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 selfabsorption 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
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
Authority, Self-Sufficiency, Superiority

Exhibitionism, Exploitiveness

Vanity, Entitlement
How Narcissistic
am I?
Quiz - NPI-40
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

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Causing significant distress (subjectively)
DSM: Diagnostic and Statistical Manual of Mental Disorders, now in its 4th Edition, TR (2000)
Narcissistic Personality Disorder
 DSM-IV TR Diagnostic Criteria

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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
Hack it, or Pack it!
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)
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Shedler et al, 2008. Refining the Construct of Narcissistic Personality Disorder: Diagnostic Criteria and Subtypes; (Am J Psychiatry 2008; 165:1473–
1481)
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
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Schore, Allan (2009). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development
Normal Human Development
Parental Attunement


Development of empathy

Tolerance of shame

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Under normal circumstances,
caregiver help child to handle
intense or stressful affect
“Monkey see, monkey do” (mirror
neurons; mimicry)
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)
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Kernberg, 1984. Severe personality disorders. New Haven: Yale University Press
Paths to Pathological Narcissism
Persistent
parental
unattunement
with Spite,
Control
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Affect
Dysregulation
Unsoothed
Shame
Low empathy
Compensatory
Grandiosity
Superiority
Contempt
Envy
Callousness
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:
Diagnostic, clinical and empirical implications
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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
revolves around him/her?
Does she downplay my feelings
or interests?
Do I have to compliment
him/her to get his attention or
approval?
If I disagree, does he become
cold, withholding or angry?
Does he constantly steer the
conversation back to himself?
Do I feel belittled, manipulated,
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.

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
By V.S. Ramachandran, 1/10/2006
 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