Narcissism Unmasked — Part 1: What is Pathological Narcissism?

What is Pathological Narcissism?

Narcissist…we hear the term quite often these days, at work, in the media, maybe even among friends and family. In fact, many of you have likely encountered one or more narcissists in your lifetime and perhaps even live, work, or are in some kind of relationship with one. Some of you are familiar with the general definition of a narcissist, and perhaps, casually label friends, acquaintances, colleagues, or some of your relatives as such. But how many of you actually know the clinical definition of a pathological narcissist?

Narcissistic personality traits can be very complicated and are sometimes difficult to understand. Decades of psychological research have shown that there is a difference between healthy narcissism and unhealthy narcissism. An individual who has healthy narcissistic traits tends to have a high level of self-esteem and/or sense of self-worth and usually takes pleasure in his/her appearance, intellect, and achievements. They are normal individuals, with healthy egos, who may also happen to indulge in a few selfies, and brag about their accomplishments.  

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An individual who has healthy narcissistic traits tends to have a high level of self-esteem and/or sense of self-worth and usually takes pleasure in his/her appearance, intellect, and achievements.

An individual who has unhealthy narcissistic traits generally has a distorted sense of self-importance or ability. In clinical terms, narcissistic individuals tend to have grandiose thoughts about their social value, particularly in relation to other people. For instance, an unhealthy narcissist truly believes that they are more valuable and important than other people, that they deserve to be praised and admired, and that they deserve to be treated better than others. These beliefs are often accompanied by a lack of empathy for others (the hallmark of narcissism), whom they believe to be insignificant. An individual with these narcissistic traits (among others) has pathological narcissism, clinically defined as Narcissistic Personality Disorder (NPD). 

A personality disorder, by definition, is a pervasive pattern of disturbance in a person’s ability to manage his or her emotions, hold onto a stable sense of self and identity, and maintain healthy relationships in work, friendship, and love. The Diagnostic and Statistical Manual of Mental Disorders5th Edition (DSM-V), wherein the clinical criteria for the classification/diagnosis of psychological disorders are outlined, requires an individual to meet the following criteria for the diagnosis of NPD:

1. Has a grandiose sense of self-importance.

2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

3. 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).

4. Requires excessive admiration (regularly fishes for compliments, and is highly susceptible to flattery).

5. Has a sense of entitlement.

6. Is interpersonally exploitative.

7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others (or, I would argue, is actually incapable).  

8. Is often envious of others, or believes that others are envious of him or her.

9. Shows arrogant, haughty (rude and abusive) behaviours or attitudes.

Pathological narcissism has always been rare, affecting an estimated one per cent of the population. True pathological narcissists may actually be evading detection because most of us don’t understand the many different forms that the condition may take.

Join me next month, when I explore how to identify the many faces of narcissism.

Dr. Debra Trevisan is a Clinical Psychologist with special interests in mood and anxiety disorders, insomnia, and personality disorders. Visit: drdebratrevisan.com or Email me directly

Originally Published in the October 2018 edition of Village Living Magazine