What is narcissistic personality disorder?

Hated because they are full of themselves, egotistical, lacking in empathy and condescending; narcissistic people feel superior to others. The one most talked about, as potentially dangerous for his victims, is the narcissistic pervert. But there are other profiles of narcissistic personalities. How do you recognise a narcissistic person? What are the causes of narcissism? How do you deal with a narcissist?

What is narcissistic personality disorder?

"Narcissistic personality disorder is characterised by a constant feeling of superiority (megalomania), a need to be admired and a lack of empathy," reads the MSD Manual, the world's leading source of medical information. Narcissism comes from the Greek character Narcissus, who fell in love with his own image reflected in the water. Narcissists are, by extension, people who love and admire themselves more than they should. The concept of narcissism entered psychiatry thanks to Sigmund Freud.

The latter distinguishes between primary and secondary narcissism. Primary narcissism is a normal infantile stage during which the child learns to love himself by eroticizing his own body. Secondary narcissism is pathological. It becomes a perversion when an adult is unable to detach himself from himself in order to invest himself with others. It is important to know that a normally developing individual detaches himself from himself in order to reach out to others, while still retaining a certain amount of self-esteem.
According to the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, narcissistic personality disorder manifests itself by at least 5 of these symptoms (they must appear in early adulthood):

1. An overestimation of one's abilities. The narcissist believes that his or her skills and accomplishments are extraordinary. Therefore, he/she must be considered superior to others.
2. The impression of being unique. The narcissist believes that he/she is special and therefore should only communicate with special, high-ranking people.
3. A constant and excessive need to be liked and admired.
4. An obsession with power, success and beauty.
5. A lack of empathy. The narcissist sees only himself or herself and therefore cannot be interested in the needs and feelings of others.
6. Arrogance and a haughty attitude.
7. A need to manipulate others to get their way.
8. A feeling that others envy him/her.
9. A feeling of entitlement.

The different profiles of narcissistic personalities

The American psychologist Theodore Milton, one of the specialists in personality disorders, distinguished several profiles of narcissistic personalities who act differently:

• The manipulative narcissist. He has no qualms about using others to get what he wants.
• The seductive narcissist. They use their irresistible charm to manipulate others. The seduction is physical but also intellectual.
• The passive-aggressive narcissist. He considers others to be less good than he is and constantly complains about his incompetence.
• The elitist narcissist. They love power and domination and show it with a haughty attitude.
• The fanatical narcissist. They think big and always want more than they have because they believe they deserve it.

These different profiles have, however, been discussed on several occasions by specialists because the same narcissistic person can display several profiles at the same time. They would then only be variants of the same disorder. Also, certain characteristics of narcissistic disorder are found in other personality disorders. It is therefore difficult to put a single label on a personality, because of its complexity. We also note that pathological narcissists often suffer from other disorders such as depression (following one or more failures that they have not been able to cope with), anorexia nervosa, a substance abuse disorder or a personality disorder (borderline or paranoid).

Narcissistic personality disorder: what are the risk factors?

There are many possible causes of narcissistic personality disorder. The risk factors are both genetic and environmental:

• Having received a strict upbringing where one always had to excel in order to be rewarded or, conversely, having received an overly lax upbringing where compliments flowed and admiration was boundless.
• A lack of self-esteem that makes one lose the means at the slightest failure. To hide this fragility, narcissists make others believe that they are sure of themselves and good at everything. This lack of esteem is also reflected in the fact that they envy people whom they (secretly) consider to be better than themselves.
• A trauma suffered in the past (abuse, aggression, betrayal). Narcissism is then a defence mechanism to avoid being destroyed again.
• Narcissistic parents who have never taught their children empathy and modesty.

How to act when faced with a narcissist?

There are two schools of thought on this subject: those who advocate opposition and those who favour empathy.

Opposing the narcissist

Narcissistic behaviour, if repeated, is often unbearable for the people who suffer it. It becomes tempting to say "stop! This reaction can be useful to make the narcissistic person understand that his or her behaviour is selfish and that you do not like it: "I would like you to stop talking about yourself so that I can talk to you about what worries or pleases me at the moment. This conversation is an exchange", "You're just putting down other people, but are they as incompetent as you say? The idea is to put them in their place, without being mean. The idea is to put them in their place, without being mean. In a relationship, the narcissist will always want to hold the reins, make them understand that they are not alone and that if they want the relationship to last, they will have to leave you some space.

Being tolerant of the narcissist

To do this, it is useful to understand the origin of the person's narcissism (strict or too flexible upbringing, old trauma, etc.) to better understand them and tolerate their behaviour. To congratulate them on what they have achieved only when it is deserved, but without exaggerating so as not to put them on a pedestal. Since narcissists cannot stand the success of others, it is better to remain discreet about their own successes and privileges so as not to arouse their jealousy and provoke a surge of egocentricity by way of overkill. For the sake of the relationship, and if you can stand his or her behaviour, do not confront him or her, as this could weaken your relationship with this person.

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