Narcissistic Personality Disorder - Who is a Malignant Narcissist?

QUESTION Number 1 - Who is a Narcissist?

Dear Dr. Vaknin,

I read the excerpts you placed on your web site with great interest.

I wanted to ask:

Isn't your definition of malignant narcissism too wide? Having read it, I think that it fits my neighbours, friends, and family to a "t". Everyone seems to be a narcissist to me now!

HELP!

ANSWER

Yours is an understandable reaction. All of us have narcissistic TRAITS. Some of us even develop a narcissistic PERSONALITY. Moreover, narcissism is a SPECTRUM of behaviours - from the healthy to the utterly pathological (known as the Narcissistic Personality Disorder, or NPD).

But the "malignant" narcissist consistently manifests at least 5 of these 9 criteria.

The DSM IV uses this language:

"An all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts."

So, what matters is that these characteristics, often found in healthy people, appear:





Jointly and not separately or intermittently



They are all-pervasive (invade, penetrate, and mould every aspect, nook, and cranny of the personality)



That grandiose fantasies are abundantly discernible



That grandiose (often ridiculous) behaviours are present



That there is an over-riding need for admiration and adulation ("narcissistic supply")



That the person lacks empathy (regards other people as two dimensional cartoon figures and abstractions, unable to "stand in their shoes")



That all these phenomena began, at the latest, in early adolescence



That the narcissistic behaviours pervade all the social and emotional interactions of the narcissist.

Here are the 9 criteria. Having 5 of these 9 "qualifies" you as a narcissist...







Feels grandiose and self-importance (e.g., exaggerates achievements and talents to the point of lying, demands to be recognized as superior without commensurate achievements)



Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion



Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions)



Requires excessive admiration, adulation, attention and affirmation - or, failing that, wishes to be feared and to be notorious (narcissistic supply).



Feels entitled. Expects unreasonable or special and favourable priority treatment. Demands automatic and full compliance with his or her expectations



Is "interpersonally exploitative", i.e., uses others to achieve his or her own ends



Devoid of empathy. Is unable or unwilling to identify with or acknowledge the feelings and needs of others



Constantly envious of others or believes that they feel the same about him or her



Arrogant, haughty behaviours or attitudes coupled with rage when frustrated, contradicted, or confronted.

The language in the criteria above is based on or summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition (DSM IV). Washington, DC: American Psychiatric Association.

By Sam Vaknin