Narcissistic Personality Disorder.pdf

3/27/24, 9:40 PM Print Preview Chapter 12: Personality Disorders: 12-3d Narcissistic Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. 12-3d Narcissistic Person...

3/27/24, 9:40 PM Print Preview Chapter 12: Personality Disorders: 12-3d Narcissistic Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. 12-3d Narcissistic Personality Disorder We all know people who think highly of themselves—perhaps exaggerating their real abilities. They consider themselves somehow different from others and deserving of special treatment. In narcissistic personality disorder (Cluster B (dramatic, emotional, or erratic) personality disorder involving a pervasive pattern of grandiosity in fantasy or behavior, need for admiration, and lack of empathy.) , this tendency is taken to its extreme (Pincus, 2020). In Greek mythology, Narcissus was a youth who spurned the love of Echo, so enamored was he of his own beauty. He spent his days admiring his own image reflected in a pool of water. Psychoanalysts, including Freud, used the term narcissistic to describe people who show an exaggerated sense of self-importance and are preoccupied with receiving attention (Ronningstam, 2012). Consider the case of Jae. Jae… It’s All about Me Jae was an office assistant in a small law firm. Now in his early 30s, Jae had an extremely poor job history. He never stayed employed at the same place for more than 2 years, and he spent considerable time working through temporary employment agencies. Your first encounter, however, would make you believe that he was extremely competent and that he ran the office. If you entered the waiting room, you were greeted by Jae, even though he wasn’t the receptionist. He would be extremely solicitous, asking how he could be of assistance, offer you coffee, and ask you to make yourself comfortable in “his” reception area. Jae liked to talk, and any conversation was quickly redirected in a way that kept him the center of attention. This type of ingratiating manner was welcomed at first but soon annoyed other staff. This was especially true when he referred to the other workers in the office as his staff, even though he was not responsible for supervising any of them. The conversations with visitors and staff often consumed a great deal of his time and the time of other staff, and this was becoming a problem. He quickly became controlling in his job—a pattern revealed in his other positions as well—eagerly taking charge of duties assigned to others. Unfortunately, he did not complete these tasks well, and this created a great deal of friction. When confronted with any of these difficulties, Jae would first blame others. Ultimately, however, it would become clear that Jae’s self-centeredness and controlling nature were at the root of many of the office inefficiencies. During a https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 1/5 3/27/24, 9:40 PM Print Preview disciplinary meeting with all of the law firm’s partners, an unusual step, Jae became explosively abusive and blamed them for being out to get him. He insisted that his performance was exceptional at all of his previous positions—something contradicted by his previous employers—and that they were at fault. After calming down, he revealed a previous drinking problem, a history of depression, and multiple family problems, all of which he believed contributed to any difficulties he experienced. The firm recommended he be seen at a university clinic as a condition of his continued employment, where he was diagnosed with major depression, as well as narcissistic personality disorder. Ultimately, his behavior—including lateness and incomplete work—resulted in his termination. In a revealing turn of events, Jae reapplied for another position at the same firm 2 years later. A mix-up in records failed to reveal his previous termination, but he lasted only 3 days—showing up late to work on his second and third days. He was convinced he could be successful, yet he could not change his behavior to conform to even the minimal standards needed to be successful at work. Clinical Description People with narcissistic personality disorder have an unreasonable sense of self-importance and are so preoccupied with themselves that they lack sensitivity and compassion for other people (Pincus, 2020). They are not comfortable unless someone is admiring them. Their exaggerated feelings and their fantasies of greatness, called grandiosity, create a number of negative attributes. They require and expect a great deal of special attention—the best table in the restaurant, the illegal parking space in front of the movie theater. They also tend to use or exploit others for their own interests and show little empathy. When confronted with other successful people, they can be extremely envious and arrogant. And because they often fail to live up to their own expectations, they are often depressed. Causes and Treatment We start out as infants being self-centered and demanding, which is part of our struggle for survival. Part of the socialization process, however, involves teaching children empathy and altruism. Some writers, including Kohut (1971, 1977), believe that narcissistic personality disorder arises largely from a profound failure by the parents of modeling empathy early in a child’s development. As a consequence, the child remains fixated at a self-centered, grandiose stage of development. In addition, the child (and later the adult) becomes involved in an essentially endless and fruitless search for the ideal person who will meet their unfulfilled empathic needs. In a sociological view, Christopher Lasch (1978) wrote in his popular book The Culture of Narcissism that this personality disorder is increasing in prevalence in most Western societies, primarily as a consequence of large-scale social changes, including greater emphasis on short-term hedonism, individualism, competitiveness, and success. According https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 2/5 3/27/24, 9:40 PM Print Preview to Lasch, the “me generation” (“baby boomers” born between 1946 and 1954) produced more than its share of individuals with narcissistic personality disorder. Indeed, reports confirm that narcissistic personality disorder is increasing in prevalence (Huang et al., 2009). However, this apparent rise may be a consequence of increased interest in and research on the disorder. Research on treatment options is extremely limited in both number of studies and reports of success (Cloninger & Svakic, 2009; Dhawan, Kunik, Oldham, & Coverdale, 2010; Ronningstam, 2014). When therapy is attempted with these individuals, it often focuses on their grandiosity, their hypersensitivity to evaluation, and their lack of empathy toward others (Beck et al., 2007; Campbell & Miller, 2011). Cognitive therapy strives to replace their fantasies with a focus on the day-to-day pleasurable experiences that are truly attainable. Coping strategies such as relaxation training are used to help them face and accept criticism. Helping them focus on the feelings of others is also a goal. Because individuals with this disorder are vulnerable to severe depressive episodes, particularly in middle age, treatment is often initiated for the depression. It is impossible to draw any conclusions, however, about the impact of such treatment on the actual narcissistic personality disorder. DSM 5 Table 12.8 Diagnostic Criteria for Narcissistic Personality Disorder A pervasive pattern of grandiosity (in fantasy or behavior), 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: 1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements). 2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. 3. 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). 4. Requests excessive admiration. 5. Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations). 6. Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends). https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 3/5 3/27/24, 9:40 PM Print Preview 7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others. 8. Is often envious of others or believes that others are envious of him or her. 9. Shows arrogant, haughty behaviors or attitudes. From American Psychiatric Association, (2022), Diagnostic and statistical manual of mental disorders (5th ed., Text Revision). Concept Check 12.3 Correctly identify the type of personality disorder described here. 1. Kayla has low self-esteem and usually feels empty unless she does dangerous and exciting things. She is involved in drugs and has casual unprotected sexual encounters, even with strangers. She threatens to take her own life if her partner suggests getting help or if they talk about leaving her. She alternates between passionately loving and hating them, sometimes going from one extreme to the next in a short time. 2. Lance is 19 and has been in trouble with the law for the past 2 years. He lies to his parents, vandalizes buildings in the community, and often fights with others. He shows no remorse for the people he injures or the grief that he causes his ailing parents. 3. Madison thinks she is the best at everything. She thinks her performance is always excellent and is extremely critical of anyone else’s success. She constantly looks for admiration and reassurance from others. 4. Tyesha is known for being overly dramatic. She cries uncontrollably during sad movies, and her friends sometimes think that she is acting. She is vain and self-centered, interrupting many of class conversations to discuss her personal life. Chapter 12: Personality Disorders: 12-3d Narcissistic Personality Disorder Book Title: Psychopathology: An Integrative Approach to Mental Disorders Printed By: Wefae Ali ([email protected]) © 2023 Cengage Learning, Inc., Cengage Learning, Inc. https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 4/5 3/27/24, 9:40 PM Print Preview © 2024 Cengage Learning Inc. All rights reserved. No part of this work may by reproduced or used in any form or by any means graphic, electronic, or mechanical, or in any other manner - without the written permission of the copyright holder. https://ng.cengage.com/static/nb/ui/evo/index.html?deploymentId=607607251305910651374883797&eISBN=9780357657881&id=1993194890&nbId… 5/5