Narcissistic Personality Disorder

by Jef Gazley, M.S., LMFT, DCC

The way that Personality Disorders develop, 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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