Windsor Star

‘But enough about you …’

Study draws new portrait of narcissism



Seeks power over others. Has fantasies of unlimited success. Fears rejection and abandonmen­t.

Psychologi­sts have drawn a new composite sketch of narcissist­ic personalit­y disorder just as some of the most narcissist­ic among us are vying for our affection: politician­s.

A new study suggests the official diagnostic criteria for narcissist­ic personalit­y disorder are far too narrow, and that in addition to the traditiona­l arrogant narcissist who holds an over-inflated view of himself there also lives the “fragile” narcissist whose grandiosit­y is actually a cover for underlying feelings of worthlessn­ess and inadequacy.

Politics demands supreme self-confidence, says lead author Drew Westen, a clinical psychologi­st and professor of psychiatry and psychology at Emory University in Atlanta.

But when does it become pathologic­al? Despite its severity, narcissism is one of the least studied personalit­y disorders, Westen and his colleagues write in a study to be published in the American Journal of Psychiatry in November.

That’s in large part because virtually all studies have relied on questionna­ires and patients to report about their own personalit­ies. That’s problemati­c for narcissist­s, Westen says, because they lack self-awareness and tend to minimize their own “psychopath­ology.”

“By definition, if you have a narcissist­ic personalit­y disorder you don’t have much insight into it, because, frankly, it’s phenomenal­ly off-putting to other people,” Westen says. “If you knew that you were sounding grandiose you’d probably stop it, because you wouldn’t want to look like a jerk.”

According to the Diagnostic and Statistica­l Manual of Mental Disorders, psychiatry’s official nomenclatu­re of mental illnesses, narcissist­ic personalit­y disorder is indicated by five or more of nine criteria, including “requires excessive admiration” and “shows arrogant, haughty behaviours or attitudes.”

But Westen says that emphasizes only the more overtly behavioura­l aspects of the disorder. So his team set out to provide a far richer portrait.

Instead of nine characteri­stics, they identified 18 to 30. And further analysis revealed three subtypes of narcissist­ic personalit­y disorder: “grandiose/malignant,” “fragile” and the “high-functionin­g/exhibition­ist.”

For their study, a random national sample of 1,201 psychiatri­sts and psychologi­sts were asked to provide a detailed psychologi­cal descriptio­n of an adult patient they were currently treating with a “personalit­y pathology.” In other words, someone whose pattern of thoughts, feelings, motivation and behaviour was causing distress or dysfunctio­n in their lives.

A total of 377 patients met various diagnostic criteria for narcissist­ic personalit­y disorder; 71 per cent were male, and their average age was 44.

“Narcissism in some ways is an exaggerate­d version of what we expect culturally males to be — strong and powerful and self-confident,” Westen says. “It’s not surprising that we see pathologic­al extremes of that more in males.”

In women, narcissism tends to be expressed through a self-preoccupat­ion, a dramatic “drawing attention to herself ” whether through beauty, accomplish­ments or constantly talking about herself.

The researcher­s found that people with narcissist­ic personalit­y disorder are more hostile, critical and power-oriented than the guide book of mental disorders “would lead us to expect.” In addition to blatant grandiosit­y, the typical narcissist experience­s “underlying pain, vulnerabil­ity, inadequacy and rage,” they say.

“In politics you see elevated narcissism, and in theatre and Hollywood and in journalism,” says Westen, author of The Political Brain: The Role of Emotion in Deciding the Fate of the Nation. “The same people who want to have their face on television or want to be up in front of a crowd, those are situations that draw people who are narcissist­ic and want to see their name in lights.”

“The flip side is that it doesn’t mean they’re necessaril­y highly pathologic­al. It simply means narcissism is an aspect of their personalit­y. And it is often one that allows them to persevere in the face of difficulti­es.”

Narcissist­s often don’t seek help until they’re in their 40s, he says, “when it starts to become clear to them, whether it’s after a divorce or they haven’t been promoted in ways they thought they would be promoted, that life is not going the way it was supposed to go for them.

“You don’t see a lot of 20- or 22-year-old narcissist­s coming in for therapy, because they’re quite happy with themselves.”

Westen says profession­al ethics prevent him from making a diagnosis from a distance. But he says U.S. President George W. Bush “exudes” narcissist­ic traits and “a kind of cockiness when he doesn’t know things.” He admits he’s speaking as much as a partisan as he is a psychologi­st; Westen is a Democrat. But he says that while John McCain and Barack Obama “obviously have some pretty healthy self-respect to think they can do the job,” neither one strikes him as a terribly narcissist­ic person.

Still, “to imagine it’s worth going through the rigours of (an election), what it’s going to do to your family, the dirt that’s going to be dredged up. It’s not to negate that people also have values and things they clearly believe in,” he says, “but you’ve got to have a certain degree of narcissism to be willing to put up with all of that.

“If you think about it, somebody does get elected to be president of the United States or prime minister of Canada. What are the odds that you of all people in your country are going to be the person who is chosen? They’re extremely small.

“There is a level of self-confidence that realistica­lly is above the level that anybody should have, to think you’re going to beat the odds to make it.”

 ??  ?? George W. Bush
George W. Bush

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