Throughout my 27 years of teaching graduate courses in personality, psychopathology and psychotherapy, certain topics and ideas emerged as among the most salient and foundational for understanding the complex and intimate exploration of the human psyche.
In the daily life of a mental health professional, it is difficult to think of an issue that permeates ones work more ubiquitously than the developmental problem of narcissism. In addition, there is no other subject that comes up more frequently in informal conversations with friends, acquaintances and family than that of understanding, surviving and coping with narcissistic parents, spouses, bosses, children, coworkers, etc. In this piece I will bring together theory, research, and clinical experience from my own work with narcissistic patients over the years.
The extent to which the word narcissism and its variants have become part of casual and public conversation in recent years has been completely unprecedented. When Donald Trump entered the race for the 2016 presidential election, mental health professionals across the country banded together to educate the public about the dangers of electing a severely personality disordered individual to the White House. The ensuing animosity, division and political power struggles have torn the nation apart raising questions about what led such a significant percentage of the public to make such a choice.
During the debates about Trump’s narcissism it was common to hear people say “aren’t all politicians narcissists?” And “isn’t everyone narcissistic to some extent?” There is truth to both statements. Narcissists are indeed drawn to positions of prominence and power and their arrogant self-assurance can be appealing to people who feel vulnerable and weak, making politics an attractive fit for narcissists.
Everyone begins life in narcissism, making it somewhat universal. The world of the infant almost literally revolves around her, with those in her orbit focused largely on meeting her needs. It isn’t until the second year that a child has separated and individuated enough to recognize other people as having their own needs apart from and competing with her own. Until that time others are seen primarily for their usefulness at satisfying felt needs for food, comfort companionship and security. Once the process of separation and individuation begins the focus of a child’s life becomes largely about mourning the loss of those feelings of being the center of the universe with others focused on meeting her needs.
One of the various uses of the word narcissism, therefore, refers to this earliest stage of human development in which the infant is incapable of such things as sharing or caring for others or, for that matter, of love which sometimes requires voluntarily sacrificing her needs or desires for the sake of another. No one has ever definitively identified the combination of nature and nurture that leaves those with severe personality disorders essentially hobbled in this early stage of development so that, although chronologically adult, they remain relationally infantile, with a primarily utilitarian view of others.
Although this use of the term refers to a developmental stage of narcissism we carry around inside us every “self” we have ever been. Everyone, therefore, is capable of regressing or at least using psychological tools or defenses from earlier stages of development. Since no ones needs are met perfectly at any stage we can remain “hungry” for certain kinds of relationships throughout our lives.
Consequently when I use the term narcissism or refer to a narcissist I might be referencing a person who has regressed to an extremely immature style of relating to others and not just to someone who has a personality disorder. Some people are “situationally” narcissistic in that they have been socialized to see others for their usefulness in certain contexts or the context itself facilitates regression to narcissistic needs. For example in life-or-death situations regression to narcissism would be somewhat normal. This particularly makes sense because in the infantile stage of narcissism survival is literally dependent on others meeting one’s needs. One could be forgiven for being narcissistic when their survival is at stake but consistently using other people to satisfy one’s desires in normal life circumstances must be labeled as an inappropriately immature and dysfunctional way of living. Toddlers in adult bodies leave pain in their wake.
This broad use I am making of the concept of narcissism is by no means universally agreed upon and can be frustrating for those who desire a more exacting, scientific definition. Attempts at quantifying a definition of narcissism have been somewhat successful in the form of the diagnosis of Narcissistic Personality Disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) but even then there is room for variation and disagreement. Some people and groups exhibit a narcissistic style of relating without meeting criteria for NPD so identifying the characteristics of narcissism is still useful.
In my opinion the single most salient quality of narcissism is a complete inability to seriously value any perspective but one’s own. This can also be a characteristic of limited intelligence but I think most people can tell the difference between a narcissist who is interpersonally very shallow versus someone with a developmental or neuropsychological disability. Assuming at least average intelligence someone with a narcissistic personality disorder should be capable of coming to self awareness at least enough to acknowledge the need to understand others’ perspectives. NPD is typically not amenable to treatment. This is not surprising—how do you fill in the gap left by stunted years of emotional development? Research and personal experience have shown that one of the best prognostic signs for NPD is the co-morbid presence of depression. This makes sense because psychological theorists have traditionally connected depression with inhibited mourning. Psychological pain is a very good sign for a narcissist because they compulsively avoid all emotional discomfort. Emotional pain is also necessary to develop empathy which, by definition, narcissists lack. Within the mental health professions there is a longstanding debate as to whether narcissists are incapable of empathy or merely unwilling to empathize. Either way the lack of feeling another’s pain is an indicator of narcissism.
Oblivious vs. hyper-vigilant narcissists
I have found it extremely helpful over the years to divide narcissists into the two subtypes proposed by Gabbard. The oblivious narcissist is the arrogant, obnoxious loud mouth always demanding the spotlight. He is oblivious to the feelings or reactions of others. His ego is so inflated he assumes that everyone else either similarly admires him or enviously wants to destroy him. There is no middle ground. Contrast the oblivious type with the hyper-vigilant narcissist. This type is very much aware of the reactions of others and has learned to be exquisitely skilled at reading others so that he may meticulously work to maintain their admiration. Unlike the oblivious type who depends on intimidating or manipulating others for his own ends the hyper-vigilant type tends to be more introverted and can be quite winsome and charming. Both types of narcissist feel a sense of emptiness and loss of identity when they lose a previously dependable source of admiration. At an unconscious level both types also experience the pain and dread of the never-ending search for admiration which numbs the absence of unconditional love which they have self-pityingly concluded is tragically unavailable to them.Qualities of Narcissism
Splitting
As infants we begin sorting our experiences of ourselves and our world using a simple binary method, things that make us feel good and things that make us feel bad. With maturity we gradually learn that nothing is one or the other but good and bad are intricately tangled. We mourn the loss of that simplicity and move on. The narcissist, however, retains the use of splitting in regard to his fragile ego. Those people or experiences that cause him to feel inadequate, sad or imperfect cause him to feel shame and are entirely bad. Those that make him feel adored, admired and successful a and are good he feels elated.Admiration is not an Adequate replacement for love because it must constantly be renewed through the facade of perfection. The threat of that facade failing is a constant unconscious stressor to the narcissist, the potential for the crushing shame of being exposed as an imposter.
Splitting is most evident in close relationships in that the narcissist functionally communicates “You either love me or hate me, there is no in between.” He surrounds himself with a select few from whom he demands absolute “loyalty” which means unquestioning admiration and support of his perspective and defense of anything he says or does.
Grandiosity
A narcissist is completely unable to find fault or imperfection in himself. He believes, in fact, that he was created unique, gifted, superior to normal humans. This quality, especially, is attractive to weaker personalities who hope to feel more significant by attaching themselves to him. It will also make him attractive to other narcissists and antisocial personalities who admire his ability to get away with his attitude and hope to profit from and share his power or influence. His grandiosity can also be mistaken for actual capacity to accomplish the things he believes he can achieve thus ensnaring some optimists, idealists and dreamers, especially those naive about human nature. If confronted, a narcissist’s greatest weapon in relationship is to be unaffected by the other or even to be a bit “amused” that they are upset.It should be noted that although a narcissist is usually capable of saying virtually anything to get what he wants, even fabricating facts, this is not necessarily the same as what most people understand as lying. He knows the difference between right and wrong, at least intellectually, and since it is inconceivable to him that he could do wrong, his mind simply does a transformation and makes anything he did synonymous with good. If cornered with proof of wrong-doing he will draw on his inflated sense of uniqueness and superiority which, he believes, gives him a “bigger picture” than others so that he can see how something they call “bad” can actually be good. I have even seen narcissists twist reality to the extent that they believe that they are doing others a favor by lying to them since it would take lesser people too long to get to the truth they understand, assuming they are even capable, so a lie is a merciful shortcut to what they feel certain is the truth. Their feeling of certainty can be quite convincing to healthier people who cannot conceive of such audacity.
Anosognosia
Anosognosia, roughly translated lack of self-awareness, is a qualitative symptom usually found in brain injury cases, especially those involving the right cerebral hemisphere. While narcissistic anosognosia has not been connected to neurologic deficit it is functionally similar. Most narcissists are, literally, incapable of forming the conscious thought of themselves being wrong, flawed, or unethical. While this does not reduce culpability it can be of some comfort to others who have tried to remain in relationship with them. It also explains why they can gravitate toward fringe groups that do not confront arrogant insistence on one’s superiority but rather reward the “courage” to stand up to “nonbelievers.”The narcissist’s blindspot in the area of self awareness usually includes an inability to recognize the fallibility of his own emotions. This is particularly true of the emotion of certainty. He cannot take a step back to see that certainty is not something he “has” but, rather, something he feels. Any attempt to prove him wrong will be perceived as an attack. He will become enraged not because the other said he is wrong but because they are “calling me a liar.” Since the narcissist believes he cannot be wrong, proof otherwise would make him a liar.
COLLECTIVE NARCISSISM
Cultures and subcultures that value humility and self honesty usually have little patience with narcissists. At the opposite extreme, some groups foster narcissism in individuals or even collectively take on the qualities usually seen in narcissistic individuals. This often takes the form of tribalism: literally the good “us” vs. the bad “them.” Nationalism, for example is the mass equivalent of narcissistic personality disorder.American Exceptionalism
It is difficult to imagine a slogan that better demonstrates narcissistic splitting than “America: Love it or Leave it.” Nationalism, unlike patriotism, demands the maintenance of a facade of perfection over a collective identity. A collective cloud of anosognosia wipes away the memory of the evils done in the name of the country’s pursuit of its entitled destiny and those who want to discuss the ongoing effects or presence of such evils are shunned as disloyal. When people invest their individual identities into a collective image of perfection they experience any criticism of that image as a personal attack.
