It’s common to label people considered self-centred or egotistical as a narcissist. But what exactly is narcissism? How common is narcissism? And how do we know when someone is living with narcissistic personality disorder (NPD)?
Narcissism is more than a personality disorder. It is believed to be a healthy developmental process in childhood, which exists in people from normal to clinical levels.
Most, if not all, of us demonstrate narcissistic tendencies over time. However, NPD is relatively rare. The estimated prevalence of NPD in the community is around 1%, although some studies say up to 6%. The data on NPD is inconclusive about whether this diagnosis is more common in men than women.
Narcissism in history
Narcissism comes from Greek mythology where the beautiful, proud young man Narcissus fell in love with his own image in a pool of water. Unable to leave, he wasted away and died. Consequently, narcissism has been considered a negative trait from ancient history to modern times.
More recently, this characteristic has attracted increased interest from psychoanalysts.
- 1911 – Otto Rank published the first psychoanalytical paper specifically concerned with narcissism, linking it to vanity and self-admiration.
- 1914 – Sigmund Freud published On Narcissism: An Introductionsuggesting narcissism was a normal part of the human psyche. He called it ‘primary narcissism’ or what lies behind each person’s survival instincts.
- 1967 – Psychoanalysts Otto Kernberg and Heinz Kohut developed the concept further, with a type of narcissism called pathological narcissism (the basis for NPD).
- 1980 – NPD was officially recognised as a disorder in the third edition of the DSM and criteria established for its diagnosis.
- 2013 – NPD was initially to be removed from the DSM-5, but was later reinstated following feedback from some clinicians.
Narcissistic personality traits on a continuum
Narcissism exists on a continuum. From normal, healthy, with a few narcissistic traits, to a pathological (clinical) full blown personality disorder on the other. Our level of narcissism can vary over time, between situations and life events.
It’s important to remember that the major distinction between narcissism and narcissistic personality disorder (NPD) is that narcissism is not a mental illness or personality disorder.
Normal narcissism
Healthy narcissism is adaptive, flexible and empathic. It causes elation and joy and helps us function everyday.
Humans need admiration and attention. Everyone has a desire for success and love. But, we all occasionally experience a lack of empathy. People like having power and control, and once in awhile we may feel grandiose or self-important.
So it’s not uncommon for someone displaying normal everyday narcissist traits to hurt our feelings or push our boundaries. This is normal. We may classify these experiences as someone being selfish, aggressive, egotistical or insensitive.
Narcissistic personality type
Further along the continuum is an unhealthier narcissism called narcissistic personality type. This is not a mental health issue, it’s a more-extreme form of narcissism. Whilst most or all of the characteristics of NPD may be present, this kind of narcissism is considered within the normal range of personality.
A person may appear obnoxious, because they feel superior to others. Some of the characteristics could behaving little or no empathy with the feelings or situations of others. Or they could feel entitled to the best of everything, while looking down on those who show admiration for them. Men experience higher rates of this personality type than women.
Pathological narcissism or NPD
The diagnosis of narcissistic personality disorder (NPD) is usually determined through clinical evaluation of the person. NPD was defined by the DSM-5 as significant impairments in personality functioning, such as looking excessively to others for the regulation of self-esteem, viewing oneself as exceptional, having impaired empathy, and having mostly superficial relationships and the personality traits of grandiosity and attention-seeking.
Pathological narcissism is maladaptive, rigid, persistent and causes significant distress and functional impairment. These qualities remain relatively stable over time and are not caused by a medical condition, drugs, or a person’s developmental stage.
Research shows that although people with NPD experience high self-esteem, it is also fragile and insecure. Their self-esteem fluctuates from moment to moment and day to day. Yet people with NPD are more likely to state their self-esteem as high rather than low. This suggests that although people with NPD describe themselves in positive terms, their nonconscious feelings are not necessarily so positive.
So, while it is common to refer to someone behaving selfishly or arrogantly as a narcissist, the psychological definition is more subtle and also relatively rare.
Finding help . . .
- SANE Help Centre – 1800 187 263
- Australian Psychological Society – 1800 333 497
- Relationships Australia – 1300 364 277
- Carers Australia – 1800 242 636
Read more . . .
About the author
Tanya Peisley is a Senior Counsellor with the SANE Help Centre.
