In our last post, we discussed the signs that Elliot Rodger has Narcissistic Personality Disorder, according to the DSM-5 criteria for Narcissistic Personality Disorder. Researchers estimate that 1% of the general population suffers from Narcissistic Personality Disorder in their lifetime. That’s about one in every hundred people. And the prevalence of narcissism may be increasing. (Twenge et al, 2014) This means that you and I encounter Narcissistic Personality Disorder quite often, in other people and perhaps in ourselves.
Not all narcissism is pathological. In addition to those who suffer from a disorder, many of us exhibit narcissistic behaviors that are less frequent or severe than the behaviors that constitute the official disorder. We may even go through phases where we are more narcissistic, such as adolescence. Some argue that a little bit of narcissism is beneficial. However, if someone experiences three symptoms (dysfunction, distress, and deviance) out of five or more of the behaviors of Narcissistic Personality Disorder, psychologists consider that person to be ill. To treat a mental illness, it’s important to understand its possible causes.
Causes: Most psychologists today understand mental illness through the biopsychosocial model. The biopsychosocial model (BPS) posits that a combination of factors contributes to a person’s physical and mental health. These factors may be biological (such as genetic predisposition), psychological (such as thought patterns), or social (such as family environment). Here are some possible factors that support narcissistic personality disorder.
Biological factors: Researchers have found that a part of the brain associated with empathy, the left anterior insula, has less gray matter in people with narcissistic personality disorder. Gray matter is made up of neuronal cell bodies and non-neuronal brain cells, which provide nutrients and energy to neurons. Neurons send and receive information in the nervous system. Researchers have found that the degree to which people empathize with others is related to the volume of gray matter in this region. MEDIUM_429_2010_260_Fig5_HTML
Psychological: In narcissistic personality disorder, the illness may also be a cause. By engaging in self-centered thinking, people may be more likely to have self-centered thoughts in the future. By not caring about the feelings and concerns of others, people don’t build their capacity for empathy or make empathy a habit. In Elliot Rodger’s case, he repeatedly told himself that people had wronged him and that they didn’t deserve respect. This may have reinforced these beliefs, making him feel entitled to treat his victims as objects rather than as individuals with rights.
Society: There’s a list of ways that researchers have found that parents may contribute to narcissistic personality disorder. This list applies to any caregiver, not just parents. There are also societal contributors to narcissism. Individualistic cultures, like the United States, train people to strive to be special or better than their peers. Jean Twenge, a professor of psychology at San Diego State University, says that parenting styles, celebrity culture, and the Internet are among the reasons that narcissistic personality disorder is on the rise.
Treatments: Psychologists have difficulty treating people with narcissistic personality disorder. One obstacle is that people with narcissistic personality disorder don’t usually seek treatment. People with narcissistic personality disorder may hate themselves at some point, but they consciously believe that they are superior and flawless. If they have problems, it’s the world’s fault, not theirs. When severe narcissists seek treatment, it’s often because of a major crisis or because someone is forcing them into treatment. Once in treatment, narcissists have difficulty getting treatment because they are uncooperative. It takes humility to try to change. Prognosis depends on the severity of a person’s symptoms and their readiness to change. Here are some possible ways to improve narcissistic symptoms.
Practice mindfulness: We talked earlier about how mindfulness can help people gain self-knowledge. Some believe that narcissists build a superior image of themselves to counteract underlying feelings of inadequacy. By practicing mindfulness, narcissists can observe their behaviors without judgment, which can fuel the drive to self-aggrandizement. If they can observe themselves without judging themselves, narcissists have less reason to deceive themselves about who they are.
Group therapy: Narcissists tend to avoid intimate relationships. This is because they do not like to interact with people who threaten their inflated self-image. If someone gets to know the narcissist well and sees beyond the image they want to present, this relationship may force the narcissist to see themselves as less than perfect. However, relationships and social interactions can benefit narcissists. In group therapy, the goal of a person with NPD is to develop a healthy sense of self within the group and to recognize other people as separate individuals. Through frequent interactions with people on an intimate level, narcissists are forced to see repeated evidence of the humanity of others and themselves within the group.
Cognitive behavioral therapy: Using cognitive behavioral therapy, psychologists teach patients how to recognize maladaptive, false beliefs and replace them with correct, healthy ones. This form of therapy can be difficult for narcissists because it requires a confrontation with their beliefs, which can make them defensive and less cooperative.
