This article examines the link between narcissistic disorder and childhood trauma. Several of my articles have already looked in some detail at the link between childhood trauma and the subsequent risk of developing a personality disorder (or disorders) if appropriate psychotherapeutic intervention is not sought.
Whilst precise mechanisms underlying the link between childhood trauma and subsequent development of a personality disorder are still being researched, it is a statistical fact that the experience of childhood trauma and personality disorder are very frequently indeed seen to be ‘co-morbid’ (this is a psychological term used to mean existing in the same patient – i.e. if the patient has a personality disorder, he/she very probably also experienced severe childhood trauma).
Suffering from a personality disorder has a profoundly damaging impact on a person’s life if it is left untreated. People who suffer from personality disorders tend to have very rigid, inflexible and damaging (both to themselves and others) ways of managing vital areas of their lives such as work, relationships and even leisure time which, naturally, causes whole host problems.
NARCISSISTIC PERSONALITY DISORDER :
A good place to start is to look at how the DSM-IV (a diagnostic manual used by psychologists and psychiatrists) defines narcissistic personality disorder. Here’s the definition :
‘a pervasive pattern of grandiosity, need for admiration, and lack of empathy’
Other features of narcissistic personality disorder are :
– a grandiose sense of self-importance
– expectations of being treated as special
– an extremely fragile sense of underlying self-esteem
The psychologist Masterson (1981) expanded upon the definition to include two particular types of a narcissist:
1) the manifest narcissist
2) the ‘closet’ narcissist
Let’s look at both of these :
1) the manifest narcissist: similar to the description provided in DSM-IV (above)
2) the ‘closet’ narcissist: the person suffering from this disorder tends to present him/herself as timid, shy, inhibited and ineffective but reveals in therapy elaborate fantasies of a grandiose self
A narcissistic personality disorder is thought to be due to ARRESTED DEVELOPMENT. In therapy s/he will tend to seek the admiration s/he craves from the therapist, and, if the therapist is skilled and experienced, s/he will often uncover an array of psychological defence mechanisms which the patient uses to protect him/herself from unbearable emotional pain. These can include :
1) IDEALIZATION: this is often the primary defence whereby the individual IDEALIZES HIS/HER RELATIONSHIPS at first, elevating both self and other, in terms of status and specialness, to (illusionary) high levels
2) DEVALUATION: this refers to the individual discounting and regarding as worthless anyone who undermines his/her grandiose vision of him/herself
3) DETACHMENT: this is linked to DEVALUATION (above) and refers to the individual’s propensity to sever links with anyone who threatens to undermine his/her exalted view of him/herself
4) ACTING OUT: this refers to performing extreme behaviours to express thoughts, feelings and emotions the person feels incapable of otherwise expressing
5) SPLITTING: this refers to the cutting off from consciousness the part of themselves that holds the emotional pain to prevent it from becoming integrated into consciousness, as, for this to occur, would be psychologically overwhelming
6) PROJECTIVE IDENTIFICATION: this is when the person (unconsciously) projects onto another (imagines the other to possess) parts of their own ego and then expects the other to become identified with whatever has been projected
7) DENIAL: in its simple form this just means not accepting certain unpleasant parts of reality to protect the ego
8) AVOIDANCE: also sometimes referred to as ‘escape coping’ – making efforts to evade dealing with particular stressors
9) PROJECTION: this defence mechanism involves attributing to others one’s own unwanted or socially/culturally unacceptable emotions, attributes or thoughts
In essence, the individual with narcissistic personality disorder lives in a world where everything is viewed in extremes of ‘good’ or ‘bad’. Underneath the defence mechanisms, there invariably lies an extremely FRAGILE SENSE OF SELF-ESTEEM. Therefore, the individual really feels EXTREMELY VULNERABLE and tends to have an overwhelming need to PROTECT HIM/HERSELF FROM ANY THREAT TO HIS/HER EXTREMELY PRECARIOUS SELF-IMAGE. The person with the disorder has a disturbance of the basic structure of the self.
NARCISSISTIC SUBTYPES :
1) ACQUIRED SITUATIONAL NARCISSISM – this type of narcissism can develop as a result of an individual acquiring great wealth, celebrity and/or status.
In the case of celebrities, for example, their narcissistic tendencies may be encouraged due to the adoring, sometimes worshipful, behaviour of fans, attention from the media, the sycophantic manner in which they are treated by deferential and submissive assistants, and the obsequiousness of general hangers-on and ‘Yes-men.’
If the person had incipient narcissistic traits prior to achieving celebrity status, these may become exacerbated by his/her new station in life leading to the development of full-blown narcissistic personality disorder (NPD).
2) AGGRESSIVE NARCISSISM – a person with this type of narcissism has a grandiose view of him/herself, is prone to pathological lying, lacks empathy, lacks the ability to feel remorse, is cunning and manipulative and, not uncommonly, will display a superficial charm (it overlaps – i.e. has features in common with – antisocial personality disorder.
3) CODEPENDENT/INVERTED NARCISSISM – the individual who suffers from this psychological condition is drawn towards/attracted to classical narcissists, feeding their emotional needs and becoming codependent upon them
4) COLLECTIVE/GROUP NARCISSISM – this syndrome entails an individual developing a grandiose, highly superior and elevated view of both him/herself and the group to which s/he belongs.
When all group members view themselves and their group in this elitist manner the group itself may morph into a narcissistic entity.
Ethnocentrism is an example of this; it involves a whole culture or ethnic group regarding itself as far superior to others, rather like many of those who oversaw the building of the British Empire.
5) CONVERSATIONAL NARCISSISM – in the case of this form of narcissism the individual has a great need to talk about him/herself and, if the conversation diverts from this topic, s/he is likely to make efforts to revert it back to being about him/herself.
6) CORPORATE NARCISSISM – this refers to an individual who runs a corporation and is obsessed with profits to the extent of being prepared to act morally unscrupulously and even criminally. S/he is not averse to exploiting those who can help him/her achieve this goal (e.g. employees).
Whilst such a strategy can be effective in the short-term, in the long term it tends to alienate employees and the general public.
7) CROSS-CULTURAL NARCISSISM – this refers to individuals who are immigrants but are also fiercely and aggressively of the view that the original culture from which they came is vastly superior to the new culture which imbues his/her new geographically location.
8) MALIGNANT NARCISSISM – the malignant narcissist can be regarded as a hybrid of a classical narcissist and someone suffering from antisocial personality disorder. Additionally, s/he frequently displays paranoid traits.
Such individuals often go to extreme lengths to gain and hold onto, power over, and control of, others.
They are likely, too, to despise, ridicule and display general contempt and disdain for anyone who has authority over them.
If it comes to the choice between another person liking them or being afraid of them, they will tend to prefer the latter scenario.
Their lust for power and success leads them to become trapped on a treadmill, forever chasing more of these things and never being satisfied with the extent to which they already have them.
Because of the obsessive nature of the condition, and the individual’s inability to ever feel satisfied, it often leads to psychological breakdown and illness, hence its name: malignant narcissism.
9) MEDICAL NARCISSISM – this refers to people in the medical profession, such as surgeons, who have an unhealthy, powerful drive to appear utterly competent and infallible at all times; it is unhealthy as it can lead such individuals to hide and cover up their errors so that their patients and colleagues are not made aware of them. This is a form of negligence which may, of course, lead to the suboptimal treatment of patients, or, in extreme cases, serious harm to them.
Those who suffer from this syndrome are sometimes referred to as having a ‘god-complex’.
10) PHALLIC NARCISSISM – those who suffer from this hold themselves in extremely high regard, tend to have great social aspirations (a desperate desire to ascend the ‘social ladder’), are desperate to obtain the admiration of others, are self-promoting, prone to boastfulness, vain and highly sensitive in relation to how they are perceived by others. They are, too, often reckless.
Whilst determined to achieve their goals and outwardly self-assured, their condition arises from a drive to overcompensate for inner feelings of deep, personal inadequacy.
11) SEXUAL NARCISSISM – individuals with this condition perceive themselves as having great sexual prowess and also have a strong sense of entitlement regarding having sex with others as if it were their natural right and due. This can lead to sexually predatory behaviour.
Again, this type of narcissism is a form of overcompensation for having low self-esteem and those afflicted by it usually have problems with experiencing emotional and psychological closeness/intimacy with others.
12) SPIRITUAL NARCISSISM – people with this condition are of the view that their religious/spiritual beliefs make them superior (especially morally) to others. Essentially, their religious beliefs feed their ego (and, again, this is likely to be a compensatory measure caused by an inner sense of inadequacy).
13) UNPRINCIPLED NARCISSISM – people with this condition have very little or no conscience, are unempathetic and uninterested in the feelings and needs of others, are duplicitous, devious, dishonest, unscrupulous, amoral, interpersonally exploitative and regard life as a game that must be won at almost any cost. Highly competitive, the quote ( I forget from whom):
‘It is not enough for me to succeed, my friends must fail’
is, perhaps, a not altogether inaccurate summation of their attitude to life.
14) AMOUROUS NARCISSIST – individuals with this type of narcissism view themselves as highly sexually desirable and use their sexuality to manipulate and control others. Seduction, for them, is a game and they need to make sexual conquests to give themselves a sense of self-worth.
They tend to exploit their partners and can often be what is colloquially referred to as ‘heartbreakers’.
15) FANATIC NARCISSISM – individuals of this type have low self-esteem which is usually due to having experienced significant childhood trauma. They compensate for a lack of success in their lives through living a rich fantasy life in which they may imagine achieving great things and gaining unlimited social admiration. They also tend to have paranoid traits.
16) COMPENSATORY NARCISSISM – this type overlaps with/underpins many of the above types of narcissism. Those suffering from the condition have feelings of inadequacy stemming from traumatic childhood experiences and retreat into a fantasy world in which they can compensate for their failure in real life by being a great success in their internal, imaginative worlds.
They are often passive-aggressive and because they are very concerned about what others think of them, are prone to experiencing high levels of social anxiety.
17) CEREBRAL NARCISSISM – with this type, the person holds themselves in excessively high regard, and views him/herself as superior to others, for the intellectual abilities of which s/he perceives him/herself to be in possession.
18) SOMATIC NARCISSISM – a person with this condition is besotted by his/her own body/body image and highly physically self-admiring. S/he regards his/her deeply attractive body ( according to his/her own estimations) as bestowing upon him/herself superior status compared to those cruelly devoid of similar physical attributes.
THE THERAPEUTIC APPROACH TO TREATING NARCISSISTIC PERSONALITY DISORDER :
Research suggests that one of the main keys to psychotherapeutic intervention is an acknowledgement of the person’s pain, their overwhelming sense of their own vulnerability and their consequent desperate need to protect themselves from further psychological suffering. The therapist needs to reassure them that their defences have been identified as self-protective, and, as such, are understandable.
RESOURCE :
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David Hosier BSc Hons; MSc; PGDE(FAHE).
