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 The
way that Personality Disordersdevelop, such as Narcissistic Personality
Disorder, is through the process of individuation. When a child is born
they are completely egocentric, which means that they do not recognize
that other people are anything other than a part of themselves. This is
nature’s way of allowing a baby to feel safe although in reality
they are totally helpless and vulnerable.
At one and a half
a child develops permanence of objects. This means that if you hide some
keys that a child is playing with “out of sight is out of mind”
before this age. Now a child realizes that things are separate and permanent.
This throws the child into the first existential anxiety, fear of abandonment,
abandonment depression, fear of dying, fear of death, separation anxiety,
which all leads to attachment hunger. A child desperately needs reassurance
by both parents and a safe world order. If parents and the world are secure
then the child feels safer.
If parents abandon
the child he will stay in this psychological state of neediness and if
parents or the world spoil them then the child does not get the idea that
other people are real people and remain semi-objects. There are numerous
kinds of personality disorders, but they all share this development with
only a few differences. Any kind of abandonment or abuse makes the development
less healthy.
The definition of
Narcissistic Personality Disorder listed in the DSM4, which is the diagnosis
bible of psychiatry is as follows. “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 5 (or more) of the following:
- Has a grandiose
sense of self-importance (exaggerates achievements and talents, expects
to be recognized as superior without commensurate achievements).
- Is preoccupied
with fantasies of unlimited success, power, brilliance, beauty, or ideal
love.
- 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).
- Requires excessive
admiration
- Has a sense of
entitlement, i.e., unreasonable expectations of especially favorable
treatment or automatic compliance with his or her expectations.
- Is interpersonally
exploitive, i.e., takes advantage of others to achieve his or her own
ends.
- Lacks empathy:
is unwilling to recognize or identify with the feelings and need of
others.
- Is often envious
of others or believes that others are envious of him or her.
- Shows arrogant,
haughty behaviors or attitudes.
All personality disorders,
like most other things, are best viewed on a continuum. There are mild,
moderate, and severe cases. In moderate to severe, the hallmark of the
disorder is that they see other people as objects and not live people.
Therefore, you can’t really have a friendship with them. It is a
difficult problem to fix because of the early developmental origin of
the problem and usually motivation is limited. A person suffering with
personality disorders often needs to be seen for years.
© 2004
Jef Gazley, M.S., LMFT, DCC
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