NARCISSISM: IT’S ALL ABOUT “ME”

Question: I thought “narcissism” was just a personality trait, like impatience or shyness, but a friend recently said it’s an actual medical condition. Is that right? And if so, is it treatable?

Answer: The more current term for narcissism is “narcissistic personality disorder.” This mental disorder is characterized by people who have an abnormally inflated sense of self-importance and superiority. Often they are preoccupied with personal success and power, and they seem to have little regard for other people’s feelings.

While people suffering from narcissistic personality disorder usually appear very confident, they often are very insecure and, beneath the perceived self-love, they harbor low self-esteem. These people also behave in socially distressing manners and have difficulty with relationships, work and school.

To some extent and at some stages of life, we all may be guilty of behavior that resembles narcissistic personality disorder. Symptoms of the disorder include a sense of superiority over others; a preoccupation with personal success, power and attractiveness; and exaggerating personal accomplishments. People with narcissistic personality disorder expect others to always go along with what they want, and they are unable to recognize the feelings and viewpoints of others. They often have a sense of entitlement or exceptionalness, and they thrive on the praise and admiration of others. When these expectations are not fulfilled, people with this condition are prone to inappropriate or even violent outbursts.

The causes of narcissistic personality disorder are not known, but the condition is probably related to early childhood development. Some believe it results from over-pampering in early childhood, but many other researchers suspect that parental neglect is a more likely explanation. Usually this disorder can be diagnosed by early adulthood.

At this time, psychotherapy is the only treatment for narcissistic personality disorder. If other complications, such as substance abuse, depression or eating disorders are also present, be sure to consult with your family physician. These complications can contribute to the problem, and often they require medical intervention. Some of the problems associated with narcissistic personality disorder can be treated with medications. Family therapy and group therapy can be helpful as well.

As with many conditions, it is important to make sure there are no underlying medical conditions causing a change in personality. If you notice these symptoms in a loved one, it is important that they see their family physician. He or she will review the medical and family histories, conduct a physical examination and possibly conduct some laboratory tests to rule out underlying medical problems.