What is an abnormal personality or narcissistic personality disorder?

Is a narcissistic personality really abnormal? And why? On my page about a normal personality and normal behavior I already outlined a model of a normal personality. I tried to explain the big problem what ‘normal’ really means. Most psychological and scientific literature consider rigid and inflexible thought and behavioral patterns as abnormal (such as in a narcissistic personality disorder). However, I consider this criterion as difficult to use in practice and therefore vulnerable to misuse, because a lot of ‘normal’ people do have rather rigid and inflexible thinking patterns.

In reading the scientific literature about personality disorders and about a narcissistic personality disorder, I tried to find a common thread that would give me a criterion to make the difference between normal versus abnormal much easier. Another used criterion is experiencing problems in society yourself. So if someone would actually know or feel that he is having problems, that would plead for a possible disorder. However, this criterion is rather weak. Most people with a personality disorder or with a narcissistic personality do not have much problems with their own behavior or thinking patterns: it is ‘ego-syntonic’. It is their own identity, sense of self, so that’s why they will not see it as deviant or abnormal. How could they? It has been built up many years ago, usually from their early upbringing.

Fortunately, there are two still very important criteria left to decide what is or is not a healthy and normal personality. The first criterion is the so-called reality testing: seeing reality as objectively as it is. With all facts and observations, as scientifically as possible. Without much or even any emotional bias, for example due to your own wishes or preferences. In Steve Pavlina’s model this is the Truth-dimension. A narcissistic personality means that this person can not see himself, the other or the world in a realistic way.

The second and probably the most important criterion to make a difference between a normal and abnormal personality is Compassion or Empathy. In Steve Pavlina’s model this is the Love-dimension in which there is a fundamental connection, binding with an other living and sentient being (not necessarily a human being). A narcissistic personality can not reliably and consistently have an empathic binding with another person, under any circumstances. This criterion is in my opinion the most important one to differentiate between normal and abnormal personalities. First of all, there are enough indications from the neurosciences and ethology (= science that studies normal behavior of animals and humans) that nature (evolution) has shaped our brain in such a way that there is a fairly reasonable balance between egotistic or narcissistic behavior and friendly or cooperative behavior. At least in the higher species such as apes and humans. It seems very strongly that normal behavior has everything to do with empathic behavior. Secondly, to stimulate and optimize a healthy personal growth and for that matter a more healthy society, it is absolutely necessary that abnormal behavior will be recognized and rejected much earlier. Especially by associating personality disorders with unethical behavior, there will be an incentive to detect such people and to treat them. Because…personality disorders do cause a whole lot of suffering and pain in this world. Or do you really believe Adolf Hitler, Stalin, Ghadaffi, or Bin Laden did or do have normal personalities?

Does this all sound a little too moralistic? Well, it should be! In Ken Wilber’s growth model AQUAL (All Quadrants, All Levels) he assumes (just as I do) that we as mankind can grow gradually towards a higher consciousness in which many things will be integrated more and more. He thinks that eventually western thought and science will integrate with very ancient eastern wisdom, to a truthful and real integral science that will incorporate áll known facts and observations in modern scientific ideas. In this growth model not only analytical intelligence should increase, but also our creative and especially our emotional intelligence.

My fundamental vision is that if we really do want to grow to a higher and more stable personality, we will HAVE to grow in our ethical consciousness and behavior. Ethics can NOT be seen apart from our developing personality or personal growth. The model of Steve Pavlina postulates this as well (see also my page on ‘normal personality’).

I can imagine that there are now readers who begin to think this becomes rather creapy, that I only want to force my ethics onto others. On the contrary! The ethics I suggest should be a universal ethics, for all humankind and a lot of higher sentient animals valid, whether someone is a christian, muslim, hindu or atheist. The normal personality model I presented earlier on another page shows this as well: no one should be harmed.

With the help of this ethical criterion: that the thinking or behavior of someone with for example a narcissistic personality disorder eventually always is harmful for other people and/or animals, it is relatively easy to detect and recognize a personality disorder. However, it will also lead to the simple conclusion that there are many more personality disorders than the scientific community claims there are. And am I not exaggerating here? Don’t I blow this out of proportions just to force more treatment onto innocent human beings? I honestly hope not. I hope that I can convince the readers of the most important difference between a normal and abnormal personality: friendliness, compassion, empathy as belonging to a normal personality and constant and frequent hostility, anger, disrespect as belonging to a clear and unmistakable sign of an abnormal personality.

For every known (assumed) personality disorder I want to demonstrate this with daily examples so that everyone can a. quickly detect people with a disturbed personality development, b. defend themselves more easily against someone with a personality disorder and c. stimulate or even convince people with a personality disorder to get help or counseling. My ultimate goal is to lessen any suffering so that we all can benefit and form a society in which optimal use is made of our best human features. Just as in the famous TV series Star Trek of which I am a huge fan. Only thén we can find solutions for the immense problems we will be faced with on our overcrowded planet earth.

A narcissistic personality: too much egoism

The Psychiatric Handbook, the Diagnostic and Statistical Manual of Mental Disorders, version 4 (DSM-IV) considers a narcissistic personality disorder whenever at least 5 out of 9 following criteria are met. A narcissist…
1. has an extreme sense of grandiosity or importance (e.g., exaggerates own achievements and talents, expects to be valued as superior)
2. is full of fantasies about beauty, unlimited succes, power
3. believes he/she is special, unique, and can only be understood by other important and high placed individuals with status
4. expects great admiration by other ‘common’ people
5. expects to be treated with special care and his/her wishes to be followed at all times
6. uses or abuses others always to fulfill his/her own wishes
7. has little or no empathic ability so he/she disrespects the feelings or wishes of others constantly
8. is usually jealous or thinks people are jealous of him/her
9. is usually arrogant or pretentious in his/her attitude, thinking or behavior

According to one of the best books about personality disorders, Cognitive Therapy of Personality Disorders by Beck, Freeman, Davies and associates (2004, 2007 paperback edition), a narcissist has a counterintuitive weak self-image. The core-belief of a narcist is namely: “I am not perfect, actually I am weak and insignificant”. This largely unconscious core-belief leads to overcompensations with conscious ideas like “I am superior, special, unique”. According to Beck’s cognitive theory (of which I am an admirer) this conscious idea is shown in extreme forms so that the real unconscious weak self-image does not show up.

Beck’s cognitive model of personality assumes (like many other researchers) that someone with a personality disorder almost always has an unrealistic and weak self-image. To compensate for this usually conscious self-images are created that are clearly unrealistic (reality testing is weak or even absent). Just because reality testing – a feature of the anterior cingulate gyrus in the prefrontal lobe – is damaged, someone with a personality disorder does not see that his/her ideas are totally unrealistic.

Also very interesting in the cognitive model of personality is the assumption that a personality disorder is largely learned: a combination of genetic factors and the environment (upbringing). DSM-IV supposes a personality disorder can only be diagnosed whenever there is evidence that the criteria are there from the early childhood. Suggesting the deviant thinking patterns are there for a very long time. However, this seems to exclude the possibility that someone can develop a personality disorder later in life. That’s strange because someone can develop a personality disorder after he/she is 12 years. Strange thinking patterns can indeed develop after the age of 12, but DSM-IV does not consider this a personality disorder unless several criteria were already present, which indeed might be the case. However, it is just an assumption because it can not really be proven.

The difference between normal and abnormal egoism?

No matter what the academic discussions are: a narcissistic personality disorder can clearly be recognized by the fact that this person thinks very highly of him- or herself and behaves very egoistically. But…a lot of people are just like that! some might think. Are they all suffering from a narcissistic personality disorder? And again the most difficult question arises: WHEN do you consider it a normal personality with egotistic traits or an abnormal one? Of course, the main problems lies in the fact that a personality consists of many, many thoughts that all differ in intensity and can even differ per situation. On this continuum there is no cut-off point, no single point where you can say: this is a disorder and beyond this point it is normal. Very frustrating indeed.

That is why DSM-IV emphasizes that there has to be a long-standing rigid attitude, thinking style and behavior that is or can not be changed easily. Furthermore, quite some psychiatrists claim that there are degrees in a personality disorder: light, moderate to severe. All this is intended to cope as best as possible with the difficult differences between normal and abnormal.

However, my plea here is that thé main difference between a normal and abnormal personality lies in ethical behavior: someone with a personality disorder can not be friendly in a consistent way to all people! For that his/her reality testing and especially his/her empathic capacities are too disturbed. This not being able to really feel normal emotions, is an essential part of a personality disorder. This whole idea is based on the fact that a personality is formed during the long term interaction with other sentient beings…and this is molded into the developing (frontal) brain cortex. It is this interaction that largely determines whether you get a deviant (or abnormal) personality growth or not. I’ve said it before: a human being is NOT born with a personality disorder.

Of course, brain dysfunctions are possible before, during and immediately after birth that can lead to abnormal behavior. This is the case in autistic behavior disorders and other developmental disorders. And very likely it will be the case that with every personality disorder there will be brain dysfunctions so that the emotional brain and the style of information processing will clearly differ from that of more ‘common’ brains. But in the large majority of people being born there are no known brain dysfunctions that lead to a personality disorder. Their personality develops itself through a complex interaction between their temperament, talents and their environment. And especially this environment (caretakers) can cause a personality disorder. Because a personality disorder can be molded and learned. And that is exactly why I do not understand that every one can have a child without obligatory child upbringing courses.

How does a narcissistic personality or egoist develop?

In fact this is quite simple. Again. A narcissistic personality has in its core a damaged self-image, very weak. Very likely caused by several traumas during his upbringing. The ‘recipe’ for this is easy to give. Just make sure you spoil your child, that it gets everything very easy. With this you learn to let it believe that everything is especially arranged for him or her. Because he/she is so special, so unique. That’s what a child can easily assume and learn to think when it gets so much attention and special care. It is also very important not to learn it to handle frustrations. For example, when it fails at school or during an activity, this failure has to be forgotten as soon as possible. It has to learn that such failure isn’t his or her fault, it’s the fault (always) of others. In this way the child learns that failure is a terrible thing and worst of all, it isn’t his doing. The problem then becomes that such a child does not learn to overcome ‘bad’ feelings like sadness or frustration. Another ‘fine’ way to make a child a narcissist is to punish it hard when it makes mistakes. To let it feel it really is very stupid, weak or inferior.

To spoil this child even further towards a narcissistic personality disorder you can learn it that things with status are very important. So take care for exclusive brand clothing, design glasses, all sorts of expensive brand stuff. Because, only the best is good enough for this child. In this way, it learns that inferiority represents things without status. And that building self-confidence only goes when you have things with high value. Thát’s the reason a lot of narcissistic men can not drive in a small compact car. That just does not fit their (weak) self-image. They really need a high value status car to feel good. Any other way their weak self-image might show up in consciousness and to realize that they are really nothing of value is to shocking.

Of course, the above short scenario is a bit too extreme and simplistic, but that’s just to make my case very clearly. But don’t be fooled. Such an upbringing is quite common. I am convinced that there are many more people with a narcissistic personality around than scientists estimate. They say only around 0.7 to 1.0% of the population has a narcissistic personality disorder. Unfortunately, this number is not backed up by any sound research, it is just a very rough indication. When just following the theory of Beck and associates about how a narcissistic personality comes to being, there have to be many more narcissists around. Possibly up to 20% of the normal population, but to be honest this is a rough guess as well.

Of course, everyone being raised as a princess should not be called a narcissistic personality disorder. The two most important criteria are reality testing and friendliness. In Steve Pavlina’s model of personal growth these are the dimensions Truth and Love. Love is thé criterion to detect a rigid and stuck personality. A narcissist can not love all people, his love is very selective.

Examples of a narcissistic personality

I’d like to give here many examples in daily life to make it as clear as possible when you are dealing with a narcissist and when not. Using Beck’s cognitive model and Steve Pavlina’s personal growth model. Furthermore, I will recognize the official DSM-IV criteria.

Someone who isn’t nice or even argues is of course not immediately seen as someone with a personality disorder. Let that be very clear. However, when this kind of unfriendliness shows up regularly, consequently, continuously, aimed at almost all people, thén something is wrong. It should not be a consequence of a temporary nervous breakdown or a so-called off-day. This kind of unfriendliness is continuously present, most of all unreal, faked and highly selective. With these criteria it is relatively easy to detect. The friendliness of a narcissist is often focused on people with status (or suspected status), high placed individuals en very often only publicly displayed. A narcissistic personality can not be unfriendly in public when his image is at stake. His image is very important for him. When being alone with one or two persons however, hardly any image damage can be done and so his unfriendliness returns. Unfriendliness is highly related to (mis)using the other, not really listening to another’s feelings. All amounts to making his- or herself more important. The lack of empathy and not really being considerate for another goes hand in hand with being unfriendly.

A narcissist can often be found in people who can do something special, for example under those who have a PhD, are professors, professionals, often medical specialists, those who earn a high income and have considerable status. All professions that have a huge impact, like pop artists, or politicians. It is not so difficult to become arrogant or egotistic in such kind of professions. Under normal circumstances caregivers should have corrected such kind of egotistic or arrogant behavior. Someone should be corrected and have learned that being unique and special still does not mean that one is more than another human being. This aspect of ethical behavior, this friendliness and humility is not something that belongs to a narcissistic personality. Thát’s how you quickly can detect them.

Other examples? Well, actually narcissists can laugh the most at their own jokes, think they are the most funny people around, have their own language and expressions for others, often showing disrespect and belittling others (‘hey sweetie’). They are highly selective in when they are friendly and to whom.

There are people who are very charming, always nice in public, apparently friendliness in person, but who are completely different at home or with friends: demanding and irritated. A narcissist will always belittle others whom he thinks are less, he will always use them for his own needs. In this way, he keeps thinking that he is more than those others. Of course, this is completely unrealistic (why being more than another when you can do something better by accident?), and completely anti-social, without any compassion or empathy for others.

A very simple and highly effective way to detect a narcissist is to publicly criticize their thinking or behavior. Having a unstable self-image they will react, either immediately in public (not usually) or later when taking you on…alone. Emotional outbursts are common in such kind of reactions, often quite uncontrolled and clearly meant to impress the other. When you can easily provoke such kind of outbursts, rather frequently and consistently, you are probably dealing with a narcissist.

Narcissistic or even more?

It is a common misunderstanding to think that someone only has 1 personality disorder. Often there are many more characteristics of several personality disorders present. However, DSM-IV culture has it that this is not often done. Usually, one picks just one personality disorder and the rest is recorded as having ‘specific traits’. Of course, all this is not reality, it is just a conventional way to code reality. Unfortunately, we are missing here real aspects of reality: rarely a personality disorder consists of just one domain.

For example, a narcissistic personality disorder can develop very quickly anti-social features: using people, without empathy, emotional blackmail and outbursts to intimidate persons. However, there is a true and significant difference between a narcissistic and anti-social personality: a psychopath does not refrain from real violence. Usually narcissists don’t do that, but…they can become capable of really physically hurting people.

Narcissistic personalities can also have a dramatic or histrionic personality (more often women than men), can be obsessive-compulsive, can have strange ideas, can have borderline traits. In fact, a lot of mixtures with other personality types are possible.

Narcissistic and useful?

There are a lot of people who do not recognize narcissists easily because…they really admire their special ‘gifts’. And yes, narcissists can often do something very special, that’s why they are often becoming very arrogant. An artist for example, can sing very good or play his guitar extremely good, and a lot of people are willing to pay for his performances. So, what the heck, when such a guy is a narcissistic personality?

Well, in fact, this is really bad. First of all, narcissistic personality traits do not tend to become less, automatically they become worse. Eventually, such a person will get more into trouble with others. Secondly, it is plain anti-social, unethical when you do not correct anti-social behavior. In such a way you implicitly condone this kind of behavior and let the world show that it is ‘good’. In doing this, this kind of anti-social behavior will spread and increase, making it all worse for everyone involved. So no, a narcissistic surgeon, however good in his operating skills, should NOT be allowed to communicate like a dictator or bully his secretary or his assistant-physician.

A very important reason I put up this website with all this psychology information, is that I want to contribute to a better world. A world that shows that we as a human race can really grow. That we all have the power, together, to grow in such ways that there will be more happiness, for more people and sentient beings. And this kind of growth will not happen when we condone anti-social behavior, when we do not learn to behave ethically. Just like Peter Singer argued in his books about Practical Ethics. Ethical thinking and practicing ethics has everything to do with personal growth. See also Steve Pavlina’s model in which Truth, Love and Power are in balance with each other. So, please NO to personality disorders!

Can a narcissistic personality disorder be treated?

No, well actually, with a lot of pain and effort. A narcissistic personality will not let himself be treated unless he or she is suffering a lot. Usually having panic attacks or a depressed mood. In the movie Analyze This! with Robert de Niro and Billy Cristal a narcissistic mafia boss is having panick attacks and seeks treatment from a psychiatrist. A very funny, hilarious movie. Another reason can be that others, like a partner or even justice forces the narcissist to undergo a treatment. But such force does not help much because a narcissistic personality do not see or realizes that he/she is unrealistic and is the source of many problems with others. Usually, the others are the problem.

The positive news is that a narcissistic personality disorder can be cured, but…this costs a lot of time (1-3 years), persistence and a skilled psychotherapist. One of the most effective psychotherapies iscognitive behavioral therapy. The narcissist learns first to see whether his behavior really leads to his own happiness or demise. Only when a narcissist realizes that there has to be changed something in his own behavior, he can be open to change his thinking styles and behavior. This then happens step by step, and doing homework, homework that the client has to practice at home or at his work.

However, when narcism is rooted very deeply, i.e. many ideas are unrealistic and too much anxiety is aroused by confronting the patient with so many wrong ideas, then a treatment will be extremely difficult, if not impossible. A lot then depends on the skills of the therapist. Whenever there is ‘click’, a bond with the narcissist, only then when using the right cognitive techniques, personality changes are possible. However, a stable environment, a patient and caring partner, stable work, are all factors that contribute largely in this positive change.

In summary

One of the most common personality disorders is a narcissistic personality. Although science uses a very rough estimate of 0.7 to 1.0% of the normal population, this simply can not be true because egoism is one of the normal developments in personality. It has to be corrected during upbringing, otherwise it is quite easy to develop a narcissistic personality.

A narcissistic personality can easily be recognized in an arrogant, bragging attitude in which there is hardly or no room for the feelings of others. Friendliness is usually faked and rarely constant, often there are emotional outbursts but not in public. Criticism or provocation a narcissist can not deal with, he will react fiercely, without humor. Such anti-social and egotistic behavior should be present for months and constantly.

The positive news is that a narcissistic personality can be treated with cognitive behavior therapy, but there has to be some form of suffering. The narcissist should feel himself that his behavior is wrong and should be changed. Then it largely depends on the therapist and his skills how succesful a treatment eventually will be.

Go from narcissistic personality to Normal Personality

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One of the best books about narcissism and how to recognize and deal with such people:

An even better book about narcissists because it helps you to move on with your life when you have become a victim of a narcissist. Furthermore, when you have seen the classic movie Wizard of Oz then you will certainly like the storyline of this book:

When suspecting being in a relationship with a narcissist or having been there I highly recommend this clearly written book. For thou shall not make this mistake ever again...:

Being in a relationship with a narcissist as a partner...: