Pathological narcissism occurs in a spectrum of severity. In its more extreme forms, it is narcissistic personality disorder (NPD). NPD is considered to result from a person's belief that they are flawed in a way that makes them fundamentally unacceptable to others.[18] This belief is held below the person's conscious awareness; such a person would typically deny thinking such a thing, if questioned. In order to protect themselves against the intolerably painful rejection and isolation that (they imagine) would follow if others recognized their supposedly defective nature, such people make strong attempts to control others’ view of them and behavior towards them.
Pathological narcissism can develop from an impairment in the quality of the person's relationship with their primary caregivers, usually their parents, in that the parents were unable to form a healthy, empathicattachment to them.[citation needed] This results in the child conceiving of themselves as unimportant and unconnected to others. The child typically comes to believe they have some personality defect that makes them unvalued and unwanted.[14]
Narcissistic personality disorder is isolating, disenfranchising, painful, and formidable for those living with it and often those who are in a relationship with them. Distinctions need to be made among those who have NPD because not each and every person with NPD is the same. Even with similar core issues, the way in which one's individual narcissism manifests itself in his or her relationships varies.[citation needed]
To the extent that people are pathologically narcissistic, they can be controlling, blaming, self-absorbed, intolerant of others’ views, unaware of others' needs and of the effects of their behavior on others, and insistent that others see them as they wish to be seen.[11]
People who are overly narcissistic commonly feel rejected, humiliated and threatened when criticised. To protect themselves from these dangers, they often react with disdain, rage, and/or defiance to any slight criticism, real or imagined.[19] To avoid such situations, some narcissistic people withdraw socially and may feign modesty or humility. In the case of feeling the lack of admiration, adulation, attention and affirmation the person can also manifest wishes to be feared and to be notorious (narcissistic supply).
Though individuals with NPD are often ambitious and capable, the inability to tolerate setbacks, disagreements or criticism, along with lack of empathy, make it difficult for such individuals to work cooperatively with others or to maintain long-term professional achievements.[20] With narcissistic personality disorder, the person's perceived fantastic grandiosity, often coupled with a hypomanic mood, is typically not commensurate with his or her real accomplishments.
The exploitative, sense of entitlement, lack of empathy, disregard for others, and constant need for attention inherent in NPD adversely affect interpersonal relationships.
[edit]Theories on narcissistic personality disorder and shame
It has been suggested that narcissistic personality disorder may be related to defenses against shame.[21]
Glen Gabbard suggested NPD could be broken down into two subtypes.[22] He saw the "oblivious" subtype as being grandiose, arrogant and thick-skinned and the "hypervigilant" subtype as easily hurt, oversensitive and ashamed.
He suggested that the oblivious subtype presents a large, powerful, grandiose self to be admired, envied and appreciated. This self is the antithesis of the weakened and internalized self that hides in a generic state of shame. This is how the internalized self fends off devaluation, while the hypervigilant subtype neutralizes devaluation by seeing others as unjust abusers. This hypervigilant type does not fend off devaluation; he is obsessed with it.
Jeffrey Young, who coined the term "Schema Therapy", a technique originally developed by Aaron T. Beck (1979), also links shame to NPD. He sees the so-called Defectiveness Schema as a core schema of NPD, next to the Emotional Deprivation and Entitlement Schemas.[23] All Schemas may incorporate maladaptive coping styles, for example, the defectiveness schema may include:
- Surrender: Chooses critical partners and significant others; puts him- or herself down.
- Avoidance: Avoids sharing "shameful" thoughts and feelings with partners and significant others due to fear of rejection.
- Overcompensation: Behaves in a critical or superior way toward others; tries to come across as perfect.
- has a grandiose sense of self-importance (e.g., exaggerates 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, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
- is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
- lacks empathy: 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
