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Old 01-12-2004, 04:42 PM
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Narcissistic Personality Disorder (NPD)
Definition, Fact Sheet and Tips


What is Narcissism?

A pattern of traits and behaviors which signify infatuation and obsession with one's self to the exclusion of all others and the egotistic and ruthless pursuit of one's gratification, dominance and ambition.

Most narcissists (75%) are men.

NPD is one of a "family" of personality disorders (formerly known as "Cluster B").

Other members: Borderline PD, Antisocial PD and Histrionic PD.

NPD is often diagnosed with other mental health disorders ("co-morbidity") - or with substance abuse, or impulsive and reckless behaviors ("dual diagnosis").

NPD is new (1980) mental health category in the Diagnostic and Statistics Manual (DSM).

There is only scant research regarding narcissism. But what there is has not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to NPD.

It is estimated that 0.7-1% of the general population suffer from NPD.

Pathological narcissism was first described in detail by Freud. Other major contributors are: Klein, Horney, Kohut, Kernberg, Millon, Roningstam, Gunderson, Hare.

The onset of narcissism is in infancy, childhood and early adolescence. It is commonly attributed to childhood abuse and trauma inflicted by parents, authority figures, or even peers.

There is a whole range of narcissistic reactions - from the mild, reactive and transient to the permanent personality disorder.

Narcissists are either "Cerebral" (derive their narcissistic supply from their intelligence or academic achievements) - or "Somatic" (derive their narcissistic supply from their physique, exercise, physical or sexual prowess and "conquests").

Narcissists are either "Classic" - see definition below - or they are "Compensatory", or "Inverted" - see definitions here: "The Inverted Narcissist".

NPD is treated in talk therapy (psychodynamic or cognitive-behavioral). The prognosis for an adult narcissist is poor, though his adaptation to life and to others can improve with treatment. Medication is applied to side-effects and behaviors (such as mood or affect disorders and obsession-compulsion) - usually with some success.

Please read CAREFULLY!

The text in italics is NOT based on the Diagnostics and Statistics Manual, Fourth Edition-Text Revision (2000).

The text in italics IS based on "Malignant Self Love - Narcissism Revisited", fourth, revised, printing (2003)

An all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts. Five (or more) of the following criteria must be met:

Feels grandiose and self-important (e.g., exaggerates achievements and talents to the point of lying, demands to be recognized as superior without commensurate achievements)

Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion

Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions)

Requires excessive admiration, adulation, attention and affirmation - or, failing that, wishes to be feared and to be notorious (narcissistic supply)

Feels entitled. Expects unreasonable or special and favorable priority treatment. Demands automatic and full compliance with his or her expectations

Is "interpersonally exploitative", i.e., uses others to achieve his or her own ends

Devoid of empathy. Is unable or unwilling to identify with or acknowledge the feelings and needs of others

Constantly envious of others or believes that they feel the same about him or her

Arrogant, haughty behaviours or attitudes coupled with rage when frustrated, contradicted, or confronted

Some of the language in the criteria above is based on or summarized from:

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, Text Revision (DSM IV-TR). Washington, DC: American Psychiatric Association.

The text in italics is based on:

Sam Vaknin. (2003). Malignant Self Love - Narcissism Revisited, fourth, revised, printing. Prague and Skopje: Narcissus Publication.

For the exact language of the DSM IV criteria - please refer to the manual itself !!!



FIVE DON'T DO'S
How to Avoid the Wrath of the Narcissist


Never disagree with the narcissist or contradict him

Never offer him any intimacy

Look awed by whatever attribute matters to him (for instance: by his professional achievements or by his good looks, or by his success with women and so on)

Never remind him of life out there and if you do, connect it somehow to his sense of grandiosity

Do not make any comment, which might directly or indirectly impinge on his self-image, omnipotence, judgment, omniscience, skills, capabilities, professional record, or even omnipresence. Bad sentences start with: "I think you overlooked ... made a mistake here ... you don't know ... do you know ... you were not here yesterday so ... you cannot ... you should ... (perceived as rude imposition, narcissists react very badly to restrictions placed on their freedom) ... I (never mention the fact that you are a separate, independent entity, narcissists regard others as extensions of their selves, their internalization processes were screwed up and they did not differentiate properly) ..." You get the gist of it.



The TEN DO'S
How to Make your Narcissist Dependent on You
If you INSIST on Staying with Him


Listen attentively to everything the narcissist says and agree with it all. Don't believe a word of it but let it slide as if everything is just fine, business as usual.

Personally offer something absolutely unique to the narcissist which they cannot obtain anywhere else. Also be prepared to line up future sources of primary NS for your narcissist because you will not be IT for very long, if at all. If you take over the procuring function for the narcissist, they become that much more dependent on you which makes it a bit tougher for them to pull their haughty stuff - an inevitability, in any case.

Be endlessly patient and go way out of your way to be accommodating, thus keeping the narcissistic supply flowing liberally, and keeping the peace (relatively speaking).

Be endlessly giving. This one may not be attractive to you, but it is a take it or leave it proposition.

Be absolutely emotionally and financially independent of the narcissist. Take what you need: the excitement and engulfment and refuse to get upset or hurt when the narcissist does or says something dumb, rude, or insensitive. Yelling back works really well but should be reserved for special occasions when you fear your narcissist may be on the verge of leaving you; the silent treatment is better as an ordinary response, but it must be carried out without any emotional content, more with the air of boredom and "I'll talk to you later, when I am good and ready, and when you are behaving in a more reasonable fashion".

If your narcissist is cerebral and NOT interested in having much sex - then give yourself ample permission to have "hidden" sex with other people. Your cerebral narcissist will not be indifferent to infidelity so discretion and secrecy is of paramount importance.

If your narcissist is somatic and you don't mind, join in on endlessly interesting group sex encounters but make sure that you choose properly for your narcissist. They are heedless and very undiscriminating in respect of sexual partners and that can get very problematic (STDs and blackmail come to mind).

If you are a "fixer", then focus on fixing situations, preferably before they become "situations". Don't for one moment delude yourself that you can FIX the narcissist - it simply will not happen. Not because they are being stubborn - they just simply can't be fixed.

If there is any fixing that can be done, it is to help your narcissist become aware of their condition, and this is VERY IMPORTANT, with no negative implications or accusations in the process at all. It is like living with a physically handicapped person and being able to discuss, calmly, unemotionally, what the limitations and benefits of the handicap are and how the two of you can work with these factors, rather than trying to change them.

FINALLY, and most important of all: KNOW YOURSELF.
What are you getting from the relationship? Are you actually a masochist? A codependent perhaps? Why is this relationship attractive and interesting?
Define for yourself what good and beneficial things you believe you are receiving in this relationship.
Define the things that you find harmful TO YOU. Develop strategies to minimize the harm to yourself. Don't expect that you will cognitively be able to reason with the narcissist to change who they are. You may have some limited success in getting your narcissist to tone down on the really harmful behaviours THAT AFFECT YOU which emanate from the unchangeable WHAT the narcissist is. This can only be accomplished in a very trusting, frank and open relationship.


(Co-authored with Alice Ratzlaff - More here: "The Inverted Narcissist")

http://www.healthyplace.com/communit...m_defined.html
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