The Fragile Self and Narcissistic Personality Disorder
Narcissistic personality disorder (NPD), has become synonymous with the perception of an individual with high self-esteem. However, the reality for those with NPD is quite different.
NPD is described through the traits listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This Cluster B personality disorder needs a minimum of five traits from the nine listed for diagnosis:
low empathy
exploitative behaviour
grandiose self-importance
sense of entitlement
envy of others or a belief that others are envious of them
fantasies of success, power, brilliance, beauty or ideal love
belief in their uniqueness
an arrogant attitude
a need for excessive admiration
The current understanding is that the reasons for the development of NPD may be as variable as its expression; whether grandiose (overt - self-aggrandising, socially confident, maybe charming; vulnerable or covert, (quieter, 'humble', envious, at times may 'create' a charming personality) or malignant (pathological - with anti-social behaviour and sadism. Cross over with psychopathic traits); the same diagnostic criteria are applied to each. Research around the variability and reasons for different expressions are ongoing for this seemingly robust personality that hides a fragile true self.
Increasingly it is hypothesised that there is a heritable element to NPD. What has a stronger evidence base, however, is that damage to the character and the ability to live a fulfilling life and create meaningful and satisfying relationships of those diagnosable with NPD, occurs during childhood and is caused by trauma.
The trauma is usually caused by the primary or secondary caregiver or both. If the child suffers emotional or physical neglect, abuse or inconsistent and highly unpredictable parenting, they create a false self as a protective survival mechanism. They then may develop into an adult who relies upon destructive coping mechanisms to maintain that false self at all costs.
The trauma can also be caused by the other extreme; excessive unbridled praise coupled with inadequate correction of bad behaviour, lack of boundaries between caregiver and child, no discussion of the need for empathy and the child is not required to take responsibility for their actions. This leads the child to believe that, whatever they do and however they behave, they can do no wrong and have no moral obligation towards others because they are special - unique.
Whether the NPD is caused by abusive, neglectful unpredictable, or overindulgent parenting with no boundaries, both result in a near complete lack of empathy towards others and insecure high self-esteem.
Self-esteem is either implicit; intrinsic to the individual, automatic and unconscious, or explicit; overt - what we express, think and feel about ourselves. Insecure high self-esteem is present when the implicit; the unconscious, embedded self-esteem - is low, and the explicit; the overt and what the individual consciously believes about him or herself - is high.
What is increasingly evident is that the expression of explicit self-esteem in those with NPD is modulated by their levels of implicit self-esteem. How this correlates to the various expressions of NPD, with self-worth and the confusing self-sabotaging nature of the narcissist's coping strategies needs further investigation.
