Narcissistic personality disorder is a personality disorder characterized by an inflated sense of self-importance and superiority. People who have this disorder are incredibly vain, conceited and egotistical, and they believe they deserve only the best. They have little regard for others, are manipulative and selfish, lack the ability to show empathy and will use others to achieve their own goals without remorse. Narcissists lack normal feelings of responsibility and compassion.
The term narcissistic comes from an ancient Greek legend about Echo and Narcissus. Echo was a nymph who fell in love with Narcissus, a young, handsome and terribly vain man. Echo pined for the man who contemptuously rejected her expressions of love and died with her love unrequited. The god, Apollo, was angered by the young man’s self-admiration, pride and ego and condemned him to die without ever experiencing human love. One day Narcissus saw his reflection in the surface of a pool of water he was going to drink from. He immediately fell in love with his reflection, but his admiration was never requited. Narcissus eventually died beside the pool with his reflection.
A key element of narcissistic personality disorder is fear of rejection and abandonment. In response to actions that they believe threaten them or their sense of entitlement, many will lash out violently and aggressively. This response is an embodiment of their fear of being accused, rejected or ignored. Some seek out substances as a tool to serve their emotional needs and to hide within the realm of an addiction. Substances provide the constant attention they desire.
The _Diagnostic and Statistical Manual of Mental Disorders_ defines narcissistic personality disorder as a pervasive pattern of grandiosity, need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts. The subject must exhibit five or more of the following characteristics to be clinically diagnosed:
* Has a grandiose sense of self-importance and is exaggerate achievements and talents; expects to be recognized as superior without commensurate achievements
* Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
* Believes 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)
* Requires excessive admiration
* Has a sense of entitlement and portrays unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
* Is inter-personally exploitative; takes advantage of others to achieve his or her own ends
* Lacks empathy and is unwilling to recognize or identify with the feelings and needs of others
* Is often envious of others or believes others are envious of him or her
* Shows arrogant, haughty behaviors or attitudes.
Narcissistic personality disorder is characterized by a number of different symptoms. Many people will have a history of short-term intense relationships with others that they lack genuine intimacy. They often exhibit violence, aggression and hypersensitivity to criticism and yet will be intensely critical of others. They are often attracted to high-profile positions or jobs that place them in the center of attention. They will shower themselves with praise and expect to receive it from others. Narcissistic personality disorder also will make a person have an intense preoccupation with their appearance and image but little regard for the inner reality of their selfishness. In many cases, they will be reckless and have little concern for the effect of their behavior on others.
A key characteristic of a narcissist is that they derive pleasure from engaging in reckless antisocial behavior or exploiting others, and they often have feelings of entitlement. Many believe that the normal laws and rules do not apply to them. They believe they have the right to humiliate, degrade and bully others into taking responsibility or covering for them. They will seek out risky activities such as drug taking which fuel their narcissistic feelings. Many will be in codependent relationships that are often abusive and manipulative.
When a narcissist abuses drugs or alcohol, they will claim that the drug is enhancing them and that they have control of their addiction. They believe they are not at risk of developing any of the mundane, boring negative health problems associated with drug or alcohol abuse. Theorists suggest that many use their drug or alcohol abuse as another tool to get attention and to make people focus on them. They fear being forgotten, ignored or not being talked about. Additionally, alcohol and drugs can dull their insecurities and fears, allowing the narcissist to continue with their self-admiration without being nagged by negative thoughts.
Research suggests that up to 50 percent of those who suffer from a narcissist personality disorder abuse alcohol and drugs, with many facing addiction and dependency. When a person has a co-occurring disorder, it can be difficult to treat either condition. Psychiatrists and other medical professionals will face the difficult task of determining which has caused the other and treating both appropriately. In many cases, each disorder maintains the other. Chronic drug use makes the symptoms of borderline personality disorder more severe, leading to the need for more drugs to self-medicate. This, in turn, makes the symptoms more severe. Tolerance and dependence are established, and the person faces addiction.
Many narcissists they feel that they are above social conventions and the law. Directing a narcissist into treatment for either their substance abuse problem or their personality disorder can be incredibly difficult. Most do not believe that they need therapy, even in the face of significant substance-related problems. A narcissist’s attitude towards treatment is competitive, hostile and aggressive. They will devalue and discard both the treatment and the medical profession who is administering it due to their ingrained resistance to authority figures.
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