Narcissistic Personality Disorder: An Essay (Part 1)

“Selfish persons are incapable of loving others, but they are not capable of loving themselves either.”—Erich Fromm Man for Himself 

It is right to think of narcissism, or self-absorption, as existing on a spectrum. At one end, narcissism is a healthy part of human development. At the other end, it has been proposed that narcissism may be at the root of human evil. At some point on this spectrum, narcissism can become a deeply ingrained, maladaptive feature of an individual’s personality. When this happens, the narcissistic tendencies result in a disordered personality. A 2009 study funded by the National Institute of Health found that the “prevalence of lifetime NPD [Narcissitic Personality Disorder] was 6.2%, with rates greater for men (7.7%) than for women (4.8%).” [Stinson et al.] While narcissism has fascinated psychoanalyst for more than a century and is a popular pop culture topic, it remains a subject in need of further study. 

In the field of psychoanalysis there seems to be agreement from Frued to present day that during some point in infancy or childhood, narcissistic thinking is relatively normal. As summarized by J. Grotstein in the forward to Narcissism A New Theory, “Simply put, it is the infant’s and child’s right and entitlement that its parents are obliged to proffer at the very least the minimum requisite ‘selfobject’ soothing, mirroring, monitoring, attuning, and idealizable companionship (“twinship”) to allow the infant/child to develop a sense of self-cohesion.” Any time spent around a group of young children will demonstrate the normality of self-absorption. A child spends considerable time learning that she or he is not the only person in the world; mom, dad, other adults, children, pets are all separate entities with separate wills. 

Current thinking on the development of Narcissistic Personality Disorder is that people are not born with the disorder. External factors such as parenting style and attachment difficulties produce situations in which the traits associated with NPD are used as a coping mechanism. Those mechanisms persist as the person grows and eventually becomes maladaptive. In discussing Symington’s concept of the genesis of Narcissistic Personality Disorder, J. Grotstein states, “The author’s main thrust seems to be that the balance between a healthy state of mind and pathological narcissism rests on the way the traumata of narcissistic injuries had been dealt with in infancy—whether the infant surrendered to them and became prisoner, as it were, to a malevolent saboteur within…or whether he chose to hold on to the gift of life…and maintained a sense of faith. ” Symington’s concept is unique in that it attributes the development of NPD to a choice made by an individual while many other scholars feel that NPD is caused by something that happens to an individual. 

This school of thought certainly finds its origins in Frued’s work and that of his psychoanalyst successors. However, epidemiological studies are now being conducted. 

An article in The Journal of Clinical Psychology, “Childhood ADHD and the Emergence of Personality Disorders in Adolescence: A Prospective Follow-up Study,” found that “The principal finding of this study is that individuals diagnosed with ADHD in childhood were more likely to be diagnosed with a personality disorder in late adolescence. Specifically, diagnoses of Avoidant, Narcissistic, Borderline and/or Antisocial personality disorders are more common.” [Miller et al.] These findings certainly don’t mean that ADHD causes personality disorders, but rather that there is some sort of relationship between the two and the link needs further explanation. Another study looked at the brain composition of grandios narcissists. They found that “White matter integrity in the frontostriatal pathway was negatively associated with narcissism. Our findings, while purely correlational, suggest that narcissism arises, in part, from a neural disconnect between the self and reward.” [Chester et al.]

*A note on authority: I have learned about narcissistic personality disorder through a great deal of research and an unfortunate amount of personal experience. However, I am not a psychiatrist, psychologist, or mental health professional. Please follow the links cited in this essay for more authoritative sources. I have intentionally refrained from adding my personal experiences as the victim of a narcissist to this easy in order to present a less biased perspective. If you need a victims perspective, please see other posts on this blog.

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