs and socialized extensively. I once jokingly asked him in the hallway of our apartment building as he was zooming by, where he gets all his energy from. There was a pause. A brief look of pain crossed his face and he blurted out, “it’s all because I am terrified of ever being alone.” Then he strode off, out of our apartment building, no doubt searching for more validation and avoiding being alone. He left a trail of hurt people including his children. His grown up son once said to me with great sadness, “I had to break ties, there was just no room for me in there.” My neighbor was always bewildered by the damage he wrought. I grew tired of his never ending interpersonal dramas as well. Did he have Narcissistic Personality Disorder?
Personality Disorders: Cluster B
In the DSM-5-TR, Narcissistic Personality Disorder is in the same cluster as Antisocial, Borderline, and Histrionic Personality Disorders. Personality is a noun and implies static personality traits. The static personality can become a self fulfilling tautology. “That’s who I am” is a dangerous paradigm. It is much healthier, more fulfilling and exciting to see oneself and others as a never ending evolution. People who can fully recognize their many contradictory forces and move past their comfort zones emotionally and intellectually become more nuanced, flexible, and adaptable to circumstances and people. People with a personality disorder like Narcissistic Personality Disorder become entrenched in their personality, and they expend extraordinary amounts of energy trying to set up their world and their relationships to be exactly as they need it to be. Behind that monumental effort and control lies fear.
Narcissistic Personality Disorder
A person with this personality disorder persistently and pervasively since young adulthood, and probably earlier, displays personality traits such as: a grandiose sense of self, being preoccupied with fantasies of unlimited power and success, believing they are special and unique and should only associate with those of high status, requiring excessive admiration, having a sense of entitlement, being interpersonally exploitative, being envious and also feeling that others are envious of them, having arrogant and haughty behaviors, and lacking empathy. (DSM-5-TR, 2022) Some of these predispositions are inherent by nature, but also at one point in their lives these behaviors, attitudes, and mindsets may have served them, and they became prisoners of their own personality. Everyone goes through narcissistic phases. In some developmental stages, it is normal. In early years toddlers struggle to recognize the needs of anyone else, as caregivers in a nursery or preschool can testify. Breaking up disputes over things and issues of control are par for the course. A similar phase usually occurs during adolescence and in young adulthood.
Narcissistic Personality Disorder and Therapy
Paradoxically, although Narcissistic Personality Disorder is a defined and categorized disorder, therapists see very little of it in individual therapy. Individuals who meet the criteria are unable to recognize their own areas of dysfunction or are satisfied with themselves. They usually show up because of comorbidities such as anxiety or depression. The most insidious and difficult thing about this disorder is that they can only see through their own lens; they see their reality as the only reality. Identifiable individuals with Narcissistic Personality Disorder are more likely found in couples therapy or family therapy. Their close interpersonal relationships suffer. Their nonstop struggle to get admiration and reassurance preempts empathy. There is some cognitive empathy, but very little empathy of feeling. Their own vulnerability as well as the vulnerability of others is frantically avoided.
Can a person with Narcissistic Personality Disorder change?
One of the traits describing individuals with a Narcissistic Personality Disorder is identified by its absence, “lack of empathy”. It is easier to add something than to take away a deeply entrenched defense mechanism. If someone with a narcissistic personality does end up in some type of therapy, empathy can be taught directly. Learning empathy needs to be presented as enrichment; as something that will make their life richer and can bring more long term and sustaining love to them.
It starts with slowing down and learning to quietly and mindfully be with one’s body, emotions and thoughts without reacting. A daily practice is needed to better familiarize oneself with one’s own perceptions, pattern of reactions and the behaviors attached to them. One builds slowly, a new set of skills that enhances awareness. This awareness of self is then brought into relationships. If you are better aware of yourself you can become better aware of others and the all powerful ability to feel empathy suddenly has a chance to grow.
It benefits us all to reflect upon narcissistic tendencies in ourselves and others. Today’s culture, in which individuality, striving for fame and acclaim on social media and elsewhere is venerated, pathological narcissism can easily hide. Identification of Narcissistic Personality Disorder can be difficult. It is a diagnosis and label that can be alienating to an extreme and amplifies the fears of those who are imprisoned by it or are enmeshed with is. Even in Greek mythology, Narcissus, ironically the son of the river God Cephissus, drowns in a pool of water while staring at his reflection. Many other gods are not condemned to such a strong fate even though they demonstrate a gamut of bad behaviors and failings. Narcissism is universally frowned upon, but its presence is recorded throughout history, especially in societies in which collective identity is not the main societal structure. Strength based counseling is important. It does not emphasize the societally abhorrent weakness, but builds up the antidote to live the fullest life possible, to set the table for change and a never ending evolution towards a more encompassing perspective and greater emotional depth.
American Psychiatric Association. (2022). Desk reference to the diagnostic criteria from
DSM-5-TR (TM). American Psychiatric Association Publishing.