Narcissistic Personalities: Identifying them, understanding them, relating to them

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Learn to identify, understand and deal with narcissistic personalities. Presented by Dr. Claudia Diez, PhD, ABPP, Jewish Community Center, New York, October 2010.

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Narcissistic Personalities: Identifying them, understanding them, relating to them

  1. 1. Narcissistic Personalities<br />Identifying, understanding and relating to them<br />Claudia Diez, PhD, ABPP<br />Board Certified Specialist in Clinical PsychologySupervising PsychologistSt. Luke’s-Roosevelt Hospital Center<br />Assistant Clinical Professor, Columbia University<br />info@drclaudiadiez.comhttp://www.drclaudiadiez.com<br />http://www.slrpsych.org<br />
  2. 2. What is “Narcissism”?<br />From Greek myth of Narcissus, a metaphor of self-absorption and inability to love<br />A normal aspect of Personality <br />self-care and self-esteem; assertiveness<br />need to secure status for self-preservation (Hogan, 1982)<br />Needed for self-sustainment <br />Normal Narcissist: Competitive, Self-Assured, Bold<br />Exists in a continuum: Normal Pathological <br />Involves adaptive and maladaptive traits<br />2<br />
  3. 3. Socio-Cultural Perspectives<br />Lasch: The Culture of Narcissism (1979)<br />Cultural criticism of contemporary American society as promoter of pathological narcissism<br />Erosion in allegiance to community; condoned individuality <br />Raskin: Narcissistic Personality Inventory (NPI, 1988)<br />Identified seven aspects of narcissism<br />Authority, Self-Sufficiency, Superiority <br />Exhibitionism, Exploitiveness<br />Vanity, Entitlement<br />How Narcissistic am I?<br />Quiz - NPI-40<br />3<br />
  4. 4. Socio-cultural Perspectives<br />“Generation Me”<br />“Today’s young Americans are more confident, assertive, <br />entitled.. . than ever before” (Twenge, 2006)<br />Narcissism Epidemic?<br />NPI-40 used to research trends in narcissism in America<br />Findings: “rampant rise of narcissism” in our society<br />Indictment of the “Self-esteem” movement of the 70’s propelled by California’s legislature "Self Esteem Task Force“<br />Met severe criticism, yet findings stand strong<br />Other cultural expressions: Honor Codes/killings?<br />4<br />
  5. 5. Organizational Psychology<br />Narcissistic Leaders<br />High Entitlement, Excessive Confidence, Fantasized Talent<br />Focused on “getting ahead”, risks excessively, berates employees, pursues personal agendas<br />“Emergent Leaders” (seek Self-Promotion)<br />Not necessarily “Effective Leaders” <br />Narcissism at the root of Managerial Derailment<br />What about the followers?<br />(Hogan, Robert, 2008)<br />5<br />
  6. 6. Narcissism in organizations<br />Gordon Gecko, “Wall Street”<br />‘If you want a friend, get a dog”<br />Gordon Gecko to Bud Fox in “Wall Street”<br />6<br />
  7. 7. Shut up, Listen and Learn!<br />“Swimmingwith sharks”, Ch. “Sweet & low”<br />7<br />
  8. 8. Pencils are more important<br />“Swimmingwith sharks”, Ch. “you are nothing”<br />8<br />
  9. 9. Narcissism as a Clinical Disorder<br />Term coined in psychology in 1898 by H. Ellis<br />Largely adopted by Freud and psychoanalysis<br />Appears in the DSM-III(1) in 1980<br />“Personality Disorder” is:<br />An inflexible, maladaptive, persisting pattern of behaviors<br />Causing significant functional impairment (in the world)<br />Or <br />Causing significant distress (subjectively)<br />(1) DSM: Diagnostic and Statistical Manual of Mental Disorders, now in its 4th Edition, TR (2000)<br />9<br />
  10. 10. Narcissistic Personality Disorder<br />DSM-IV TR Diagnostic Criteria<br />Pervasive pattern of grandiosity, need for admiration, lack of empathy; beginning in adulthood, indicated by five (+) of the following:<br />grandiose sense of self-importance<br />fantasies of unlimited success, power, beauty, etc.<br />believes he/she is "special"<br />requires excessive admiration<br />has a sense of entitlement<br />is interpersonally exploitative<br />lacks empathy<br />is often envious, or believes that others are envious of him<br />shows arrogant behaviors or attitudes<br />10<br />
  11. 11. Hack it, or Pack it! <br />The Great Santini, “failed score”<br />11<br />11<br />
  12. 12. Narcissism as a Clinical Disorder<br />Not all narcissists are created equal<br />Shedler’s Typology (1) <br />Grandiose/malignant<br />Fragile<br />High Functioning/Exhibitionistic<br />Other distinctive features<br />Emptiness, sense of “being false, fraudulent”<br />(1) Shedler et al, 2008. Refining the Construct of Narcissistic Personality Disorder: Diagnostic Criteria and Subtypes; (Am J Psychiatry 2008; 165:1473–1481)<br />12<br />
  13. 13. Faces of Pathological Narcissism<br />Abusive Partners Rapists<br />Celebrities Cult Leaders<br />Con Artists Stalkers <br />White Collar Criminals Gang Members<br />Moderate Narcissism<br />Overbearing/obnoxious /cruel parents, demanding or callous partners, inconsiderate coworkers, etc…. <br />13<br />
  14. 14. Empathy, Shame, Envy<br />Empathy <br />inner capacity of sharing and comprehending the psychological state of another person<br />Shame <br />painful social emotion caused by the experience of feeling inferior or losing value in the estimation of others <br />Envy <br />painful social emotion caused by the thought of another person having something that one does not have oneself<br />14<br />
  15. 15. Origins of Narcissism<br />No known link to genetics<br />Biological (neurophysiological paths) imprints in early childhood (1)<br />Origins ascribed to early attachment and parenting, resulting in specific pattern of affect regulation<br />(1) Schore, Allan (2009). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development <br />15<br />
  16. 16. Normal Human Development<br />Parental Attunement<br />Under normal circumstances, caregiver help child to handle intense or stressful affect<br />Development of empathy<br />Tolerance of shame<br />“Monkey see, monkey do” (mirror neurons; mimicry)<br />16<br />
  17. 17. Origins of Pathological Narcissism<br />Unattuned Parents cannot model affect regulation<br />Resulting in diminished capacity for empathy <br />Child is in some way “Special” to the parent<br />“Narcissistic children often occupy a pivotal point in the family structure, such as being ….the one that is supposed to fulfill family aspirations….”<br />Child raised in overtly well-organized home, but with parent(s) present a degree of callousness and subtle aggression<br />Child may have an inherent quality that arouses admiration or envy such as beauty, special talent, etc. ( I.e: Pageant Queen/Mother)<br />Kernberg, 1984. Severe personality disorders. New Haven: Yale University Press<br />17<br />
  18. 18. Paths to Pathological Narcissism<br />18<br />
  19. 19. Narcissistic Cognitions<br />Entitlement/Grandiosity<br />Emotional Deprivation<br />Defectiveness/Shame<br />Subjugation /Control<br />Approval Seeking<br />Insufficient Self-Control<br />Mistrust/Abuse<br />Unrelenting Standards<br />Underlying Assumptions (Schemas) <br />Young,  (1998). Schema-focused therapy for narcissistic patients.  In E. Ronningstam (Ed.), Disorders of narcissism: Diagnostic, clinical and empirical implications<br />19<br />
  20. 20. Extreme (Malignant) Narcissism<br />Charles Manson<br />20<br />
  21. 21. Pathological Narcissism: Origins<br />Manson's mother was a promiscuous heavy drinker whospent years in prison for robbery. Manson was placed at reform schools and relatives while she was away.<br />Manson did not know his biological father; his step-father was an alcoholic, abusive offender<br />His mother’s physical embrace of him when she returned from prison was, he reported, his sole happy childhood memory<br />21<br />
  22. 22. Children at Risk<br />Children of Narcissistic Parents<br />Abused Children<br />Overindulged, Overpraised, Wealthy Children<br />Adopted Children (chosen, yet abandoned)<br />Kernberg, P. (1998). In E. F. Ronningstam (Ed.), Disorders of narcissism.  Diagnostic, clinical, and empirical implications. Developmental aspects of normal and pathological narcissism<br />22<br />
  23. 23. Course and Prognosis<br />Room for improvement in certain cases<br />As a result of significant losses/personal costs, or<br />As a result of corrective emotional experiences (i.e., relationship, achievement) <br />In severe cases, symptoms may worsen over time, (i.e., mid life crisis, aging parents)<br />Narcissists do not typically seek help<br />(as they do not find fault in themselves)<br />Difficult to treat; may seek help because “mandated” by others<br />23<br />
  24. 24. Is there a Narcissist in my life?<br />Does the person act as if life revolves around him/her? <br />Do I have to compliment him/her to get his attention or approval? <br />Does he constantly steer the conversation back to himself?<br />Does she downplay my feelings or interests? <br />If I disagree, does he become cold, withholding or angry?<br />Do I feel belittled, manipulated, or feel I can’t please him/her?<br />If you answered “yes” to three or more questions, it is likely that this person’s narcissism is affecting your life<br />Adapted from Judith Orloff’s “Emotional Freedom” (Three Rivers Press, 2011) <br />24<br />
  25. 25. How to Relate to a Narcissist<br />DO-NOTS<br />Do not retaliate<br />Do not shame, belittle, “pay back”<br />Do not expect fairness or reciprocity<br />Do not isolate from friends, other family<br />Do not surrender to the narcissist’s attempts to control/disparage<br />25<br />
  26. 26. How to Relate to a Narcissist<br /> DO(s)<br />Know yourself <br /><ul><li>Identify your motives to stay in the relationship: desire to please? gain his/her regard? feel protected? bask in their power? Etc.
  27. 27. Identify your “hot buttons” and your problematic responses</li></ul>Know your own worth, independently of his/her valuation<br />Cultivate reciprocal, satisfying relationships<br />Be empathic, respectful, fair<br />Be mindful of his/her sensitivity to shame/humilliation<br />Practice self-control and patience<br />Use non-confrontational limit-setting<br />26<br />26<br />
  28. 28. How to Relate to a Narcissist<br />DO(s)<br />Set boundaries<br />Re-engineer the terms of the interactions<br />What you can do, what you won’t<br />Reinforce positive behavior (i.e., kindness, attentiveness)<br />Avoid criticism; Try to understand his/her mind frame<br />Agree with acceptable part of his/her statements, and add: “I wonder if…”, “how about…” “this could be of benefit for you”<br />Discourage negative behaviors (belittling, dominance)<br />27<br />27<br />
  29. 29. How to Relate to a Narcissist<br />DO(s)<br />Consider the costs (risk/benefit analysis) of staying in the relationship<br />Assess damages/severity of behaviors<br />If risk/damage is high, consider an exit plan<br />Avoid/Minimize contact<br />Seek external help<br />Build a support network<br />Be mindful of characteristic feelings of shame/guilt <br />28<br />28<br />
  30. 30. Recommended Readings<br />Ronningstan, E. Hotchkiss, S Behary, W. Twenge, J. <br />29<br />
  31. 31. More suggested readings<br />Neurobiology of Empathy ; Attachment Theory<br />Mirror neurons and the brain in the vat. ByV.S. Ramachandran, 1/10/2006<br />The mind’s mirror.(on mirror neurons and its relation to empathy) By L. Winerman, Monitor Staff, 10/2005, Vol 36, No. 9. American Psychological Association<br />Effects of a Secure Attachment Relationship on Right Brain Development, Affect Regulation and Infant Mental Health. A. N. Schore, in Infant Mental Health Journal 22, 1-2 (2001): 7-66<br />Narcissism in organizations and leadership<br />Leadership. By Hogan and Fico, 2009. Chapter to appear in W. K. Campbell & J. Miller (Eds.) The handbook of narcissism and narcissistic personality disorder. New York: Wiley, in press. <br />Cultural Aspects<br />What the Experts Are Saying Now . By K. Hymowitz, 8/25/2009,. A Review of the “self-esteem movement” as per new book, “Nurture Shock” by Po Bronson & Ashley Merryman<br />Best Weapons against Honor Killers: Shame.By Kwame A. Appiah. 9/25/2010. On the customs of honor codes (dueling, honor killings) and public dishonor. Listen to him also in “Talk of the Nation”, NPR<br />30<br />
  32. 32. CONTACT INFORMATION<br />Claudia Diez, PhD, ABPP<br />info@drclaudiadiez.com<br />For more information visit us at<br />http://www.drclaudiadiez.comhttp://www.slrpsych.org<br />

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