The narcissists in our midst

Recently our son Nathan decided that because he’d run out of things to say, he would stop seeing his current psychologist. While his decision was a little disappointing, we appreciated it when Nathan suggested that my husband and I use his next appointment to get Dr M’s impressions.

Dr M told us he too was disappointed that their sessions would be ending. He had looked forward to seeing Nathan: “He’s no barrel of laughs, but he’s so interesting!”

As far as diagnoses, Dr M stated that Nathan fits the criteria for Aspergers AND schizoid personality disorder. (The previous psychologist, Dr S, believed that Nathan had schizoid personality disorder, instead of Aspergers. This post talks about the confusion between the two disorders.)

While I was still absorbing the dual diagnosis, Dr M added, “Oh, and he has a narcissistic streak.”

That statement also gave me pause. Nathan, who avoids people and doesn’t care about his appearance, a narcissist?

Clearly, it was time to find out more about narcissism. What is it, exactly? And is it more common in people who have other neurological differences?

It turns out that lots has been written about narcissists and narcissistic personality disorder (NPD), which affects 1% of the population. No doubt you’ve crossed paths with at least a few “official” narcissists in your lifetime.

The supportive website regarding personality disorders, Out of the Fog, supplies this in-a-nutshell summary:

Narcissism is characterized by an extreme self-interest and promotion with an accompanying lack of concern for the needs of others.

Behaviors that typify narcissists include expecting special treatment, lying, manipulating people, and shifting blame. Doesn’t that scream “stay far, far away?” And yet, narcissists can be fun, charming, and talented. (By the way, being stuck on how good-looking they are – which many of us laypeople equate with narcissism – isn’t necessarily a big part of the package.)

The DSM-V criteria for diagnosis can be seen in this Wikipedia entry. (In most articles that I read about narcissism, the criteria referenced were from the now-oudated DSM-IV.)

Basically, according to DSM-V, a narcissist is impaired by:

  • excessive reference to others in evaluating his/her self-esteem
  • having personal standards that are unreasonably high (I am exceptional) or too low (I am entitled)
  • little ability to recognize or identify with the feelings and needs of others
  • largely superficial relationships: little real interest in the other person, coupled with a need for personal gain
  • grandiosity (self-centered, condescending, entitled)
  • excessively seeking admiration

For an official narcissism diagnosis, these traits must be stable over time and across situations; unusual for the person’s developmental stage and social/cultural environment; and not explained by substance abuse or physiology (like head trauma).

About that developmental stage: I’ve read that teenagers in general tend to display narcissistic traits (no kidding!) Furthermore, maturity is typically delayed for people with ADHD and other disorders (raise your hand if you’re hanging on until their late 20’s!) So we might be seeing narcissistic traits well past the teen years. But when the traits strongly persist past the age of 30, there’s reason to suspect NPD.

Regardless of whether the narcissism in your loved one is transitional or here to stay, it can be really difficult to deal with – anywhere from “irritating” to “exhausting” to “toxic.”

To help us understand what we may be dealing with, the page about narcissism on the Out of the Fog website includes: a long list of unofficial characteristics often seen in narcissists, the old DSM-IV criteria, and a brilliant essay titled “What it feels like to live with someone with NPD.”

The Out of the Fog website also provides a toolbox of what seems to help, as well as what doesn’t work, when dealing with individuals with personality disorders. You can also search the support forum for discussions similar to your situation, or find pages with links to books or other websites dealing with NPD.

There is no cure for NPD. Therapy may help, but narcissistic individuals are unlikely to seek or consent to therapy. If they do, their focus tends to be on blaming others, and they will probably resist personal change. The rest of us are the ones who can benefit from tips and therapy for the ongoing damage narcissists cause.

As for what causes NPD to develop, I’ve been squirming because many articles talk about poor parenting: too indulgent, too neglectful, too erratic, too dependent on our children for our own self-esteem, or we modeled manipulative behavior. Jeez, did we do any of that? Severe emotional abuse is also mentioned as a factor. Did that happen?

But Psychology Today states that genetics plays a significant role (up to 50%) in the development of narcissism. Other recent research points to neurological differences as a potential cause. Phwew: maybe we’re off the hook!

Neurological differences also result in conditions like ADHD, Aspergers, and bipolar disorder. What is their relation to narcissism?

This excerpt from the Out of the Fog essay addresses co-occurring disorders:

Narcissists are addictive personalities and narcissism is commonly co-morbid with addictions to drugs, alcohol, sex, food, spending and gambling. It has been suggested that Narcissists have a higher rate of ADHD than the general population.

Another discussion reinforces the idea of a relationship between ADHD and personality disorders, including NPD. Findings suggest that people diagnosed with ADHD in childhood are more likely to meet criteria for a personality disorder in adulthood, often one of the impulsive or “Cluster B” personality disorders. Besides narcissism, these include Borderline, Antisocial, and Histrionic PDs. The discussion goes on to state that no one really knows the nature of the relationship between ADHD and PDs.

This link, although framed to address struggling marriages, does a great job talking about the similarities and differences of people with Aspergers or narcissism. They both seem to be self-absorbed and have little regard for others’ feelings. But in contrast to narcissists, Aspies don’t need the approval of others and prefer not to be noticed; depend on rules, instead of imagining they’re exempt; and overlook others’ feelings out of “blindness” rather than conniving.

Here is a post from the blog “Mind Retrofit”, written by an Aspie who’s done a lot of Internet searching on the differences between Aspergers and narcissism – with the emphasis on differences.

If you are wondering about how schizoid personality disorder compares to narcissistic personality disorder, this article provides a nice summary. Both can appear arrogant, but people with schizoid personality disorder do not want to interact with others, whereas the narcissist craves interacting with people to “prove” his/her superiority.

Finally, I found this article about narcissism and bipolar disorder. Just as Aspies and narcissists share a key characteristic (disregard of others’ feelings), people with bipolar disorder and narcissism share the trait of grandiosity. The distinction is that narcissists display grandiosity all the time, whereas the bipolar individual mainly shows the trait during mood phases. However, the article also states that about 5% of people with bipolar disorder have narcissistic personality disorder. So, as in people with ADHD, NPD occurs in the bipolar population at higher rates than in the general population.

Almost all of us display narcissistic traits from time to time, or maybe some of the traits at low levels all of the time – but that doesn’t mean we all have NPD. The disorder occurs when someone’s inflated sense of self and determination to get what s/he wants consistently presents problems in social interactions.  Narcissism seems to be on a spectrum – which means that those with NPD can differ in how annoying or toxic they are.

It isn’t known for sure what triggers narcissism, but biology and upbringing may contribute, either separately or in combination. Narcissism seems more prevalent in people with ADHD or bipolar disorder, for reasons that appear to be unclear.

At this point I don’t really agree with Dr M’s statement about Nathan having a narcissistic streak. Nathan values his own thoughts and not those of others, but he isn’t making an effort to impress anyone about anything. However, I do see a lot of narcissistic traits in our other son, Alan. It makes for some tough interactions, but we’ll do what we can to contain the damage and hope for the traits to lessen over time.

A final note: None of the material here is meant to take the place of an official diagnosis. You may develop suspicions based on what you’ve read (as I have), but you (and I) may be mistaken, especially because so many narcissistic traits overlap with other personality disorders and mental disorders. Let a professional do the diagnosing.

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About janet565

I've lived in the Inland Empire of Southern California since 1982. Born and raised in New Jersey, I've also lived in upstate New York and in Oregon. My profession involves maps and geography, which is usually very interesting. My hobbies are pretty boring - none of them involve tigers (or ligers) or jumping out of aircraft - so they do not bear mention here. I hope you find the blog useful, and wish you well....

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