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Interventions in the Narcissistic Disorders



Introduction



Understanding the Narcissistic Phenomenon



The so called ‘narcissistic personality disorder’ is a complex and often misunderstood disorder. The cardinal feature of the narcissistic personality is the grandiose sense of self importance, but paradoxically underneath this grandiosity the narcissist suffers from a chronically fragile low self esteem. The grandiosity of the narcissist, however, is often so pervasive that we tend to dehumanize him or her. The narcissist conjures in us images of the mythological character Narcissus who could only love himself, rebuffing anyone who attempted to touch him. Nevertheless, it is the underlying sense of inferiority which is the real problem of the narcissist, the grandiosity is just a facade used to cover the deep feelings of inadequacy.



The Makeup of the Narcissistic Personality



The narcissist’s grandiose behavior is designed to reaffirm his or her sense of adequacy. Since the narcissist is incapable of asserting his or her own sense of adequacy, the narcissist seeks to be admired by others. However, the narcissist’s extremely fragile sense of self worth does not allow him or her to risk any criticism. Therefore, meaningful emotional interactions with others are avoided. By simultaneously seeking the admiration of others and keeping them at a distance the narcissist is usually able to maintain the illusion of grandiosity no matter how people respond. Thus, when people praise the narcissist his or her grandiosity will increase, but when criticized the grandiosity will usually remain unaffected because the narcissist will devalue the criticizing person.



Akhtar (1989) [as cited in Carson & Butcher, 1992; P. 271] discusses six areas of pathological functioning which characterize the narcissist. In...