Diseases What is narcissistic personality disorder?

What is narcissistic personality disorder?


People who feel special, who believe they are above the rest and who demand to be treated in a preferential way. These are some of the symptoms of narcissistic personality disorder. We explain how it manifests itself, what is behind it and how it can be treated.

In our society we use the term “narcissistic” as a wasteful insult especially when we want to disqualify someone without compassion. We then describe a vain, egotistical, and self-satisfied person, lacking the slightest empathy and consideration for the needs of others, and we do so because we think it helps us to explain many of the harsh difficulties that we grapple with in some of the cases. our relationships and also as a way of requesting understanding. This is how we water our conversations with this adjective and we talk about my ex-boyfriend, a very narcissistic guy, or my boss, a narcissist by now and back who doesn’t listen to anyone, talks non-stop about himself, what he needs, about his infinite goodness, etc.

By using the term “narcissism” we are referring to a type of people who are self-absorbed and chronically believe that they are better and superior to others. The other does not count or counts a little.

It is possible that if we sincerely delve into ourselves, we sometimes discover the presence of narcissistic attitudes in our way of proceeding and acting. But when we speak of “narcissistic personality disorders” we refer to a clinical condition of mental health where excessive consideration of oneself, both of their own faculties and of their works, significantly affects and hinders life, both in the type of relationships that the person establishes as in everyday life.

The narcissistic personality disorder has been included since 1980 in the classification offered by the Diagnostic and Statistical Manual of Mental Disorders and is included in that group characterized by the predominance of unstable emotions and the existence of a distorted self-image. It is as if these people are looking at themselves through concave or convex mirrors. It appears already in the first stages of adult life and affects more men than women.


If we were to summarize a necessary condition it would be an excessive consideration of its own importance that is expressed in the following symptoms:

  • They show a feeling of greatness and arrogance (they exaggerate their achievements and talents; they hope to be recognized as superior without counting on the corresponding successes).
  • They are engrossed in fantasies of unlimited success, power, brilliance, beauty, or ideal love.
  • They believe that they are “special” and unique and that they can only understand them or can only relate to special or high-status people (or institutions).
  • They have an inordinate need for admiration, which is exhausting for those around them.
  • They exhibit a sense of privilege (for example, they have unreasonable expectations of being treated especially favorably simply for being themselves or that others will immediately comply with their wishes and expectations).
  • They exploit interpersonal relationships and take advantage of others for their own purposes.
  • They lack empathy and do not seem willing to recognize or identify with the affections and needs of others.
  • They often envy others or believe that others envy them.
  • They exhibit arrogant and superior attitudes.


These people have a hard time accepting criticism and are easily hurt. When a conflict arises, they do not recognize that they may also have done something wrong, they are authentic experts in blaming others and also get very angry if others do not follow their orders or dispositions.

The grim consequence is that they have serious difficulties in their relationships due to their inability to listen to the other, their chronic lack of empathy, especially when expressing feelings of vulnerability and fragility, a frivolous way of rejecting friends in the face of small or imaginary disagreements., and so on. They are also at high risk of using drugs and alcohol as well as social isolation.

However, hidden from this arrogant way of showing himself to others, his inner world is inhabited by painful feelings of insecurity and low self-esteem that can be reversed with the appropriate treatment, giving space to more positive and considerate attitudes and behaviors in their relationships.


As with other personality disorders, there is no specific consensus on its causes. It is considered that a set of genetic and psychological factors, as well as certain early childhood experiences in the construction of the personality that favor an unrealistic representation of the self, influence.

There are two prominent authors Otto Kernberg and H. Kohut, both coming from the psychoanalytic model, who have contributed enormously to the understanding of the narcissistic personality.

  1. Kohut in 1971 explains that narcissistic disorder is a normal childhood development disorder. These people maintain a fixation on a normal phase of child development of narcissism that was not adequately overcome by pathology of external objects, and, therefore, would correspond to a pathology of structural deficit. It would be something like a house built with crooked pillars.

Psychotherapists observe in their treatment how in the therapeutic context a grandiose self is displayed and reactivated, that is, an ideal I, a distorted and idealized image of the self that in a child would be seen as an expression of normal childhood narcissism.

Throughout the psychological and emotional maturational development, we all build a more accurate representation of ourselves. We can observe it, for example, in how as adults we deal with and resolve the conflict between our desires and aspirations and our real possibilities without feeling that not achieving everything we want or desire compromises the sense of our own personal worth.


When a person suffers from this disorder and there is no other type of additional problem, these people can be treated by a Psychotherapist, Psychologist or Psychiatrist, specialists in these types of disorders.

What is really important is to encourage them to carry out a work of personal, internal change that helps them to locate themselves in life from a more appropriate view of themselves and to relate to the world and others in a more friendly, creative, hopeful and meaningful way.

Psychotherapy is considered to be the most appropriate approach and can be carried out from different approaches:

  • Dynamic Psychotherapy based on the Psychoanalytic Model: Focused on helping the person understand their emotions, thoughts and disruptive behaviors. There they discover other perspectives on their difficulties. These insights, or new knowledge, help in the therapeutic process to understand reality in a more adequate way and aim to build more harmonious and healthy relationships. Otto Kernberg, as early as 1975, suggests that when there is also a limit functioning, it should be combined with measures aimed at structuring the sessions and the patient’s life.
  • Cognitive-Behavioral Model (CBT): helps people to identify negative maladaptive thought patterns and replace them with more productive and positive ones.
  • Family Therapy and Couples Therapy: This type of disorder can seriously affect family relationships. Attending a session can help people in their relationships, working positive communication and helping them find a way to solve their problems. It is not addressed through pharmacological treatment, although in some moments if the person develops symptoms of anxiety or depression and in that case antidepressant treatment can help.
MindFixes Staffhttp://mindfixes.com
MindFixes is dedicated to promoting mental health, preventing mental disorders and advocating, educating, and serving all people with mental and substance use conditions. MindFixes is determined to persevere, learn, grow, love and laugh through our wellness journey and we invite all to join.


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