Psichiatria

Narcissistic Personality

The term narcissism leads immediately to the character of Greek mythology, Narcissus, the beautiful young man who fell in love with his own reflection in the water.

The concept of narcissism has been dealt with by many authors in psychoanalysis: among them, the most important we can remember are Freud, Kernberg and Kohut.

Kohut, the founder of Self Psychology, focused his work primarly in understanding narcissistic issues. According to this author, individuals who suffers from narcissism, “arrested” in an evolutionary period in which the responses from the environment are critical, in order to maintain self-cohesiveness.

According to Kohut, if those answers went missing (parent figures fail to give empathic and validating responses) a tendency to fragmentation of the Self develops. People will therefore be carriers of archaic, frail, and prone to fragmentation Self.

Simplifying, it means that  they will “keep themselves together” with the confirmations they receive from people and from the world around them.

Psychiatry also has dealt with narcissism, creating the diagnostic entity of “Narcissistic Personality Disorder.”

The main features of the disorder, according to DSM IV-TR, ie the Diagnostic and Statistical Manual of Mental Disorders (DSM) are grandiosity, need for admiration and lack of empathy

• grandiosity (in behaviours and in fantasy): subjects suffering from narcissism, tend to feel different from others, they can feel superior and special. This can also lead them to feel really rarely understood, and above all, only by others considered equally special. The grandiosity is also manifested in their fantasy: these people have high ambitions, and often, in a perfectionistic way, they impose high demands both for themselves and for others, sometimes in a unrealistic and “omnipotent” way
• need for admiration: the grandiosity is supported by the confirmations of the outside world. People suffering narcissistically tend to feel the need to constantly obtain results, that means to always and compulsively be performing in relation to reality. For example, they may feel the urge, the need, to obtain a success after another, feeling only briefly satisfied, “always wanting more” from themselves.                                                       Similarly they need (often unconsciously) to be supported in their self-esteem by those around them. When there isn’t a recognition from others, they can experience strong emotions of anger, shame, envy and humiliation
• lack of empathy; being very focused on themselves, sometimes these people are “unaware” of others and they may not be tuned on their emotions and feelings. They may also have a tendency to consider the needs of others of secondary importance, too absorbed with their own.                                                                                                 They tend to be excellent Transmitters, seeking acclaim and popularity, and poor Receptors!

This presentation of narcissism seems to refer exclusively to its overt characteristics.

Some psychological considerations on narcissism.

Everything said so far is a description of the “external” aspects of narcissism, and does not allow to grasp the core, the depth of it.

These characteristics often depend on an unconscious and deep sense of inadequacy, of which the person is not necessarily conscious. This is not the only aspect involved, but an element often present and central, and whose causes vary from person to person.

A share of narcissism is present in all of us, and is not to be considered necessarily a pathological aspect of personality: it can be one of the “engines” that drives us to gain recognition and satisfaction.

When does it become “abnormal” (abnormal doesn’t mean wrong in itself, but simply disabling or bearer of suffering in the life of the subject)?

Here are some common situations that may be indicators of a “pathological narcissistic suffering”:

• Excessive performance anxiety in performance situations (creates great discomfort; when there is the need to use psychotropic substances to manage it)
• Hypochondria, excessive attention to the body and need for unnecessary and expensive medical tests
• Depressive episodes in front of failures, disappointments, frustrations
• Chronic feelings of emptiness
• Relationship difficulties: includes a very broad form of manifestations such as the “collection” of failed relationships (“getting bored” immediately with partners, inability to tolerate other people’s faults), difficulty understanding problems and emotions of partners (etc).

Ultimately, the term “narcissism” is a label that is meant to represent a very broad set of different relational situations and problems.

Each person is in fact “a universe unto itself,” which is complex: many elements and many factors (biological, social, psychological) contribute and interact leading to the situation of suffering. What is important and useful is the deep understanding of the specific suffering of each individual, which must be contextualized within the person’s life path.

Can I get better?

You can, through psychotherapy, you could become more aware of yourself and find new ways to relate to others, that cause less pain and suffering.

Only taking care of the individual in its complexity and entirety, dealing also with their existential crisis, will be possible to support a path to a better well-being. The calm and constancy, not always present in this type of people, however, are the fundamental tools to foster the success of psychotherapy.