Key Points

Narcissistic Personality Disorder is a severe mental illness rooted in attachment trauma and emotional dissociation.
The narcissist’s inner psyche involves a complex interplay of developmental deficits and defensive compensations.
A deeper understanding of narcissistic patterns is needed to identify the pathology and mitigate its traumatic effects at the societal level.

To understand the trauma that narcissists cause others, we often focus on their outward behaviors and how these behaviors affect the people around them. But what is going on in a narcissist? Let’s delve deeper into the anatomy of the narcissistic personality beyond the superficial traits listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Narcissistic Personality Disorder

Narcissistic Personality Disorder is a mental illness rooted in identity instability and self-esteem resulting primarily from insecure attachments to caregivers in infancy and childhood. There may be genetic predispositions to narcissistic defenses in a child that are activated by experiences of alienation in the environment.

Looking closely at the narcissistic personality, we find many developmental defects and defensive compensations, including emotional splitting, distorted relationships with objects (others), weak individualism, emotional alienation, grandiose delusions, envy and victimhood, reliance on external sources of self-esteem, reactivity, self-referentiality, cognitive distortions, deliberate denial and projection, moral corruption, relational hostility, and masquerading.

1. Internal split. At the core of narcissism is the emotional splitting of the self between two distorted extremes: the worthless and inferior self and the superior self. One way to understand narcissism is as an inferiority complex managed by a compensatory superiority complex. Narcissistic people constantly work to suppress awareness of the inferior self and inflate and elevate the superior self. They experience internal oscillations between these two states, especially when under stress, and subject others to the same idealized and devalued oscillations.
2. Unrealistic/incomplete relationships with objects (others). Narcissistic children who are caught in emotional splitting are unable to achieve full relationships with objects (others) and object (other) constancy, the psychological milestones that involve integrating and sustaining awareness of the realistic positive and negative aspects of self and others. As a result, narcissists see themselves and those around them in binary terms of all good or all bad and experience out-of-sight and out-of-mind fluctuations in their relationships.
3. Lack of Individual Identity/Emptiness. Narcissists lack an individual sense of identity and experience destabilizing feelings of self-doubt and emptiness. This is often the result of emotional neglect and being treated as an extension of idealized or devalued projections by narcissistic parents. Narcissistic individuals often spend their lives experimenting with identities and/or clinging rigidly to external forms of identification.
4. Emotional Alienation/Lack of Empathy. Lacking a stable sense of self and empathic connection with those around them, narcissists are emotionally detached from themselves and others. Their fundamental lack of confidence leads them to avoid vulnerability, which they see as a weakness, and to view relationships as struggles for dominance and control rather than opportunities for personal growth and intimacy.
5. Delusional Grandiosity. The flip side of narcissistic emptiness and inferiority are delusions of superiority, special entitlement, and, on the more socially disturbing end of the narcissistic spectrum, absolute power and control. Outsiders with the ability to accurately test reality will recognize that the narcissist’s grandiosity is an illusion, but it seems like a psychological survival for the narcissist. This is why narcissists react with anger (overt or passive-aggressive) when others do not reflect what they would like to believe about themselves.

6. Envy/Victimhood. One dimension of narcissistic grandiosity is the belief that narcissists never get enough of what they deserve. This sense of injustice and deprivation creates feelings of envy and victimhood that can become central aspects of the narcissist’s identity, especially in the more subtle and vulnerable form of narcissism.
7. External Self-Esteem. Narcissists lack the internal ego strength to maintain stable feelings of self-esteem and need excessive support for their exaggerated sense of importance. This makes them highly dependent on others and external status-enhancing factors to process their feelings and feel good about themselves. Their need to manage external self-esteem leads to excessive demands for attention, admiration, special privileges, status, care, and/or control in their relationships.
8. Dysregulation/Interaction. The narcissists’ low self-esteem and delusional vanity create a perfect storm for emotional and emotional disturbances in response to disappointments, losses, insults, and conflicts.
9. Self-Referral. Narcissists are emotionally detached from others and constantly struggle to boost their self-esteem. They are excessively self-obsessed and tend to be highly self-referential in how they perceive and interpret their experiences and relationships.
10. Cognitive Distortions. In addition to self-aggrandizement, narcissists are prone to cognitive distortions such as catastrophizing, minimizing, personalizing, and magical thinking.
11. Denial and Projection. Denying aspects of reality and projecting our uncomfortable feelings and behaviors onto others are natural childhood emotional defenses that narcissists continue to engage into great effect as adults. Unlike psychotic individuals, people with narcissistic personality disorder can distinguish between fact and fiction, truth and falsehood, so their use of denial and projection involves deliberate selection and forms of rational justification.
12. Immorality. The narcissist’s fragile sense of self is a precariously built house of cards of internal division, delusional self-beliefs, and primitive defenses. To keep from collapsing, narcissists maintain a distance from reality by avoiding self-reflection and accountability. Lacking everything but a primary corrective ego (conscience) means that the narcissist operates outside of normative standards of justice, morality, and virtue.
13. Relational Hostility. Narcissistic personalities are hostile in their relationships, acting competitively and exploitatively rather than cooperatively and responsibly in their relationships. Suffering from delusions of entitlement and lacking the dampening influence of emotional empathy, narcissists habitually exploit others for material and emotional resources and devalue, humiliate, and violate the dignity of others to bolster their self-esteem.
14. Camouflage. Narcissists’ compulsive need for attention and self-validation from others often drives them to cultivate a socially successful public persona. All but the most antisocial narcissists want to believe they are “good” and capable of love, and some will go to great lengths to project this image to outsiders. But whether the narcissist’s mask is based on material wealth, piety, fame, good looks, charm, or professional status, it is superficial. Beneath the mask, the narcissist is an unstable, isolated, delusional, hostile, and morally irresponsible person.

Conclusion

Narcissism is a severe form of mental illness that causes the narcissist great suffering and has a devastating impact on family members, social groups, and society as a whole. Because narcissism is often so well disguised, and because narcissists often seek positions of power and exercise power abusively, it is especially important that the mental health community, educators, the justice system, and people from all walks of life recognize and expose its signs, and protect and support its victims.