NARCISSISTIC PERSONALITIES
Identifying, understanding and relating to them
Claudia Diez, PhD, ABPP
Board Certified Specialist in Clinical Psychology
Supervising Psychologist
St. Luke‟s-Roosevelt Hospital Center
Assistant Clinical Professor, Columbia University
info@drclaudiadiez.com
http://www.drclaudiadiez.com
http://www.slrpsych.org
What is “Narcissism”?
From Greek myth of Narcissus, a metaphor of self-
absorption and inability to love
A normal aspect of Personality
self-care and self-esteem; assertiveness
need to secure status for self-preservation (Hogan, 1982)
Needed for self-sustainment
Normal Narcissist: Competitive, Self-Assured, Bold
Exists in a continuum: Normal Pathological
Involves adaptive and maladaptive traits
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Socio-Cultural Perspectives
Lasch: The Culture of Narcissism (1979)
Cultural criticism of contemporary American society as
promoter of pathological narcissism
Erosion in allegiance to community; condoned individuality
Raskin: Narcissistic Personality Inventory (NPI,
1988)
Identified seven aspects of narcissism
How Narcissistic
Authority, Self-Sufficiency, Superiority
am I?
Exhibitionism, Exploitiveness Quiz - NPI-40
Vanity, Entitlement
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Socio-cultural Perspectives
“Generation Me”
“Today‟s young Americans are more confident, assertive,
entitled.. . than ever before” (Twenge, 2006)
Narcissism Epidemic?
NPI-40 used to research trends in narcissism in America
Findings: “rampant rise of narcissism” in our society
Indictment of the “Self-esteem” movement of the 70‟s
propelled by California‟s legislature "Self Esteem Task Force“
Met severe criticism, yet findings stand strong
Other cultural expressions: Honor Codes/killings?
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Organizational Psychology
Narcissistic Leaders
High Entitlement, Excessive Confidence, Fantasized Talent
Focused on “getting ahead”, risks excessively, berates
employees, pursues personal agendas
“Emergent Leaders” (seek Self-Promotion)
Not necessarily “Effective Leaders”
Narcissism at the root of Managerial Derailment
What about the followers?
(Hogan, Robert, 2008)
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Narcissism in organizations
Gordon Gecko, “Wall Street”
„If you want a friend, get a dog”
Gordon Gecko to Bud Fox in “Wall Street”
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Shut up, Listen and Learn!
“Swimming with sharks”, Ch. “Sweet & low”
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Pencils are more important
“Swimming with sharks”, Ch. “you are nothing”
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Narcissism as a Clinical Disorder
Term coined in psychology in 1898 by H. Ellis
Largely adopted by Freud and psychoanalysis
Appears in the DSM-III in 1980
“Personality Disorder” is:
An inflexible, maladaptive, persisting pattern of behaviors
Causing significant functional impairment (in the world)
Or
Causing significant distress (subjectively)
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DSM: Diagnostic and Statistical Manual of Mental Disorders, now in its 4th Edition, TR (2000)
Narcissistic Personality Disorder
DSM-IV TR Diagnostic Criteria
Pervasive pattern of grandiosity, need for admiration, lack of
empathy; beginning in adulthood, indicated by five (+) of the following:
grandiose sense of self-importance
fantasies of unlimited success, power, beauty, etc.
believes he/she is "special"
requires excessive admiration
has a sense of entitlement
is interpersonally exploitative
lacks empathy
is often envious, or believes that others are envious of him
shows arrogant behaviors or attitudes
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Hack it, or Pack it!
11 The Great Santini, “failed score”
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Narcissism as a Clinical Disorder
Not all narcissists are created equal
Shedler‟s Typology (1)
Grandiose/malignant
Fragile
High Functioning/Exhibitionistic
Other distinctive features
Emptiness, sense of “being false, fraudulent”
(1) Shedler et al, 2008. Refining the Construct of Narcissistic Personality Disorder: Diagnostic Criteria and Subtypes; (Am J Psychiatry 2008; 165:1473–
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Faces of Pathological Narcissism
Abusive Partners Rapists
Celebrities Cult Leaders
Con Artists Stalkers
White Collar Criminals Gang Members
Moderate Narcissism
Overbearing/obnoxious /cruel parents, demanding or
callous partners, inconsiderate coworkers, etc….
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Empathy, Shame, Envy
Empathy
inner capacity of sharing and comprehending the
psychological state of another person
Shame
painful social emotion caused by the experience of feeling
inferior or losing value in the estimation of others
Envy
painful social emotion caused by the thought of another
person having something that one does not have oneself
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Origins of Narcissism
No known link to genetics
Biological (neurophysiological paths) imprints
in early childhood
Origins ascribed to early attachment and
parenting, resulting in specific pattern of
affect regulation
15 Schore, Allan (2009). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development
Normal Human Development
Parental Attunement
Under normal circumstances,
caregiver help child to handle
intense or stressful affect
Development of empathy
Tolerance of shame
“Monkey see, monkey do” (mirror
neurons; mimicry)
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Origins of Pathological Narcissism
Unattuned Parents cannot model affect regulation
Resulting in diminished capacity for empathy
Child is in some way “Special” to the parent
“Narcissistic children often occupy a pivotal point in the family structure,
such as being ….the one that is supposed to fulfill family aspirations….”
Child raised in overtly well-organized home, but with parent(s) present a
degree of callousness and subtle aggression
Child may have an inherent quality that arouses admiration or envy such as
beauty, special talent, etc. ( I.e: Pageant Queen/Mother)
Kernberg, 1984. Severe personality disorders. New Haven: Yale University Press
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Paths to Pathological Narcissism
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Narcissistic Cognitions
Underlying Assumptions (Schemas)
Entitlement/Grandiosity Approval Seeking
Emotional Deprivation Insufficient Self-Control
Defectiveness/Shame Mistrust/Abuse
Subjugation /Control Unrelenting Standards
Young, (1998). Schema-focused therapy for narcissistic patients. In E. Ronningstam (Ed.), Disorders of narcissism:
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Diagnostic, clinical and empirical implications
Extreme (Malignant) Narcissism
Charles Manson
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Pathological Narcissism: Origins
Manson's mother was a promiscuous heavy drinker
who spent years in prison for robbery. Manson was
placed at reform schools and relatives while she
was away.
Manson did not know his biological father; his
step-father was an alcoholic, abusive offender
His mother‟s physical embrace of him when she
returned from prison was, he reported, his sole
happy childhood memory
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Children at Risk
Children of Narcissistic Parents
Abused Children
Overindulged, Overpraised, Wealthy Children
Adopted Children (chosen, yet abandoned)
Kernberg, P. (1998). In E. F. Ronningstam (Ed.), Disorders of narcissism. Diagnostic, clinical, and empirical implications.
Developmental aspects of normal and pathological narcissism
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Course and Prognosis
Room for improvement in certain cases
As a result of significant losses/personal costs, or
As a result of corrective emotional experiences (i.e.,
relationship, achievement)
In severe cases, symptoms may worsen over time,
(i.e., mid life crisis, aging parents)
Narcissists do not typically seek help
(as they do not find fault in themselves)
Difficult to treat; may seek help because
“mandated” by others
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Is there a Narcissist in my life?
Does the person act as if life Does she downplay my feelings
revolves around him/her? or interests?
Do I have to compliment If I disagree, does he become
him/her to get his attention or cold, withholding or angry?
approval?
Does he constantly steer the Do I feel belittled, manipulated,
conversation back to himself? or feel I can‟t please him/her?
If you answered “yes” to three or more questions, it is likely that this person‟s
narcissism is affecting your life
Adapted from Judith Orloff’s “Emotional Freedom” (Three Rivers Press, 2011)
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How to Relate to a Narcissist
DO-NOTS
Do not retaliate
Do not shame, belittle, “pay back”
Do not expect fairness or reciprocity
Do not isolate from friends, other family
Do not surrender to the narcissist‟s attempts to
control/disparage
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How to Relate to a Narcissist
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DO(s)
Know yourself
Identify your motives to stay in the relationship: desire to please? gain
his/her regard? feel protected? bask in their power? Etc.
Identify your “hot buttons” and your problematic responses
Know your own worth, independently of his/her valuation
Cultivate reciprocal, satisfying relationships
Be empathic, respectful, fair
Be mindful of his/her sensitivity to shame/humilliation
Practice self-control and patience
Use non-confrontational limit-setting
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How to Relate to a Narcissist
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DO(s)
Set boundaries
Re-engineer the terms of the interactions
What you can do, what you won‟t
Reinforce positive behavior (i.e., kindness, attentiveness)
Avoid criticism; Try to understand his/her mind frame
Agree with acceptable part of his/her statements, and
add: “I wonder if…”, “how about…” “this could be of
benefit for you”
Discourage negative behaviors (belittling, dominance)
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How to Relate to a Narcissist
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DO(s)
Consider the costs (risk/benefit analysis) of
staying in the relationship
Assess damages/severity of behaviors
If risk/damage is high, consider an exit plan
Avoid/Minimize contact
Seek external help
Build a support network
Be mindful of characteristic feelings of shame/guilt
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Recommended Readings
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More suggested readings
Neurobiology of Empathy ; Attachment Theory
Mirror neurons and the brain in the vat. By V.S. Ramachandran, 1/10/2006
The mind‟s mirror. (on mirror neurons and its relation to empathy) By L. Winerman, Monitor Staff, 10/2005,
Vol 36, No. 9. American Psychological Association
Effects of a Secure Attachment Relationship on Right Brain Development, Affect Regulation and Infant
Mental Health. A. N. Schore, in Infant Mental Health Journal 22, 1-2 (2001): 7-66
Narcissism in organizations and leadership
Leadership. By Hogan and Fico, 2009. Chapter to appear in W. K. Campbell & J. Miller (Eds.) The
handbook of narcissism and narcissistic personality disorder. New York: Wiley, in press.
Cultural Aspects
What the Experts Are Saying Now . By K. Hymowitz, 8/25/2009,. A Review of the “self-esteem
movement” as per new book, “Nurture Shock” by Po Bronson & Ashley Merryman
Best Weapons against Honor Killers: Shame. By Kwame A. Appiah. 9/25/2010. On the customs of
honor codes (dueling, honor killings) and public dishonor. Listen to him also in “Talk of the Nation”, NPR
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CONTACT INFORMATION
Claudia Diez, PhD, ABPP
info@drclaudiadiez.com
For more information visit us at
http://www.drclaudiadiez.com
http://www.slrpsych.org