Recognizing the Signs of Narcissistic Personality Disorder

Narcissism: the term is casually used to describe people who are vain, egotistical or self-absorbed. It’s true that many people may display certain narcissistic tendencies and these traits may be annoying or bothersome. However, they are very different and much less damaging than the characteristics of a person with a full-fledged narcissistic personality disorder.

A person with narcissistic personality disorder may display a powerful sense of entitlement or wildly exaggerated self-importance. He is probably arrogant and may lack empathy for the feelings of other people. In fact, he may be comfortable with taking advantage of other people or demanding that they recognize his superior qualities and talent. A narcissist requires
constant admiration and may be preoccupied with fantasies of beauty, wealth, power, omnipotence and success. In some cases, narcissism is accompanied by severe depression or anxiety.

Although women can have the disorder, narcissists are predominantly men. The symptoms may intensify through the years, reaching a fever pitch by the time the person reaches middle age. The disorder can threaten not only personal relationships, but also employment and financial affairs.

Living with a narcissistic is extremely difficult. Narcissists tend to be manipulative, critical, controlling and may be verbally or emotionally abusive. Their partners may feel crazy, guilty, anxious or confused by the behavior. They often blame themselves and become hopeless and depressed. Stress and lack of sleep can lead to physical illness.

People with narcissistic personality disorder rarely seek help because they don’t think they have a problem, or they blame other people. However, a narcissist may seek treatment when the disorder begins to interfere with their daily lives, or if the stress becomes too much to handle. Diagnosis should be made by a trained mental health professional, not a family physician
or general practitioner.

Experts don’t know for sure what causes the disorder, but most agree it is a combination of biological, genetic and social factors. Treatment usually consists of intensive psychotherapy. Medication isn’t usually prescribed for the disorder, but may be used to treat symptoms of depression or anxiety. Group therapy is sometimes helpful.

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  • I have a very long time friend that  told me he has NPD. I think your information is very thorough but you did not focus on the flip side of the condition. While all the things you said are true- there is another thing that people with NPD have happen. After they have done all those things you mentioned they go thru a period of very critical self loathing and excessive guilt. It is as thought (as I understand from some sources on this disorder)  deep inside that is the way that the individual truly feels to begin with (unworthy and loathsome). They put forth this very brutal shell personae in an effort to compensate (overly so) for their very low sense of self worth. When the individual with NPD does not truly believe their own performance, or feels very bad because of it they can sink into a very deep depression and become quite critical of their own self being. It is my understanding this is almost a cyclical phase and the triggers depend on whether they are somatic or cerebral.

    My question is- even with group therapy or cognitive behavior therapy can people with NPD level off some of their more radical behavioral traits? If I was to believe Sam Vaknin it would seem the answer would be no. I don't know if I completely believe that. Is there better resources on this condition available? What can I do as a friend to be a good friend to someone with NPD?

  • One person who has this kind of narcissistic personality disorder is actually a famous director named Woody Allen. I'm not sure if you've heard of him, but his movies are all narcissistic. He often conveys the same message in most of his movies, wherein he states that the world is so temporary and within years we'll all be gone and forgotten.

    Because of that sad truth, the protagonists in his movies are all quite narcissistic.
  • I understand NPD too well.  Also covert narcissism is interesting....You know, the ones who need all that attention, yet they don't come right out and say it...So they do all sorts of nice things for people, like a charity or something.  They come across as heroes, but they are certainly not doing it for the right reason.  It is very frustrating to deal with a narcissist. Most cannot ever see their "issue", so efforts to get them to change can be fruitless. Sometimes you just have to walk away and wish them well.  
  • I believe that this condition also links to several personal insecurities and narcissism is just a person's defense mechanism to actually help the self feel good.  In most cases, if you trace back to a person's personal history, you'll see several instances where a person got very disappointed about something that they ended up hating themselves.  However, what happens on the contrary is that this hate towards self comes out as too much self-loving.  
  • I think NPD comes across as a masculine disorder, in the way that the traits are described in the DSM IV. But in reading about it, I think females may just go undiagnosed, as their presentation of the disorder can be slightly different than men's. I read a great article about narcissists who often cry, they act like a wounded victim, always searching for attention, their illnesses and problems are always center stage.  This is different than the image of a male narcissist who is pretentious and arrogant, showing off his achievements. 
    It's is a very interesting disorder considering the different ways it can present itself. Also my understanding is that there really is no help for these people. 
  • I can't stand narcissistic people. They are just so annoying!

    Also, I think narcissism pairs very well with eating disorders and online / social media addictions. I had a narcissistic "friend" who was like this. Just kept insulting me and tell me how she was better than me, but in fact she was just a loser and didn't do anything good with her life. Now she is an anorexic marijuana smoker.
  • First of all, no narcissist will ever tell you that they are a narcissist or that they have been diagnosed with NPD (even if they have) - narcissists are not willing to even consider that they may be narcissistic and will deny it until their death. That is one of the  main characteristics of NPD - denial and repression.

    Most narcissists are male but female narcissism is usually more covert (i.e. covert narcissism). It's very unlikely that you can ever get a narcissist to go to therapy, they do not have a problem, it's everyone else who is the problem, and even if you did get them to go you would be asking for trouble - they will usually manipulate the therapist into tag-teaming you/the victim. Diagnosis of NPD is usually done via proxy but is not official.

    No type of therapy has been shown to be beneficial to those inflicted with NPD, it requires a traumatic, false-self shattering experience to be initiated and even then they wouldn't get far. NPD is incurable and there is no medication for it. Narcissists inflict emotional abuse, emotional blackmail, mental abuse, psychological manipulation and financial abuse on their victims whilst destroying their identity in both an official and personal capacity, ostracizing them and cutting off their contact with family and friends.

    Once your in the grasp of a narcissist, there will be no escape.  Narcissists are not either somatic or cerebral, there are also many other types of (malignant) narcissism - elite narcissism, covert narcissism, co-narcissism (inverted narcissism) and many more.  Narcissists have a complete lack of empathy and cannot relate to other people's emotions.

    It's also well known within the mental health community that most narcissists were subject to extreme forms of long-term abuse during their childhoods, with a high percentage of them having suffered sexual childhood abuse. It should also be noted that overly spoiling and smothering a child is also a form of abuse at the opposite end of the spectrum, which can lead to inverted narcissism.

    All rapists and murderers are narcissists but not all narcissists are rapists/murderers.
  • @Androl, I would agree with part of what you are saying about NPD, but I think there are two important arts you skimmed over, first being many people with NPD do have secondary sources that serve to help them maintain a sense of inner balance when the world is not going like they think it should. I am not certain that people with NPD are 100% devoid of feelings or emotions, it is my understanding they actually are very sensitive emotionally and the out narcissistic shell is the defense. If you approach the issue from that standpoint it is easier to understand the motivation behind all the crazy making that will be a given.  I think you will always find a few people that have been around as secondary sources, if they are not around or rotated out is because things just got to close. They will be back, like you said there is no escape.

    The second point I wanted to mention is some people with NPD will indeed be straight forward about what is going on, it is indeed something that can be diagnosed more often in the course of an incarceration then by free will. It has been my experience if a person with NPD losses a stable secondary source or gets in enough trouble they will not hesitate to play the mental illness card to get out of it. Definitely manipulation, but it can be the beginning cracks that help to temper the walls that were built. I have wondered in these cases if there is a possibility of things like aspergers or autism presenting more like NPD.
  • @sunnydaze, that is a good point you bring up about NPD's having emotions and actually being very sensitive. I believe that is very true. I think NPD's are filled with emotions, but the emotions will always have to do with them, and how something effects them, never a feeling of sadness or happiness for another. 
  • I think that this sort of disorders actually is because they are really fragile people and they cover it up like if they own the world.
  • @SunnyDaze
    Oh, I absolutely agree that they are not 100% devoid of emotion, neither are they devoid of conscience. They actually have an overwhelming amount conscience and the emotions that they do have are so pronounced, unbearable and overwhelming to deal with that they repress them, or at least what they can. When you say secondary sources, do you mean sources of narcissistic supply? That's what it sounds like you're describing.

    "The second point I wanted to mention is some people with NPD will indeed be straight forward about what is going on"
    - the only time this has ever happened is in the case of 'self-styled'  narcissists. They may be narcissistic but they do not genuinely have the full Narcissistic Personality Disorder.

    "it is indeed something that can be diagnosed more often in the course of an incarceration then by free will" - this is true. It has also been diagnosed by proxy but that's not usually an official diagnosis. I believe there has only been one court case where NPD was used and that was used as a defense for the narcissist under mitigating circumstances.
  • @androl ; " this is true. It has also been diagnosed by proxy but that's not
    usually an official diagnosis. I believe there has only been one court
    case where NPD was used and that was used as a defense for the
    narcissist under mitigating circumstances."

     I think the reason for this is because it is possible that because NPD is a mental illness more of these individuals that get in trouble are sent to psychiatric hospitals then prisons. You can bet your bottom dollar that when things go wrong in the NPD world they will not hesitate to put on a grand show of some sort, they will say they are suicidal or even say they are mentally ill (if they know) because it is a far easier ride then doing time.

    If the individual with NPD is oblivious of their state, I think once in a position of powerlessness it can be determined that something is just not right and perhaps an eval is in order.  More often then not, if it is something minor the narc is more then able to talk themselves out of a situation. They just do not throw off the same tell a tale signals that other people do. Eventually though, if they are really the bad sort... it catches up to them in one form or another.

    "When you say secondary sources, do you mean sources of narcissistic supply? That's what it sounds like you're describing."     Yes in the writings on narcissism by Sam Vaknin he states that people with NPD tend to incorporate a system of narcissistic supply thats divided as primary supply and a secondary supply. When the primary supply is insufficient they will return to a secondary source. Hence the hoovering and things of that nature- these tactics are designed to help reel back in people that can better feed the emotional needs of the narc. A secondary source can be around for decades, usually a family member, relative or some closer relation of some sort. They are the ones that get the worst of the crazy making, yet ironic are the de facto nurturers of the narc. 
  • I don't really have problems with narcissistic people as long as they don't harm or they don't do anything wrong with me. But sometimes, it's quite annoying when they tend to be arrogant and consider themselves of highly importance to the point that they treat others badly such as just belittling them. The most narcissistic person I know is Kanye West. That guy is really getting on my nerves.
  • It's annoying by the simple fact that we have to relate with them dyan, it's a bad vibe I feel when someone think that they are the center of the universe. 
  • this has been a good thread and very informative. thank you so much everyone and especially @androl and @sunnydaze for your expertise and thoughts.
  • Yes, I am very sad to say that I married a narc. Now, my children's father is a narc, which is why I am writing a book on taking your dating life seriously.  I met him at 18, and I have told people he was like a boa constrictor...  I could not get out.  He was extremely emotionally abusive, and then when I would break up with him...   he would stalk me until I gave him (weak will, low self-esteem type person, yes).  I have since learned that that's the type of person they prey on, unfortunately. 

    And... yeah...  if you know anything about the cycle of abuse...  I was stuck in that.  I finally got away when I was 42...   I told him I would get a restraining order out on him, and he knew if that hit the news it could harm him professionally, so that was that. Ironically, he married again, and his second wife ended up leaving him, and moving in with me. She, too, was in her 40s, and I saw him reeling her back in!  And... she was a smart girl!  I wonder why there seems to be a correlation between intelligence and narc? 

    But...  yeah...  he had extreme abuse in his childhood (as did I), but my dysfunction showed up in other ways.  His  mom once said that the movie Radio Flyer was their life to a T!  Extremely abusive step father, and mother was always away working. 
  • Oh yeah...  second wife did not go back to him, so he has moved on to another vunerable soul.  My daughter said that she had all this plastic surgery done (probably due to his criticism), and she told my daughter...   Your dad said that if I lost 5 lbs, I would be perfect (and this is a grown woman...  NOT a teenager).  So sad. 
  • I dated a guy like that. I had a really hard time leaving him. When I would think about it I would think to myself: " If i don't love him, then who will?" everybody deserves love, even him.
  • I'm curious as to why this would be considered primarily a male disease - I've known many women who posses these same traits, and are constantly starving for attention and are very manipulative. 

    I once worked at an office, where several of our other employees were all siblings. In addition, they had another sister, who wasn't an employee of the place but she didn't work either and she would spend all day hanging around our office bothering us. She acted like she was gods gift to mankind, and anyone with a penis should fawn over her 24/7. Her husband divorced her (I don't blame him one bit) and since then she refuses to pursue a career of her own and support herself, and instead makes her family pay all her bills - while she just flakes out and does nothing with herself. 

    She would stand outside my office door literally for hours, twirling her hair and interrupting me to chat about stupid crap non-stop. I would literally have to get up and shut my office door in her face. It's so exhausting and infuriating to be around people like this, especially when you can't make them go away.
  • I suspect my MIL is a narcissist.  She often does all kind of charades to get all the attention, like for example good actions.  I know they are all charades though, because she is not a good person, she enjoys making fun of people, even how they look, she always wants to be right, even if she is wrong.  

    She I will often start a debate or contradict everyone.  All conversations have to be about her, most of the time it's only her talking... she always turns any conversation on her. It's all about how wonderful she is, how smart she is, how she always knows more than you and you are a total idiot. Horrible woman.   If she really meant all those good deeds she'd not be telling everyone about them. 
  • My mom is a classic NP. Nothing she does can ever be wrong or incorrect. Anything wrong that she does, if you point it out - she twists everything around and says that you actually did what you're accusing her of doing! She's very good at it. I grew up not knowing what was real and what was her made up version of the world. She acted like everyone was out to get her and taught me that. I actually have to take medication for paranoia now due to being raised that way.
  • I found this thread to be very informative.  For years I've been trying to pinpoint my brother's odd behavior, (he no longer speaks to me--in reading what I have I now realize that it is because he can't stand what I found out about him years ago and it is easier for him to label and blame me).  He always had trouble finding a girlfriend despite the fact that he had a good job and a good deal of money.  He is not unattractive  so what was the problem. His attitude.  When I would double date with him he would make everyone feel uncomfortable by putting down complete strangers that were at the same event as us.  Furthermore, he would carry on conversations designed to highlight his achievements and subjects he would be the expert on, and any attempt to change it to something lighter met with a disdainful sigh of impatience from him.  
    He finally married a woman and continues to think that he is better than everyone else.  He has one daughter and it seems as if she follows in his footsteps.  She is 23 almost 24 and a university graduate.  Yet she has never had a job and won't take one that she thinks is beneath her but how is she ever going to get any experience.  She spends her days dabbling in oil paints but isn't very good at it.  She has no friends to speak of and has never been on a date.  Before she ends up as stuck up and alone as my brother, what can a person to shake her out of this?  Her and my brother sit around having long discussions and excluding everyone else.  I know all this because we all live in the same city and they visit with my mother often who tells me about it.  
    I also have an uncle that we think might be autistic.  Is a narcissistic personality almost just a different form of autism? I almost see similarities even if some of the things are almost opposite.
  • The only way to fix people like this is to ignore them completely and become very productive and successful in your life. As they see that your life is changing and theirs is not, they will start to adjust their attitude. Because they feed of your attention and draining you emotionally and taking your valuable time.
  • @SunnyDaze That's what I thought you meant but don't rely on Vaknin's material too much. Sam Vaknin himself is a fraud and is a self-styled narcissist and psychopath. Don't get me wrong, he does have some excellent information about NPD out there but he has also deliberately tried to twist the truth about inverted narcissism and covert narcissist in order to try to portray himself in a different light. Neither is he qualified. His diploma is fake and is not in either psychology or psychiatry.
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