As you spend more time discussing goals and challenges with your Talkspace therapist, you may have questions or are interested in learning more about specific mental health topics and conditions. The Talkspace Bookshelf offers up-to-date mental health information directly from our behavioral health team to provide a better understanding of condition origins, diagnoses, various forms a condition may take, and different treatment options. Feel free to use this resource as a starting point to open up a dialogue and pose questions for your Talkspace therapist.
Narcissism is a trait that is a part of every personality to varying degrees. Those with Narcissistic Personality Disorder differs from the average narcissism that we often talk about in social settings as it can produce significant disruptions in a person’s life. It is a condition which affects a very small percentage of the United States population. Some sources estimate the lifetime prevalence to be around 6.2% of the American population.
Risk Factors
Research on Narcissistic Personality Disorder has not yielded definitive root causes of the condition. As is the case with many psychological conditions, there is a belief that a mixture of biological (genetic) and environmental factors may contribute to the development of Narcissistic Personality Disorder. More specifically, it is believed that certain parenting styles that reinforce a child’s uniqueness coupled with low empathy for the child’s fears and other concerns may be contributing factors.
It should be noted that narcissism is commonly thought of as a psychology trait which all people have, in varying degrees. For those with Narcissistic Personality Disorder, they meet a specific threshold of symptoms which leads to a formal diagnosis.
Symptoms
There is still a lot to be learned about Narcissistic Personality Disorder, however, there are symptoms defined by the psychiatric community.They are as follows:
- Require excessive praise or admiration
- Seems arrogant and acts in accordance with the thought of superiority to others
- Has an elevated sense of self-importance (typically involves the person speaking highly of his/her talents and achievements with a belief in being superior to others)
- Expects to achieve great, often unrealistic goals (based on actual aptitude, experiences, and efforts)
- May have a strong belief that he/she is extremely rare and unique and can only be understood by very few others
- May make use of others (take advantage) to gain leverage and meet their own personal goals
- Generally lacks empathy
- Expects others to fall in line with his/her desired circumstances, behaviors, and expectations
- Generally feels entitled and may become aggressive, argumentative, or combative when desires are not readily met
Narcissistic Personality Disorder, as you have read, has a grandiose nature to it. This means that it can be a big factor in relationships. The entitlement, coupled with a lack of empathy, may also lead to many feelings of agitation and frustration in someone living with the condition. This can be quite overwhelming, and as such, may impede effective and productive communication with others. This can make the creation and maintenance of close relationships challenging.
Many people often assume that those living with NPD are inherently gregarious, strong, and unshakeable. However, those with NPD often struggle with a fragile sense of self. When exposed to narcissistic injury (when someone does not agree with their high self-assessment), the negative impact can be staggering. It may lead to emotional outbursts as well as increased anxiety or depressive feelings in those living with NPD. Often, those with Narcissistic Personality Disorder feel as if they are unable to control their thoughts or behaviors. Treatment with a therapist can help a person with NPD learn and practice new ways of engaging with others.
Treatment
As you can imagine, given the symptoms defined previously, it can be difficult for those living with Narcissistic Personality Disorder to maintain healthy relationships. The cluster of symptoms presented here may disrupt social connections, work or career aspirations, romantic or other familial relationships. Therapy is a powerful tool in helping people living with Narcissistic Personality Disorder to engage in healthier, socially acceptable behaviors, and to improve and maintain social relationships.
Medication or Pharmacotherapy
There are no known medications frequently used to treat Narcissistic Personality Disorder, however, those living with NPD may also experience anxious or depressive conditions that accompany NPD. In that case, a therapist may recommend that a person living with NPD consult with a psychiatrist to effectively treat those symptoms.
Interpersonal Therapy (Relational)
Talk therapy has been shown to be the most effective treatment for Narcissistic Personality Disorder. Many therapists who work with people living with NPD may opt for a therapeutic process that focuses heavily on the therapist-client relationship as a microcosm of the way the person exists and behaves outside the confines of the therapy hour (with other relationships).
This particular kind of therapy can be quite challenging for someone living with NPD as the condition often leaves the person feeling the need to defend and protect their thoughts, behaviors, attitudes, and perceptions. As such, it may take quite some time to build trust with a therapist.
As a part of this interpersonal focused therapy, a therapist may also provide education on social skills to help the person with NPD communicate more effectively with others. A therapist may also help a person with NPD explore previously unexamined beliefs and thoughts about self and others to access more reality-based perceptions.
Group Therapy (and Family Therapy)
As Narcissistic Personality Disorder is, at its core, a condition of disrupted interpersonal skills, group therapy can be an effective adjunct to individual talk therapy. A therapist may recommend that a person living with NPD join a therapy group in which the person can meet with others who live with similar conditions and learn and practice new ways of engaging with others. Support groups for related conditions, such as anxiety or depression, may also be indicated.
In addition to group work, family therapy can be a very powerful tool in working through NPD. As the condition may disrupt intimate relationships, a facilitated conversation among the person with NPD and relatives (or other close loved ones) can be tremendously powerful in educating others about the person’s condition, as well as helping the family as a unit work through the impact of diagnosis and symptoms.
Therapeutic Note
Remember your therapist is here to help you figure out the best way to address your concerns. Therapy works best when it is a collaboration between you and your therapist. It is important to be open, honest, and an active participant in this process. Talk to your therapist about your goals for therapy so that together you can come up with the best plan to achieve your goals.
Questions You Might Have For Your Talkspace Therapist
- How do you think NPD affects my relationships?
- Is it possible to have a long-term romantic partner if I have NPD?
- I think that my ex-partner was narcissistic, can you tell me if they were?
- What if I really am very smart, talented, and better than most people? How is that a mental health condition?
- This word “narcissistic” gets used all the time. How can you really tell when someone has NPD?
Sources
American Psychiatric Association. "Personality Disorders." Desk Reference to the Diagnostic Criteria From DSM-5®. Washington: American Psychiatric Publishing, 2014. 321-332.
Dingfelder, S. F. (n.d.). Retrieved June 22, 2017
Narcissistic personality disorder. (2014, November 18). Retrieved June 14, 2017
Narcissistic Personality Disorder. (2017, April 17). Retrieved June 14, 2017
Stinson, F. S., Dawson, D. A., Goldstein, R. B., Chou, S. P., Huang, B., Smith, S. M., … Grant, B. F. (2008). Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Narcissistic Personality Disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. The Journal of Clinical Psychiatry, 69(7), 1033–1045.