Spotting Narcissistic Personality Disorder and How to Take Steps to Remedy It

Narcissistic personality disorder (NPD) is a mental condition wherein the affected individual is highly self-obsessed and desires to be the centre of attention of others. Individuals with NPD are called narcissists. These people often struggle to maintain a healthy and long-lasting relationship and exercise manipulative behaviour to get what they want. Many individuals may display narcissistic traits, but this does not mean they meet the criteria for a diagnosis of narcissistic personality disorder.  

Causes

Narcissistic personality disorder is a mental health condition with unclear origins. While subtle differences in the brain structure are often observed in individuals with NPD, it remains uncertain whether these differences cause the disorder or result from it. The causes of narcissistic personality disorder include:

• Genetics: A higher likelihood of NPD is seen in individuals with parents or close relatives who have the disorder.
• Observation and imitation: Children may develop narcissistic traits by observing and imitating behaviours they see in others.
• Negative childhood experiences: Trauma, rejection, neglect and lack of support during childhood can contribute to the development of narcissistic traits.
• Parenting style: Overindulgent or overprotective parenting can lead children to expect and demand similar treatment from others. This may also hinder their ability to regulate emotions, causing difficulties when things don’t go their way.
• Culture: Cultural influences play a role, with higher risks of NPD in cultures that emphasise individualism and personal independence. Conversely, cultures that promote community and collective action tend to have lower incidences of NPD.

Understanding these factors can help identify and address the root causes of NPD.

Narcissistic personality disorder symptoms  

Identifying people with narcissistic personality disorders can be challenging as it can be mistaken for confidence or assertiveness. However, here are some key symptoms to look for:

• Grandiosity: Individuals with NPD demonstrate excessive self-esteem accompanied by superiorities over their status to others.
• Need for admiration: This personality type requires continual recognition, praise, appreciation and admiration from everyone.
• Lack of empathy: People with this condition lack emotional intelligence and abilities to both comprehend and appreciate the emotional needs of others.
• Manipulative behavior: Using others to achieve their goal, often without regard for the impact on the others through manipulation. This attitude brings no concern for what it means for the affected person.
• Arrogance: Narcissists treat others only if they meet their needs. They believe that everyone should fulfil their desire, and, in return, they may face aggression or be ignored if anyone asks something.
• Entitlement: Individuals demand distinctive or special treatment but express strong negative feelings when this demand goes unfulfilled.
• Interpersonal exploitation: The behavior involves exploiting others to fulfil their personal objectives.
• Reactive to criticism: They demonstrate tangible sensitivity toward criticism or defeat, often reacting with anger, shameful actions or humiliation.

Diagnosis  

While not everyone who exhibits narcissistic symptoms has a narcissistic personality disorder, as NPD is a clinical diagnosis where individuals should meet certain criteria. Only a mental health professional can diagnose NPD based on certain criteria, which include:

• An exaggerated sense of self-importance
• Fantasies of unlimited success, power and brilliance
• A belief that they are special and should always associate with high-status people
• A desire for excessive admiration
• Exploiting others for personal gain
• Arrogant behaviour
• A belief that others are envious of them
• Lack of empathy
• A sense of entitlement

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, out of these nine criteria, if there is a consistent presence of at least five of these symptoms, the individual might be diagnosed as a narcissist.

Impact of narcissistic personality disorder

NPD can have a profound impact on both the individual and the people around them:

• Personal relationships: Their relationship with their spouse, family or friends can be deteriorated due to their manipulative and self-centred behaviour.
• Working as a team: The workplace gets affected by their arrogant attitude, leading to conflicts, reduced productivity and challenges to working in teams.
• Mood disorders: The occurrence of mood disorders, including bipolar disorder, is notably higher among people with NPD.
• Mental health: It increases the risk of depression, anxiety, substance abuse and even suicide due to internal instability and external pressure.

How to remedy narcissistic personality disorder

NPD can be challenging to treat but not impossible. Here are some strategies to treat narcissistic personality disorder:

• Cognitive behavioural therapy (CBT): This therapy focuses on recognising unhealthy signs of thought and behaviour with healthier ones. A certified CBT therapist will help you by teaching you new skills to overcome unhealthy patterns. The goals of the therapy include:
• Restructuring negative thoughts
• Developing empathy
• Behavioural exercise to test the validity of behaviour in real-life situations
• Educating individuals about NPD and its impact
• Psychotherapy: This is a form of talk therapy that helps you connect with others in a meaningful way. It helps gain self-awareness and makes you understand the causes of emotions and behaviours. Gestalt therapy is another form of psychotherapy that emphasises the present moment. You’ll reflect on current experiences and work on improving self-awareness and self-responsibility.
• Transference-focused psychotherapy (TFP): TFP is a structured psychodynamic treatment which focuses on the relationship between a psychologist or therapist and the patient. This therapy utilises the concept of transference, which refers to feelings and attitudes a patient projects onto their therapist. These feelings are often rooted in past relationships and experiences. This therapy involves
• Engaging the patient in the present moment and helping to reveal unconscious conflicts.  
• The therapist regularly interprets the patient’s distorted perceptions and behaviours during sessions.  
• TFP involves structured twice-weekly sessions with a clear treatment contract and defined goals.
• Dialectical behaviour therapy (DBT): This is a form of therapeutic approach that helps individuals with NPD symptoms manage intense emotions and teaches coping strategies for dealing with stress and crises without resorting to harmful behaviours. This therapy involves:
• One-on-one sessions with a therapist to work on personal challenges and develop tailored coping strategies
• Group therapy and sessions where individuals practice new skills in a supportive environment, gaining feedback and encouragement from peers
• Homework assignments and practical exercises to reinforce skills learned in therapy and apply them to real-life situation
• These therapeutic approaches can help individuals with NPD develop healthier coping mechanisms and improve their relationships and overall well-being.

Conclusion

Narcissistic personality disorder can be treated with the right approach and support. By seeking professional help, practicing self-reflection and building empathy, the person with NPD can take steps towards a healthier and more fulfilling life. If you or your family or friend is struggling with NPD symptoms, it is critical to reach out for support to make a positive change.