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Narcissistic Personalities

Narcissistic Personalities. Identifying, understanding and relating to them. Claudia Diez, PhD, ABPP Board Certified Specialist in Clinical Psychology Supervising Psychologist St. Luke’s-Roosevelt Hospital Center Assistant Clinical Professor, Columbia University

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Narcissistic Personalities

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  1. Narcissistic Personalities Identifying, understanding and relating to them Claudia Diez, PhD, ABPP Board Certified Specialist in Clinical PsychologySupervising PsychologistSt. Luke’s-Roosevelt Hospital Center Assistant Clinical Professor, Columbia University info@drclaudiadiez.comhttp://www.drclaudiadiez.com http://www.slrpsych.org

  2. What is “Narcissism”? • From Greek myth of Narcissus, a metaphor of self-absorption and inability to love • A normal aspect of Personality • self-care and self-esteem; assertiveness • need to secure status for self-preservation (Hogan, 1982) • Needed for self-sustainment • Normal Narcissist: Competitive, Self-Assured, Bold • Exists in a continuum: Normal Pathological • Involves adaptive and maladaptive traits

  3. Socio-Cultural Perspectives • Lasch: The Culture of Narcissism (1979) • Cultural criticism of contemporary American society as promoter of pathological narcissism • Erosion in allegiance to community; condoned individuality • Raskin: Narcissistic Personality Inventory (NPI, 1988) • Identified seven aspects of narcissism • Authority, Self-Sufficiency, Superiority • Exhibitionism, Exploitiveness • Vanity, Entitlement How Narcissistic am I? Quiz - NPI-40

  4. Socio-cultural Perspectives • “Generation Me” • “Today’s young Americans are more confident, assertive, entitled.. . than ever before” (Twenge, 2006) • Narcissism Epidemic? • NPI-40 used to research trends in narcissism in America • Findings: “rampant rise of narcissism” in our society • Indictment of the “Self-esteem” movement of the 70’s propelled by California’s legislature "Self Esteem Task Force“ • Met severe criticism, yet findings stand strong • Other cultural expressions: Honor Codes/killings?

  5. Organizational Psychology • Narcissistic Leaders • High Entitlement, Excessive Confidence, Fantasized Talent • Focused on “getting ahead”, risks excessively, berates employees, pursues personal agendas • “Emergent Leaders” (seek Self-Promotion) • Not necessarily “Effective Leaders” • Narcissism at the root of Managerial Derailment • What about the followers? (Hogan, Robert, 2008)

  6. Narcissism in organizations Gordon Gecko, “Wall Street” ‘If you want a friend, get a dog” • Gordon Gecko to Bud Fox in “Wall Street”

  7. Shut up, Listen and Learn! “Swimmingwith sharks”, Ch. “Sweet & low”

  8. Pencils are more important “Swimmingwith sharks”, Ch. “you are nothing”

  9. Narcissism as a Clinical Disorder • Term coined in psychology in 1898 by H. Ellis • Largely adopted by Freud and psychoanalysis • Appears in the DSM-III(1) in 1980 • “Personality Disorder” is: • An inflexible, maladaptive, persisting pattern of behaviors • Causing significant functional impairment (in the world) Or • Causing significant distress (subjectively) (1) DSM: Diagnostic and Statistical Manual of Mental Disorders, now in its 4th Edition, TR (2000)

  10. Narcissistic Personality Disorder • DSM-IV TR Diagnostic Criteria • Pervasive pattern of grandiosity, need for admiration, lack of empathy; beginning in adulthood, indicated by five (+) of the following: • grandiose sense of self-importance • fantasies of unlimited success, power, beauty, etc. • believes he/she is "special" • requires excessive admiration • has a sense of entitlement • is interpersonally exploitative • lacks empathy • is often envious, or believes that others are envious of him • shows arrogant behaviors or attitudes

  11. Hack it, or Pack it! The Great Santini, “failed score” 11

  12. Narcissism as a Clinical Disorder Not all narcissists are created equal • Shedler’s Typology (1) • Grandiose/malignant • Fragile • High Functioning/Exhibitionistic • Other distinctive features • Emptiness, sense of “being false, fraudulent” (1) Shedler et al, 2008. Refining the Construct of Narcissistic Personality Disorder: Diagnostic Criteria and Subtypes; (Am J Psychiatry 2008; 165:1473–1481)

  13. Faces of Pathological Narcissism • Abusive Partners Rapists • Celebrities Cult Leaders • Con Artists Stalkers • White Collar Criminals Gang Members • Moderate Narcissism • Overbearing/obnoxious /cruel parents, demanding or callous partners, inconsiderate coworkers, etc….

  14. Empathy, Shame, Envy • Empathy • inner capacity of sharing and comprehending the psychological state of another person • Shame • painful social emotion caused by the experience of feeling inferior or losing value in the estimation of others • Envy • painful social emotion caused by the thought of another person having something that one does not have oneself

  15. Origins of Narcissism • No known link to genetics • Biological (neurophysiological paths) imprints in early childhood (1) • Origins ascribed to early attachment and parenting, resulting in specific pattern of affect regulation (1) Schore, Allan (2009). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development

  16. Normal Human Development • Under normal circumstances, caregiver help child to handle intense or stressful affect • Development of empathy • Tolerance of shame • “Monkey see, monkey do” (mirror neurons; mimicry) Parental Attunement 16

  17. Origins of Pathological Narcissism • Unattuned Parents cannot model affect regulation • Resulting in diminished capacity for empathy • Child is in some way “Special” to the parent • “Narcissistic children often occupy a pivotal point in the family structure, such as being ….the one that is supposed to fulfill family aspirations….” • Child raised in overtly well-organized home, but with parent(s) present a degree of callousness and subtle aggression • Child may have an inherent quality that arouses admiration or envy such as beauty, special talent, etc. ( I.e: Pageant Queen/Mother) Kernberg, 1984. Severe personality disorders. New Haven: Yale University Press

  18. Paths to Pathological Narcissism

  19. Narcissistic Cognitions • Entitlement/Grandiosity • Emotional Deprivation • Defectiveness/Shame • Subjugation /Control • Approval Seeking • Insufficient Self-Control • Mistrust/Abuse • Unrelenting Standards Underlying Assumptions (Schemas) Young,  (1998). Schema-focused therapy for narcissistic patients.  In E. Ronningstam (Ed.), Disorders of narcissism: Diagnostic, clinical and empirical implications

  20. Extreme (Malignant) Narcissism Charles Manson

  21. Pathological Narcissism: Origins • Manson's mother was a promiscuous heavy drinker whospent years in prison for robbery. Manson was placed at reform schools and relatives while she was away. • Manson did not know his biological father; his step-father was an alcoholic, abusive offender • His mother’s physical embrace of him when she returned from prison was, he reported, his sole happy childhood memory

  22. Children at Risk • Children of Narcissistic Parents • Abused Children • Overindulged, Overpraised, Wealthy Children • Adopted Children (chosen, yet abandoned) Kernberg, P. (1998). In E. F. Ronningstam (Ed.), Disorders of narcissism.  Diagnostic, clinical, and empirical implications. Developmental aspects of normal and pathological narcissism

  23. Course and Prognosis • Room for improvement in certain cases • As a result of significant losses/personal costs, or • As a result of corrective emotional experiences (i.e., relationship, achievement) • In severe cases, symptoms may worsen over time, (i.e., mid life crisis, aging parents) • Narcissists do not typically seek help • (as they do not find fault in themselves) • Difficult to treat; may seek help because “mandated” by others

  24. Is there a Narcissist in my life? • Does the person act as if life revolves around him/her? • Do I have to compliment him/her to get his attention or approval? • Does he constantly steer the conversation back to himself? • Does she downplay my feelings or interests? • If I disagree, does he become cold, withholding or angry? • Do I feel belittled, manipulated, or feel I can’t please him/her? If you answered “yes” to three or more questions, it is likely that this person’s narcissism is affecting your life Adapted from Judith Orloff’s “Emotional Freedom” (Three Rivers Press, 2011) 24

  25. How to Relate to a Narcissist • DO-NOTS • Do not retaliate • Do not shame, belittle, “pay back” • Do not expect fairness or reciprocity • Do not isolate from friends, other family • Do not surrender to the narcissist’s attempts to control/disparage

  26. How to Relate to a Narcissist • DO(s) • Know yourself • Identify your motives to stay in the relationship: desire to please? gain his/her regard? feel protected? bask in their power? Etc. • Identify your “hot buttons” and your problematic responses • Know your own worth, independently of his/her valuation • Cultivate reciprocal, satisfying relationships • Be empathic, respectful, fair • Be mindful of his/her sensitivity to shame/humilliation • Practice self-control and patience • Use non-confrontational limit-setting 26

  27. How to Relate to a Narcissist • DO(s) • Set boundaries • Re-engineer the terms of the interactions • What you can do, what you won’t • Reinforce positive behavior (i.e., kindness, attentiveness) • Avoid criticism; Try to understand his/her mind frame • Agree with acceptable part of his/her statements, and add: “I wonder if…”, “how about…” “this could be of benefit for you” • Discourage negative behaviors (belittling, dominance) 27

  28. How to Relate to a Narcissist • DO(s) • Consider the costs (risk/benefit analysis) of staying in the relationship • Assess damages/severity of behaviors • If risk/damage is high, consider an exit plan • Avoid/Minimize contact • Seek external help • Build a support network • Be mindful of characteristic feelings of shame/guilt 28

  29. Recommended Readings Ronningstan, E. Hotchkiss, S Behary, W. Twenge, J. 29

  30. More suggested readings • Neurobiology of Empathy ; Attachment Theory • Mirror neurons and the brain in the vat. ByV.S. Ramachandran, 1/10/2006 • The mind’s mirror.(on mirror neurons and its relation to empathy) By L. Winerman, Monitor Staff, 10/2005, Vol 36, No. 9. American Psychological Association • Effects of a Secure Attachment Relationship on Right Brain Development, Affect Regulation and Infant Mental Health. A. N. Schore, in Infant Mental Health Journal 22, 1-2 (2001): 7-66 • Narcissism in organizations and leadership Leadership. By Hogan and Fico, 2009. Chapter to appear in W. K. Campbell & J. Miller (Eds.) The handbook of narcissism and narcissistic personality disorder. New York: Wiley, in press. • Cultural Aspects What the Experts Are Saying Now . By K. Hymowitz, 8/25/2009,. A Review of the “self-esteem movement” as per new book, “Nurture Shock” by Po Bronson & Ashley Merryman Best Weapons against Honor Killers: Shame.By Kwame A. Appiah. 9/25/2010. On the customs of honor codes (dueling, honor killings) and public dishonor. Listen to him also in “Talk of the Nation”, NPR

  31. CONTACT INFORMATION For more information visit us at http://www.drclaudiadiez.comhttp://www.slrpsych.org Claudia Diez, PhD, ABPP info@drclaudiadiez.com

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