Identifying, understanding and relating to themIdentifying, understanding and relating to them

NARCISSISTIC PERSONALITIESNARCISSISTIC PERSONALITIES

Claudia Diez, PhD, ABPPClaudia Diez, PhD, ABPPBoard Certified Specialist in Clinical PsychologyBoard Certified Specialist in Clinical Psychology

Supervising PsychologistSupervising PsychologistSt. Luke’s-Roosevelt Hospital CenterSt. Luke’s-Roosevelt Hospital Center

Assistant Clinical Professor, Columbia UniversityAssistant Clinical Professor, Columbia Universityinfo@drclaudiadiez.comhttp://www.drclaudiadiez.com

http://www.slrpsych.org

What is “Narcissism”?What is “Narcissism”?

From Greek myth of Narcissus, a metaphor of self-absorption and inability to love

A normal aspect of Personality self-care and self-esteem; assertiveness

need to secure status for self-preservation (Hogan, 1982)

Needed for self-sustainment

Normal Narcissist: Competitive, Self-Assured, Bold

Exists in a continuum: Normal Pathological

Involves adaptive and maladaptive traits22

Socio-Cultural PerspectivesSocio-Cultural Perspectives

Lasch: The Culture of Narcissism (1979) Cultural criticism of contemporary American society as

promoter of pathological narcissism

Erosion in allegiance to community; condoned individuality

Raskin: Narcissistic Personality Inventory (NPI, 1988) Identified seven aspects of narcissism

Authority, Self-Sufficiency, Superiority

Exhibitionism, Exploitiveness

Vanity, Entitlement

How Narcissistic

am I?

Quiz - NPI-40

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Socio-cultural PerspectivesSocio-cultural Perspectives

“Generation Me” “Today’s young Americans are more confident, assertive,

entitled.. . than ever before” (Twenge, 2006)

Narcissism Epidemic? NPI-40 used to research trends in narcissism in America

Findings: “rampant rise of narcissism” in our society

Indictment of the “Self-esteem” movement of the 70’s propelled by California’s legislature "Self Esteem Task Force“

Met severe criticism, yet findings stand strong

Other cultural expressions: Honor Codes/killings?44

Organizational PsychologyOrganizational Psychology

Narcissistic Leaders High Entitlement, Excessive Confidence, Fantasized Talent

Focused on “getting ahead”, risks excessively, berates employees, pursues personal agendas

“Emergent Leaders” (seek Self-Promotion)

Not necessarily “Effective Leaders”

Narcissism at the root of Managerial Derailment

What about the followers?

(Hogan, Robert, 2008)55

Narcissism in organizationsNarcissism in organizations

‘If you want a friend, get a dog”

Gordon Gecko to Bud Fox in “Wall Street”

Gordon Gecko, “Wall Street”

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Shut up, Listen and Learn!Shut up, Listen and Learn!“Swimming with sharks”, Ch. “Sweet & low”

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Pencils are more importantPencils are more important“Swimming with sharks”, Ch. “you are nothing”

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Narcissism as a Clinical DisorderNarcissism as a Clinical Disorder

Term coined in psychology in 1898 by H. Ellis

Largely adopted by Freud and psychoanalysis

Appears in the DSM-III(1)

in 1980

“Personality Disorder” is: An inflexible, maladaptive, persisting pattern of behaviors

Causing significant functional impairment (in the world)

Or

Causing significant distress (subjectively)

(1) DSM: Diagnostic and Statistical Manual of Mental Disorders, now in its 4th Edition, TR (2000)99

Narcissistic Personality DisorderNarcissistic Personality Disorder

DSM-IV TR Diagnostic Criteria Pervasive pattern of grandiosity, need for admiration, lack of

empathy; beginning in adulthood, indicated by five (+) of the following:

grandiose sense of self-importance

fantasies of unlimited success, power, beauty, etc.

believes he/she is "special"

requires excessive admiration

has a sense of entitlement

is interpersonally exploitative

lacks empathy

is often envious, or believes that others are envious of him

shows arrogant behaviors or attitudes

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Hack it, or Pack it! Hack it, or Pack it! The Great Santini, “failed score”11

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Narcissism as a Clinical DisorderNarcissism as a Clinical Disorder

Not all narcissists are created equal

Shedler’s Typology (1)

Grandiose/malignant

Fragile

High Functioning/Exhibitionistic

Other distinctive features Emptiness, sense of “being false, fraudulent”

(1) Shedler et al, 2008. Refining the Construct of Narcissistic Personality Disorder: Diagnostic Criteria and Subtypes; (Am J Psychiatry 2008; 165:1473–1481)1212

Faces of Pathological NarcissismFaces of Pathological Narcissism

Abusive Partners Rapists

Celebrities Cult Leaders

Con Artists Stalkers

White Collar Criminals Gang Members

Moderate Narcissism

Overbearing/obnoxious /cruel parents, demanding or callous partners, inconsiderate coworkers, etc….

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Empathy, Shame, EnvyEmpathy, Shame, Envy

Empathy inner capacity of sharing and comprehending the

psychological state of another person

Shame painful social emotion caused by the experience of feeling

inferior or losing value in the estimation of others

Envy painful social emotion caused by the thought of another

person having something that one does not have oneself

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Origins of NarcissismOrigins of Narcissism

No known link to genetics

Biological (neurophysiological paths) imprints in early childhood (1)

Origins ascribed to early attachment and parenting, resulting in specific pattern of affect regulation

(1) Schore, Allan (2009). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development 1515

Normal Human DevelopmentNormal Human Development

Under normal circumstances, caregiver help child to handle intense or stressful affect

Development of empathy

Tolerance of shame

“Monkey see, monkey do” (mirror neurons; mimicry)

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Parental Attunement

Origins of Pathological NarcissismOrigins of Pathological Narcissism

Unattuned Parents cannot model affect regulation Resulting in diminished capacity for empathy

Child is in some way “Special” to the parent

“Narcissistic children often occupy a pivotal point in the family structure, such as being ….the one that is supposed to fulfill family aspirations….”

Child raised in overtly well-organized home, but with parent(s) present a degree of callousness and subtle aggression

Child may have an inherent quality that arouses admiration or envy such as beauty, special talent, etc. ( I.e: Pageant Queen/Mother)

Kernberg, 1984. Severe personality disorders. New Haven: Yale University Press1717

Paths to Pathological NarcissismPaths to Pathological Narcissism

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Narcissistic CognitionsNarcissistic Cognitions

Entitlement/Grandiosity

Emotional Deprivation

Defectiveness/Shame

Subjugation /Control

Approval Seeking

Insufficient Self-Control

Mistrust/Abuse

Unrelenting Standards

Underlying Assumptions (Schemas)

Young,  (1998). Schema-focused therapy for narcissistic patients.  In E. Ronningstam (Ed.), Disorders of narcissism: Diagnostic, clinical and empirical implications1919

Extreme (Malignant) NarcissismExtreme (Malignant) NarcissismCharles Manson

2020

Pathological Narcissism: OriginsPathological Narcissism: Origins

Manson's mother was a promiscuous heavy drinker who spent years in prison for robbery. Manson was placed at reform schools and relatives while she was away.

Manson did not know his biological father; his step-father was an alcoholic, abusive offender

His mother’s physical embrace of him when she returned from prison was, he reported, his sole happy childhood memory

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Children at RiskChildren at Risk

Children of Narcissistic Parents

Abused Children

Overindulged, Overpraised, Wealthy Children

Adopted Children (chosen, yet abandoned)

Kernberg, P. (1998). In E. F. Ronningstam (Ed.), Disorders of narcissism.  Diagnostic, clinical, and empirical implications. Developmental aspects of normal and pathological narcissism

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Course and PrognosisCourse and Prognosis

Room for improvement in certain cases As a result of significant losses/personal costs, or

As a result of corrective emotional experiences (i.e., relationship, achievement)

In severe cases, symptoms may worsen over time, (i.e., mid life crisis, aging parents)

Narcissists do not typically seek help (as they do not find fault in themselves)

Difficult to treat; may seek help because “mandated” by others

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Is there a Narcissist in my life?Is there a Narcissist in my life?

Does the person act as if life revolves around him/her?

Do I have to compliment him/her to get his attention or approval?

Does he constantly steer the conversation back to himself?

Does she downplay my feelings or interests?

If I disagree, does he become cold, withholding or angry?

Do I feel belittled, manipulated, or feel I can’t please him/her?

Adapted from Judith Orloff’s “Emotional Freedom” (Three Rivers Press, 2011)

If you answered “yes” to three or more questions, it is likely that this person’s narcissism is affecting your life

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How to Relate to a NarcissistHow to Relate to a Narcissist

DO-NOTS Do not retaliate

Do not shame, belittle, “pay back”

Do not expect fairness or reciprocity

Do not isolate from friends, other family

Do not surrender to the narcissist’s attempts to control/disparage

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How to Relate to a NarcissistHow to Relate to a Narcissist

DO(s)Know yourself Identify your motives to stay in the relationship: desire to please? gain

his/her regard? feel protected? bask in their power? Etc. Identify your “hot buttons” and your problematic responses

Know your own worth, independently of his/her valuation

Cultivate reciprocal, satisfying relationships

Be empathic, respectful, fair

Be mindful of his/her sensitivity to shame/humilliation

Practice self-control and patience

Use non-confrontational limit-setting

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How to Relate to a NarcissistHow to Relate to a Narcissist

DO(s)Set boundaries Re-engineer the terms of the interactions

What you can do, what you won’t

Reinforce positive behavior (i.e., kindness, attentiveness)

Avoid criticism; Try to understand his/her mind frame

Agree with acceptable part of his/her statements, and add: “I wonder if…”, “how about…” “this could be of benefit for you”

Discourage negative behaviors (belittling, dominance)

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How to Relate to a NarcissistHow to Relate to a Narcissist

DO(s)

Consider the costs (risk/benefit analysis) of staying in the relationship

Assess damages/severity of behaviors

If risk/damage is high, consider an exit plan

Avoid/Minimize contact

Seek external help

Build a support network

Be mindful of characteristic feelings of shame/guilt

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Recommended ReadingsRecommended Readings

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More suggested readingsMore suggested readings

Neurobiology of Empathy ; Attachment Theory Mirror neurons and the brain in the vat. By V.S. Ramachandran, 1/10/2006

The mind’s mirror. (on mirror neurons and its relation to empathy) By L. Winerman, Monitor Staff, 10/2005, Vol 36, No. 9. American Psychological Association

Effects of a Secure Attachment Relationship on Right Brain Development, Affect Regulation and Infant Mental Health. A. N. Schore, in Infant Mental Health Journal 22, 1-2 (2001): 7-66

Narcissism in organizations and leadership

Leadership. By Hogan and Fico, 2009. Chapter to appear in W. K. Campbell & J. Miller (Eds.) The handbook of narcissism and narcissistic personality disorder. New York: Wiley, in press.

Cultural Aspects

What the Experts Are Saying Now . By K. Hymowitz, 8/25/2009,. A Review of the “self-esteem movement” as per new book, “Nurture Shock” by Po Bronson & Ashley Merryman

Best Weapons against Honor Killers: Shame. By Kwame A. Appiah. 9/25/2010. On the customs of honor codes (dueling, honor killings) and public dishonor. Listen to him also in “Talk of the Nation”, NPR

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http://www.slrpsych.orghttp://www.slrpsych.org

CONTACT INFORMATIONCONTACT INFORMATION

Claudia Diez, PhD, ABPPClaudia Diez, PhD, ABPP

info@drclaudiadiez.cominfo@drclaudiadiez.com