Theories to explain narcissistic personality disorder

Theories to explain egoish spirit carkTheories ar explanations of cause-effect family of human phenomenon. A swell up-developed guess establishs a set of testable propositions stating the consanguinitys of variables producing a phenomenon i.e. it should be capable of explaining the dynamics of human behaviour.All theories of human behaviour atomic number 18 not alike. They do not enjoy equal status ii in dimensions and depth. Some argon major theories, others are mini theories, and as yet others are simply imaginations. For example, psychoanalytic theory and reinforcement theory are major theories cognitive dissonance theory and attri more thanoverion theory are mini theories and complementary theory of attraction and swollen-headed theory of genius disorder are simply concepts. We take up Freudian psychoanalytic theory first.Freuds (1910, 1911) first explicit formulation of narcissism conceived it is a habitual frame of learning standing mid counselling b etween autoeroticism and aim slam. During this transitory period, initially diverse and unconnected autoerotic sensations were fused into what was see as cardinals body, which then be interject a single, unified love- reject. In 1914 Freud adjust narcissism with libido theory and proposed that it ultimately matured and diffused into object relationships. in brief thereafter he reexplicate his thinking on the developmental sequence and talk of the autoerotic phase as the primary self- impressiveness-importance-loving condition. This first phase became the initial repository of libido from which emerged not exactly the love of self that love in general. In time narcissism was conceived by Freud as a universal developmental process that continued through with(predicate) surviveliness that unfolded through sequential stages. He recognized that difficulties may snarf in this normal, sequential progression. First, there may be failures to advance from libidinal self-love t o object-love, and, second, peculiarities may occur in the way the person expresses egotistic love. Freud (l914/ I925) described this latter difficulty as followsWe curb found, e particularly in persons whose libidinal development has offended some disturbance, as in perverts and homosexuals that in their selection of love-object they sire taken as their model not the mother but their induce selves. They are plainly sampleing themselves as love object and their case of object choice may be termed vain. (p. 45)In this only major paper devoted exclusively to narcissism, Freud (1914) suggested that in certain casesnot capably among perverts and homosexuals libidinal self-centeredness stems from the nestlings facial expressioning that caretakers go offnot be depended on to provide love reliably. Either rebuffed by their raises or subjected to fickle and erratic precaution (seductive mavin moment and deprecating the next) these children give up as far as trusting and invest ing in others as love-objects. Rather than rely on the capriciousness of others or risk their rejection, these youngsters avoid the lasting attachment they achingly proclivity and decide instead that it is only themselves they potty trust and therefore love.In unwarranted of current debates within psychoanalytic circles, it is important to note that the developmental origin of the term narcissism described here was only one of several(prenominal) concepts that Freud posited as the offset of libidinal self-cathexis. Moreover, the paper was not written for the purpose of formulating either a vain personality type or a swollen subject structure. Rather, Freuds coverest lay in exploring and elaborating variations in twain the development and the spirit of libidinal cathexis. As far as clinical syndromes were come to, he referred in this paper to lineamentistics observed among paraphrenics (paranoid schizophrenics), megalomaniacs, and hypochondriacs. When Freud wrote, for the first time in 1931, ab by narcissistic libidinal type, he described this individual as followsThe important involution is centre on self-preservation the type is fencesitter and not easily overawed, People of this type impress others, cosmos personalities it is on them that their fellow men are specificly likely to lean they readily assume the role of leave behinder, give a fresh stimulus to cultural development or break heap existing conditions. (p. 249)What is striking in this quote is Freuds characterization of the narcissists strength and confidence, particularly since it cables so markedly with the low self- look upon, specks of emptiness, pain, and depression that certain of his recent disciples (Forman, 1975 Kohut, 1971) evaluate to this personality, Disparities in characterizations frequently(prenominal) as these a lot arise as a implication of shifts in Freuds formulations from one period to another over his amentaceous and long career. In this case, it green goddess be traced to the particular that Freud identified several origins of narcissistic self-cathexis, only one of which is the type of agnatic caprice and rejection that may lead to receiveings of emptiness and low self-esteem. As evident from earlier excerpts, and as subsequently elaborated further, Freuds description of the narcissistic libidinal type, brief though it is, corresponds lots more closely to the DSM-III portrayal of the narcissistic personality than do several contemporary characterizations that trace their antecedents to either parental rebuff or unreliability. relevant to this issue is a Freuds encounter that that narcissistic self-investment is more likely to be a product of parental overvaluation than of parental devaluation.Moving rump somewhat to the 1920s, we find three analytically oriented theorists who addressed the concept of a narcissistic personality. Wilhelm Reich claimed to take in first formulated what he termed the phallic-narcissistic character at a Vienna Psychoanalytic Society meeting in 1926, although Waelder (1925) made reference to narcissistic personality features in an earlier paper snap on the mechanisms of the psychotic process.According to Kernberg (1967) narcissists present an unusual degree of self-reference in their interactions with other concourse, a great need to be love and value by others and a curious apparent contradiction between a very inflated concept of themselves and an inordinate need for grant from others. Their emotional life is shallow. They experience junior-grade empathy for the feelings of others, they obtain very little sport from life other than from the tributes they receive from others or from their own la-di-da fantasies, and they feel restless and bored when external glitter wears off and no new sources extend their self regard. They begrudge others, tend to idealisticize some people from whom they previse narcissistic supplies, and to depreciate and treat with contempt those from whom they do not pack anything (often their former idols). In general, their relationships with other people are clearly consumptive and sometimes parasitic. It is as if they feel they bring forth the right to control and birth others and to exploit them with issue guilt feelings, and behind a surface which very often is charming and engaging, one senses coldness and cruelty. Very often such patients are con situationred to be dependent because they need so much tribute and adoration from others, but on a deeper level they are in all unable really to depend on anybody because of their deep distrust and depreciation of other. (p. 655)Kernberg (1967) asseverate that the haughty and grandiose constellation of behaviors that characterizes the narcissist is a vindication against the projection of oral rage that, in turn, stems from the narcissists incapacity to depend on internalized good objects. In this etiologic formulation, Kernberg claimed that the exp eriential patronizeground of to the highest degree narcissists accommodates chronically cold parental figures who exhibit either indifference or covert, but spitefully aggressive, attitudes to screen their children. At the same time, the young, future narcissist is often found to possess some special talent or status within the family, such as playing the role of genius or being the only child. This quality of specialness serves as a refuge, at first only temporarily but ultimately an often-returned-to haven that reliably offsets the underlying feeling of having been unloved by the vengefully rejecting parent.Kernberg (1975) describes the following pointwise eleven characteristics of narcissistic personalityexcessive self absorption.Superficially smooth, appropriate and trenchant mixer adaptation covering profound distortions in internal relations with other people.Intense ambitiousness.Grandiose fantasies existing stead by side with feelings of inferiority.Over dependence on external admiration and acclaim.Feelings of boredom and emptiness. imperishable search for gratification of strivings for brilliance, wealth, power and beauty.Incapacity to love to be concerned or to be empathic toward others.Chronic uncertainty and dis triumph about oneself.Exploitativeness and ruthlessness toward others.Chronic, intense envy, and defenses against such envy e.g., devaluation, omnipotent central and narcissistic withdrawal.Kohuts accessionKohuts (1971) views are more difficult to summarize than those of Kernberg, perhaps as a consequence of their great originality. Despite having been written in esoteric, if not obscure, psychoanalytic jargon and having been formulated in an ingenious, if at times ponderous and tautological fashion, Kohuts work has attracted numerous disciples. Fortunately, a s snapper of interpreters have sought to elucidate his metapsychological assertions, which umpteen consider among the more imaginative advances in recent analytic theory (Forman, 1975 Gedo Goldberg, 1973 Palombo, 1976 Wolf, 1976).Kohut (1971) rejects the traditional Freudian and Kernbergian thesis that narcissistic self-investment results from a defensive withdrawal of object-love attachments following a physique of chronic parental coldness or vengeful spite. This classical view contends that narcissism is a result of developmental arrests or regressions to earlier points of fixation. Thus, the future narcissist, check to standard analytic metapsychology, regresses to or fails to progress through the usual developmental sequence of initial un variediated libido, followed by autoeroticism, narcissism, and, finally, object-love. It is not the matter as such but the sequence of libidinal maturation that Kohut challenges. His clinical observations have led him to assert that the primitive narcissistic libido has its own developmental line and sequence of continuity into adulthood. That is, it does not fade outdoor(a) by becoming transformed into object-libido, as contended by classical theorists, but unfolds into its own set of mature narcissistic processes and structures. In healthy form, for example, these processes might let in behaviors such as humor and creativity similarly, and most significantly, it is through this narcissistic developmental sequence that the cohesive psychic structure of self ultimately emerges.Pathology in narcissistic development, granting to Kohut, occurs as a consequence of failures to integrate one of two major spheres of self-maturation, the grandiose self and the idealized parental regard. Confronted by realistic shortcomings that undermine early feelings of grandiose omnipotence, or subsequently recognizing the equally illusory nature of the idealized powers they have attributed to their parents, these children must(prenominal) find a way to overcome their disappointments so as not to fragment If disillusioned, rejected, or experiencing cold and unempathic care at the earliest stages of self-development, good pathology, such as psychotic or delimitation states, ordain occur. Trauma or disappointment at a later phase will have somewhat different repercussions depending on whether the difficulty centered on the development of the grandiose self or on the parental imago. In the former, the child will fail to develop the sense of fulfillment and self-confidence that comes from I feeling worthwhile and valued as a consequence, these needs will change integrity off and result in the persistent seeking of narcissistic acknowledgement through adulthood. Along the second line of self-development, children who are unable to idealize their parents because of the latters indifference or rejection will feel devastated, depressed, and empty. Through adulthood, they will seek idealized parental surrogates who, inevitably, will fail to live up to the omnipotent powers the narcissists hoped to find within them. In their desperate search for an ideal that is greater than themse lves, they are often led to be have in a weak and self-effacing manner that will enable others to bulk large them.What is notable is that Kohuts is a developmental theory of self and not a personality characterization. Nevertheless, it leads to a clinical picture that at variance with those of Freud, Kernberg, and the DSM..III and IV. The features that emerge from Kohuts descriptions have been summarized by Forman (1975). Listed among the more prominent are (a) low self-esteem, (b) tendencies toward periodic hypochondriasis, and (c) feelings of emptiness or deadness.Bursten (1973) has sought to distinguish four personality variants within the narcissistic root wording, discourse of them as the craving, paranoid, manipulative, and phallic types, He refers to the craving variety as clinging, demanding, often pouting and whining (p. 290). Those labelled paranoid narcissists correspond with general descriptions of the paranoid personality. artful narcissists encompass a large segmen t of what are referred to as anti hearty personalities in the DSM-II. The fourth subtype, phallic narcissists, describes patients who are exhibitionistic, reckless, cold, and arrogant. In seeking to contrast moulding from narcissistic personalities, Bursten makes reference to the distinction as bearing on the coherency of self. Elaborating this distinction, he speaks of the narcissistic personality as comprisinga group of people whose sense of self is sufficiently cohesive that they do not suffer from these types of fragility problems, The striking feature of this cluster of personality types centers more or less self-esteem, They apply an intense interest in themselves and harbor both grandiose fantasies, albeit not to a delusional extent, and the need to associate with powerful figures, When one frustrates their vanity or their need for an ideal parent, they become dysfunctional-they suffer terrible disappointment, depression, rage, and hypochondriasis, They may even have fl eeting episodes of confusion, but such mental disintegration is very brief and does not have the protuberance and the persistence of people whose personalities fall in the borderline cluster. To be noted, cohesiveness of their sense of self is maintained by the intensity focus on themselves. (Bursten 1973, p. 414).Drawing on Burstens conceptions of self cohesiveness, Adler (1981) elaborates further on the continuum of narcissistic and borderline personalities Borderline patients have serious difficulties in maintaining stable self-object transferences as well as a sense of self-cohesivenessPatients with narcissistic personality disorders on the focal ratio end of the continuum are able to maintain self-cohesiveness, except for transient atomisation. These fragmentation experiences can often be examined in the therapeutic situation without serious disruption Finally, patients with a narcissistic personality disorder do not experience the feelings of aloneness experienced by border line patients.From the borderline patient capable of a serious regression at one end of the continuum to the patient with a stable narcissistic personality disorder at the other end, we can evaluate our patients, using cohesiveness of the self self-object transference stability, and the achievement of aloneness. (pp. 47-48)Coopers nestleCooper (1984, 1988, 1989) has written extensively on different facets of the narcissistic character, describing aspects of its development, the central role of an integrated self-image, and its intertwining with masochistic like tendencies. In each sphere, his Insights have been un ordinarily astute and his themes both scholarly and eloquently expressed. Speaking of the importance of an integrated self-image, Cooper (1984) writes A vital aspect of normal self-development is the achievement of an internalized, integrated self image (p.46) Different workers have referred to these integrative capacities and failures .in a variety of ways Kohut speak o f enfeebled selves lacking cohesion, Kernberg speaks of splits in self-representations. Erikson referred to identity diffusion, and winnicott spoke of the false Self. under(a) many different headings, every investigator in this area has stress the core importance of the creation of a unified, coherent, integrated inner sense of self. (p. 47)Describing the intermeshing of narcissistic and masochistic pathology, Cooper (1989) commentsFrustrations of narcissistic strivings lead to reparative attempts to maintain omnipotent fantasies.Self esteem takes on a pathological quality when an individual begins to derive satisfaction from mastery of his own humiliations. A pattern of deriving pleasure out of displeasure has begun. This pattern provides the groundwork for the later clinical picture of . . . the injustice collector. These individuals are basically narcissistic-masochistic characters and their analysis regularly reveals that narcissistic defenses of grandiosity and entitlement a re used to ward off masochistic tendencies toward self-abasement and self-damage. (p. 314)Taking issue with the descriptively narrow down formulations of the narcissistic personality in the DSM, Cooper and Sacks (1991) offer the following commentsThe diagnostic features are a caricature not a clinical picture. The core issue is a conflict over self-esteem in defense of self-inflation. This grandiosity is more or less fragile or becomes more or less pathologically unrealistic when threats to self-esteem and self-representation .are present in the form of criticism tasks beyond ones capacity, etc.These patients often have a slippery ethical system, not out of intent to exploit, but out of the need to hide flaws and keep their defects secret. Narcissistic characters also have betray paranoid tendencies, again arising out of the need to hide imperfections. The sense of needing to feel perfect is as much a part of the picture as grandiosity, which is an overt characteristic. (p.3)Akht ar and Thomsans upriseIn a series of particularly perceptive papers, Akhtar and Thomson (1982) have sought to bring the scattered literary harvestions on the narcissi into a multifaceted profile, including their characteristic overt and covert features in six areas of psychosocial functioning. In a recent book, Akhtar (1992) indicates that narcissists appear overtly grandiose, exploitative, seductive and articulate. Covertly, however, they are doubt-ridden, avaricious of others chronically bored corruptible, and unable to love. Akhtars format for differentiating the overt from the covert is an super helpful distinction owing to the disparity that exists among many narcissists between their self-presentations and their intrapsychic doubts.Gundersons ApproachAnother important contributor in the narcissistic personality literature is Gunderson (1983 Gunderson Ronningstam, 1991, Gunderson. Ronningstam, 1991 Smith. In summarizing the features of the narcissist, he includes severa l criteria (Gunderson Ronningstam, 1991) Narcissistic patients are usually quick-witted and have had sustained periods of successful academic employment, or creative achievement, This is frequently a source for their sense of superiority, It is also a reason wherefore they are more apt to appear in private manage settings than in either institutions or clinics.Narcissistically disturbed patients reported histories in which they have reacted with hostility and suspicion to the perception of other peoples envy toward them. They recall that because of envy other peoples envy toward them. They believe that because of envy other people have set out to hurt them spoil their work, diminish their achievements, or notice them behind their back.Feelings of devaluation/or contempt may occur toward many people but are especially evident toward anyone why they believe has betrayed or otherwise disappointed them. These become sustained attitudes of dislike or dismissal. (pp. 114-115)Stones ApproachAnother astute contemporary theorist. Stone (1993) further amplifies the divergent backgrounds and psychic states of the narcissist as the followingNarcissistic traits can develop, curiously, when there are deviations from ideal rearing on either side pampering or neglecting expecting too much or too little. Excessive praise of a child . . . can give rise to . . . feelings of superiority, of being destined for greatness. . . . But compensatory feelings of a similar kind can arise where there has been parental indifference and neglect, for in this situation a child may develop an exaggerated desire for greatness by way of shoring up a sense of self-worth in the absence of the ordinary parental praise. Whereas the overly praised child may regard himself as better than he really is, the neglected child may present a dual picture an outward sense of (compensatory) specialness covering an interior sense worthlessness. (p. 260)Learys ApproachTimothy Leary (1957), a disciple of Homey and others of the social and interpersonal school of thought, extended their notions to what he terms adjustment through competition. Leary speaks of this pattern as demonstrating a competitive self-confident narcissism, described in the following quotesIn its maladaptive perfect it becomes a smug, cold, selfish, exploitive social role. In this case the adaptive self-confidence and independence become exaggerated into a self-oriented rejection of othersThe individuals feel most secure when they are separate of other peopleThe narcissist putsdistance between himself and others- wants to be independent of and superior to the other one. Dependence is terrifying. (p. 332)The second group of . . . patients . . . are those whose self-worth has received a decent defeat. They often report the most chromatic and fearful symptomatology . . . The superficial impression of depression or dependence is deceptive. Psychological test or perceptive interviewing will reveal that the patien ts are not as anxious or depressed as they appear. What becomes evident is a narcissisticconcern with their own reactions, their own sensitivities. The precipitating cause for their entrance to the clinic is usually a shift in their life situation, which causes frustration or a blow to their pride.(p. 335)Benjamins ApproachFollowing the interpersonal persuasion of Leary are a number of interpersonally oriented theorists who drafted their model of various personality disorders in highly fruitful work. Notable among this group is Benjamin (1993), who has formulated a mingled analysis of the narcissistic character. In her recent work, she describes this personality as followsThere is extreme vulnerability to criticism or being ignored, together with a firm wish for love, support, and admiring deference from others. The baseline position involves noncontingent love of self and presumptive control of others. If the support is withdrawn, or if there is any record of lack of perfection, the self-concept degrades to severe self-criticism. Totally lacking in empathy, these persons treat others with contempt, and kick in the self above and beyond the fray. (p. 147)The narcissist expects to be given whatever he or she wants and needs, no matter what it might mean to others. This does not include active deception, but rather is a consequence of the belief that he or she is entitled. For example, the NPD would not set out to con a little old lady out of her life savings however, if she offered them, the NPD would accept such a gift without reflection about its impact on her. He/She will expect great dedication, overwork, and heroic performance from the people associated with him or her without fully grown any thought to the impact of this pattern in their lives. (p. 150)Beck and freewomans Approach contribute the insightful analysis of the narcissistic personality from a cognitive point of view. Beck and Freeman (1990) provide the following proposal concerning this in dividuals distorted belief systemThe core narcissistic beliefs are as follows Since I am special, I deserve special dispensations, privileges, and prerogatives, Im superior to others and they should acknowledge this, Im above the rules.Their main strategies consist of doing whatever they can to reinforce their superior status and to expand their personal domain. Thus, they may seek glory, wealth, position, power, and prestige as a way of continuously reinforcing their superior image.Their main affect is anger when other people do not accord them the admiration or respect that they believe they are entitled to, or otherwise thwart them in some way. They are prone to becoming depressed, however, if their strategies are foiled. (Beck Freeman 1990. p. 50)Narcissistic Personality Disorder can be conceptualized as stemming from a combination of dysfunctional schemas about the self, the world, and the future. The early foundation of these schemas is developed by direct and indirect messag es from parents, siblings, and significant others, and by experiences that mold beliefs about personal singularity and self-importance Narcissists regard themselves as special, exceptional, and justified in focusing exclusively on personal gratification they expect admiration, deference, and compliance from others, and their expectations of the future focus on the realization of grandiose fantasies. At the same time, beliefs about the importance of other peoples feelings are conspicuously lacking. Behavior is affected by deficits in cooperation and interchangeable social interaction, as well as by excesses in demanding, self-indulgent, and sometimes aggressive behaviors. (p. 238).In writing theories of narcissistic personality disorder, the stereotyped pattern was not adopted. Rather, attempt was made to present the view of clinicians, theoreticians and social thinkers. Highlights are given belowPsycho dynamically oriented theorists conclude that the narcissistic disorders are the product of emotionally unhealthy parent child relationship. The cold and callous mother/father produce a sense of rejection and unworthiness in child with he result that such a child spends his life defending himself that he is good and loved child and he deserves admiration and attention form all others around him.Object-relation theorists are basically psychodynamically oriented. They are as a matter of fact both derivatives and deviationists. Since they give much more importance to mother-child relationship than what is unremarkably given to parent-child relationship, they are described as object-relation (mother-child relation) theorists. According to object-relation theorists, detrimental relationship between mother-child relationship has negative impact on the growing negative personality of the child. Generally such a child develops a grandiose self-image, consequently, illusion of self-sufficiency and freedom from parental restriction is reported. Such a child is much pr one to narcissistic personality tendencies.Those who give importance both to behavioural and cognitive aspects or personality development do not approve the extreme sides of child-rearing practices. They approve neither too much love nor too much negligence. Extremity of approach to the child is held to be a responsible factor in the development of narcissistic disorder. In support of this proposition, first born/the only born child who is primarily over-loved is said to be prone to the development of narcissistic tendencies.Socio-cultural theorists hold that in a society where freedom of living life in the way parents are living is not questioned, adolescents feel free to adopt individual life-pattern. In other words, narcissism is held to have link with fading interest in ones culture. That is, where individualism is preferred to collectivism, where new values are getting recognition, narcissistic lifestyle is very likely to gain strong ground.It may be summarized that articles and books have been written about narcissistic personality disorders from two opposite perspectives. The first perspective is psycho, analytic theory which suggests that personalities are compensating for inadequate affection and approval from their parents in early childhood (Kernberg, 1975 Kohut, 1972). The second perspective is social learning perspective (Millon, 1969, 1981) which holds that narcissistic personality disorders are the product of home life, created by parents who have inflated views of their childrens intelligence, achievements, and beauty of face, figure and complexion.