Narcissistic personality type: healthy narcissism or "radio self"? Often humiliates, intimidates, poisons and belittles others. How Narcissistic Personality Disorder Occurs. Methods of diagnosis and treatment

Narcissism is a mental disorder that is expressed in a person's inflated self-esteem, complacency and narcissism. Such pathological love self expressed in close attention to own person, while a person cannot control his ambitions, strives for wealth and external attractiveness, infantilism is manifested in manners and actions.

A bit of history

The term "narcissism" comes from the name of the ancient Greek mythological hero Narcissus. The young man was incredibly handsome: the narcissistic hero rejected the love of the nymph Echo, for which he was punished. ancient greek gods sentenced Narcissus to lifelong admiration of his face through the reflection on the water surface.

According to Sigmund Freud, narcissism is a manifestation of specific intimate behavior. Many children on early stages life show a narcissistic feeling, admire themselves. At the same time, if the personality of the child develops harmoniously and correctly, and the parents participate in the full-fledged upbringing of the child, such narcissism does not bring any harm and disappears on its own as it grows older. In the process of creating the methodology of psychoanalysis, Freud finally introduced the concept of narcissism into psychiatric practice.

Narcissistic personality disorder and its causes

This mental disorder can be various reasons. When examining the brains of patients, scientists found a thickening of the cortex and an altered structure of some nerve cells. Deviations affect the part of the brain that is responsible for the feeling of compassion.

According to experts, the feeling of empathy depends on the concentration of gray matter: in narcissists, its amount is significantly less than in healthy people.

Narcissism is a mental illness that occurs for the following reasons:

1. Low self-esteem in childhood. At the same time, such features of behavior can be laid by the parents or the environment of a person, constant reproaches and censures provoke the emergence of protective mechanisms.
2. No parental restrictions childhood, excessive praise and idealization of the child's personality by parents.
3. Permissiveness, in which the child does not understand what he can do and what is forbidden to him.

Please note that certain features of narcissism often appear during puberty, but this does not mean that such a phenomenon will develop into a mental disorder.

Some theorists believe that narcissism is a pathology that is also hereditary. An important role is played by the presence of an idol in a teenager. In some cases, this phenomenon is associated with a more serious mental illness(for example, with schizophrenia), in this case the patient completely loses touch with reality, considers himself a messenger of a deity or another idol.

Signs of Narcissism

Below are the symptoms of this disease, on the basis of which the psychiatrist makes a diagnosis.

1. An exaggerated sense of self-importance.
2. Constantly emerging fantasies of overwhelming success and fame, incredible wealth.
3. Conviction in one's own uniqueness, the desire to communicate with people only with a high social position.
4. Demanding admiration and reverence from other people.
5. Arrogant and ambitious (some narcissists make mean and cynical jokes about other people).
6. Lack of empathy and compassion.
7. Negative attitude towards criticism.
8. Inflated self-esteem is just a mask for other people; deep down, such patients are weak personalities with many psychological complexes.
9. Careful disguise of their own shortcomings.
10. Using other people for your own benefit.

All people who suffer from this disease try to protect themselves from envious feelings towards others, so they are often not interested in their personal lives and professional activity their friends and acquaintances. A sick person often expresses uncertainty in his opinion: at first he perceives this or that person as an idol or idol, and then expresses contempt for her and considers this or that person unreasonable.

Narcissists are people who are addicted to praise, very often they do not react in any way, do not respond with gratitude when they hear compliments. In most cases, patients show no interest in generally accepted values ​​(moral or aesthetic).

Narcissism in women and men: features and main differences

The psychology of narcissism in men is deep, and the reasons lie in child education. Moreover, this disease is most often found in the representatives of the stronger sex. Male patients are trying with all their might to achieve their own significance in the eyes of society. By all means they achieve career growth and a high financial position. When the desired goal is achieved, the patient's joy from the received lasts only a few minutes, after which their needs increase again, and they begin to want more.

Before reaching adulthood, growing goals and needs do not disturb the patient, he gradually realizes certain tasks and sees no reason to worry. Later, however, the narcissist begins to realize that he never achieved happiness. Men with this diagnosis are not able to build full-fledged relationships with people, they destroy families, while the children of the narcissist also begin to suffer from negative impact father.

As for female narcissism, it is expressed in the inability to understand your child, the inability to rejoice simple things and consequently dissatisfaction. own life. Patients force their children to study day and night, to receive only excellent grades, conflicts often occur against the background of the fact that the child did not live up to the expectations of his mother.

Personal inter-gender relationships also suffer from female narcissism: patients choose exclusively caring and attentive men as partners, but they themselves do not respect them, because they consider them weak-willed and do not care for anything. capable people. If in a couple both people have signs of narcissism, a relentless struggle of characters begins: these people will compete with each other in absolutely everything, while such a tense relationship is unlikely to last long.

Features of diagnostics

It is possible to determine such a pathology already during a personal conversation with the patient. The format of the conversation in the form of an interview is best suited for these purposes. Based on the results of the survey, points are given, on the basis of which the psychiatrist determines whether the patient has a serious personality disorder or a borderline condition, which is expressed in high self-esteem.

Among the questions are the following:

1. Why do you think you deserve close attention and special treatment of your person?
2. In your opinion, who might deserve your attention, and why exactly?
3. What kind of people are you willing to sacrifice your free time for?
4. Is it important for you to spend time exclusively with influential people with a high social position?

At the same time, it is important to distinguish narcissism from the usual inflated self-esteem, as well as from the symptoms of other diseases (for example, from schizophrenia).

Why is narcissism dangerous? If the correction of the individual's behavior is not started in a timely manner, the mental disorder may progress. As a result, the patient will be unable to maintain social ties and engage in professional activities, gradually moving away from social life, which leads to the development of other mental disorders. In some cases, aggression and psychosis appear, the patient ceases to control his behavior. Treatment in such situations is possible only in a hospital.

Disease testing

In modern psychiatry there are several effective methodologies aimed at identifying narcissism. One of these methods includes a special questionnaire, which includes 163 questions. different nature. When studying the answers to them, the specialist studies the so-called Likert scale.

The patient must express the degree of his approval or the degree of disagreement with a particular statement. As a result, the psychiatrist calculates the coefficient of narcissism. It is worth noting that this technique also has contraindications: for example, it cannot and is not advisable to use during a period of severe depression or acute psychosis.

How to treat narcissism?

Treatment of this mental disorder is ineffective at home. If signs of such a disease appear, it is necessary to contact a psychotherapist who will conduct necessary diagnostics and appoint effective therapy to normalize self-esteem.

At the same time, doctors are not recommended to show weakness in the presence of the patient, since he can take advantage of the uncertainty of the specialist and exert his influence on the course of therapy, as well as pressure on the medical staff. At the same time, the psychiatrist must treat the patient with respect, so that the patient cannot constantly demonstrate a sense of self-importance.

The treatment of narcissism in men and women includes individual psychotherapeutic techniques. During psychotherapy, the specialist must refrain from excessive criticism of the patient, otherwise his self-esteem will be further violated. You should not show a feeling of pity and sympathy: such a person may simply not understand the compassion of a doctor.

It is worth noting that not all patients are aware of their problem, so the specialist needs to act very carefully and first identify exactly what signs this disease has (it is best to do this using the example of other narcissistic people).

Of no small importance is group psychotherapy, during which the patient develops a healthy and adequate personality (rather than pathological narcissism): regular group conversations with the right bias will allow the patient to get rid of inflated self-esteem, begin to correctly understand other people and consider them full-fledged personalities.

In some cases, therapy also includes medication. The patient may be prescribed psychotropic drugs to eliminate increased excitability and anxiety (if such symptoms are present). If the patient has depressive conditions associated with deep psychological complexes, a course of antidepressants is prescribed. All these drugs are prescribed only by the attending physician. If the treatment is in stationary conditions, there should be control of medical personnel over the intake of medicines. Medicines are prescribed in strictly defined dosages, since they have many side effects.

Only in severe cases therapy is carried out in stationary conditions. As his well-being improves, the patient can be treated on an outpatient basis, that is, at home with regular visits to a specialist for psychotherapy sessions. The exact duration of such sessions and their number are determined on an individual basis, depending on the specifics of the mental disorder. Often it is not possible to completely get rid of the manifestations of narcissism and inflated self-esteem, however, with the help of complex therapy it is possible to correct the patient's judgments and personal characteristics, help him begin to fully communicate with other people, establish family and friendship ties with a minimum of conflict situations.

Preventive measures

How to act so that the child grows up as a full-fledged personality with adequate self-esteem? The following preventive measures will help prevent the development of narcissism:

1. During puberty, children are especially vulnerable, prone to excessive shyness and psychological complexes. In order for the growing personality to fully develop, it is important to maintain in the child a sense of dignity and independence from the opinions of others.
2. Children often cry, expressing their dissatisfaction with something. Let the child do this, because that is how he will understand that not all needs can be met immediately. It is important to firmly refuse the child if he makes high demands and is capricious (of course, this does not apply to natural needs).
3. It is better to confess your love to your child more often, while not focusing on his beauty. Otherwise, the personality will form unpleasant feeling vanity.
4. Praise a child for really worthy things is normal phenomenon. However, too frequent and exaggerated praise is guaranteed to lead to further narcissism.
5. Don't brag about positive qualities and the actions of a son or daughter in his presence, it is better to do this when he does not hear.
6. You don't have to practice the good and bad parenting technique. Such an imbalance will upset the child's value system, causing him to not distinguish between positive and negative actions.
7. The child must understand that he will have to live in society, while society should not live for him.

Thus, narcissism is a personality disorder that is expressed in excessively inflated ambitions, a tendency to narcissism and a lack of compassion. In most cases, this disease develops in childhood and adolescence, as a result of which already an adult remains infantile and unable to maintain normal social ties. Treatment of such a mental disorder is carried out under the supervision of professional psychotherapists, treatment is provided both in inpatient and outpatient settings.

Alexander the Great, Napoleon, Adolf Hitler, Madonna, Kim Kardashian, Kanye West and finally Donald Trump... What do all these people have in common? That they are considered the most famous daffodils of the past and present.

narcissism- this is a property of character, which consists in excessive narcissism and inflated self-esteem, in most cases not corresponding to reality.

In any field, climbing to the top requires incredible self-confidence and belief in your own strength. But at what point does this confidence grow into narcissism? In modern psychology, the term "narcissism" can describe three of its various shapes.

The most famous is the so-called grandiose type narcissism. Such a narcissist is usually a person with a strong inflated conceit, arrogant or charismatic type, perhaps an extrovert, manipulator, using other people.

Narcissist Manipulation and More: 20 Dirty Ways Narcissists, Sociopaths and Psychopaths Manipulate Us. - Ed.

If you imagine a classic narcissist, for example, an actor or a politician, then this is most likely to be a narcissistic personality of the "grand" type.

Another form of narcissism, much less well known, is "vulnerable" narcissism. Such people also feel that everyone owes them, and they are also fixated on themselves, but on top of that they are vulnerable and shy. They may experience anxiety and low self-esteem, as well as being extremely sensitive to criticism. These covert narcissists are very difficult to spot. Although they crave attention, they are too afraid to go out in public.

Both of these types of narcissism are character traits, that is, they are present in " healthy doses"in each of us. But when manifestations of narcissism are so prevalent in a person that they become an obstacle for her at work, in relationships with other people, and she cannot control it in any way, this can develop into a diagnosis - narcissistic personality disorder.

Popular in the section personal experience A: I have a narcissistic mother. How to overcome the toxic influence of parents. - Ed.

narcissistic personality disorder is a personality disorder in which there is a long-term pattern abnormal behavior, characterized by an exaggerated sense of self-importance, an excessive need for admiration and a lack of understanding of other people's feelings. In Russia, unlike the United States, such a diagnosis is not made. in use in our country International classification diseases (ICD-10) it is absent.

Most likely to a person who demonstrates obvious deviations from social norms will be diagnosed with F60.8 - Other specific personality disorders.

According to Western statistics, about 1% of the population suffers from narcissistic personality disorder, and more men than women. Its causes are not completely known, but it has been established that in some cases the disorder may be hereditary. Narcissistic disorder often co-occurs with other mental disorders, in particular with depression, bipolar disorder, anorexia, and substance abuse.

People with narcissistic personality disorder have been found to have less gray matter in the left anterior sheath, the part of the brain responsible for empathy, emotional regulation, compassion, and cognition.

If you have a narcissistic personality disorder, then it probably affects your everyday life...negatively. It is possible that you are dissatisfied with life in general and are upset when others do not admire you or do not give you special attention. Your work, personal life, and relationships with other people are also likely to suffer, however, you do not see your own role in this. People with narcissistic personality disorder are rarely able to recognize devastating consequences that their behavior has on themselves and on others.

The concept of narcissistic personality disorder (NPD), as defined in DSM III and DSM-III-R(Table 11.1) is primarily based on psychoanalytic case literature (Akhtar & Thomson, 1982; Frances, 1985). As with other personality disorders, the assessment of the presence or absence of diagnostic criteria for clinical narcissism is highly subjective and is based on various assumptions (Stangl, Pfohl, Zimmerman, Bowers, & Corenthal, 1985; Widiger & Frances, 1985; APA, 1980, p. 7). Diagnostic reliability for this personality disorder is low (Spitzer, Forman, & Nee, 1979). Improving diagnostic reliability and demonstrating conceptual validity requires a more representative set of independent, observable behaviors, along with defined criteria for the chronic nature of the disorder and association between situations, and possibly a measure of case prototypicality (Widiger & Frances, 1985). Research that aims to isolate complex behaviors associated with particular traits (eg Buss & Craik, 1983; Livesley, 1986) is promising. The cognitive focus of research may also contribute to the specification of observable features of narcissism.

Table 11.1. Diagnostic criteria for narcissistic personality disorder according toDSM-III-R

A pervasive pattern of grandiosity (whether in fantasy or behavior), lack of empathy, and hypersensitivity to the judgments of others, beginning in early adulthood and existing in different contexts, as indicated by at least five of the following signs:

1) reacts to criticism with anger, shame or humiliation (even if these feelings are not expressed);

2) prone to exploitation in interpersonal relationships: uses others to achieve their own goals;

3) has an exaggerated sense of self-importance, for example, exaggerates achievements and talents, expects a “special” attitude towards himself without corresponding achievements;

4) believes that his problems are unique and can only be understood by certain people;

5) preoccupied with fantasies of unlimited success, power, splendor, beauty, or ideal love;

6) feels like having special rights: unreasonably expects especially good treatment, for example, believes that he should not wait in line like others;

7) requires constant attention and admiration, for example, constantly asking for compliments;

8) lack of empathy: inability to understand and experience the feelings of others, for example, annoyed and surprised when a seriously ill friend cancels an appointment;

9) preoccupied with feelings of envy.

Note. From The Diagnostic and Statistical Classification Manual of Mental Disorders (3rd ed., rev.), ( Diagnostic and Statistical Manual of Mental Disorders(3rd ed., rev.). American Psychiatric Association, 1987, Washington, DC: Author, p. 351). ©1987, American Psychiatric Association. Reproduced with permission. Historical review.The development of psychoanalytic ideas.

The term "narcissism" comes from the classic Greek myth of Narcissus, a young man who fell in love with his reflection in the water. His fate was such that he died out of unsatisfied desire and turned into a narcissus flower. The first reference to this myth in the psychological literature came from Havelock Ellis (Ellis, 1898), who described the masturbatory or "autoerotic" practice of a young man.

Freud subsequently included the term "narcissistic" in his early theoretical essays on psychosexual development (Freud, 1905/1953) and later developed the idea of ​​narcissism as a distinct psychological process (Freud, 1914/1957). He interpreted narcissism as a stage normal development which follows the autoerotic stage and eventually develops into object love. Fickle, unreliable guardians in early age or parents who value their child too much were seen as the main obstacles to the development of object love, causing fixation at the narcissistic stage of development. Narcissistic personalities were considered incapable of forming lasting attachments due to fixation on the self-infatuation stage.

Subsequently, psychoanalytic theorists focused on the interpersonal aspects of narcissism, and the concept of the "narcissistic personality" began to emerge (for example: Waelder, 1925). Akhtar and Thomson (1982) point to controversy as to whether narcissism is a component of neurosis, psychosis, or character disorder. In the research of the current generation of object relations theorists, narcissism is viewed as a personality or character disorder. Among them, the works of Kernberg (Kernberg, 1967, 1970) and Kohut (Kohut, 1966, 1971) stand out.

Kernberg sees the narcissistic personality's sense of grandiosity and exploitative tendencies as evidence of "oral anger," which is a pathological process in libidinal (psychosexual) development. This is presumably due to emotional deprivation caused by the mother's chronic indifference or secret malice. At the same time, some unique talent or role gives the child a sense of being special, which in turn becomes an emotional safety valve in a world of indifference or danger. A sense of grandiosity or special entitlement is necessary to hide the "split" "true self" or awareness of the real circumstances. The true self is believed to contain strong but largely unconscious feelings of envy, fear, deprivation, and anger. Since, according to Kernberg's theory, a sense of grandiosity develops as a result of a pathological process, his approach to treatment requires the identification and interpretation of unconscious conflicts in order to restore intrapsychic structures damaged as a result of developmental delay.

Kohut, on the other hand, sees narcissism as a form of normal libido development, not as pathological deviation during the development of libido. In Kohut's theory, pathological narcissism is the result of a developmental delay that occurs when such important personality structures as the "grand self" and the "idealized parent image" are not properly integrated. It occurs as a result of traumatic disappointment caused by a mother who was not assertive enough in her emotional reactions to the child, or, conversely, did not allow the child to appreciate her real limits. Thus, the archaic sense of grandiosity and the idealized parental image are separated and become the cause of repeated subconsciously motivated attempts to realize them. Kohut's approach to treatment requires a compassionate psychotherapist who works to solve developmental problems by reducing the patient's sense of grandiosity and accepting the frustration that comes with realizing that idealized people have realistic limits.

Other psychoanalytic writings describe in detail the various emotional and behavioral manifestations of clinical narcissism (eg Bursten, 1973; Modell, 1976; Svrakic, 1985). Some of them contain observations that are relevant to cognitive-oriented psychotherapy. Bach (Bach, 1977), for example, considers a "narcissistic state of mind" that is associated with a variety of cognitive distortions. These include the dominance of a self-oriented perception of reality and a tendency to over-stimulate oneself. The speech and thinking of the narcissistic personality fluctuate between extreme forms of the abstract and the concrete. Narcissistic personalities are difficult to engage in the learning process because of their emotional reactions to the lack of certain knowledge. To regulate their mood, narcissistic personalities usually rely on certain external circumstances, such as frequent praise or attention from others. Time, place, and causality are also interpreted in a personal rather than an interpersonal context. Horowitz (1975) pointed to a defective style of information processing, consisting in too great attention to sources of praise and criticism, which leads to the emergence of incompatible psychological attitudes. These attitudes obviously contribute to the formation of a subjective feeling of insecurity and a need for approval.

Thus, the theme of self-love and self-indulgence has evolved from an explanation of masturbation to a description of a wide range of character disorders, united under the name "narcissism". The psychoanalytic literature on narcissism describes in detail the phenomenology of this disorder. But the psychoanalytic theory of the etiology of narcissism seems to be limited by an overemphasis on the alleged inadequacy of the mother's emotional responses.

It is important to note that there is no empirical evidence that unequivocally links childhood neglect with characteristics of narcissism in adulthood. Studies of early parental deprivation in animals and humans indicate the development in such cases of emotional apathy, withdrawal, inappropriate social behavior (Harlow, 1959; Provence, & Lipton, 1962; Yarrow, 1961) and developmental delay syndrome, which also has been termed "growth impossibility" (Cupoldi, Hallock, & Barnes, 1980; Gagan, Cupoldi, & Watkins, 1984; Oates, Peacock, & Forest, 1985). These disorders are incompatible with the exploitative nature of narcissistic individuals, their sense of grandiosity, and the need for constant admiration.

Studies of personality adaptation in adulthood in people deprived of parental care in childhood have not been conducted at all. In one recent longitudinal study of 456 men prone to delinquent behavior in youth (Vaillant & Drake, 1985), it was reported that the "immature defense mechanisms" associated with personality disorders in adulthood were independent of the individual's childhood in terms of clinical assessments. home environment and belonging to a “problem family”. Thus, psychoanalytic assumptions about the etiology of narcissism do not find any direct empirical support, apart from descriptions of individual cases. Indeed, relevant studies appear to refute the assumptions about the causal role of maternal inappropriate behavior.

The possibility of distortions related to the sex of the studied sample should also be noted as a factor influencing the psychoanalytic theory of the etiology of narcissism. Existing observations have been made on male patients (Akhtar & Thomson, 1982) and mostly by male investigators. Akhtar and Thomson suggest that perhaps men are somehow especially vulnerable to narcissism. A full exploration of narcissism is probably hampered by a lack of understanding of traditional theoretical assumptions and their uncritical acceptance. For example, mothers continue to be held responsible for the development of narcissism. One recently published psychoanalytic work puts forward the idea that the future narcissistic personality is born as a replacement for the mother of the significant other after his death; she thus regards the child as "special," but unreacted sadness renders her maternal care inadequate (Volkan, 1981).

Blaming the mother is a serious and widespread problem that certainly influences the professional clinical literature (Caplan & Hall-McCorquodale, 1985). It has become clear in research on deprivation that it is more appropriate to study deprivation of parental rather than maternal care, and that lack of maternal support and care is an important aspect of this problem (Gagan et al., 1984). Thus, the psychoanalytic theory of narcissistic personality disorder can be influenced by the gender of the researcher and the subject of study, as well as underlying assumptions about causes. Alternative approaches need to be developed that take into account such influences. Application of social learning theory.

Millon's (1969) treatment of narcissism in terms of social learning theory is not related to the maternal deprivation hypothesis and focuses primarily on the overestimation of the child by parents. According to Millon, when parents react to a child in this way, it overdevelops the child's sense of self-worth, and the child's internal self-image grows to such an extent that he cannot find confirmation in external reality. This exaggerated image of the "I" is the basis for the development of a narcissistic personality style. Parents (not only mother) still play a major role. But their impact is related to the information they give the child directly - through feedback, and indirectly - through modeling. The considered intrapsychic structures are limited by the image of the "I" of the child. Cognitive comprehension.

Cognitive theory can extend social learning theory to narcissism. Using the concept of the cognitive triad formulated by Beck, Rush, Shaw & Emery (Beck, Rush, Shaw & Emery, 1979), we propose that NPD develops as a result of a combination of dysfunctional schemas of self, world, and future. The groundwork for these schemas is laid early in life through direct and indirect influences from parents, siblings, and significant others, as well as experiences that build a belief in one's own uniqueness and worth. The cumulative result of these influences is a multitude of distorted beliefs that are difficult to overcome and highly active. Narcissistic personalities see themselves as special, exceptional, and entitled to claim rewards; they expect admiration, respect, and approval from others, and their expectations for the future are centered on the fulfillment of grandiose fantasies. At the same time, they noticeably lack convictions about the importance of other people's feelings. Their behavior is influenced by a lack of cooperation and social interaction, as well as an excess of demands on others, self-indulgence and sometimes aggressive behavior.

A sense of one's own uniqueness, importance, and difference from others can develop as a result of a variety of experiences. Obviously, emphasizing flattery, condescension, and favoritism can contribute to the development of narcissism. A belief in one's own uniqueness can also develop as a result of experienced deficits, limitations, or rejection. Some examples of such experiences might include parental abuse, parental treatment as weak or sickly, or community treatment of the entire family as "different" based on ethnic, geographic, racial, or economic status. This self-image based on rejection or deficits is similar to the pattern of narcissism, which Francis (Frances, 1985) considers a more subtle form, characterized by feelings of inferiority, envy, fantasy proneness, and attachment to powerful others. The common denominator for lower and higher beliefs about oneself may simply be the perception of oneself as being different from others in some important way. This difference can then be associated with too intense emotional reactions, as it is considered wonderful or terrible.

The actual presence of a talent or physical feature that is valued (or not valued) in a given culture will elicit social reactions that reinforce the "superiority/importance" schema. Feedback that would change such a scheme may be absent or distorted. For example, narcissistic personalities may receive very little feedback about their similarities with other people. Parents may also systematically deny or distort negative feedback given to their child from outside. Isolation from negative feedback provokes hypersensitivity to evaluation, which is characteristic of narcissistic personalities. Conversely, in a more subtle way, constant negative feedback can cause experiences that support extreme, catastrophic reactions to perceived criticism and hypervigilance to other people's attention. Problems arise mainly when these schemas of the self become overly active and are not balanced by more integrative judgments.

Cognitive assessment.General clinical context.

Narcissistic people usually seek treatment when they develop an embarrassing Axis I disorder or when they face some serious relationship problem. The main reason narcissistic patients seek treatment is depression. The following forms of depressive disorder are characteristic of narcissistic personalities: adjustment disorder with depressive mood, dysthymic disorder, and sometimes major depression. Narcissistic people do not tolerate discomfort well, so they usually seek treatment for their depression. But the more severe the depression, the more difficult it is to accurately assess the presence of a personality disorder.

Factors contributing to the development of depression often include some kind of relationship problem or breakup, trouble at work, or some kind of crisis in which the sense of grandiosity is stifled as a result of disappointment or insult. Sometimes for certain time unfulfilled grandiose expectations accumulate, and this leads to dysphoric conclusions that big dreams will never come true. A sense of grandiosity and uniqueness can continue to be expressed through the emphasis on the exclusivity of despair.

Narcissistic depression usually involves a discrepancy between expectations/fantasies and reality. Automatic thoughts reflect a constant focus on the unfulfilled expectations, shortcomings and inferiority of others and the uniqueness of the patient's problems. There may be a sense of doubt that things will ever go "really well", as well as avoidance of pleasurable activities and contacts. The narcissistic patient may also feel humiliated by being depressed.

A narcissistic patient may also seek treatment for other than depression, symptomatic disorders or problem behaviors. Significant others may get tired of tormenting themselves with a narcissistic personality and may give such a person an ultimatum that will force him to resort to psychotherapy. Occasionally, narcissistic individuals may seek treatment to relieve the discomfort caused by a symptomatic disorder other than depression. Such disorders typically include social phobias, hypochondria and stimulant substance abuse. Hypersensitivity to evaluation by others can manifest itself in the form of social phobia. Excessive preoccupation with perceived shortcomings in appearance contributes to phobic behavior because people are both seeking attention and fearing judgment.

In the case of hypochondria, excessive self-interest turns into a focus on protecting your body and satisfying physical needs. This provides a socially acceptable way to spend time and energy on oneself and allows for the classic secondary benefit of the attention and empathy of others. Physical vulnerability is the basis for the need for special treatment and an explanation of why reality cannot match imagined abilities. Illness, or potential illness, provides an acceptable explanation for why things are not as "could be".

Substance abuse may develop as part of a general narcissistic pattern of self-indulgence and self-indulgence. Drugs such as cocaine, which are a sign of "high status", are also particularly attractive to narcissistic personalities. Immediate relief from discomfort and a sense of self-worth and power can sometimes be achieved with the help of chemicals. The unconscious tension caused by hypersensitivity to judgment can be easily relieved with a little alcohol or pills. Belief in their own uniqueness prevents narcissistic individuals from admitting their dependence on alcohol or drugs. It also makes them think that they will avoid the negative effects of the addiction and can easily stop using these drugs.

In some cases, paranoid tendencies may develop in the thinking of narcissistic patients. At the same time, the “me against the world” attitude prevails, since narcissistic personalities perceive other people as envious of their special talents and therefore ready to “get to them” or somehow humiliate them. Information that contradicts the grandiose fantasies of narcissistic personalities can cause intense anger, verbal or physical aggression towards other people, and active actions aimed at self-defense. In extreme cases where reality checks are not available, paranoid narcissists may violently attack people they perceive as a threat to their superiority.

An example of this is the following tragic case. The person who was later diagnosed with NPD went through a series of stresses that caused various difficulties and isolation from others. He was divorced from his wife, but retained custody of four young children, two of whom bore his last name. He had problems at work. He had financial difficulties, which ended with the seizure of furniture for non-payment. He worked at night and took care of the children during the day.

The man's ex-wife, he says, called him several times, taunting him with stories about her new friend's sexual virtues and material wealth, such as his new gun. The man became increasingly irritated and worried at the thought that this friend “had a bigger gun than I had” and that the wife and her friend conspired to steal the children one weekend. To prevent this, he bought a rifle from a discount store and planned to kill his ex-wife and her friend. On the day he was about to do so, he "took care" of his four children as well, killing each one so that his wife and her lover would not get them. He then killed his wife as well as her mother. Then he waited six hours for his wife's lover at his work and shot him when he appeared, but only wounded him.

After careful evaluation, it was concluded that this extreme act of violence was primarily an attempt to prevent further blows to the man's self-esteem and was driven by a desire to avenge those who had humiliated him and regain his sense of superiority and dominance. He was declared sane and responsible for the murder of his wife and mother-in-law and the wounding of his wife's friend, but temporarily insane in the murder of children. This case indicates the need to be prepared for aggressive behavior, especially when a suspicious, angry narcissistic person is plotting revenge.

The presence of NPD tends to complicate the standard treatment of an Axis I comorbid disorder. Quite often, an additional diagnosis of a personality disorder is made when treatment for the symptomatic disorder is blocked or there is no expected improvement. We recommend simultaneously analyzing Axis I and Axis II disorders when both are present. In practice, this may mean that some time should be allowed to develop cognitive interventions for both disorders in the same session. Axis I disorder should be treated in the standard way, increasing the amount of time allotted for this, depending on the severity of the symptoms. But if at the same time not enough attention is paid to narcissism, the overall improvement in the patient's condition will be minimal. Separate evaluation procedures.

An accurate assessment of NPD is difficult, especially when there is an Axis I disorder in addition to it. In addition, the patient may have features that are characteristic of other personality disorders. Histrionic, antisocial, and borderline personality disorders are most commonly associated with narcissism (Stangl et al., 1985). Perhaps the most important assessment tool in diagnosing narcissism is the discreet clinical interview. Including another person as an additional source of information in the interview process is also very helpful.

The severity of the patient's condition can be assessed using standard symptomatic measures such as the Beck Depression Inventory. Other standard psychometric tools can help determine the level of discomfort and the presence of certain personality characteristics. Profile MMPI, is likely to show clinical elevations on individual scales that are consistent with the complaints presented. Scale 4 (psychopathic deviance) is likely to be significantly elevated due to the fact that narcissistic personalities consider themselves special, exceptional and tend to do things their own way. Scores on scales 6 (paranoia) and 9 (mania) are also sometimes modestly elevated due to the hypersensitivity and grandiosity of narcissistic personalities. Evidence from non-clinical student samples suggests that increases in scores on the 8 (schizophrenia), 9 (mania), and validity scales produced a profile most typical of narcissistic personality style (Raskin & Novacek, 1989). The Dysfunctional Attitudes Survey is likely to confirm beliefs about achievement, perfectionism, and approval.

Direct questioning about narcissistic features is difficult because of the patient's limited ability to objectively evaluate these characteristics (eg: "Do you exaggerate your achievements?") or his unwillingness to admit that he has some forms of behavior (for example, exploitation of people). Alternatively, the therapist may systematically assess the patient's narcissistic features in sessions, self-reports of social relationships, and self-reports of work performance or professional achievement. The following descriptions give some general guidelines for what to look for in each of these areas. Behavioral manifestations

An attentive psychotherapist can spot potential signs of narcissism based on their first impression of a new patient. Often, new patients demonstrate their claim to special rights by making detailed arrangements for their first visit to a psychotherapist. Upon meeting, the therapist may first notice a very elegant or attractive appearance, which is the result of constant attention to their appearance, the condition of their body and wardrobe. Excessive concern for one's appearance and comfort, however, is a more reliable diagnostic sign than good looks or good looks alone. Patients show this over-concern in numerous details of verbal and non-verbal behavior. In some patients, this manifests itself in the fact that they often shake dust off themselves, smooth their hair, straighten and check their appearance. Some may adopt exceptionally relaxed postures or sit pointedly upright and maintain an expression that appears haughty. Minor physical deficiencies, such as a broken nail, or minor physical inconveniences, such as a slight feeling of hunger, cause them to have a characteristic overreaction. When one of these behavioral signs is detected, a brief examination of the patient's thoughts and feelings can help determine whether this is a sign of narcissism or just a random feature caused by some other circumstance (for example, hunger can be an important problem if the person has sugar diabetes).

The narcissistic person may be dissatisfied with or resist diagnostic testing, both because it requires some effort, and because it categorizes the problem in a certain way, which implies that it is ordinary, just like any other person. Resistance to testing or feedback procedures can also be a sign of hypersensitivity to evaluation and potential negative feedback. Narcissistic people have difficulty taking feedback, reacting with characteristic anger or shame. Patients may be quite comfortable talking about themselves, sometimes overtly exalting themselves. They may often mention their talents, achievements, connections, or material wealth. A self-confident attitude towards difficulties and a tendency to complain about the shortcomings of others is also a characteristic of narcissism.

How the patient interacts with the therapist is a source of important diagnostic information. In more obvious cases, patients willingly describe themselves as arrogant, arrogant, or brash. They may emphasize their high position, their family's fame, or their celebrity status and expect special respect in return. Narcissistic personalities may also try to manipulate the therapist in order to maintain their sense of grandiosity or their claim to special rights. In addition to waiting for compliments, possible signs of this disorder are multiple questions about the therapist's qualifications (“Are you sure you can work with someone as unique or complex as me?”) and a constant desire to discuss in detail the time of meetings with the therapist and the terms of payment for his services. These patients may become resentful when they are not satisfied with the time or terms of payment.

The narcissistic tendency to idealize or devalue others will usually be evident in interactions with the therapist. The therapist may understand that he is being treated as special person. Conversely, the psychotherapist's interventions may automatically be criticized or rejected. Narcissistic patients sometimes even insult the therapist. In addition to his own experience, the therapist can also discover these attitudes from the patient's description of his treatment with other psychotherapists. Examination of previous psychotherapeutic contacts can help to understand how patients relate to such experiences and how they experienced the end of psychotherapy. One would expect a pattern of high expectations followed by disappointment and abrupt termination of treatment.

Characterized by the belief in one's own uniqueness, special position, superiority over other people; inflated opinion about their talents and achievements; preoccupation with fantasies about their successes; expectation certainly good relationship and unquestioning obedience from others; seeking the admiration of others to confirm their uniqueness and significance; inability to show empathy; ideas about their own freedom from any rules, that those around them envy them.

origin of name

The name comes from the hero of Greek mythology Narcissus, who, according to legend, saw his reflection in the water, fell in love with it and could not tear himself away from contemplating his beauty and died. After his death, he was turned into a narcissus flower by the gods.

Descriptions

by McWilliams

according to Kernberg

The narcissistic mother is generally unable to meet the emotional needs of her child and contributes to the transmission of narcissistic pathology from generation to generation.

Diagnostic criteria

ICD-10

There are no specific diagnostic criteria in the ICD-10, there is only a mention among "other specific personality disorders". Formally, to make a diagnosis, it is enough to match the general diagnostic criteria personality disorders; and non-compliance with diagnostic criteria for other specific personality disorders.

DSM IV

Literature

• Kernberg, Otto. Aggression in Personality Disorders And Perversions = Aggression in Personality Disorders And Perversions. - M .: Klass, 2001. - 368 p. - (Library of psychology and psychotherapy). - ISBN 5-86375-103-7
• Kernberg, Otto. Relationships of love, norm and pathology = Love Relations. Normality and Pathology. - M .: Klass, 2006. - 256 p. - (Library of psychology and psychotherapy). - 2000 copies. - ISBN 5-86375-124-X
• McWilliams, Nancy. Psychoanalytic diagnosis: Understanding personality structure in the clinical process. - M .: Klass, 1998. - 480 p. - ISBN 5-86375-098-7
• Sokolova, Elena Teodorovna. The psychology of narcissism: tutorial for students of the faculty of psychology of universities in the direction 521000 - "Psychology" and specialty 022700 - "Clinical. psychology” / E. T. Sokolova, E. P. Chechelnitskaya. - M .: Educational and methodological collector "Psychology", 2001. - 89 p. - ISBN 5-93692-029-1

Notes

Wikimedia Foundation. 2010 .

I live with a diagnosis of Narcissistic Personality Disorder (NPD). What does it mean? First, it took a lot of effort for me not to put my real name under this article. After all, even a repentant story about how unbearable I am for my relatives would flatter my sick pride. Second: only I (well, okay, and another 1% of the male population of developed countries) really have the right to be called a narcissist and an egoist. My diagnosis is, in fact, medical definition selfishness.

I brought to depression - real, clinical - two of my failed wives. Therapists are reluctant to work with me, afraid of hurting their own psyche in the first place. I need to take pills just to not act like a scum (and yes, at the end of the article I will reveal the secret of what these wonderful pills are). And I will also pass on my egoism by inheritance with a gigantic probability. Like this. And what your women are offended by is most likely a healthy indifference, well, or is there the usual redneck ...

Here's my confession. If you find the same thing - welcome to the ranks of NRL carriers! If not, then thank God, believe me.

5 Signs You Have NPD

All this information can, in principle, be gleaned from the Internet, but I have flourished it with examples ... In addition, not a single real egoist voluntarily admits that he is sick and does not get into the Internet to read something supposedly about himself. At least not before the onset of personality decompensation, when the disease itself becomes a self-object ... stop! My five signs are also different in that I do not use Clever words which are really only confusing.

Feature 1
Do you have empathy issues?

Sympathy, willingness to help, concern for others - not that the owner of the NRL was completely deprived of all this. The narcissist understands what his interlocutor is thinking (sometimes better than himself). But - it understands, but does not feel! Putting yourself in the place of another person is already an impossible task for him. For example, I usually know that they are worried about me. I can see that they are not happy with me. However, the emotions of the interlocutor, whether it be a girlfriend, cohabitant or even a mother, are an empty phrase for me. I do not experience TOGETHER with people. And therefore I cannot “discharge” them - give them what they achieve by expressing this or that emotion. To say what they want to hear from me, I still somehow can. But to support a quarrel with screams, when a person wants to scream ... Or stroke his hair and pat on the shoulder ... I don’t know how. If only by chance.

At the same time, I'm not some cracker with whiskey with ice instead of a heart, like Kai from a children's fairy tale. I can cry over The Green Mile and The Lion King, I can be restless when it's two in the morning and someone doesn't answer the phone and I don't know where. But in order to feel anxiety for another, I have to “wind”, “tighten” or, as they say, “irritate” myself. But even then my emotions are only an appearance, a tribute to social etiquette. I really don't care. Even when the little lion cub tugs on his dead dad's ear and cries, "Get up, let's go!"

I am by no means proud of this feature of my psyche. I'm ashamed of her. And by the way...

Feature 2
You often feel ashamed

Not guilt, but shame - this is important! Because guilt is when you're having fun in the family bed with an intern from the legal department, and your wife suddenly walks in the door. And shame is when you are having fun on the same bed with the same trainee, your wife is definitely in Istanbul, but the thought is still in your head: “What am I doing? What if the wife comes in ?!

Shame is always mixed with fear: "What will they think of me?" They laugh nearby, and you tensed up: isn’t it over you? it typical manifestation NRL… On early stages disorders of shame and fear provoke only real failures or strong feelings on the topic, “I didn’t pierce.” Thus, it is difficult for a novice narcissist to cheat on his wife: shame is so strong that it can cause erectile dysfunction(leave it out of brackets, how do I know this).

It's hard to take criticism. It's hard to hear jokes addressed to you, even the most harmless ones. For example, I still remember all the jokes addressed to me over the past 20 years! Especially one. At work, someone asked: “There is someone’s book “How to live with a small penis” on the table, Igor, yours?” It is clear that such a book does not exist. It is clear that even if she had been lying on the table, she would not have been mine. But the instantly rolling shame “what if someone thinks that this is true” does not go away for years, destroying the psyche. Narcissus is first and foremost a Samoyed. A seemingly cynical snake that secretly constantly eats its own tail.

If treatment is not started in time, the disorder drags its owner into such a black thicket of shame, where any stump begins to seem like a terrible monster. Simply put, over time, you begin to react painfully to the most innocent remarks. You stop doing something for fear of making a mistake and feeling ashamed of a future puncture. You drive the intern out into the street in the middle of the night in only her underwear and throw the family sheets into the wash - although no one even stained them that evening ...

Worse, the realization that you are entangled in the chains of shame itself begins to provoke shame: what if someone finds out that I am helpless and cannot cope with myself? This recursion can continue indefinitely.

Feature 3
You can't conflict

In essence, this is a consequence of the features already listed. The narcissist all the time, on the one hand, does not guess other people's emotions, and on the other hand, he tries to understand what they think of him. This creates an insidious, albeit rather stupid, trap. Narcissus, as our president's speechwriter would say, is a typical "tolerant". He is able to marry an unloved woman. Travel to hateful relatives. Bend under a stupid boss. And all this - out of fear that they will think badly about him when he tries to change the situation. A person with NPD is afraid of being thrown in the face with an “ungrateful pig!” - and as a result endures such treatment of himself, which turns out to be more traumatic than rebellion, conflict.

On the other hand, when the narcissist still finds himself in a situation where he does not depend on the opinion of the conditional “enemy”, he brings down on him such anger that he did not deserve! Luckily I'm still at the beginning adult life realized that asserting itself at the expense of the waiters "is not cool." However, before the start of treatment, I often caught myself talking too rudely with a taxi driver or secretary. Yes, and domestic despotism was not alien to me ... Fortunately, this is one of the most easily corrected symptoms. Unfortunately, he is not the only one.

Feature 4
You are always dissatisfied with something

This feeling should not be confused with perfectionism, a craving for excellence. A perfectionist has a clear ideal, a plan, a scheme in his head. For example: an article about NPD should be six pages long, five signs should be listed, then the treatment regimen, etc. Having imagined such an ideal, a perfectionist will be dissatisfied with himself only if he cannot achieve it. “Well, Danila-master, doesn’t a stone flower come out?” is perfectionism.

At the same time, the narcissist, the clinical egoist, is dissatisfied in principle. Not only by the results of your work, but also by everyone around you - and first of all by yourself. Salary, sporting achievements, another girlfriend's foot size - all this irritates and even infuriates the narcissist, not because "it could be better." And because of the constant awareness that it can be OTHERWISE. You have probably experienced this feeling in its small manifestations. For example, when you are trailing in the tail of a half-dead traffic jam, it always seems that the next row is going a little better, a little faster. Here you go. And I always have. For any reason. Yes, I'm dating a model. Well, he could - with a gymnast! Not that the model is bad ... Although ...

Everything that the narcissist has already achieved is instantly devalued. Everything that cannot be obtained right now, on the contrary, is idealized. I am like a child who was let into a toy store and told: take what you want, but you can take one thing. Any situation of choice destroys the psyche. Makes me wonder if I made the wrong choice.

Most often, the narcissist begins to "sort out" women. Why - science does not yet know. Personality disorder guru Nancy McWilliams believes that the narcissist cripples the psyche of women because he does not know how to get rid of them in time. To extend the toy analogy, you love your new car. But you know, they won't buy you a new one until this one breaks. And as soon as feelings for the toy begin to weaken, you break it yourself in order to get a new one faster. There is even a name for this: Don Juan syndrome. Of course, not every womanizer is a narcissist. However, if this is so - well, as they say, lock up your daughters ...

Feature 5
You don't have a true inner self

The most terrible secret that is unlikely to be revealed to you at the first session of psychotherapy. All of the above signs are, in essence, symptoms, side effects. But the fifth sign is the root of the disorder. And the secret lies in the fact that there really is no narcissist! ..

That is, there is nothing inside the personality that would constitute its core. The narcissist is brought up (see below) in such conditions that in the place that in other adults is occupied by his own "I", he has a black hole, a funnel closed on itself. An emptiness that feeds self-doubt - and a doubt that sucks everything good and good out of the emptiness. The whole life of a narcissist is an illusion. All the objects of his pride are the external attributes of fame, wealth, success.

In psychiatry, this is called the "external locus of self-esteem." Not being able - at least without treatment - to be proud of himself and love himself, the narcissist creates the so-called self-objects. These are completely external things, people, phenomena with which the carrier of NPD associates himself. "I work in a cool design bureau" - instead of "I'm a designer." “And this is me in front of my car” - instead of just “and this is me.” "I'm dating a gymnast" - instead of "thank you, everything is fine with my personal life." All of these are typical NRL formulations.

For the time being, creating dozens of such self-objects is easy. Narcissus can even give the impression of a super-successful minion of fate and almost a child prodigy. Ah, he is the winner of Olympiads in seven subjects! Ah, he was awarded such and such a medal at the age of fifteen! Ah, he is the youngest winner of anything in history! Don't be deceived: these are all just attempts to fill a void. At some point, the mechanism for creating self-objects breaks down - this becomes the moment when a recently healthy narcissist (there are some, although this is a temporary stage) gets upset.

This is where the name of the disease comes from. As you probably remember from Kuhn's book "Myths Ancient Greece”, Narcissus’s problem was not just that he fell in love with his reflection and died from it. Self-admiration is still half the trouble. In fact, Narcissus was under a curse: he was doomed to love an object that was unable to return his love! So appreciate the evil wit of the psychotherapists who came up with the name for my disorder. I idealize objects, pump them up with my self-esteem - and as a result I create a false "I", based, for example, on work, money, relationships, well-being.

And then, at the very first crisis, I understand that all these years there was a cold something in front of me, flowing through my fingers along with my self-esteem.

How is it treated

First and foremost, under the supervision of a doctor! Self-medication is generally contraindicated in personality disorders, and even more so in narcissistic ones. In addition, not a single dealer, not to mention wine supermarkets, will still have that assortment. magic elixirs owned by a psychiatrist.

Take at least alimemazine antipsychotics. Of course, in business this is not the most best helper: the feeling is that carpet bombing was suddenly allowed in a pillow fight - and you were covered with about three tons of caked fluff. There is fog in the eyes, the head is wadded, the movements are slow. But! No Don Juan syndrome (such nonsense as women simply does not bother, except in a dream - if you suddenly forget to take an evening pill). No sense of shame. And most importantly, no desire to attract attention to yourself, to get a surrogate for love: no antics, no scandals, no self-criticism, no accomplishments ... Hmmm, a miserable semblance of a former life. But I warned you: you better not find signs of NPD in yourself.

Of course, neuroleptics alone are not enough. Following them, antidepressants, nootropics, and psychostimulants are sent into the furnace of a broken body. The complexity of the cocktail and the intensity of intraday sensations depend on whether you still need to work in the process of treatment - or you prudently sold your assets or simply quit with an entry in your work: "Due to extreme intolerance" ...

One way or another, the pharmacological period is only a prelude to a long and mutual brainstorming, which you will be doing with a psychotherapist in the next year (minimum). At the same time, it is pointless to choose a prettier specialist, because in a couple of months he will probably refuse you anyway. But maybe the second or third will sooner or later discover the cause of the disorder, which - no surprise here - most likely dates back to childhood. In my treatment, this moment has not yet arrived. Therefore, I am still able to write with narcissism about my sore.

How to water daffodils

Since NPD begins in childhood, I recommend reading Alice Miller's Gifted Child Drama: even healthy man he will find himself in it, and the book is read almost faster than the instructions for an air freshener. Miller believes that narcissism in a healthy, rudimentary form is characteristic of most children. Using their example, we will consider how to deal with small narcissistic bastards so that big bastards and intractable bastards do not grow out of them.

If a child shows signs of narcissism, the worst thing you can do with him is to start loving, encouraging and praising him not just like that, but for SOMETHING. “What, you’re not a man, can’t you cast a lure normally?”, “If you don’t wash behind your ears, not a single girl will even look at you”, “Well, how many fives did you bring today?” These and similar phrases get stuck like nails not only in the brain, but also in the lid of the coffin. A coffin in which the true "I" of the future narcissist will writhe in agony. Just love a child. Whatever he brought from school, even chlamydia.

Play ahead of the narcissist. If a child brings you a plasticine craft or shouts: “Dad, look how I can” and “Mom, mom, I masturbate without hands!” - that means it's a mess. He ALREADY didn't get any attention. Do you remember the feeling of shame and eternal discontent? Giving compliments to a narcissist only when he himself asks for them will only give him reason to suspect that he is doing something WRONG. They don't praise me?.. Maybe I'm doing the wrong thing? Maybe I'm not crying out loud enough for lack of attention? Maybe something needs to be blown up in this house so that dad will break away from the TV and chase me a little? .. If you “water” the narcissist without waiting until he starts to dry, his craving for self-expression can be channeled into a healthy direction.

The narcissist needs to be taught to speak in time. Not in the sense of all sorts of “but how does the cow speak? That's right: mu-mu. We are talking about a more complex process of articulating emotions. When you talk to a child who is a candidate for NPD, a complex bouquet of shame, resentment, conspiracy theories, dissatisfaction (with himself and you), fear and a thirst for greatness is ALWAYS blooming in his head. If you teach a child to freely express these feelings already at the age of 7–10–12, you will save the life of not only him, but also that poor fellow, whom he would eventually bring to depression. The main thing is to show that the child HAS the RIGHT to resentment, anger, jealousy, disobedience. Remind more often that people may not always be good. Moreover, they SHOULD NOT be like that. If the narcissist learns to love not only his beautiful reflection in the water, but also the back of his head and his hairy back, this will save him. Well, or at least delay the first intake of alimemazine for a couple of years ...

Well, what about adult daffodils, you ask? How to be with the narcissistic girlfriend? Well, in fact, she will have to be dealt with in the same way as with a painfully self-obsessed child. With one difference: from a woman, unlike a child, you can escape in time. And that is exactly what I recommend you do if you suspect that you have come across a genuine narcissist. Jokes aside.