Living with someone who has narcissistic personality disorder

Narcissistic personality disorder is a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others.

Beneath this mask of extreme confidence lies a fragile self-esteem that is vulnerable to the slightest criticism

A narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial affairs. People with this disorder may be generally unhappy and disappointed when they are not given the special favours or admiration they believe they deserve. They may find their relationships unfulfilling, and others may not enjoy being around them.

The symptoms of narcissistic personality disorder and the severity of symptoms can vary considerably. The most common symptoms, however, include:

■ An exaggerated sense of self-importance and self-esteem.

■ An unrealistic sense of entitlement and require constant, excessive admiration.

■ An expectation to be recognised as superior even without achievements that warrant it. ■ An exaggeration of achievements and talents.

■ A preoccupation with fantasies about success, power, brilliance, beauty or the perfect mate.

■ A belief that they are superior and can only associate with equally special people.

■ Monopolising conversations and belittle or look down on people they perceive as inferior.

■ Expectation of special favours

and unquestioning compliance with their expectations.

■ They take advantage of others to get what they want.

■ They have an inability or unwillingness to recognise the needs and feelings of others; a lack of empathy.

■ They are envious of others and believe others envy them.

■ They behave in an arrogant or haughty manner, appearing to be conceited, boastful and pretentious.

■ They must have the best of everything, for example, the best car or office.

At the same time, people with narcissistic personality disorder have trouble handling anything they perceive as criticism, and they can:

■ Become impatient or angry when they do not not receive special treatment.

■ Have significant interpersonal problems and easily feel slighted.

■ React with rage or contempt and try to belittle the other person in order to make themselves appear superior.

■ Have difficulty regulating emotions and behaviour.

■ Experience major problems dealing with stress and adapting to change.

■ Feel depressed and moody because they fall short of perfection.

■ Have secret feelings of insecurity, shame, vulnerability and humiliation.

People with narcissistic personality disorder may not want to think that anything could be wrong, so they may be unlikely to seek treatment. If they do seek treatment, it is more likely to be for symptoms of depression, drug or alcohol use, or another mental health problem. Due to perceived insults to self-esteem, they may make it difficult to accept and follow through with treatment.

Narcissism results in a very brittle personality, built on delusion

Those who recognise aspects of their personality that are common to narcissistic personality disorder or feel overwhelmed by sadness, should consider reaching out to a trusted doctor or psychotherapist. Getting the right treatment can help make life more rewarding and enjoyable.

It is not known what causes narcissistic personality disorder. As with personality development and with other mental health disorders, the cause is likely to be complex, but most often linked to the person’s environment, such as mismatches in parent-child relationships with either excessive adoration or excessive criticism that is poorly attuned to the child's experience. Parenting styles that are overprotective or neglectful may have an impact.

Narcissistic personality disorder affects more males than females, and it often begins in the teens or early adulthood. Although some children may show traits of narcissism, this may simply be typical of their age and does not mean they will go on to develop the disorder.

Living with someone that has this disorder depends of the severity of the condition.

Minor conditions can be lived with but when the disorder is more severe, a partner or spouse can be in for a difficult relationship. It must be stressed, however, that if partners have met each other while in their early twenties, it is probable that the condition is already existing and the partner has taken on the person knowing what they are like. There is no reason to believe that the condition will worsen; in most cases, life teaches people with the disorder to expect less. The problem is when a partner enables the narcissist to believe their delusion. They do this by pandering to the person’s desires and beliefs, thereby confirming their existing expectations. Life can then be very hard for the narcissist and for the partner.

It is common for narcissists to have a long series of failed relationships as each successive partner discovers how they behave and cannot live with the person. The relationships fail with the narcissist believing that their partners were not good enough.

One of the problems is when new partners meet a narcissist. They are unaware of the disorder and initially believe the person, the delusions and unrealistic ambitions. They are taken in and only later discover the truth. They often feel a need to try to help the person, but that just makes the relationship worse. The narcissist does not want reality; their need is to remain in their fantasy world and expect the world to provide their needs.

Narcissists are fragile characters

Treatment for narcissistic personality disorder centres around psychotherapy. Treatment can be very difficult because the person will believe that everyone else has the problem and they have none. Coming to terms with reality can be very painful, their ego can collapse and must be managed with care. Living with a narcissist can be challenging, with unrealistic beliefs and expectations followed by failures that are blamed on everyone else. Though initially, the narcissist can be very attractive, charming and exciting, when reality comes calling, the disappointment can be devastating.