Human Brain Diagram

Symptoms of Narcissistic Personality Disorder

Narcissism is widely misunderstood and underestimated. It isn’t about vanity. It isn’t self-love. Not every “narcissist” is personality-disordered. Everyone is capable of exhibiting narcissistic traits from time to time. Some, more than others. That’s generally not much of a problem. A cluster B personality disorder, like Narcissistic Personality Disorder is a big problem. Cluster B disorders are very severe and include Antisocial, narcissistic, borderline and histrionic personality disorders. All cluster B disorders share traits in common and they can be difficult to differentiate.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), narcissism is defined as:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. ┬áBelieves that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
  4. Requires excessive admiration
  5. Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  6. Is inter-personally exploitative, i.e., takes advantage of others to achieve his or her own ends
  7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
  8. Is often envious of others or believes that others are envious of him or her
  9. Shows arrogant, haughty behaviors or attitudes

By another, related model, people with narcissistic personality disorder suffer impairment in two or more of these areas:

  1. Individuality
  2. Self-direction
  3. Empathy
  4. Closeness

A narcissist’s outward symptoms may depend on whether the narcissist is “overt,” tending to be more grandiose, cocky and prone to rage or “covert,” and tending towards victimhood and secrecy.

Overt narcissists know they’re better than everyone else and they’ll say so. Coverts know they’re extra special but keep that to themselves while using manipulation to garner sympathy and admiration. They probably feel misunderstood.

All narcissists are driven by the interaction of two core deficiencies. The need for “supply” and the lack of empathy. They need external validation of their existence, which can come in the form of either positive or negative attention, called “narcissistic supply, or “fuel.” Nothing at all could ever be more important than supply to a narcissist. Because the parts of the brain responsible for empathy are underdeveloped or damaged in a narcissist, they don’t care who they hurt in pursuit of supply.

Not mentioned in the psychologists’ diagnostic manuals, but well-documented and understood by those who study narcissism is the lack of “object constancy,” meaning they aren’t able to maintain an emotional connection to another person who is away from them and they engage in “splitting,” or “black and white thinking.” It’s an inability (or extreme difficulty) to consider the dichotomy of both positive and negative qualities of others as a cohesive, whole (i.e., an individual’s actions and motivations are all good or all bad with no middle ground).

Also not covered in the manual, but well known by every victim of narcissistic abuse is the narcissists’ tendency toward compulsive or pathological lying and reality-warping gaslighting.

This article is gleaned from my independent research, filtered though personal experience as a victim of narcissistic abuse. I am not a doctor or licensed psychologist and make no claims to diagnose any condition.

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