Clarifying Narcissistic Personality Disorder

I spent my summer vacation doing lots of wonderful things; adventures in the Canadian Rockies, kayaking, gardening, visiting friends all over the West Coast AND finding out the latest information about my specialty of Narcissism. As you know by reading this blog, my specialty is treating the victims of narcissistic abuse, not the narcissists themselves. Narcissists almost never show up in psychotherapy except as part of a couple to complain how awful their partner is. What I found out through my studies this summer was revealing and hopefully helpful to those of you who live and work with narcissists.

As I have mentioned in several previous posts, narcissism is on a spectrum. The most disturbing and difficult of the narcissists are those with Personality Disorders. It’s important to note that any Personality Disorder (PD) is not an illness, it’s a disorder. Illnesses are acquired, disorders are developed. You can’t “catch” a disorder and they are easier managed than cured. Disorders are pervasive and enduring and THEY DON’T UPSET THE PERSON WHO HAS THEM. Just the rest of us! Disorders have characteristics. In terms of narcissistic personality disorder, these characteristics include a pervasive pattern of grandiosity, need for admiration and lack of empathy. These people have a grandiose sense of self-importance, believe that they are special or unique and rules don’t apply to them, have a strong sense of entitlement, are interpersonally exploitive, and are unable or unwilling to identify with the feelings and needs of others. Any of this sound familiar? If so, know this, THEY WILL NOT CHANGE. They have one rigid way of dealing with the world, one trait that they use to function. That trait in the narcissist is undeserved grandiosity. Their core deficit is equality. They see nobody as equal. Yet, they are secretly terrified that they are ordinary. They can’t make relationships work because they see nobody as equal to them. Entitlement arrogance is another way of speaking of this. They set you up to steal your self-esteem and they set you up to be depressed. They are thieves of your emotional world.

Narcissists have pieces missing in them. Medications and traditional forms of psychotherapy can repair what’s broken. Narcissists aren’t broken, they were never formed. While you cannot treat a person with Narcissistic PD with medications for the personality dysfunction, you can treat the symptoms such as anxiety or depression. A narcissist is a person who persists in behavior in the face of knowing that there are ongoing negative consequences to that behavior and clear evidence of its inappropriateness. AND YET THEY WILL NOT CHANGE. Normal people have the ability to self-correct and self-monitor. People with personality disorders lack this ability. They can’t apply the information and feedback they receive or make use of interpersonal data. When something goes wrong in a narcissist’s life, they go to drama instead of problem solving. Having a personality disorder changes the fundamental operating system in that person’s psyche. A personality disordered person is a human being with a profound inability to interpersonally problem solve. The purpose of all of this drama is to validate the identity of the narcissist’s fragile self. They have an internal experience of “non-existence”. It’s hard to imagine anyone like this, unless, of course, you are living, dating or working with them.

For decades, clinicians have been treating narcissists as victims of childhood abuse or trauma. Now, after 70 years of study, verified throughout various countries, we find that no trauma is predictive of personality disorder or exclusive to personality disorder. In fact, the vast majority of humans who experience childhood abuse, do NOT develop PD. Humans, generally, are more resilient than that. That’s not to say that people with PD haven’t had traumatic childhoods. It’s more about what they DO with the fall out of those traumas. Another way of stating this is that PD is a brain phenomenon, a brain-based condition. So, it’s not trauma that causes PD, but the way the brain processes it. This has important implications for the way PD is treated by the clinical community. Clinical treatment, however, is not the focus of this post. But suffice it to say that for you, the target of the narcissist’s wrath, be brief, concise and definite in your responses to them and DON’T GET INVOLVED IN THE DRAMA. Be aware that you are probably telling yourself “He will change if only I…” or “if only he realizes…” That is not going to happen. The current best hope is that these people get into treatment (unlikely) and that they get into treatment with someone who really understands the new research and data and knows how to work with them (difficult to find).

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If This Time Has Taught Me Anything 

"Know that you are more than your scars. 

Know that every wound that you have healed along the way has taught you what it is to fight back. 

To start again from where you are and with what you've got. 

If this time has taught me anything, it is this: HOPE matters and we cannot live without it. 

The future can be better and can be brighter and we each have it within us to make it so." 

Kevin McCormack






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