PSYCH66 - Narcissistic Personality Disorder

Narcissistic Personality D/O (NPD) definition

pervasive pattern of grandiosity, need for admiration, lack of empathy

NPD Characteristics

• boastful/pretentious

• sense of entitlement

• build up their accomplishments

• see themselves as superior, special, unique - EXPECT others to see them this way (are surprised + irritated when they don’t)

• lack of empathy + sensitivity

• believe others should prioritized them, can be very jealous + controlling in romantic relationships

• often diagnosed in men

• purposely seek out nurturing people + prey on them - Lie and manipulate

• can NOT handle criticism

What is the most important characteristic of people with NPD?

their self-esteem = very fragile

deep down they hate themselves

Diagnostic Criteria for NPD

5 or more of the following

• has a grandiose sense of self-importance

• preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

• believes that he or she = special/unique

• feel like they can only be understood by/associate with other people of high talent or status

• has a sense of entitlement

• manipulative (interpersonally exploitative)

• lacks empathy

• often envious of others/thinks others are envious of them

• arrogant attitudes

Why do people with NPD act and think this way?

because of parental rejection

Treatment of NPD

Psychodynamic: help pt recognize and work through their underlying insecurities + defenses

CBT: redirect client focus —> opinions of others instead of self-focused thinking

Which is the most difficult personality D/O to treat from cluster B and Why?

NPD

• can’t acknowledge their own weaknesses or areas that need growth

• don’t take feedback - view it as criticism