What is Narcissistic Personality Disorder?

narcissistic-disorderAlthough we do not use stigmatizing labels like “narcissist” or “Narcissistic Personality Disorder (NPD)” , we do provide treatment for persons who have experienced trauma or neglect in childhood and who manifest certain behavior and personality features such as an exaggerated sense of self-importance or uniqueness and a preoccupation with receiving attention. Persons with these features will often overstate their own achievements and talents, or focus upon the special nature of their problems. In essence, a fragile self-esteem is revealed by a preoccupation with how others regard them. Features of narcissism include a preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love. There is also a need for constant attention and admiration, and either a cool indifference or feelings of rage, inferiority, shame, humiliation, or emptiness in response to criticism, indifference of others, or defeat.

What are characteristics?

  • Entitlement, or the expectation of special favors without assuming reciprocal responsibilities (surprise and anger at people when they do not do what they want).
  • Interpersonal exploitativeness, or taking advantage of others to indulge their own desires or for self-aggrandizement (a disregard for the personal integrity of others).
  • Relationships that characteristically alternate between the extremes of over-idealization and devaluation.
  • Lack of empathy, or the inability to recognize how others feel (unable to appreciate the distress of someone who is seriously ill).

It is important to note that these traits exist on a continuum, with some experiencing milder forms of the disorder and others a more extreme position. The disorder affects men more than women.

What causes Narcissism?

Narcissism is believed to arise primarily from early neglect or trauma in childhood, as no specific genetic pattern has been demonstrated. Developmentally, narcissistic traits appear commonly in adolescence. While most people outgrow these traits, those who develop the characteristics maintain these issues from adolescence through adulthood.

Narcissism originates from experiences in childhood such as loss of a father figure, an excessively condescending or critical environment, or unpredictable or unreliable caregiving from parents. Other forms of childhood psychological trauma, including physical or sexual abuse increase the risk of developing interpersonal problems. Chronic insomnia, overworking, exposure to high levels of stress, substance abuse, medical problems, and difficulties with family or other interpersonal relationships can exacerbate the symptoms of trauma related personality issues.

Frequently Asked Questions about Narcissism

How is it diagnosed?

Narcissism (or “narcissistic personality disorder”) in adults is recognized by severe disturbances of interpersonal relationships. Younger persons with narcissism display grandiosity, which tends to be less pronounced in adults with “stable” Narcissistic Personality Disorder. Unfortunately, symptoms of this personality disorder tend to be vague and difficult to isolate. For example, lack of empathy and exploitative interpersonal relationships are hallmarks of narcissism, but they can be present with other psychological disorders.

It is primarily characterized by patterns of self-centered and egotistical behavior that negatively impact interpersonal relationships. The dimensionality of narcissistic characteristics (i.e., ranging from normal expressions of an emotion to pathological exaggerations) make diagnosis difficult, as the same emotional issues can be found on a smaller and less intense scale in many normal individuals.

What is the Prognosis?

NPD is generally a life-long disturbance with periods of remission and exacerbation (worsening) dependent on life circumstances. Persons with this disorder rarely enter treatment. Once in treatment. they find it difficult to stay, as they have trouble believing a therapist is really helping them.

Psychotherapy over time, coupled with sleep and stress management, and psycho-education, can address related problems. When a person with NPD develops depression or substance abuse, treatment becomes imperative. Clients who do receive effective treatment will experience significant improvement in their ability to function normally in their daily lives, with improvement in their interpersonal relationships.

What factors can slow recovery?

As discussed, establishing the diagnosis of Narcissistic Personality Disorder may be difficult. Narcissists rarely enter treatment and when in treatment feel they are wasting their time. Depression and substance abuse (especially alcohol, marijuana or cocaine) are also prevalent among persons with this disorder.

Concurrent substance abuse dramatically interferes with effective psychological and medical treatment. Persons with NPD usually have interpersonal problems with family, loved ones, or co-workers. Their impaired social support structure makes it difficult for them to enter or stay in therapy. Persons who are excessively impulsive or self-destructive will require more intensive therapy and may have a slower resolution of their problems..

When Should a Client enter a treatment center?

Narcissism often manifests as serious problems within the family or workplace. In these cases, an intensive treatment program is an appropriate option. Once per week psychotherapy is usually ineffective at managing serious consequences. A treatment facility, like PCH Treatment Center, can be a more effective option than simple outpatient therapy, especially when the client is suffering from other issues such as depression, substance abuse, or estrangement from family or loved ones.

How does PCH Treatment Center treat Narcissistic Personality Disorder?

PCH Treatment Center offers a unique way to help people with Narcissism. Dr. Jeff Ball, the Executive and Clinical Director, has over 25 years of experience in treating trauma related personality issues. He has assembled a highly qualified staff that is familiar with the challenges this disorder presents.

When a Client enters PCH Treatment Center, they are carefully assessed by a Psychologist and Psychiatrist. In conjunction with Dr. Ball and the treatment team, an accurate diagnosis is made, discarding inappropriate or stigmatizing labels. Dr. William Wirshing, the PCH Psychiatrist, is an expert in psychopharmacology. He assesses each Client’s medication regimen and adjusts their medication usage to a minimal level, when indicated.

In conjunction with individual psychotherapy, we offer somatic experiencing, group therapies such as Dialectical Behavioral Therapy (DBT), anger management, sleep management, and psycho-education. Neurofeedback is also an important adjunct. Holistic therapies including yoga, meditation, acupuncture and massage therapy are also utilized for recovery and healing. Family therapy groups are available which incorporate family members or significant others into the Client’s treatment environment. This can be extremely effective in dealing with personality disorders.

Contact PCH Treatment Center

11965 Venice Blvd., Suite 202, Los Angeles, CA 90066


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