narcissism

The narcissistic personality disorder or the narcissism belongs to the mental disorders that are associated with a particularly strong and non-adaptable personality. The narcissist appears to be very self-indulgent, but actually has very low self-esteem and is always on the lookout for approval.

What is Narcissism?

The narcissist thinks of himself as special and unique. This results in the fact that he is very self-centered and tries to impress others.
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The personality disorder was named after the legend of Narciss, who is so in love with his reflection in the mirror that he neither recognizes nor can reciprocate the love of the nymph Echo. He dies of his despair of not being able to reach his reflection in the mirror.

One could now assume that the narcissist is characterized by a great self-love. It is not that simple, however narcissistic personality disorder is a complex mental disorder with many symptoms.

Affected people suffer from a strong internal rejection of their own person, combined with a very low level of self-confidence. Outwardly, due to their constant search for admiration and recognition, this has the effect of excessive self-confidence, arrogance and as if those affected take themselves very seriously.

causes

The narcissistic personality disorder is a complex mental disorder that is largely similar to borderline symptoms.

However, narcissists differ in important ways from those affected by borderlines. They usually have very good impulse control and do not suffer from self-destructive behavior. The similarity of the two disorders, however, shows in their causes.

Both disorders are early childhood and arise due to insufficient or excessive parental care. These traumatic experiences are repeated in adulthood in a lack of self-confidence and an excessive search for recognition with compulsion to perform and reproduced in the environment.

It must be said, however, that those affected are usually not aware of their behavior and therefore cannot be spoken of as an intentional act by the individual.

Symptoms, ailments & signs

Narcissism shows itself primarily in a greatly increased self-esteem. The narcissist thinks of himself as special and unique. This results in the fact that he is very self-centered and tries to impress others. Lies and self-delusions are often part of the picture the narcissist tries to maintain of himself.

Social skills are lost in the process. People with narcissistic personality disorder are less capable of empathy. In interpersonal relationships, they are not at all or hardly able to reciprocate emotions. Often, narcissists appear cool and arrogant to those around them.

The urge to be important can express itself in two forms: The narcissist can either constantly show his (supposed) ability or act very modestly. Narcissistic people often have dreams and fantasies about money and status. Their behavior is designed accordingly.

Expectations towards other people are fed by the idea that they are there to meet the needs of the narcissist. Similarly, narcissists take advantage of other people. They sometimes react viciously when their expectations are not met. There are outbursts of anger and revenge. Accordingly, narcissists get angry easily. Narcissists are also prone to envy and believe that others are jealous of them.

Diagnosis & course

The diagnosis of narcissistic personality disorder follows the survey pattern for all mental disorders and takes place in the outpatient department of a psychiatric clinic.

Although self-tests can be found on the Internet, their informative value may be doubted, especially since these tests can only cover a few facets of behavior and only a few symptoms. A detailed diagnosis of a personality disorder usually takes several hours and includes personal discussions with a therapist as well as filling out numerous questionnaires.

This exact diagnosis is important in order to make a specific diagnosis, to be able to identify the strongly pronounced symptoms and thus the exact disorder. Because only then can individual therapy be initiated. Like all serious personality disorders, narcissism cannot be completely treated, the person affected can only be helped to lead a life free of symptoms.

Complications

Narcissistic personalities place high demands on themselves and their environment. Their grandiose demeanor and the strong sensitivity to criticism make it difficult to deal with other people. Especially those affected with the grandiose manifestation of narcissism often offend or get angry when they do not receive the longed-for confirmation and recognition from those around them.

Although there is a desire to belong, a lack of empathy leads to recurring social conflicts. As a result, narcissists experience rejection from their fellow human beings and become isolated. Those affected with vulnerable narcissism, on the other hand, are often over-adjusted and suffer from a lack of self-worth. For them, too, dealing with other people is a challenge due to social fears and fear of rejection. You tend to be avoidant.

As a result of the social difficulties that arise due to this personality structure, those affected can develop depression or anxiety disorders. Not infrequently they also tend to be addictive. Psychotherapy and psychoanalysis based on depth psychology help those affected to deal better with their specific problems.

The aim is to stabilize self-worth. However, the patterns of behavior are profound and difficult to deal with. In therapy, too, conflicts can arise due to experiences of hurt.

When should you go to the doctor?

The problem with narcissism is that the person concerned has no insight into their narcissistic personality structure. He therefore does not consider this to be in need of treatment. Those around him often suffer significantly from the narcissist's behavior. It is therefore not uncommon for victims to seek treatment from narcissists.

A narcissistic personality disorder is considered untreatable. The suffering of a narcissist can be high. But most of the time he will still not see a therapist. Other people do not dare to advise him on therapy. You should expect corresponding reactions. One of the hallmarks of a narcissist is complete lack of insight, coupled with an unwillingness to want to change.

Treatment & Therapy

Treatment of the narcissistic personality disorder takes place with psychotherapeutic measures and, depending on the severity and severity of the symptoms, psychotropic drugs. The therapy of accompanying symptoms and problems is also important. For those with narcissistic personality disorder, these are primarily depression and substance abuse.

As a rule, the patient can determine which form of therapy suits him best: inpatient or outpatient. Depth psychological, psychoanalytic or behavioristic. However, the diagnosis and the assessment of the need for therapy made there play a major role in finding the right therapy. If it is determined that the patient needs several weeks of inpatient therapy due to the severity of his symptoms, outpatient measures are usually not effective.

What makes the search for a therapist more difficult is that many psychologists feel overwhelmed with severe personality disorders and do not include those affected in their patient files, so that they actually have much less leeway in choosing the right therapy than would theoretically be possible.

In order to be able to initiate a successful therapy, the person concerned must show a pronounced level of suffering that motivates him to cooperate. Forced therapy or psychological intervention against the patient's will or in the case of insufficient motivation are not promising and are therefore not carried out.

You can find your medication here

➔ Drugs for personality disorders

Outlook & forecast

The prognoses for people with narcissistic personality disorder vary widely. Overall, people in therapy have a better prognosis. The decisive factor is the ability to learn a correct self-awareness. Stable interpersonal relationships that allow a high degree of trust and reflection to grow, as well as personal experiences of success that arise through one's own skills are also considered helpful.

These factors have a beneficial effect on narcissism, as they keep the person concerned clearly aware of their abilities and confront them with the consequences of their actions.

Inaccessible narcissists have a much worse prognosis. This is especially true for people who experience a lot of failures and are inaccessible to therapy. In these cases, alcohol and other drugs often make things more difficult. Accordingly, narcissism is experienced in the sense of a perceived high level of self-worth. But the reality does not match this self-image.

Narcissists also run the risk of severe failure frustrating them so much that they experience depressive episodes. On the other hand, these personal breakdowns are often cited by patients as a reason for seeing a therapist.

prevention

Of the narcissistic personality disorder can not be prevented on your own. Parental love and care and timely intervention if necessary are the most important keys to prevention.

Aftercare

People who have narcissistic personality disorder often have to work on themselves throughout their lives to walk the tightrope between normal and excessive narcissism. A high willingness of the patient to actively participate in treatment and aftercare often has a positive influence on further personal development.

In the final phase of psychotherapy, therapists often work out strategies for follow-up care with their patients. It is often about how those affected can maintain the success of the therapy. After inpatient therapy, clinics offer special programs to support their patients in the period after discharge.

These are usually outpatient offers that are intended to facilitate the transition from the clinic to everyday life. In this context, various therapeutic approaches can be used, for example discussion groups, psycho-education programs or individual discussions with a psychiatrist or psychotherapist. Aftercare can also include care or support from a social worker.

Narcissistic personality disorder is not equally severe in every patient. The aftercare can therefore also be designed with different levels of intensity, for example by adjusting the frequency of the discussions.

You can do that yourself

Narcissists often have trouble empathizing with other people. It can therefore be helpful if you consciously deal with the topic of empathy. For example, if a person reacts differently than expected, they can pause and consider how the situation went from the other person's point of view.

Often people feel offended by narcissists because they perceived a situation completely differently. The narcissist's lack of understanding often makes it even more difficult for them or provokes anger. Narcissists often first have to learn to recognize such negative and hurt reactions from friends, acquaintances and family members as legitimate.

Some narcissists have a tendency to manipulate other people. The influence does not have to be malicious - it typically aims to please others and to put yourself at the center. A common tool is to make other people dependent on you. If a narcissist is prone to such behaviors, they should be aware of their own patterns. He can then consider why he is behaving in a certain way and whether the intention is appropriate.

Support groups can help support this reflection. The Internet offers the possibility of anonymously asking for opinions - for example on typical situations in which the person concerned cannot put himself in other people's shoes.