A narcissistic personality disorder is often equated with the superficial, selfie-loving braggart who eats up your patience.
However, there is much more to this condition. Their behavior and mood are often dependent on and driven by feedback from their environment; They usually need the message from others to be positive. The impression they wish to make and the intense protection of their fragile self-esteem is a powerful determinants of their actions and thoughts.
Some narcissists can develop anger, anxiety, depression, shame, etc. if the information they receive does not match their inflated, protected inner selves. From a neuropsychological perspective, narcissistic personality disorder reflects problems with self- and emotional regulation.
#How do you know if he is a malignant narcissist?
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People who meet the diagnostic criteria can have very fragile and fluctuating self-esteem. There is a disconnection from their true selves. This condition often hurts the lives of people they love or interact with.
What are the symptoms?
Narcissistic personality disorder includes symptoms such as poor self-identity, inability to value others, entitlement, lack of authenticity, need for control, intolerance for the views/opinions of others, emotional detachment, grandiosity, lack of awareness or concern about the impact of their behavior, and minimal Emotional reciprocity, a strong need for others’ approval and positive attention.
Not everyone with pathological narcissism or narcissistic personality disorder will have the same presentation of the condition. There is heterogeneity, of course, because people are complex. There are different levels of intensity and dimensions. For example, some people with pathological narcissism are shy and avoidant (vulnerable), while others are extroverted and overtly boastful (most).
Narcissistic personality disorder falls into the Cluster B personality disorder category of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Conditions within this group include borderline personality, narcissistic personality, histrionic personality, and antisocial personality. Psychopathy, a condition characterized by unconscientiousness, inability to relate, aggression, and interpersonal transgressions, is a subgroup within antisocial personality disorder.
Although the disorders are distinct and reflect different categories of symptoms, it would not be unusual for someone to have symptoms of more than one group B condition. As many psychologists and psychiatrists will attest, the personality traits of our patients do not always fit into a nice little box. There can be features of other personality disorders accompanying the primary condition. Take, for example, the combination of narcissistic and antisocial personality in describing malignant narcissism.
Self-enhancement and the malignant narcissist
“I’m so smart! My IQ is over 140.”
Self-enhancement is a prominent feature of narcissistic personality disorder, regardless of dimension. They view themselves in a very positive light and believe that they are unique and superior to others.
Related: 3 Ways To Make A Narcissist Stop Being A Cold-Hearted JERK
In a meta-analytic review, researchers Grijalva and Zhang explored the insight of individuals with narcissistic personality disorder. Studies have supported that people high in narcissism tend to overestimate their abilities, status (e.g., intelligence), and appearance, more than reality can support.
They believe they are better than others, and the self-enhancing variants are usually related to “power and status” (agency). Even if evidence to the contrary is presented, such as IQ test results
Often this reality will be challenged rather than accepted. They may become very defensive and verbally attack or belittle the examiner who gave the test or the test itself (“What a stupid test!”). Indisputable evidence of their inaccurate and exaggerated self-evaluation does not change the self-view of a person with a high degree of narcissism.
Low self-esteem and malignant narcissism
“Make them believe I’m smart and handsome. I won’t stand for anything else!”
In Section III of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (“DSM-5 Alternative Model of Personality Disorders”), personality-related conditions are conceptualized differently from current diagnostic criteria.
Consideration is given to both an individual’s ‘performance’ as well as personality ‘traits’ and is considered along a dimensional continuum. As a clinician, I find this approach more attuned to the complexity of human behavior.
Regarding narcissistic personality disorder, the third section highlights that people with this condition have “poor self-esteem.”
This is regardless of whether the person is an extrovert or introvert, or the “weak” or “arrogant” type. It requires regulation from the outside world to maintain many aspects of the self. Therefore, they often use people to stabilize their emotions and feelings regarding who they are and what they want to do or be.
