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Can You Diagnose Your Narcissist?

Uploaded 5/4/2011, approx. 3 minute read

My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited.

Can anyone diagnose a narcissist? Can you diagnose your narcissist?

Narcissistic personality disorder is a disease. It is defined only by and in the Diagnostic and Statistical Manual, the DSM. All other so-called definitions and compilations of criteria are irrelevant and very misleading oftentimes.

People go around putting together lists of traits and behaviors, usually based on their experience with one person who was never officially diagnosed with Narcissistic Personality Disorder. They decide that these compilers decide that these lists constitute the essence and definition of narcissism, but often they don't.

People erroneously use the term narcissist to describe every type of abuser or obnoxious and uncouth person. That is wrong. Not all abusers or jerks are narcissists, although all narcissists are abusers and jerks.

Remember, only a qualified mental health diagnostician can determine whether someone suffers from Narcissistic Personality Disorder in this following lengthy tests and personal interviews.

It is true that narcissists can mislead even the most experienced professional, but this does not mean that laymen possess the ability to diagnose mental health disorders.

The same signs and symptoms apply to many psychological problems, and differentiating between them takes years of learning and training and exposure to case studies.

So here's a list of the diagnostic criteria in the Diagnostic and Statistical Manual of the DSM augmented by findings from recent studies and research.

The narcissist feels grandiose and self-important. He exaggerates accomplishments, talents, skills, contacts and personality traits to the point of lying. He demands to be recognized as superior without commensurate achievements.

The narcissist is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequal brilliance, bodily beauty or sexual performance.

The narcissist believes in ideal, everlasting, all-conquering love or passion. The narcissist is firmly convinced that he or she is unique, and being special can only be understood by and should be treated by or associate with other special, unique or high-status people or institutions.

The narcissist requires excessive admiration, adulation, attention and affirmation, or failing that, wishes to be feared and to be notorious. This is what I call narcissistic supply.

The narcissist feels entitled. He demands automatic and full compliance with his or her unreasonable expectations for special and favorable priority treatment.

The narcissist is interpersonally exploited. In other words, the narcissist uses others to achieve his or her own ends and goals.

Most importantly, the narcissist is devoid of empathy. He is unable or unwilling to identify with, acknowledge or accept the feelings, needs, preferences, priorities, wishes and choices of other people.

The narcissist is constantly envious of others, and he seeks to hurt or destroy the object of his or her frustration.

The narcissist suffers from persecutory, paranoid delusions, as he or she believes that they feel the same about him or her, and are likely to act similarly.

The narcissist behaves arrogantly and haughtily. He feels superior, omnipotent, omniscient, invincible, immune, above the law, and only present.

This whole complex is known as magical thinking.

The narcissist rages when he is frustrated, contradicted or confronted by people he or she consider inferior to him or her. The narcissist regards other people with contempt. This dame is unworthy.

So this is an exhaustive list. It is enough for five of these criterias to coexist in a patient, for that patient to be diagnosed with narcissistic personality disorder.

But remember, you cannot diagnose people. You cannot go around labeling them. It is not proper. You are not qualified.

It is true that narcissists rarely attend therapy, and they rarely subject themselves to diagnostic tests.

But that does not mean that it grants you the right to label them.

If you enjoyed this article, you might like the following:

Narcissist: Is He or Isn't He?

Narcissism is a spectrum of behaviors, from healthy to pathological, and the Diagnostic and Statistical Manual specifies nine diagnostic criteria for narcissistic personality disorder (NPD). A malignant narcissist is someone who has NPD and wreaks havoc on themselves and their surroundings. They feel grandiose and self-important, exaggerate accomplishments, and demand recognition as superior without commensurate achievements. They require excessive admiration, adulation, attention, and affirmation, and are interpersonally exploitative, devoid of empathy, and constantly envious of others.


Narcissistic Personality Disorder Diagnostic Criteria (DSM IV-TR)

Narcissistic Personality Disorder (NPD) is an extreme form of pathological narcissism, which is one of four personality disorders in Cluster B. The International Classification of Diseases, Edition 10, does not recognize NPD as a personality disorder, while the Diagnostic and Statistical Manual, 4th Edition, text revision, provides a diagnostic criteria for NPD. The DSM defines NPD as an all-convasive pattern of grandiosity in fantasy or behavior, need for admiration or adulation, a lack of empathy, usually beginning by early adulthood and present in various contexts such as family life or work. The narcissist feels grandiose and self-important, is obsessed with fantasies of unlimited success, and is devoid of empathy.


Bipolar Disorder Misdiagnosed as Narcissistic Personality Disorder (NPD)

The manic phase of bipolar disorder is often misdiagnosed as narcissistic personality disorder due to the similarities in symptoms. However, the manic phase of bipolar disorder is limited in time and followed by a depressive episode, whereas narcissistic personality disorder is not. The source of the bipolar patient's mood swings is brain biochemistry, not the availability or lack of availability of narcissistic supply. Additionally, the bipolar patient is dysfunctional, while the narcissist is functional.


Narcissistic Personality Disorder Prevalence and Comorbidity

Pathological narcissism is a lifelong pattern of traits and behaviors that signify infatuation and obsession with oneself to the exclusion of all others. Healthy narcissism is adaptive, flexible, empathic, and causes elation and joy. Narcissistic Personality Disorder is diagnosed in between 2 and 16% of a population in clinical settings or between 0.5% and 1% of the general population. Narcissistic Personality Disorder is often diagnosed with other mental health disorders, and this is known as comorbidity.


Narcissist Loves his Disorder and Narcissistic Personality

Narcissists may modify their behavior to become more socially acceptable, but they never heal or get better because they have an emotional investment in their disorder. Narcissistic personality disorder serves two critical functions: it endows the narcissist with a sense of uniqueness and provides an alibi for their misconduct. Narcissists reject the notion that they are mentally ill or disturbed, and their disorder becomes an integral and inseparable part of their inflated self-esteem and grandiose fantasies. The narcissist is emotionally attached to their narcissistic personality disorder and loves their disorder passionately.


Lonely, Schizoid Narcissist

Narcissistic personality disorder is often diagnosed with other mental health disorders, such as borderline, histrionic or antisocial psychopathic personality disorder. Narcissism is often also accompanied by substance abuse and other reckless and impulsive behaviors, and this we call dual diagnosis. There is one curious match, one logic-defying appearance or co-appearance of mental health disorders, narcissism, together with schizoid personality disorder. A minority of narcissists, therefore, choose the schizoid solution. They choose to disengage, to detach both emotionally and socially.


NPD Narcissist, Or Merely Narcissistic Sick, Or Just A Hole

Narcissistic personality disorder (NPD) is a rare clinical condition, affecting approximately 1% to 3% of the population, and should not be confused with individuals who merely exhibit narcissistic traits or behaviors. The distinction between true narcissists and those with narcissistic styles is crucial, as many people display narcissistic tendencies without meeting the criteria for NPD. Recent trends indicate a rising number of diagnosed female narcissists, often exhibiting both narcissistic and borderline traits, which can lead to more dangerous behaviors compared to their male counterparts. The pandemic is expected to exacerbate mental health issues, potentially leading to a significant increase in personality disorders and psychotic conditions, highlighting the need for better understanding and differentiation of narcissistic behaviors.


Your Empathy as Narcissistic Injury: Narcissist Never Learns, No Insight

Narcissists reject empathy and intimacy because it challenges their grandiosity, and they become paranoid and aggressive when someone tries to be intimate with them. Narcissists lack empathy and access to positive emotions, leading to a truncated version of empathy called "cold empathy." Narcissists are self-aware but lack the incentive to get rid of their narcissism, and therapy is more focused on accommodating the needs of the narcissist's nearest and dearest. Cold Therapy is experimental and limited, as it removes the false self but does not develop empathy or improve the narcissist's interpersonal relationships.


Covert Narcissist = Borderline+Psychopath+Passive-Aggressive

Narcissism exists on a spectrum, with individuals displaying varying degrees of narcissistic traits, personality styles, and disorders. The distinction between narcissistic personality disorder and narcissistic personality style is crucial, as the former is dysfunctional and self-destructive, while the latter can be a positive adaptation that allows for social functioning. Narcissists often lack emotional empathy and perceive others as extensions of themselves, leading to exploitative behaviors and a reliance on narcissistic supply for self-regulation. Covert narcissists, in particular, may exhibit a fragile self-image and can be more dangerous due to their hidden nature, often engaging in passive-aggressive behaviors and manipulation.


Is Narcissism Like Bipolar or Depression, Mood Disorder? (Addiction, Depression, Suicide, Webinar)

Narcissism and depression often coexist, particularly exacerbated by the pandemic, leading to a troubling combination of grandiosity and mood disorders. Individuals may react to feelings of helplessness with narcissistic defenses, resulting in distorted perceptions of reality and impaired impulse control. Misdiagnosis is common, as conditions like bipolar disorder can be confused with narcissistic personality disorder due to overlapping symptoms, yet they differ significantly in their manifestations and underlying causes. The narcissist's dysphoria is often reactive and tied to external validation, while depression in bipolar disorder is more profound and internally driven. Ultimately, understanding these distinctions is crucial for effective diagnosis and treatment.

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