Understanding and Managing Narcissism: Symptoms and Treatment with Online Therapy.
Overview
Narcissism is a personality trait characterized by excessive self-involvement, a preoccupation with gaining approval from others, and disregard for the needs of others. Individuals with Narcissistic Personality Disorder (NPD) display chronic narcissistic traits and rarely seek therapy. Therapy, however, can help individuals with NPD understand the harmful effects of narcissism and cultivate empathy. This article explores the prevalence of narcissism, its symptoms, and its treatment.
Prevalence of Narcissism
Prevalence estimates of narcissism vary and may not be reliable since few people with NPD seek treatment. A 2008 study puts the lifetime prevalence rate of NPD at 6.2%, while a 2010 analysis of seven previous studies found an average prevalence of 1.06%, with a prevalence range of 0%-6.2%. Narcissism is more common in men than in women, with a lifetime rate of NPD among men at 7.7%, compared to 4.8% among women.
Symptoms of Narcissism
Individuals with narcissism may display a grossly inflated sense of self, excessive self-involvement, disregard for the needs of others, and a sense of entitlement. They may engage in narcissistic abuse, either using someone as a tool to feed their ego or neglecting the needs of someone who depends on them. Symptoms may include preoccupation with fantasies of extreme success, power, or fame, a constant need for admiration and affirmation, envy of others, and a strong sense of entitlement.
Types of Narcissism
The DSM-5 has characterized NPD as significant impairments in sense of self and interpersonal life, a personality dominated by one or more harmful traits, impairments in personality stable over time and which appear across many contexts, and impairments not better described by the person's environment, developmental stage, or substance abuse. A 2015 American Journal of Psychiatry review suggests four sub-types of NPD: high-functioning, middle-functioning, vulnerable, and malignant. High-functioning and middle-functioning individuals may not seek treatment unless a threat to their sense of self occurs. Vulnerable and malignant individuals struggle more with daily functioning and are more likely to seek treatment.
Treatment for Narcissism
Individuals with NPD rarely seek therapy, and therapy outcomes are often poor. However, therapy can help individuals with NPD understand and prioritize the needs of others, repair broken relationships, and cultivate empathy. Therapy can also help individuals in relationships with narcissists understand narcissistic behavior, identify the effects of the narcissist on their thoughts and feelings, set clear boundaries with the narcissist, talk with others about the abuse, and rebuild self-esteem.
Narcissism is characterized by excessive self-involvement, disregard for the needs of others, and a preoccupation with gaining approval from others. Prevalence estimates vary, and few individuals with NPD seek treatment. Therapy can help individuals with NPD understand the harmful effects of narcissism, including to themselves, and cultivate empathy. Narcissism is a challenging personality trait to treat, but therapy can help individuals in relationships with narcissists understand narcissistic behavior, identify the effects of the narcissist on their thoughts and feelings, and set clear boundaries.
Narcissistic behavior is often associated with a self-centered and egotistical person who craves admiration. However, narcissistic traits exist on a continuum and can vary in severity and context. Some examples of narcissistic traits include entitlement, attention-seeking, self-involvement, and approval-seeking.
A person with a sense of entitlement may trample on the rights of others to obtain what they believe is rightfully theirs. Attention-seeking behaviors may manifest in a variety of ways, such as becoming a perfectionist or adopting aggressive or withdrawn behaviors when not receiving the desired attention. Self-involvement can lead to intense preoccupation with one's own needs, often at the expense of others. A person with NPD may also continuously seek approval from individuals they perceive to be powerful or important while disregarding the needs and rights of others.
Narcissistic personality disorder (NPD) is distinct from antisocial personality disorder (APD), although they may co-occur. People with APD lack empathy, exhibit callousness, disregard the rights of others, engage in impulsive behavior, and fail to conform to moral norms. While narcissistic behavior may appear sociopathic, it is motivated by excessive self-involvement that blunts empathy, whereas sociopathic behavior occurs when a person lacks empathy entirely or derives pleasure from the suffering of others.
Personality disorders are difficult to treat, and people with NPD are often defensive about their condition and may struggle to recognize their narcissistic traits or seek treatment. However, therapy is the most effective treatment for narcissism, focusing on the emotions and beliefs that drive NPD and the associated behaviors. Some treatment approaches that may be helpful include psychodynamic approaches, therapy for other personality disorders, and approaches that target psychological skills.
Online narcissism quizzes are not supported by clinical research, and it's best to seek a diagnosis from a licensed clinician who specializes in personality disorders. Effective therapy for NPD is free of judgment and stigma and honors the client's goals, helping them understand the effects of their condition and move towards healthier behaviors. While people with NPD can and do change, they must be willing to put in significant effort, and more extreme narcissism, especially when it co-occurs with APD, is more resistant to treatment.