What is Narcissistic Personality Disorder? (NPD)

NPD is a mental health condition that usually develops in adolescence or early adulthood and is characterized by;

• Persistent Grandiosity
• A superior sense of self/Inflated sense of self-importance/ arrogant
• Abuse of Power & Control/ Impersonally exploitative behaviour
• A need for Excessive admiration and praise
• A fragile self-esteem
• Lack of empathy/ An inability or unwillingness to recognize the needs of others
• Sense of Entitlement/Pretentious and boastful
• A belief that they are special & unique
• Preoccupied with fantasies of unlimited success, power, Ideal love
• Arrogant & Demanding
• Reacts negatively/Aggressively to criticism
• Encounter difficulties in relationships
• Accept no responsibility for their actions

What are the causes of NPD?

While the causes of NPD are not well known, and the area requires further study, many cases are believed to be due to:

• Childhood abuse/neglect
• Unpredictable or unreliable caregiving by parents
• Unrealistic expectations from parents
• Excessive parental control
• Excessive praise for good behaviours in childhood
• Excessive criticism for bad behaviours in childhood
• Cultural influences
• Heritability

How is NPD diagnosed?

In order to qualify as symptomatic of NPD, the individuals manifested personality traits must substantially differ from the cultural norms of society. Identifying the distinctive traits of narcissism is a core element in the diagnostic process. A mental health professional must first rule out all other potential causes for symptoms (other personality disorders, accident/brain injuries, etc.

NPD is rarely the primary reason for someone seeking treatment, due to the nature of the illness, narcissists do not accept that the problems with their behaviour or the difficulties that they encounter in life, is of their own doing. Diagnosis is usually prompted by other difficulties, for example; finding themselves on the wrong side of the law due to being abusive in a relationship, losing their temper or because of substance misuse, etc.

Treatment of NPD

Counselling and psychotherapy, CBT, and transference-focused therapy are often used to treat NPD. There are mixed findings on how successful these treatments are, further study is required. It is reported, however, that psychotherapy for treating NPD has a high drop out rate. Psychiatric medications are not considered effective in treating NPD but may be given to treat co-existing symptoms, such as anxiety or depression.