NARCISSISM IN PRACTICE – PART I

What do we know about Narcissism

introduction

In Greek mythology, Narcissus was the son of the river-god Cephissus and the nymph Liriope. He was very beautiful and was pursued by many, including the wood nymph Echo. Having fallen deeply in love with Narcissus, Echo followed him through the woods, calling his words back to him. However, when she revealed herself, Narcissus rejected her and she pined away, leaving only her echo behind. Nemesis, the God of revenge, decided to punish Narcissus for his cruelty. She drew him to a pond where he fell in love with the beautiful face reflected in its waters. His fate was to remain gazing at his own reflection until he finally melted away, consumed by the passionate fire that burned inside him as a result of his love for himself. In death, Narcissus turned into the gold-and-white flower that bears his name.

The concept of narcissism in contemporary society provokes a range of ideas, associations and reactions in each of us, but what do we really know about it? Is it a myth that satisfies our desire for a unifying story to explain a range of slightly unpleasant related behaviours? Is it a psychiatric disorder that can be treated? Is it, as we are led to believe by the current zeitgeist, a phenomenon which is on the increase due to the prevalence of social media?  This article sets out to examine the state of research into the concept of narcissism, the evidence for what it is and how and when it might be considered productive and useful, and when it might be more harmful or dangerous. Critically, we try to understand from the current evidence base how to best define and understand narcissism and how it plays out in contemporary society, particularly in regard to our relationships.

Mad, bad or dangerous?

Mad?

Let’s put narcissism in context. To some extent, madness and mental ill-health are social constructs. Narcissism in particular (although not exclusively) differs from many other areas of mental health because of the way in which we are ambivalent about it; in many cultures, confidence, self-belief, ambition and self-promotion are admired and encouraged behaviours, although of course there are cultures which value these individualistic traits much less. We might gently mock or tease those who consistently demonstrate such behaviours, but where is the line between self-confidence or self-esteem and less attractive and constructive narcissism? When does self-belief become unhealthy and self-deluding self-aggrandizement? Contemporary thinking influences our understanding of the causes of illness, and of treatment plans and so on, and in itself that is shaped by culture, religion, politics, economics, technology, and more. The Diagnostic and Statistical Manual of Mental Disorders (DSM V) sets out the criteria that charts mental health conditions. While the DSM is not without its critics, all over the world mental health professionals access it for diagnosing mental ill health. Most mental health conditions are given a set of criteria that identify the number and duration of symptoms an individual must display in order to have a positive clinical diagnosis. To achieve a diagnosis of Narcissistic Personality Disorder (NPD), individuals must display five or more of the following:

• a grandiose sense of self-importance (exaggerates achievements, expects to be recognised as superior without actually completing the achievements);

• preoccupation with fantasies of success, power, brilliance, beauty or perfect love;

• a sense of specialness that means he or she can be understood by or should associate with only other special people (or institutions);

• a need for excessive admiration;

• a sense of entitlement, such as an unreasonable expectation of favourable treatment or compliance with his or her expectations;

• an attitude that is exploitative and takes advantage of others to achieve his or her own ends;

• an inability to empathise and an unwillingness to identify with the needs of others;

• envy, or a belief that others are envious of him or her;

• arrogance or haughtiness in behaviour and attitude.

BAD?

Crucially, the symptoms must be causing some material disruption to the individual’s ability to function productively in society. This is especially significant in the context of narcissism. That we view narcissism in a way that is different from other mental ill health is evidenced in the fact that few narcissists present for treatment for narcissism itself. It’s more likely a narcissist would see a clinician for depression and suicidality – but even then, it’s unlikely. The result is that narcissists live among us in numbers far greater than their clinical populations would have us believe. A great many narcissists function publicly despite probably having crossed the line from sub-clinical to clinical. While some of the general stereotypes of narcissism sit well with the psychological concepts of it, some don’t. And so for these reasons, for the purposes of this article we’ve taken a view that it is more useful to focus on narcissistic behavior (narcissism as a verb) rather than clinically diagnosable Narcissistic Personality Disorder (narcissism as a noun), because those with NPD are exactly those who would typically not see themselves as being at fault or needing help.  Narcissists are masterful at managing self-denial and defensiveness – they are brilliant at blaming others rather than looking inwards. These mechanisms keep them psychologically safe from the damaging effects that their behaviours would otherwise have on their own self-esteem. They may well be causing themselves untold relationship dissatisfaction and remain in a state of chronic self-esteem vulnerability, but their ego leaves them fighting, looking for causes beyond themselves. Psychologically, they are indeed victims – although they rarely engender sympathy.

So, as we understand it from the evidence base, the behaviours that make up the sub-clinical syndrome recognizable as Narcissism include immodesty, self-promotion, self enhancement, a strong sense of entitlement, antagonism and agentic aspects of extraversion, such as achieving high status and dominance. The evidence suggests that there are two presenting ‘forms’ of narcissist: one characterized primarily by grandiosity, the other more by vulnerability, and much of the literature makes a distinction between the two. Grandiose narcissism entails immodesty, interpersonal dominance (I win, you lose), callousness (or lack of empathy) and manipulativeness. This type of narcissism tends to be seemingly higher in self-esteem and lower in psychological distress. Vulnerable narcissism entails feelings of inferiority, egocentricity, and more passive–hostile interpersonal behaviours, with seemingly lower self-esteem and higher psychological distress and negative emotions (such as anxiety or shame). The research around these two forms of narcissism has tried to establish whether in fact they are connected through causality and/or presentation, and if they are, whether they are sufficiently connected that they can be considered variants of the same syndrome. Whilst  both types share childhood attachment difficulties and ego and self-esteem fragility, in diagnosing NPD using DSM V criteria, there tends to be more convergence with the grandiose form of narcissism, with focus on the strongly antagonistic interpersonal style, with the exception of the emphasis on emotional and psychological fragility. From a nonclinical perspective we see degrees of narcissism all around, varying from mild to extreme, and probably understand that it exists on a continuum from a slightly unattractive habit of self-admiration, like Narcissus himself, to a very dysfunctional personality disorder.

dangerous?

In everyday terms, the description of narcissism often overlaps with commonly held ideas about psychopathic behaviours. To understand how the two variants of narcissism and psychopathy are related and differ, it is useful to look at them through the lens of a model of personality. The best model that we currently have is the Five-Factor model which is the culmination of 100 years or so of research into human personality whereby we are now fairly confident that there are 5 broad dimensions to personality and that these are reliable, valid, universal and separate; they are Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness, each a continuum, the two ends of which are as you can see in the following box:

The research into Narcissism and psychopathy using this model reveals the inter-relationships as follows:

The relationship between narcissism and psychopathy

We can see that psychopathy and the two forms of narcissism are connected in that they all involve antagonistic behavioural styles, or low agreeableness, as it is conceptualised in the five-factor model of personality. However, they differ in terms of extraversion, neuroticism and conscientiousness. Furthermore, vulnerable narcissism is associated with low extraversion (that is, introversion) and grandiose narcissism with extraversion. There is some evidence to suggest that it is this dichotomy – introversion vs extraversion – that drives or moderates how a person expresses their narcissism: extraverts tend to express it through grandiosity (‘I am superior and I am going to let you know it’) and introverts express it less overtly through their vulnerability  (‘Secretly I know that I am superior, but you can’t see it’). As we can see from the diagram, a key characteristic of psychopathy is lack of empathy, and much of the literature emphasises this characteristic as the key driver of dangerous (often violent) behavior towards others. 

How to spot Narcissism?

Underlined by the notion of a sense of entitlement, having their needs thwarted or falling short of their own expectations, the narcissist might react emotionally or practically in the following ways, in turn resulting in problematic behaviour or psychological ill health:

• Impatience or anger  

• Feeling slighted and having significant interpersonal problems

• Rage or contempt and attempts to belittle others

• Emotional or behavioural lack of control

• Inability to deal with stress and adapt to change

• Depression or low mood

• Feelings of insecurity, shame, vulnerability and humiliation

• Tendency to lay claim to others’ successes

• Tendency to put others down

Beneath every narcissist is there a sad creature suffering from low self-esteem?

Well no, actually. Research tells us that while there are some behavioural manifestations of both of these that are similar, the two are actually distinct from one another. Self-esteem is about feelings of self-worth. What we see in grandiose narcissism is, of course, an inflated sense of self-worth. However, grandiose narcissism is more than this – it involves feelings of superiority. That is, for a narcissist to win, someone else needs to lose – narcissism is a zero-sum game. This is not so with high self-esteem: I can have high self-esteem but that does not mean that you can’t. 

What to expect if you think that you might be in a relationship with a narcissist.

Given that we know that narcissists seek admiration from others, idealise others who are close to them for short periods of time, are highly sensitive to criticism, show little empathy for close others, and are willing to exploit or take advantage of them, it would not be surprising to learn that their relationships, romantic or otherwise, are dysfunctional. But is this really the case?

Grandiose narcissists will tend to seek out relationships, romantic or otherwise with those they perceive to be of high status, as this reflects well on them and serves the self-enhancement aspect of their narcissism. Less is known about vulnerable narcissists, but evidence suggests that they share the entitlement and self-absorption traits and behaviours of grandiose narcissists and so maybe they also seek partners to fulfil self-enhancement.  On the other hand, their introverted and neurotic personalities may make this more difficult and their proneness to anxiety and depression may also impact their romantic relationships.

Fundamentally, narcissists are likely to be less satisfied in relationships, because while their game-playing and sensation-seeking means that they enjoy the pursuit of a romantic partner, their initial idealisation of a new partner quickly fades; they are likely less invested in the relationship than their partner (because they are more self-centred and selfish); and they believe themselves to have plenty of alternative options and so are likely to be on the lookout for someone better. Those in relationships with narcissists often report a greater reduction in satisfaction over time than those who aren’t. This has been called the ‘Chocolate Cake Model’ (Campbell 2005). What starts out as enjoyable, soon becomes too much! The narcissist may initially seem quite attractive, given their positive self-view, but in the longer term, the narcissist’s need to maintain his or her self-esteem by derogating others becomes very unattractive. Similarly, the manipulative behaviour of narcissists – that is, their ability to recognise emotions and use them to control interactions to their advantage – as well as their inconsistent commitment (alternating between aloofness and attraction) probably becomes more apparent over time. Furthermore, it seems that more generally, the narcissist’s romantic relationships are often transitory and shallow, lacking in commitment. They begin with an inflated or idealised infatuation, which often ends quickly – either because the narcissist forms a more realistic view or finds a better partner, or perhaps because they perceive true commitment as threatening and/or risky. Many of these findings have held true for non-romantic relationships, too.

So why are narcissists so compelled to look out for and pursue alternative partners? One hypothesis, known as the ‘going for the better deal’hypothesis, speaks to the narcissist’s frequent need to bolster their self-image by constantly seeking higher status and more attractive partners. Think of the trophy spouse, who is often younger or richer than the previous one.

There may also be problems with everyday communication. There is a substantial body of evidence that higher narcissist scorers respond more negatively to criticism, rejection and failure than lower scorers. In relationship couples, narcissistic individuals are more likely to engage in hostility (insults, criticisms) when discussing a conflict with their partner. In competitive games, higher narcissism partners are more likely to exhibit angry and aggressive behaviour toward their partner during the task. However, these types of study have tended to invoke conflict, and while we know less about the presentation of narcissistic behaviour when an individual is not necessarily threatened or challenged, there is some evidence to suggest that hostility and anger can be expressed even in non-conflictsituations.

Oh, the youth of today! Is narcissism on the rise?

There continues to be an oft-cited (and perhaps age-old) contention that our youngsters are becoming more egocentric and entitled – that is, more narcissistic. One substantial database of many thousands of measurements looks at narcissism, as measured by the Narcissistic Personality Inventory (NPI - the most commonly used non-clinical measure of narcissism) in college students over the last three or so decades, mostly in the USA. The evidence is now fairly consistent in showing a small rise in NPI scores over recent decades. Such rises appear to have gone hand in hand with the rise of individualistic traits in some, mainly Western cultures – such traits as assertiveness, extraversion, self-esteem and self-efficacy. Therefore, the generational difference in narcissism may simply be attributable to the way in which individualism is increasingly valued in Western societies. Another explanation is that narcissism in young people is developmentally normal. Evidence in support of this explanation includes the finding that narcissism does diminish with age, although this evidence comes from cross-sectional rather than longitudinal studies.

In whatever way we choose to interpret or explain these increases in narcissism, we should remember that they are small increases, much smaller than the amount of sensationalism in the popular press warrants. So, while we now have some empirical evidence to put behind the assertion that narcissism is increasing, it is also tempting to point out that the notion of the generation below us being more entitled, egotistic, differently motivated and so on has been around since time immemorial

Who or what can we blame? 

Blame the parents?

Early psychodynamic conceptions of narcissism hypothesised that poor parental attachment – aloofness and/or indifference of parent towards child – could be a cause of narcissism in childhood and beyond. However, more recent research, while acknowledging that there is some inherited propensity towards narcissism, suggests that narcissism more likely arises from parental over-valuation. Although the evidence is by no means conclusive, studies have shown that the rise of parenting styles that attach great importance to emphasising a child’s ‘specialness’ and entitlement are increasingly materialistic in nature and are accompanied by a reluctance to say ‘no’ to the child, and that these parenting attitudes are going hand-in-hand with a rise in narcissism. However, it is also true that poor attachment with parents has been found to lead to lower self-esteem, and while there is some common perception that narcissism is closely related to or arises from low self-esteem, the two are in fact distinct constructs and not significantly related. 

Blame social media?

Social media has made the world seem much smaller in many respects. We are all more connected regardless of geography, and the news, both fake and genuine, travels further, quicker. Given, also, that we are fairly sure that narcissism has been increasing over the last two to three decades, it is tempting to suspect that that it is no coincidence that the last two decades have seen a much increased use of social media, too. Is it the case that social-media use is fuelling the rise in narcissism? Or is it the case that the opposite is true – that is, that increasing narcissism is finding its best expression through the use of social media? Put another way, does social-media use reflect or drive narcissism. Alternatively, the relationship could of course, simply be a coincidence – the two go hand in hand, but perhaps they are not, in fact, causally related.

The evidence is not yet conclusive. Similarly, there has been little research on the relationship between Narcissistic Personality Disorder (that is, pathological narcissism) and social-media use. While it seems that there is no conclusive evidence for a relationship between absolute levels of social-media use and narcissism, there is some evidence about the way in which narcissists use social media. There is definitely a relationship between grandiose narcissism and exhibitionistic and self-presentational motives. There are modest relationships between grandiose narcissism and number of relationships on Facebook, time spent on social media, frequency of status updates and posting of selfies. Similarly, there are some studies (far fewer in number) that suggest that there is a relationship between vulnerable narcissism and number of friends and frequency of status updates on Facebook. There is evidence to suggest that problematic social-media use (that is, addictive use of social media, primarily of Facebook) is associated with both the grandiose and vulnerable forms of narcissism. It seems that social media are used as means of self-enhancement among those who rate highly on measures of grandiose narcissism. However, much of the evidence so far is only about the association between narcissism and social-media use, not about causal directionality.

There are a number of moderating factors that probably affect the relationship between narcissism and social-media use, some of which are cultural. For example, there are some cultures in which individualism is more highly valued than communalism, and there is evidence to suggest that narcissism is higher in the former type of societal culture. Similarly, there are indications that social-media use and narcissism increased together up until the economic collapse of the last decade, but have subsequently moved apart a little as the realities of underemployment and financial hardship have mitigated against narcissistic fantasy and display. There has also been a fair amount of research investigating the relationship between narcissism and self-esteem in general, and on the potential moderating effect of self-esteem on the relationship between narcissism and social-media use in particular. There is reason to suspect that self-esteem moderates the relationship between grandiose narcissism and the posting of selfies; the primary objectives of narcissists are to both engage in self-enhancement and to mitigate the negative ways in which others may perceive them. As yet, though, the evidence base is not substantive enough to allow for firm conclusions about the relationship between narcissism, self-esteem and selfie posting.

So – Are narcissists mad, bad or dangerous?

Mad – a little bit, probably. 

Bad – certainly, if you are trying to have a productive and healthy relationship with one.

Dangerous – unlikely to be physically dangerous, but definitely bad for your psychological health. And probably bad for society too, especially when you consider the range of platforms available to individuals from which they can purvey their thoughts and ideas across contemporary society. This is when narcissism can turn from being unpleasant and distasteful to something dangerous - when power and platforms come together, and this is what we continue to explore in the next article in our series about narcissism.