ICD-10 Criteria
Narcissism
The origin of the term narcissist lies in the Greek myth of Narcissus, who rejected the desire of the nymph Echo. He wanted to love, yet could not recognise the love of the nymph. Instead, he sat by the lake, staring into the water, desiring his own reflection – which he could never possess. He despaired over this until he finally died. At the place of his death, a flower grew – the narcissus.
So we could simply say: “a narcissist is in love with himself” – unfortunately, the disorder is far more complicated than the word suggests.
Distinction from Borderline Personality Disorder
Section titled “Distinction from Borderline Personality Disorder”You will find many similarities to Borderline Personality Disorder here, yet it is not the same thing. Many therapists confuse the two and thereby cause more harm than good. In the DSM, the items are almost identical – no wonder that many misdiagnoses are made.
Furthermore, the narcissist very often chooses a person with Borderline Personality Disorder or Dependent Personality Disorder for a relationship (complementary disorder).
The myth continues: After the death of Narcissus, the nymph Echo comes weeping to the lake. Murky and dirty lies the once so clear water before her, and she asks the lake “Why are you so murky?” The lake answers “I am sad that no one mirrors themselves in me any more. Every day I reflected Narcissus, it was my purpose in life, it felt so good to mirror him.”
Historical Development
Section titled “Historical Development”Narcissism as such was long neglected by psychology. This is demonstrated by the fact that not even the ICD-9 (only from ICD-10 onward) classified it as a standalone disorder. Different in the DSM, where it has existed as a standalone disorder for much longer.
When Is the Line to Illness Crossed?
Section titled “When Is the Line to Illness Crossed?”Judging this is difficult even for professionals, because a healthy level of narcissism exists in every one of us and is necessary.
Pathological Narcissism
Section titled “Pathological Narcissism”People with this disorder suffer from a deficit in their self-confidence, which however is connected to their object relations (that is, the people they “love” or like). This often manifests as omnipotence (all-powerfulness / “I am the greatest”), but also simultaneously as “I need you in order to be great.”
Typical Behaviours
Section titled “Typical Behaviours”- They stand out through an unusual degree of self-centredness
- They have a strong urge to be loved and admired by others
- They typically have a very inflated self-concept
- They feel little empathy for others – they lack empathy
- They put up a facade that projects glory and grandeur to others
- Behind this facade, they are restless, agitated
- Intense envy of others occupies their daily life
Interpersonal Relationships
Section titled “Interpersonal Relationships”The interpersonal relationships of these individuals have a distinctly exploitative character. They take the right to control and dominate other people without feelings of guilt.
Defence Mechanisms
Section titled “Defence Mechanisms”Narcissists are also subject to primitive defence mechanisms such as:
- Splitting
- Denial
- Idealisation
- Projective identification
In contrast to Borderline Personality Disorder, however, the narcissist has better impulse control. They display an extreme degree of self-composure in challenging social situations.
Ego Boundaries and Projection
Section titled “Ego Boundaries and Projection”In Narcissistic Personality Disorder, the ego boundaries do not blur – unlike in Borderline Personality Disorder. The narcissist knows very well how to distinguish between “self and other.” They have an “ego ideal” which they merge with the ideal object (possibly the partner).
But they too are subject to strong projection: Every person has aspects they dislike. The narcissist projects their unacceptable aspects onto the other person – the aspects that cannot be integrated into their self-concept – and devalues them there. They devalue the other person’s personality, yet in reality only devalue themselves. This in turn causes them pain, whereupon they devalue even more. A vicious circle.
The Inner Experience
Section titled “The Inner Experience”The narcissist is a starving person – angry, restless, inwardly empty – and tries to compensate for this deficit through other people. Within them works an impotent rage over childhood injuries, yet simultaneously a fear of the world that is presented to them.
They follow the maxim: “This person can do something for me or they cannot.”
All persons with whom the narcissist is involved serve a purpose. Should this purpose not be fulfilled (except for the persons they are currently idealising), they experience the person as a lifeless shadow.
Self-Love and the Capacity to Love
Section titled “Self-Love and the Capacity to Love”We can say that narcissism encompasses not only the pathological extreme of selfishness, but also the pathological striving for self-love.
Philosophy and psychology speak of the notion that one can only love if one loves oneself. This is true in principle, yet here the whole thing tips into the opposite: The narcissist’s love for themselves is so strong that it allows nothing else. They are therefore incapable of love.
Fundamental Fears
Section titled “Fundamental Fears”Since narcissism is an early childhood disorder, the narcissist is burdened by the same fears as the person with Borderline. The narcissist lacks security – security in the face of life. They cannot surrender to the “fabric” of their environment. They must be something “special,” not least because of their fear, which is compensated through this.
Narcissism in Relationships
Section titled “Narcissism in Relationships”The narcissist longs for the primordial state – that is, the first months of life in which there was no separation between object (environment) and self. Since symbiosis (absolute fusion) can no longer occur in adulthood, the narcissist can only allow partial aspects of a relationship – namely those that do not provoke fear.
Relationship Dynamics
Section titled “Relationship Dynamics”In the partnership, the narcissist painfully confronts their “separateness.” For this reason, narcissistic relationships are very vulnerable to disturbances from both within and without.
Partner Choice
Section titled “Partner Choice”The narcissist fears a committed partnership, even though they long for one. As a rule, the partner they choose is inferior in intelligence and social background. This must be so, since the narcissist always manipulates in relationships in order to satisfy their own needs.
Relationship Conflicts
Section titled “Relationship Conflicts”A narcissistic relationship is in constant conflict:
- “I am angry because you impose obligations on me and restrict me”
- “I restrict you because you are inconsiderate toward me”
The more rigid and extreme this stance, the greater the relationship conflict.
Mutual Dependency
Section titled “Mutual Dependency”Narcissistic relationships are always based on mutual dependency. The narcissist often chooses the hysterical, infantile, dependent personality or the borderline personality. Through the dependency and focus on the partner, however, the narcissist increasingly isolates themselves, which fosters the feeling of being trapped in a “relationship cage.”
The Mirror
Section titled “The Mirror”The saying “love thy neighbour as thyself” is pure horror for the narcissist. Because deep down, the narcissist does not like themselves. They love the mirror in which they see themselves. Through it they live, through it they exist.
Take away the narcissist’s mirror, and they are like a worm beneath the earth. The mirror can be many things: you as the partner, money, power. As a rule, they will try to bring these three things together.
Further Information
Section titled “Further Information”DSM-IV Criteria
In-Depth Analysis
Psychodynamics
Relationship Dynamics