Transcription
[Music] [Music] All right, hi everyone. Welcome to the podcast. My name is Dr. Mark Eatonson. I'm a clinical psychologist specializing in the treatment of pathological narcissism and related disorders, and I'm also the author of the book, *Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life*, currently available on Amazon and at major book retailers.
So this is the first episode of this podcast, and today I'd like to start us off with what seems to be a frequently asked question. There are lots of people out there who are wondering about this disorder, and more specifically, they wonder if they're a narcissist, or maybe they wonder if someone that they love is a narcissist, but they don't know where to find accurate and non-stigmatizing information about the disorder.
So first, just a standard disclaimer: that in order to get an accurate diagnosis, you need to speak personally with a licensed mental health professional. The information that I'm offering here is for educational purposes only.
Now, for today's episode, I'll be using the Psychodynamic Diagnostic Manual, currently in its second edition, published in 2017. I find the PDM-2 to be much more useful than the DSM-5 for thinking about mental illness and, in particular, thinking about personality disorders. Unlike the DSM-5 definition of NPD, the PDM-2 provides a more comprehensive picture of narcissism that doesn't just focus on checkboxes.
So, to determine if someone is narcissistic, we really need to know two things. The first thing we need to know is whether that person typically engages in the sorts of defensive adaptations that characterize a narcissistic personality style, and these are things like characteristic beliefs about the self and others, characteristic feelings or affects that occur within the person, and also characteristic issues that often sit at the very center of narcissism.
The second thing we need to know is something about severity. Just because somebody has a narcissistic personality style doesn't mean that they are a pathological narcissist or that they have narcissistic personality disorder. All personality styles exist on a continuum from healthy and adaptive functioning at one end to severe personality disorder at the other end, and the main way we look at severity is by asking the question: how much does this individual's central insecurities and preoccupations that go along with their personality style impact their life, okay, and the lives of those around them?
So, in other words, a person may have a narcissistic personality style, but it might not be very disruptive, and another person may have essentially the same personality style, but the disruptions are severe and pervasive, and we would say that they have a personality disorder. Okay.
So let's take a look at the narcissistic personality style. The main issue is typically self-image or self-esteem. Narcissists have difficulty maintaining a realistic, stable, and relatively positive self-image. They struggle with issues pertaining to self-worth. For people at the healthier end of the spectrum, these issues with self-esteem and self-worth are often funneled through productive endeavors like art or high achievement in the person's professional life. There are many high-functioning narcissists in theater and film; many people who become performers do so because they found a productive outlet to cope with their insecurities about self-worth. And for people with mild narcissism, these self-esteem issues may only become obvious when the person is under extreme emotional stress. But for individuals at the lower end of the spectrum, the personality-disordered end of the spectrum, issues with self-esteem dominate their life; all endeavors are touched by the fundamental instability of the person's self-image. They may experience extreme fluctuations in self-esteem, sometimes believing they're literally the best person who has ever existed, and at other times experiencing a complete loss of self.
Now, the narcissistic personality style is also typically dominated by certain characteristic feelings: things like shame, envy, contempt, and humiliation. Now, people at the higher end of the spectrum will typically find productive and non-harmful ways to cope with those feelings; maybe they convert them into drive and ambition, or maybe they use them as the basis to empathically understand and connect with other people, right, because they know something about this kind of unique form of insecurity, they can sort of see it in other people, right, and somebody at the healthier end of the spectrum will use that information to actually connect with and help other people. Now, people at the lower end of the spectrum will be consumed by these feelings. For those individuals, the feelings of shame and envy, contempt, and humiliation can be so overwhelming that they actually color everything in the person's world; every relationship becomes about managing the person's hypersensitivity to shame; every person in the individual's life is viewed through a lens of superiority versus inferiority; people are either better than the narcissist, in which case they're either idealized or treated with contempt, or they're inferior to the narcissist, in which case they're devalued and also typically treated with contempt.
Now, people with a narcissistic personality style also tend to have certain central beliefs about the self, and we sometimes call these schemas. These are typically unconscious, so the person may or may not be able to articulate them; they may or may not even be aware that they have them, but the beliefs nevertheless can be found underneath many of the person's behaviors. The most common one goes something like this: I need to be perfect to feel okay. At the higher end of the spectrum, this belief actually motivates high achievement; these are people who are never really satisfied with where they are in life, always striving to do more or to be better, while at the lower end of the spectrum, the personality-disordered end, this belief becomes disabling; the person's unconscious perfectionism can be so severe that they are actually never able to live up to their own standards, and neither can anyone else. They tend to fluctuate between periods of unrealistically high self-esteem, in which they sort of become aligned with their ideal self and feel like they are literally the picture of perfection, and terrifying falls into feelings of utter worthlessness. During such periods, when they kind of at the bottom of the self-esteem scale, the person may actually be at risk of suicide.
Narcissistic individuals also tend to have certain central beliefs or schemas about other people, and those beliefs tend to be along the lines of: others have things that I don't have, like beauty, riches, or fame, and the more of those things that I can get, the better I will feel. Now, of course, this belief is, to some extent, true; however, what narcissistic people lack is a basic sense of their own self-worth that's grounded in an enduring experience of being good enough simply for being the person that they are. And this feeling tends to come from being loved, seen, validated, and accepted when we're very young. In fact, the experience of not having been seen or empathically understood on a chronic basis by caregivers when we were first putting together the basic building blocks of a self is considered to be the primary narcissistic wound that lies underneath the narcissistic personality style. That's why I referred to it as a defensive adaptation earlier in this episode; like a tree that's kind of growing around an obstacle, the personality develops a structure to compensate for what was missing in early development. Narcissists tend to look outside of themselves for what they should be able to find inside of themselves; they perceive others as having the things that they lack; they may think that they want riches, fame, beauty, etc., but what they really seek is the feeling of being a self that has enough, and by that I mean that has enough love, enough stability, enough of the things that we all need to feel okay in the world.
Another characteristic belief for this personality style is that others will betray or humiliate them. Narcissistic people are always on guard for the next experience of the ground falling out from under them. Ironically, they tend to create such situations by trying to be larger than life; they put themselves out on a limb, and then when the limb breaks underneath them and they're in free fall, they think it's because other people failed them. Now, at the higher end of the functioning spectrum, the healthier end, this belief looks like an ever-present distance that's kept from other people, sort of like a subtle but pervasive wall around the narcissistic person; they tend to only allow other people to get just so close before their automatic defenses kick in that are designed to protect the self from the experience of shame or humiliation. And at the lower end of the spectrum, the belief that other people will betray or humiliate them can actually look like abject paranoia.
Finally, people with a narcissistic personality style tend to employ characteristic ways of defending themselves, and the main ones are idealization and devaluation. Narcissists tend to believe that they must be perfect to be okay, so they naturally see the world through a sort of polarized lens where things are either perfect or worthless; just like a hungry person sees the world in shades of food and not food, or a thirsty person sees the world in shades of water and not water. At the higher end of the spectrum, this tendency may look like an artist who is filled with inspiration but tends toward depression when their work isn't up to their own standards; high-functioning narcissists may be a bit moody or mercurial. When they're feeling well put together, this feeling tends to extend outward, and those around them naturally gravitate toward the person's charisma, but when they feel like they're falling apart, they tend to socially isolate or become hypercritical of themselves or the people in their lives. Now, at the lower end of the spectrum, this tendency to idealize and devalue takes on a more pervasive and extreme flavor, and we actually call this splitting; it's the tendency to view the self and other people in shades of black and white; people are seen as literally being perfect or literally being completely and utterly worthless, and this tendency to split also involves the person's self-image as well. At the personality-disordered end of the spectrum, narcissists are actually an at-risk population for substance abuse, perpetration of domestic violence, uh, and even suicide, and this again is due to the sort of extreme polarization in how they view the self and other people, and the quality of that polarization shifts depending on whether the person is feeling well put together or grandiose or whether they feel like they're at risk of falling apart, which we call vulnerable narcissism.
Okay, so that's it for today. If you recognize yourself in any of the things that I've talked about in this episode, then you may have a narcissistic personality style, and if those issues are dominating your life or negatively impacting your relationships, then you might have narcissistic personality disorder. It's important to remember that this is simply a broad overview, and I'll be addressing some of the more specific issues in the personality that cause someone to be at a higher or lower end of the spectrum in a different episode. But for now, remember that narcissism is a treatable issue; the person needs to want help, and they need to be willing to commit to the process, but it's very possible to heal the self and to move up the spectrum toward better functioning.
Okay, so thanks for joining me today. Please reach out with questions or suggestions for future topics, and until next time, take care. [Music] [Music] You