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Understanding Narcissistic Personality Disorder


In modern times, calling someone a narcissist has become a cultural norm, often interchanged with someone we believe to be self-centered. However, a narcissistic personality disorder is a mental condition that actively inhibits an individual’s daily life in every facet — their relationship with themselves and those around them, their job and livelihood, and their reputation.

What is narcissistic personality disorder?

Experts estimate that up to 5% of people have narcissistic personality disorder, among the ten types of personality disorders an individual can have. NPD is a mental condition that causes individuals to possess an inflated sense of self-importance and a deep desire for admiration and attention from external parties, a lack of empathy for those around them, and a fraught experience of relationships in their lives as a result. 

NPD affects several areas of an individual’s life, including personal relationships, family, friends or romantic partners, work, and school. Those with NPD tend to experience general unhappiness and disappointment when they do not receive the special treatment and praise they think they deserve, thus unfulfilling their relationships.

What causes narcissistic personality disorder?

While there’s no specific singular cause of NPD, there are believed to be several biological and environmental factors that lead to NPD in adulthood. In addition, there have been studies conducted that have suggested there is a genetic predisposition to NPD. When it comes to common traits in those with the condition, there tends to be a presence of aggression, a lowered tolerance for personal distress and inhibited affect regulation, which is how we take control of our moods to enjoy the high periods and mitigate our lows.

Other studies have shown negative developmental experiences, such as facing rejection in our youth or experiencing a bruised ego during adolescence. Receiving excessive praise as a child can also contribute to NPD as an adult.

What are the signs and traits of narcissistic personality disorder?

There are several traits that an individual with NPD will exhibit that will present themselves by early adulthood. For example, it’s common for those with the disorder to show five or more of the following traits, including a sense of self-importance, preoccupation with their fantasies of success, power, and beauty, believing that they are special and can only associate with other special people, desire for excessive admiration, entitlement, lack of empathy, envy, and arrogance.

These individuals also can expect recognition without putting in the necessary work, tend to over exaggerate their successes, belittle and take advantage of others, and want the best of everything in their lives.

To be diagnosed with NPD, a mental health professional, including a psychologist or psychotherapist, can determine if someone possesses the traits of an individual with the condition. They will tend to review the root cause of one’s distress, go through patterns of behaviors, thoughts, and feelings, and try to rule out other mental health conditions that the individual could have to mitigate a misdiagnosis.

Can narcissistic personality disorder be treated?

While someone with NPD can seek treatment and complete the process successfully, it can be rare due to their sense of self-importance and generally defensive behaviors toward help and change. Therefore, for those with this condition, it is essential to find a therapist trained explicitly in individuals with NPD for the individual to learn how to be more compassionate and understanding when it comes not only to themselves but to the people they interact with, too. 

Several modalities are used, with some explicitly tailored for NPD and others for some, but not all, narcissistic patients. One of the modalities is psychodynamic and psychoanalytic treatment, which includes psychodynamic psychotherapy, mentalization-based treatment, clarification-oriented psychotherapy, intensive psychoanalytic psychotherapy, and psychoanalysis. Another modality includes cognitive-behavioral treatment, which can entail schema-focused therapy, metacognitive interpersonal therapy, cognitive behavioral therapy, and dialectical behavioral therapy. 

There is often a heavy focus on relationship building and community to forge healthier connections, repair one’s self-esteem and develop a healthier approach, set realistic expectations of others, and find positive ways to relate to others.

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