What is narcissistic personality disorder?

By Cristiano Antonino Last updated Jun 19, 2023

The essential feature of Narcissistic Personality Disorder is a pattern of superiority tendencies, a need for admiration, and a lack of sensitivity for others

Individuals with narcissistic disorder have, most of the time, a high self-esteem

They habitually exaggerate their abilities, often appearing conceited.

They believe they are special, superior, that they must be satisfied in every request and that they are entitled to special treatment.

They also expect others to recognize their status as special people and, if this happens, idealize them.

Conversely, if others question their qualities, they react with anger, resulting in an inability to question themselves and accept criticism.

Individuals with narcissistic personality disorder generally have difficulty recognizing that others also have wants, feelings, and needs.

They believe that their own needs come before everything and that their way of seeing things is the only universally right one, showing indifference to the point of view of others and inability to grasp it.

Thus, for example, individuals with narcissistic disorder may expect to avoid waiting in line and to be served immediately by shop assistants and waiters.

In any case, even if they don’t expect it, they get extremely annoyed when they find themselves having to respect expectations, shared rules, reluctantly tolerating not seeing their needs immediately satisfied.

Narcissistic patients usually have a very high level of perfectionism and want things that somehow reflect their image (clothes, car, home, etc.) and their abilities (study, job, etc.) to be perfect.

Unfortunately they apply this perfectionistic mechanism even to the most intimate people (e.g. partners or children), towards whom they are very demanding and critical, since they expect them to always make them “look good”.

The interpersonal relationships of the patient with narcissistic personality disorder are therefore typically compromised due to problems deriving from excessive demands, the need for admiration and the relative disinterest in the sensitivity of others.

Finally, narcissistic individuals are often envious of others, or believe that others are envious of them. They tend to view others in a competitive light and struggle to establish and maintain a position of supremacy.

Very often, in the high roles of any hierarchy (corporate, institutional, etc.), we find subjects with narcissistic personalities, as their characteristics are functional to job competition.

They achieve high results without realizing how many people pay for their attitudes or are hurt by them.

In interpersonal relationships, people with narcissistic personality disorder are failures

They generally choose weak and submissive partners who look up to them and make them feel important.

After a while, however, they get bored, feel dissatisfied and go in search of new flirtations, aimed at stimulating them again, or they try to transform their partner, manipulating them as they please.

Even in love they live with a constant sense of competition and the taste they draw from the relationship is mainly that of conquering the “prey”.

They experience sexual relationships with high performance anxiety, which sometimes makes them victims of sexual dysfunctions, which for them constitute a tragedy.

Patients with narcissistic personality disorder, in the rare cases in which they enter into relationships with a person “on their level”, who does not admire them, to whom they are truly attached, suffer from high abandonment anxiety and, in the In the event of a breakup, they sink into depression.

The same fate awaits them in the event that they get serious failures at work or lose an important competition.

In any case, even when narcissists feel they have everything they want (success, love, money, etc.), they feel constantly dissatisfied and go through depressive phases for which they cannot explain.

Treatment of narcissistic personality disorder is very difficult, also due to their total unawareness of the disorder and the effect it causes in others.

They usually only come to treatment because they feel depressed, but traditional antidepressant therapies are ineffective.

Cognitive therapy in the medium to long term (1 to 2 years) offers some possibilities for improvement, although it is very difficult to modify a personality structure and, in these cases, also to win the trust of the patient with a narcissistic personality and keep it high.

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