Narcissistic Personality Disorder
Narcissistic personality disorder (NPD) is a personality disorder in which there is a long-term pattern of abnormal behavior characterized by exaggerated feelings of self-importance, an excessive need for admiration, and a lack of understanding of others’ feelings. People affected by it often spend a lot of time thinking about achieving power or success, or about their appearance. They often take advantage of the people around them. The behavior typically begins by early adulthood, and occurs across a variety of situations. The cause of narcissistic personality disorder is unknown. It is a personality disorder classified within cluster B by the Diagnostic and Statistical Manual of Mental Disorders. Diagnosis is by a healthcare professional interviewing the person in question. The condition needs to be differentiated from mania and substance use disorder. Treatments have not been well studied. Therapy is often difficult as people with the disorder frequently do not consider themselves to have a problem. About one percent of people are believed to be affected at some point in their life.
Persons with narcissistic personality disorder (NPD) are characterized by their persistent grandiosity, excessive need for admiration, and a personal disdain for, and lack of empathy for other people. As such, the person with NPD usually displays the behaviors of arrogance, a sense of superiority, and actively seeks to establish abusive power and control over other people. Narcissistic personality disorder is a condition different from self-confidence (a strong sense of self); people with NPD typically value themselves over other persons to the extent that they openly disregard the feelings and wishes of others, and expect to be treated as superior, regardless of their actual status or achievements. Moreover, the person with narcissistic personality disorder usually exhibits a fragile ego (Self-concept), an inability to tolerate criticism, and a tendency to belittle others in order to validate their own superiority.
The DSM-5 indicates that persons with NPD usually display some or all of the following symptoms, typically without the commensurate qualities or accomplishments:
- Grandiosity with expectations of superior treatment from other people
- Fixated on fantasies of power, success, intelligence, attractiveness, etc.
- Self-perception of being unique, superior, and associated with high-status people and institutions
- Needing continual admiration from others
- Sense of entitlement to special treatment and to obedience from others
- Exploitative of others to achieve personal gain
- Unwilling to empathize with the feelings, wishes, and needs of other people
- Intensely envious of others, and the belief that others are equally envious of them
- Pompous and arrogant demeanor
People with NPD tend to exaggerate their skills and accomplishments as well as their level of intimacy with people they consider to be high-status. Their sense of superiority may cause them to monopolize conversations and to become impatient or disdainful when others talk about themselves. In the course of a conversation, they may purposefully or unknowingly disparage or devalue the other person by overemphasizing their own success. When they are aware that their statements have hurt someone else, they tend to react with contempt and to view it as a sign of weakness. When their own ego is wounded by a real or perceived criticism, their anger can be disproportionate to the situation, but typically, their actions and responses are deliberate and calculated. Despite occasional flare-ups of insecurity, their self-image is primarily stable (i.e., overinflated).
To the extent that people are pathologically narcissistic, they can be controlling, blaming, self-absorbed, intolerant of others’ views, unaware of others’ needs and the effects of their behavior on others, lie pathologically, are promiscuous, and insist that others see them as they wish to be seen. Narcissistic individuals use various strategies to protect the self at the expense of others. They tend to devalue, derogate, insult and blame others, and they often respond to threatening feedback with anger and hostility Since the fragile ego of individuals with NPD is hypersensitive to perceived criticism or defeat, they are prone to feelings of shame, humiliation and worthlessness over minor or even imagined incidents. They usually mask these feelings from others with feigned humility or by isolating themselves socially, or they may react with outbursts of rage, defiance, or by seeking revenge. The merging of the “inflated self-concept” and the “actual self” is seen in the inherent grandiosity of narcissistic personality disorder. Also inherent in this process are the defense mechanisms of denial, idealization and devaluation.
Antisocial Personality Disorder (Psychopath, Sociopath)Antisocial personality disorder (ASPD) is a personality disorder in which a person fails to conform with socially accepted behavior. People with this disorder often disregard social norms or the rights of other people. Other names for the condition are psychopathy, sociopathy and dissocial personality disorder (DPD). However, because of the many definitions of psychopathy and sociopathy, those words are no longer used in a medical context; they are used, however, in the criminal justice setting.
The ASPD pattern begins in childhood or adolescence and continues into adulthood. People with ASPD have no conscience or sense of morality, although the large majority know right from wrong. Those with ASPD often commit crimes, have legal problems, and show behavior that is aggressive and, in the large majority of cases, impulsive, reckless and destructive.
According to the latest version of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-IV), a person has ASPD if they fit the following requirements:
A. Since age 15, the person has shown a pattern of not caring about and violating others’ rights. This pattern must be pervasive, meaning that the person habitually acts this way in different settings. This pattern is shown by at least three of the following actions:
- The person does not obey the law, and repeatedly does things for which he or she could be arrested
- The person often deliberately misleads and deceives others. He or she may do this by lying repeatedly, using aliases (false names), or conning other people (either for money or enjoyment).
- The person is impulsive or does not plan ahead.
- The person becomes irritated or angry easily and is aggressive. He or she repeatedly gets into physical fights or assaults others.
- The person shows no concern for other people’s safety or his/her own safety.
- The person is consistently irresponsible. He or she may not try to keep a job or honor financial obligations, like bills and debts.
- The person shows no remorse for hurting others; he or she hurts, steals from, or treats others badly, without remorse.
B. To be diagnosed with ASPD, the person must be at least 18 years old.
C. By age 15, he or she seemed to exhibit conduct disorder.
D. The person’s antisocial behavior is not caused by schizophrenia or a manic episode.
ASPD is not the same as psychopathy or sociopathy. The two are similar; people with both conditions may show similar behaviors. However, they are diagnosed differently. Using the DSM criteria, a diagnosis of ASPD is based on a person’s behaviors. No official, agreed-upon definition or set of diagnostic criteria exists for psychopathy, but most tools that measure psychopathy focus on personality characteristics as well as behaviors.
People with this illness may seem charming on the surface, but they are likely to be irritable and aggressive as well as irresponsible. They may have numerous somatic complaints and perhaps attempt suicide. Due to their manipulative tendencies, it is difficult to tell whether they are lying or telling the truth.
Psychopathy as a term had been inconsistently used in the medical community for years, but is now recognized as either a subcategory or extension of antisocial personality disorder. Critics have argued both for and against the idea that antisocial personality disorder and psychopathy are synonymous, but there has yet to be a concrete decision on the issue. The hallmarks of what’s typically seen as a psychopath include a lack of empathy and feeling for others, selfishness, lack of guilt, and a superficial charm that manifests exclusively to manipulate others.
The most commonly used device for identifying psychopaths is the psychopathy checklist-revised (PCL-R), a 20-item inventory of personality traits and recorded behaviors. Developed by Robert D. Hare in the 1970s, the checklist is administered in a semi-structured interview format, and operates on a point system based on whether a behavior (pathological lying, for example) can be reasonably matched to the subject. The subject is assigned a score between 0 and 40, with 40 being the maximum psychopathy and 0 the minimum. The cutoff for being labeled as a psychopath is 30 in the United States and 25 in the UK.
The twenty traits assessed by the PCL-R score are:
- glib and superficial charm
- grandiose (exaggeratedly high) estimation of self
- need for stimulation
- pathological lying
- cunning and manipulativeness
- lack of remorse or guilt
- shallow affect (superficial emotional responsiveness)
- callousness and lack of empathy
- parasitic lifestyle
- poor behavioral controls
- sexual promiscuity
- early behavior problems
- lack of realistic long-term goals
- failure to accept responsibility for own actions
- many short-term marital relationships
- juvenile delinquency
- revocation of conditional release
- criminal versatility
The terms malignant narcissist and psychopath are often used interchangeably because there is little to clinically separate the two. They all display similar traits which are outlined in the Hare Psychopathy Checklist. The primary difference is the psychopath is not an attention-seeker, but the malignant narcissist is still trapped by his or her need for approval, attention and adulation from others. The terms psychopath and sociopath are also often used to describe a similar subset of individuals with Antisocial Personality Disorder. The major difference between these two personality constructs is that a psychopath has no conscience, whereas a sociopath does, only it’s weak it doesn’t impact behavior.
In this blog, the terms psychopath, sociopath and [malignant] narcissist are used interchangeably.
Malignant Narcissism: A Combination of NPD and APD
Malignant narcissism is a psychological syndrome comprising an extreme mix of narcissism, antisocial personality disorder, aggression, and sadism. Often grandiose, and always ready to raise hostility levels, the malignant narcissist undermines organizations in which they are involved, and dehumanizes the people with whom they associate.
Why is the behavior of malignant narcissism often considered dangerous?
Individuals with this profile can form connections with others. However, they process information in ways that can hurt society in general, but also the people who love or depend on them. Family, co-workers, employees, and others in their lives often have to walk on eggshells to appease a fragile ego and minimize the occurrence of their unstable, impulsive, or aggressive behaviors.
They lash out or humiliate others for infractions of even the most frivolous nature (for example, you gave an opinion that differed from theirs; you demonstrated confidence, and it made them look bad; you told a joke that involved poking fun at them).
For some, their grandiosity and protection of their fragile “true self” can be at such extreme levels that they will lie and give the impression that simply because they say it, that makes it reality. Many will become angered if their lies are challenged with truth or facts. Of course, this can create problems for the people close to them, as this pattern of behavior can easily veer into gaslighting.
Their decisions can hurt others, because they rank relationships and people based on superficial standards and categories. They want to land on top, even when pretending to be altruistic or engaging in an activity that should not be “all about them.” They often view the world through a primitive binary lens (for example, winner/loser; smart/dumb; rich/poor; pretty/ugly; black/white) — all the while sustaining the belief that they are superior. This is likely associated with problems processing emotional information, which reflects faulty neurobiology.
They Have a “Sixth Sense” for Spotting the Right People to Manipulate
Narcissists and psychopaths / sociopaths are extremely good at sniffing out trusting, vulnerable people, who tend to see the good in others. Thus, they can be very difficult for “nice” people to spot until the offender has wreaked tremendous and undeniable havoc. Relatedly, because people tend to view others as subscribing to a generally accepted moral code (such as that lying and harming others is “wrong”), even an otherwise savvy person can work hard to find the “good reason” why someone is acting “off” rather than identifying problem personalities and behaviors for what they are. Feelings of anger, distrust, or fear about what we “know” about a loved one will cause great distress, otherwise known as “cognitive dissonance.” As a result, most of us wind up resolving this cognitive dissonance by reinterpreting facts that feel at odds with what we need and want to believe about someone.
“Chameleons” That Adapt and Change per Their Environment, Little Sense of “True Self”
The most amazing thing about a narcissist is their ability to change to suit any relationship. They are similar to chameleons in that they can change on a dime effectively altering who and what they are to blend into any environment for their own self gain. It’s all about power and control and keeping others below them. The narcissist senses a sort of power, has a grandiose ego, they feel they are truly above the law. These subtle ways of inquiry helps provide them with exactly what they need. However, it’s important to note these inconsistencies serve one purpose to get attention, the ego stroked, and their needs met. The truth is their behavior, the narc rage, the devalue and discard is exactly the same. All of the projection, the malicious acts, the lying, hoovering, smearing, lack of conscience, and the lack of remorse is identical to past relationships.
20 Traits of the Malignant Narcissist
1. THE PATHOLOGICAL LIAR is skillfully deceptive and very convincing. Avoids accountability by diverting topics, dodging questions, and making up new lies, bluffs or threats when questioned. His memory is self serving as he denies past statements. Constant chaos and diverting from reality is their chosen environment.
2. THE CONTRACT BREAKER agrees to anything then turns around and does the opposite. Marriage, Legal, Custody agreements, normal social/personal protocol are meaningless. This con artist will accuse you of being the contract breaker. Enjoys orchestrating legal action and playing the role of the ‘poor me’ victim.
3. THE HIGH ROLLER Successfully plows and backstabs his way to the top. His family a disposable prop in his success facade. Is charismatic, eloquent and intelligent in his field, but often fakes abilities and credentials. Needs to have iron-fisted control, relying on his manipulation skills. Will ruthlessly support, exploit or target others in pursuit of his ever-changing agenda. Mercilessly abuses the power of his position. Uses treachery or terrorism to rule or govern. Potential problem or failure situations are delegated to others. A vindictive bully in the office with no social or personal conscience. Often suspicious and paranoid. Others may support him to further their own Mephistophelian objectives, but this wheeler-dealer leaves them holding the bag. Disappears quickly when consequences loom.
4. THE SEXUAL NARCISSIST is often hypersexual (male or female). Pornography, masturbation, incest are reported by his targets. Anything, anyone, young, old, male/female, are there for his gratification. This predator takes what is available. Can have a preference for ‘sado-maso’ sexuality. Often easily bored, he demands increasingly deviant stimulation. However, another behaviour exists, the one who withholds sex or emotional support.
5. THE BLAME-GAME NARCISSIST never accepts responsibility. Blames others for his failures and circumstances. A master at projection.
6. THE VIOLENT NARCISSIST is a wife-Beater, Murderer, Serial Killer, Stalker, Terrorist. Has a ‘chip-on-his-shoulder’ attitude. He lashes out and destroys or uses others (particularly women and children) as scapegoats for his aggression or revenge. He has poor impulse control. Fearless and guiltless, he shows bad judgement. He anticipates betrayal, humiliation or punishment, imagines rejection and will reject first to ‘get it over with’. He will harass and push to make you pay attention to him and get a reaction. He will try to make you look out of control. Can become dangerous and unpredictable. Has no remorse or regard for the rights of others.
7. THE CONTROLLER/MANIPULATOR pits people against each other. Keeps his allies and targets separated. Is verbally skillful at twisting words and actions. Is charismatic and usually gets his way. Often undermines our support network and discourages us from seeing our family and friends. Money is often his objective. Other people’s money is even better. He is ruthless, demanding and cruel. This control-freak bully wants you pregnant, isolated and financially dependent on him. Appears pitiful, confused and in need of help. We rush in to help him with our finances, assets, and talents. We may be used as his proxy interacting with others on his behalf as he sets us up to take the fall or enjoys the performance he is directing.
8. THE SUBSTANCE ABUSER Alcohol, drugs, you name it, this N does it. We see his over-indulgence in food, exercise or sex and his need for instant gratification. Will want you to do likewise.
9. OUR “SOUL MATE” is cunning and knows who to select and who to avoid. He will come on strong, sweep us off our feet. He seems to have the same values, interests, goals, philosophies, tastes, habits. He admires our intellect, ambition, honesty and sincerity. He wants to marry us quickly. He fakes integrity, appears helpful, comforting, generous in his ‘idealization’ of us phase. It never lasts. Eventually Jekyll turns into Hyde. His discarded victims suffer emotional and financial devastation. He will very much enjoy the double-dipping attention he gets by cheating. We end the relationship and salvage what we can, or we are discarded quickly as he attaches to a “new perfect soul mate”. He is an opportunistic parasite. Our “Knight in Shining Armor” has become our nightmare. Our healing is lengthy.
10. THE QUIET NARCISSIST is socially withdrawn, often dirty, unkempt. Odd thinking is observed. Used as a disguise to appear pitiful to obtain whatever he can.
11. THE SADIST is now the fully-unmasked malignant narcissist. His objective is watching us dangle as he inflicts emotional, financial, physical and verbal cruelty. His enjoyment is all too obvious. He’ll be back for more. His pleasure is in getting away with taking other people’s assets. His target: women, children, the elderly, anyone vulnerabie.
12. THE RAGER flies off the handle for little or no provocation. Has a severely disproportionate overreaction. Childish tantrums. His rage can be intimidating. He wants control, attention and compliance. In our hurt and confusion we struggle to make things right. Any reaction is his payoff. He seeks both good or bad attention. Even our fear, crying, yelling, screaming, name calling, hatred are his objectives. If he can get attention by cruelty he will do so.
13. THE BRAINWASHER is very charismatic. He is able to manipulate others to obtain status, control, compliance, money, attention. Often found in religion and politics. He masterfully targets the naive, vulnerable, uneducated or mentally weak.
14. THE RISK-TAKING THRILL-SEEKER never learns from his past follies and bad judgment. Poor impulse control is a hallmark.
15. THE PARANOID NARCISSIST is suspicious of everything usually for no reason. Terrified of exposure and may be dangerous if threatened. Suddenly ends relationships if he anticipates exposure or abandonment.
16. THE IMAGE MAKER will flaunt his ‘toys’, his children, his wife, his credentials and accomplishments. Admiration, attention, even glances from others, our envy or our fear are his objective. He is never satisfied. We see his arrogance and haughty strut as he demands center stage. He will alter his mask at will to appear pitiful, inept, solicitous, concerned, or haughty and superior. Appears the the perfect father, husband, friend – to those outside his home.
17. THE EMOTIONAL VACUUM is the cruelest blow of all. We learn his lack of empathy. He has deceived us by his cunning ability to mimic human emotions. We are left numbed by the realization. It is incomprehensible and painful. We now remember times we saw his cold vacant eyes and when he showed odd reactions. Those closest to him become objectified and expendable.
18. THE SAINTLY NARCISSIST proclaims high moral standing. Accuses others of immorality. “Hang ’em high” he says about the murderer on the 6:00 news. This hypocrite lies, cheats, schemes, corrupts, abuses, deceives, controls, manipulates and torments while portraying himself of high morals.
19. THE CALLING-CARD NARCISSIST forewarns his targets. Early in the relationship he may ‘slip up’ revealing his nature saying “You need to protect yourself around me” or “Watch out, you never know what I’m up to.” We laugh along with him and misinterpret his words. Years later, coping with the devastation left behind, his victims recall the chilling warning.
20. THE PENITENT NARCISSIST says “I’ve behaved horribly, I’ll change, I love you, I’ll go for therapy.” Appears to ‘come clean’ admitting past abuse and asking forgiveness. Claims we are at fault and need to change too. The sincerity of his words and actions appear convincing. We learn his words are verbal hooks. He knows our vulnerabilities and what buttons to push. We question our judgement about his disorder. We can disregard “Fool me once…” We hope for change and minimize past abuse. With a successful retargeting attempt, this N will enjoy his second reign of terror even more if we allow him back in our lives.
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