The DSM-5 lists the criteria for having a diagnosis of Narcissistic Personality Disorder as five or more of the following:
1. Grandiosity with expectations of superior treatment from other people
2. Fixated on fantasies of power, success, intelligence, attractiveness, etc.
3. Self-perception of being unique, superior, and associated with high-status people and institutions
4. Needing continual admiration from others
5. Sense of entitlement to special treatment and to obedience from others
6. Exploitative of others to achieve personal gain
7. Unwilling to empathize with the feelings, wishes, and needs of other people
8. Intensely envious of others, and the belief that others are equally envious of them
9. Pompous and arrogant demeanor
We all have a personality and we all can possess characteristics or traits such as narcissism, but one of the hallmarks of having a personality disorder such as NPD is that it usually persists throughout the lifespan and it is very difficult to effect positive change upon this individual’s internal character structure. This person externalizes all of his problems. Thus, when things go right, it is attributed to that individual’s achievements. When things go wrong, it is someone else’s fault. When people aren’t falling in line as yes men who support and boost up the narcissist’s grandiose sense of self, then slights are experienced as threats, attacks, and injuries.
It comes as no surprise that many individuals with NPD rise to the top of their organizations. The entertainment industry, politics, medicine, academia, law, and corporate America are rife with people with NPD. What is most egregious is when these individuals sexually harass, physically abuse and verbally attack those around them and never face any significant repercussions for their behavior.
It is very rare that a person with NPD will ever seek out therapy to address their problems. Again, they attribute their problems to the shortcomings of others and they need to hold fast to believing a grandiose fantasy of themselves. Therapy would be threatening. If this person ever does go to therapy, it is probably because he has encountered a life tragedy that has brought him into treatment. A threat of divorce, a loss of a job, a serious illness.
What is all too common is to see patients who have been directly and negatively impacted by the behavior of a narcissist. Children who have a parent with NPD. People who have had employers with NPD. People who have been sexually harassed or even raped by a narcissist who is incapable of empathy. Often these patients have been living with the experience of being an object to meet the narcissist’s needs, unable to see themselves as a separate individual with needs of their own. They often describe feeling guilty for disappointing the narcissist. When the child of a narcissistic parent moves away or chooses a career path that is counter to what the parent wants for them, this is wounding to the parent. For some parents with NPD, even simply developing and growing up is perceived as a threat.
It is very sad and disturbing that so many individuals inhabit this Earth with untreated Narcissistic Personality Disorders and continue to inflict harm on others. And it is incredibly infuriating to live in a world where so many narcissists are lauded and given accolades. These people are often rewarded for their narcissistic behaviors. We just lived through four years with a President who is the textbook example of this disorder. Society bolsters up these behaviors and sends the message that this is acceptable, even admirable. And so many, many lives are negatively impacted by it. Our society celebrates those who have the most wealth, the most beauty, and the most talent. We exalt celebrities to a godlike status. Donald Trump, who became famous by building a real estate empire and becoming known as a reality tv personality, then managed to be elected to the highest political office in the world and still continues to garner large numbers of followers even after leaving office. Many celebrities have come under fire for sexually harassing or even raping young men and women, only to face relatively little to no legal consequences. OJ Simpson quite possibly even got away with murder.
I wish I could feel hopeful that things will improve on this front. I do believe that it is important for us to work at not being complicit by colluding with a narcissist’s behavior. Too often people don’t speak up because they are understandably afraid of what will happen if they do. And others blame the victims instead of the abusers. This should collectively concern and upset all of us.