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Definition of Narcissistic Personality Disorder

Narcissistic Personality Disorder (NPD) is a pattern of self-centered or egotistical behavior that shows up in
thinking and behavior in a lot of different situations and activities. People with NPD won't (or can't) change
their behavior even when it causes problems at work or when other people complain about the way they act,
or when their behavior causes a lot of emotional distress to others or themselves. Narcissists rarely ever
admit to being distressed by their own behavior -- they always blame other people for any problems. This
pattern of self-centered or egotistical behavior is not caused by current drug or alcohol use, head injury,
acute psychotic episodes, or any other illness, but has been going on steadily at least since adolescence or
early adulthood.

Characteristics of Narcissistic Personality Disorder

• The narcissist regards himself as being on a constant mission, whose importance is cosmic and
whose consequences are global.

• The narcissist adopts a physical posture which implies and exudes an air of superiority, seniority.

• The narcissist frequently asks for "special treatment" of some kind.

• The narcissist is the one who – vocally and demonstratively – demands the undivided attention of the
head waiter in a restaurant, or monopolizes the hostess, or latches on to celebrities in a party. The
narcissist reacts with rage and indignantly protests when denied his wishes and if treated equally
with others whom he deems inferior.

• If asked to relate directly to his emotions, the narcissist intellectualizes, rationalizes, speaks about
himself in the third person and in a detached "scientific" tone or composes an autobiographical
narrative—sometimes substituting a fictitious character.

• The narcissist instantly idealizes or devalues his peers depending upon how he appraises them as a
potential Narcissistic Supply Source.

• Narcissists are frequently polite in the presence of a potential Supply Source, but may deteriorate
into barbs and thinly-veiled hostility when opposed.

• The narcissist always tries to "belong". Yet, at the very same time, he maintains his stance as an
outsider.

• The narcissist likes to talk about himself and only about himself. He is not interested in others or
what they have to say, unless they constitute potential Sources of Supply and in order to obtain said
supply.

• The narcissist is easily hurt and insulted (narcissistic injury). Even the most innocuous remarks or
acts are interpreted by him as belittling, intruding, or coercive.

• Narcissists can't tolerate disagreement. In fact, if you say, "Please don't do that again," narcissists
will turn around and do it again--often more blatantly--to prove that they were right the first time.

• Any suggested help, advice, or concerned inquiry are immediately cast by the narcissist as coercive
or humiliating, implying that the narcissist is in need of help and counsel and, thus, imperfect and
less than omnipotent.

• Any attempt to set an agenda is, to the narcissist, an intimidating act of enslavement. In this sense,
the narcissist is both schizoid and paranoid and often entertains ideas of reference.**

**The narcissist sees himself as the center of the world and feels certain that he is the source of all events
around him. This constant obsession with with one's centrality leads to the conviction that one is at the
receiving end of other people's behaviors, speech, and even thoughts. The person suffering from delusional
ideas of reference is at the center and focus of the constant (and confabulated) attentions of an imaginary
audience. When people talk - the narcissist is convinced that he is the topic of discussion. When they quarrel
- he is most probably the cause. He is convinced that his behavior is continuously monitored, criticized,
compared, dissected, approved of, or imitated by others. He deems himself so indispensable and important,
such a critical component of other people's lives, that his every act, his every word, his every omission - is
bound to upset, hurt, uplift, or satisfy his audience.
Treatment and Prognosis of Narcissistic Personality Disorder
Narcissists are generally not candidates for conventional analytical treatment, since psychological analysis is
a dialogue and narcissism is a soliloquy. Because of narcissists' incapacity for genuine relationship, their
treatment tends to be of the "Band-Aid" variety that deals with specific acute difficulties, such as depression,
which can be treated with drugs. Part of Narcissistic Personality Disorder is the conviction is that "I'm okay,
it's everybody else who's not okay," so narcissists rarely seek treatment voluntarily. Some wait until they are
in such bad shape that they require hospitalization. Because narcissists' self-image is so scanty and fragile,
they depend on the reflection of themselves in others' perception to be aware of themselves; sometimes it is
really as if these people do not have bodies, have no real material existence. Therefore, social isolation, such
as comes following the loss of a job, the failure of a marriage, or the alienation of friends and family, has
swift and terrible effects on narcissists. Their thinking quickly deteriorates into chaotic incoherency and
disorganization. For this reason, when they do receive treatment, the therapists' first order of business is to
restore and fortify the narcissists' ego defenses -- i.e., the therapist must help the narcissist recover the
habitual grandiose and self-obsessed self-image. When reasonably recovered, the narcissist usually leaves
therapy before any work can be done on the underlying personality disorder.