Narcissism

Narcissism is the pursuit of gratification from vanity or egotistic admiration of one's idealised self-image and attributes. The term originated from Greek mythology, where a young man named Narcissus fell in love with his own image reflected in a pool of water. Narcissism or pathological self-absorption was first identified as a disorder in 1898 by Havelock Ellis[1] and featured in subsequent psychological models, e.g. in Freud's On Narcissism (1914). The American Psychiatric Association has listed the classification narcissistic personality disorder in its Diagnostic and Statistical Manual of Mental Disorders (DSM) since 1968, drawing on the historical concept of megalomania.

Not to be confused with Egocentrism.

It is distinct from concepts of distinguishing the self (egocentrism or egoism) and healthy forms of responsibility and care for oneself ("primary narcissism"). Narcissism by contrast is considered a problem for relationships with self and others and for maintaining a functional culture. In trait personality theory it features in several self-report personality inventories including the Millon Clinical Multiaxial Inventory. It is one of the three dark triadic personality traits (the others being psychopathy and Machiavellianism).

History
Main article: History of narcissism
The myth of Sisyphus tells about a man punished for his hubristic belief that his cleverness surpassed that of Zeus himself. He has to push a stone up a mountain each day, only to have to recommence the task on the next day.

The term narcissism comes from the Greek myth about Narcissus (Greek: Νάρκισσος, Narkissos), a handsome Greek youth who, according to Ovid, rejected the desperate advances of the nymph Echo. This caused Narcissus to fall in love with his own reflection in a pool of water. Unable to consummate his love, Narcissus "lay gazing enraptured into the pool, hour after hour," and finally changed into a flower that bears his name, the narcissus.[2] The concept of excessive selfishness has been recognized throughout history. In ancient Greece the concept was understood as hubris. It is only since the late 1800s that narcissism has been defined in psychological terms.[1]

  • In 1752 Jean-Jacques Rousseau's play Narcissus: or the Self-Admirer was performed in Paris.[3]
  • In 1898 Havelock Ellis, an English psychologist, used the term "Narcissus-like" in reference to excessive masturbation, whereby the person becomes his or her own sex object.[1]
  • In 1899, Paul Näcke was the first person to use the term "narcissism" in a study of sexual perversions.[4]
  • Otto Rank in 1911 published the first psychoanalytical paper specifically concerned with narcissism, linking it to vanity and self-admiration.[1]
  • Sigmund Freud published a paper on narcissism in 1914 called "On Narcissism: An Introduction".[5]
  • In 1923, Martin Buber published an essay "Ich und Du" (I and Thou), in which he pointed out that our narcissism often leads us to relate to others as objects instead of as equals.[6]

Traits and signs
Life is a stage, and when the curtain falls upon an act, it is finished and forgotten. The emptiness of such a life is beyond imagination.

—Alexander Lowen describing the existence of a narcissist[7]

Four dimensions of narcissism as a personality variable have been delineated: leadership/authority, superiority/arrogance, self-absorption/self-admiration, and exploitativeness/entitlement.[8]

Numerous studies (Miller & Campbell, 2008; Russ, Shedler, Bradley, & Westen, 2008; Wink, 1991) have demonstrated that narcissism has two or more variants, grandiose narcissism and vulnerable narcissism. The grandiose variant, which is usually measured using the NPI is strongly linked to the DSM-IV conceptualization and is the variant associated with NPD, a Cluster B personality disorder which reflect traits related to self-importance, entitlement, aggression, and dominance. Vulnerable narcissism reflects a defensive and fragile grandiosity, which functions mainly as a cover for feelings of inadequacy. Vulnerable narcissism characterized by hypersensitivity, defensiveness, and withdrawal and is strongly associated with BPD, which is characterized by the fear of abandonment, interpersonal and affective instability, impulsivity, chronic feelings of emptiness, suicidal ideation, and self-mutilation. Pathological narcissism is when both grandiose and vulnerable narcissism is concurrent, which is linked to poor self-esteem, lack of empathy, feelings of shame, interpersonal distress, aggression, and significant impairments in personality functioning across both clinical and non-clinical samples. Pathological narcissism, as measured by the Pathological Narcissism Inventory (PNI), is embedded within the personality disorders organized at the borderline level, which include antisocial, borderline, narcissistic personality disorders. PNI scales exhibited significant associations with parasuicidal behavior, suicide attempts, homicidal ideation, and several aspects of psychotherapy utilization.[9] Despite the phenomenological and empirical distinction between vulnerable and grandiose narcissism, there is experimental evidence from studies that have employed direct or indirect ego-threat to suggest that grandiose narcissists have also a fragile, vulnerable core.[10]

Clinical and research aspects

Narcissistic personality disorder
Main article: Narcissistic personality disorder

Narcissistic personality disorder affects an estimated 1% of the general population.[11][12] Although most individuals have some narcissistic traits, high levels of narcissism can manifest themselves in a pathological form as narcissistic personality disorder (NPD), whereby the individual overestimates his or her abilities and has an excessive need for admiration and affirmation. NPD was revised in the DSM-5. The general move towards a dimensional (personality trait-based) view of the Personality Disorders has been maintained. Some narcissists may have a limited or minimal capability to experience emotions.[13]

Treatment and management

The Cochrane Collaboration has commissioned two reviews of the evidence for psychological and medical treatments for Narcissistic Personality Disorder (NPD).[14] In both cases, they suspended their initiatives after the authors had made no progress in over a year. There are no clear treatment strategies for NPD,[15] neither medication nor psychotherapy.[16] There is evidence that therapies effective in the treatment of other personality disorders do not generalise to NPD.[17]

Required element within normal development

Karen Horney saw the narcissistic personality as a temperament trait molded by a certain kind of early environment. She did not see narcissistic needs and tendencies as inherent in human nature.[18]

Normal or healthy narcissism is an essential component of mature self-esteem and basic self-worth.[19][20][21] Dr. Craig Malkin describes a lack of healthy narcissism as echoism, a term inspired by the nymph Echo in the mythology of Narcissus.[22]

Freud said that narcissism was an original state from which the individual develops the love object.[23] He argued that healthy narcissism is an essential part of normal development.[5] According to Freud, the love of the parents for their child and their attitude toward their child could be seen as a revival and reproduction of their own narcissism.[5] The child has a megalomaniac omnipotence of thought;[23] the parents stimulate that feeling because in their child they see the things that they have never reached themselves. Compared to neutral observers, parents tend to overvalue the qualities of their child. When parents act in an extreme opposite style and the child is rejected or inconsistently reinforced depending on the mood of the parent, the self-needs of the child are not met.

Freud contrasted the natural development of active-egoistic and passive-altruistic tendencies in the individual with narcissism, in the former, and what Trevor Pederson referred to as echoism, in the latter.[24]

This is the place for two remarks. First, how do we differentiate between the concepts of narcissism and egoism? Well, narcissism, I believe, is the libidinal complement to egoism. When we speak of egoism, we have in view only the individual's advantage; when we talk of narcissism we are also taking his libidinal satisfaction into account. As practical motives the two can be traced separately for quite a distance. It is possible to be absolutely egoistic and yet maintain powerful object-cathexes, in so far as libidinal satisfaction in relation to the object forms part of the ego's needs. In that case, egoism will see to it that striving for the object involves no damage to the ego. It is possible to be egoistic and at the same time to be excessively narcissistic—that is to say, to have very little need for an object, whether, once more, for the purpose of direct sexual satisfaction, or in connection with the higher aspirations, derived from sexual need, which we are occasionally in the habit of contrasting with 'sensuality' under the name of 'love'. In all these connections egoism is what is self-evident and constant, while narcissism is the variable element. The opposite to egoism, altruism, does not, as a concept, coincide with libidinal object-cathexis, but is distinguished from it by the absence of longings for sexual satisfaction. When someone is completely in love, however, altruism converges with libidinal object-cathexis. As a rule the sexual object attracts a portion of the ego's narcissism to itself, and this becomes noticeable as what is known as the 'sexual overvaluation' of the object. If in addition there is an altruistic transposition of egoism on to the sexual object, the object becomes supremely powerful; it has, as it were, absorbed the ego." (Freud, Introductory Lectures (1919), pp. 417–18)

Where the egoist can give up love in narcissism, the altruist can give up on the competition, or "the will," in echoism. The individual first has a non-ambivalent relations of fusion with authority or love figures, which are characterized by the egoistic or altruistic drives. Second, the individual can move to defusion from authority or love figures which leads to repetitions of ambivalent, narcissistic or echoistic relations. In the third movement, the individual becomes the dead or absent parental figure that never returned love to the echoist, or the perfect, grandiose parental figure in narcissism.[24] While egoism and narcissism concern dynamics of power and inferiority/superiority, Pederson argues that altruism and echoism concern dynamics of belonging and inclusion/exclusion. Pederson has two types of echoists: the "subject altruist" and the "object altruist", with the former being concerned with the belonging of others and loving them, and the latter being concerned with their own belonging and being loved. The subject altruist is self-effacing, a people pleaser, and sacrifices her desire to help others who are outsiders become insiders, or to be the submissive helper of an insider. The object altruist is gregarious, a people person, and wants to be interesting which is based on wanting to fit in and not be an outsider or wanting to be unique as an insider. Both types of echoists show issues with being submissive, having problems saying no, and avoiding conflict.[24]

In relation to the pathological condition

Freud's idea of narcissism described a pathology which manifests itself in the inability to love others, a lack of empathy, emptiness, boredom, and an unremitting need to search for power, while making the person unavailable to others.[25]

Healthy narcissism has to do with a strong feeling of "own love" protecting the human being against illness. Eventually, however, the individual must love the other, "the object love to not become ill". The individual becomes ill as a result of the frustration created when he is unable to love the object.[26] In pathological narcissism such as the narcissistic personality disorder, the person's libido has been withdrawn from objects in the world and produces megalomania. The clinical theorists Kernberg, Kohut and Theodore Millon all saw pathological narcissism as a possible outcome in response to unempathic and inconsistent early childhood interactions. They suggested that narcissists try to compensate in adult relationships.[27] The pathological condition of narcissism is, as Freud suggested, a magnified, extreme manifestation of healthy narcissism.

Healthy narcissism has been suggested to be correlated with good psychological health. Self-esteem works as a mediator between narcissism and psychological health. Therefore, because of their elevated self-esteem, deriving from self-perceptions of competence and likability, high narcissists are relatively free of worry and gloom.[28]

Other researchers have suggested that healthy narcissism cannot be seen as 'good' or 'bad', but that it depends on the contexts and outcomes being measured. In certain social contexts such as initiating social relationships, and with certain outcome variables, such as feeling good about oneself, healthy narcissism can be helpful. In other contexts, such as maintaining long-term relationships and with outcome variables, such as accurate self-knowledge, healthy narcissism can be unhelpful.[29]

Narcissistic Personality Inventory
Main article: Narcissistic Personality Inventory

The Narcissistic Personality Inventory (NPI) is the most widely used measure of narcissism in social psychological research. Although several versions of the NPI have been proposed in the literature, a forty-item forced-choice version (Raskin & Terry, 1988) is the one most commonly employed in current research. Another shorter version, a sixteen-item version NPI-16 (Ames, Rose & Anderson, 2013) is also present. The NPI is based on the DSM-III clinical criteria for narcissistic personality disorder (NPD), although it was designed to measure these features in the general population. Thus, the NPI is often said to measure "normal" or "subclinical" (borderline) narcissism (i.e., in people who score very high on the NPI do not necessarily meet criteria for diagnosis with NPD).

Millon Clinical Multiaxial Inventory
Main article: Millon Clinical Multiaxial Inventory

The Millon Clinical Multiaxial Inventory (MCMI) is a widely used diagnostic test developed by Theodore Millon. The MCMI includes a scale for Narcissism. The NPI and MCMI have been found to be well correlated, r(146) = 0.55, p < 0.001.[30] Whereas the MCMI measures narcissistic personality disorder (NPD), the NPI measures narcissism as it occurs in the general population. In other words, the NPI measures "normal" narcissism; i.e., most people who score very high on the NPI do not have NPD. Indeed, the NPI does not capture any sort of narcissism taxon as would be expected if it measured NPD.[31]

Empirical studies

Within the field of psychology, there are two main branches of research into narcissism: (1) clinical and (2) social psychology.

These two approaches differ in their view of narcissism, with the former treating it as a disorder, thus as discrete, and the latter treating it as a personality trait, thus as a continuum. These two strands of research tend loosely to stand in a divergent relation to one another, although they converge in places.

Campbell and Foster (2007)[29] review the literature on narcissism. They argue that narcissists possess the following "basic ingredients":

  • Positive: Narcissists think they are better than others.[32]
  • Inflated: Narcissists' views tend to be contrary to reality. In measures that compare self-report to objective measures, narcissists' self-views tend to be greatly exaggerated.[33]
  • Agentic: Narcissists' views tend to be most exaggerated in the agentic domain, relative to the communion domain.[32][33]
  • Special: Narcissists perceive themselves to be unique and special people.[34]
  • Selfish: Research upon narcissists' behaviour in resource dilemmas supports the case for narcissists as being selfish.[35]
  • Oriented toward success: Narcissists are oriented towards success by being, for example, approach oriented.[36]

Narcissists tend to demonstrate a lack of interest in warm and caring interpersonal relationships.[29] There are several ongoing controversies within narcissism literature, namely: whether narcissism is healthy or unhealthy; a personality disorder; a discrete or continuous variable; defensive or offensive; the same across genders; the same across cultures; and changeable or unchangeable.

Campbell and Foster (2007) argue that self-regulatory strategies are of paramount importance to understanding narcissism.[29] Self-regulation in narcissists involves such things as striving to make one's self look and feel positive, special, successful and important. It comes in both intra-psychic, such as blaming a situation rather than self for failure, and interpersonal forms, such as using a relationship to serve one's own self. Some differences in self-regulation between narcissists and non-narcissists can be seen with Campbell, Reeder, Sedikides & Elliot (2000)[37] who conducted a study with two experiments. In each experiment, participants took part in an achievement task, following which they were provided with false feedback; it was either bogus success or failure. The study found that both narcissists and non-narcissists self-enhanced, but non-narcissists showed more flexibility in doing so. Participants were measured on both a comparative and a non-comparative self-enhancement strategy. Both narcissists and non-narcissists employed the non-comparative strategy similarly; however, narcissists were found to be more self-serving with the comparative strategy, employing it far more than non-narcissists, suggesting a greater rigidity in their self-enhancement. When narcissists receive negative feedback that threatens the self, they self-enhance at all costs, but non-narcissists tend to have limits.

Sorokowski et al. (2015) showed that narcissism is related to the frequency of posting selfie-type pictures on social media. Sorokowski's study showed that this relationship was stronger among men than women.[38]

A 2020 study found that females scored significantly higher on vulnerable narcissism than males, but no gender differences were found for grandiose narcissism.[39]

Research indicates that being in a devalued social group can encourage narcissism in some members of that group, as said individuals attempt to compensate for their low social status (due to being a member of a stigmatised group) by exaggerating their own self-worth by engaging in narcissism, which may also help them psychologically cope with negative treatment at the hands of others, though it may also cause them to engage in behaviour detrimental to themselves.[40][41]

Heritability research using twin studies

Livesley et al. concluded, in agreement with other studies, that narcissism, as measured by a standardized test, was a common inherited trait.[42] Additionally, in similar agreement with those other studies, it was found that there exists a continuum between normal and disordered personality. The study subjects were 175 volunteer twin pairs (ninety identical, eighty-five fraternal) drawn from the general population. Each twin completed a questionnaire that assessed eighteen dimensions of personality disorder. The authors estimated the heritability of each dimension of personality by standard methods, thus providing estimates of the relative contributions of genetic and environmental causation. Of the eighteen personality dimensions, narcissism was found to have the highest heritability (0.64), indicating that the concordance of this trait in the identical twins was significantly influenced by genetics. Of the other dimensions of personality, only four were found to have heritability coefficients of greater than 0.5: callousness, identity problems, oppositionality and social avoidance.

Stigmatising attitude towards psychiatric illness

Arikan found that a stigmatising attitude to psychiatric patients is associated with narcissistic personality traits.[43]

In evolutionary psychology

The concept of narcissism is used in evolutionary psychology in relation to the mechanisms of assortative mating, or the non-random choice of a partner for purposes of procreation. Evidence for assortative mating among humans is well established; humans mate assortatively regarding age, IQ, height, weight, nationality, educational and occupational level, physical and personality characteristics, and family relatedness.[44] In the "self seeking like" hypothesis, individuals unconsciously look for a "mirror image" of themselves in others, seeking criteria of beauty or reproductive fitness in the context of self-reference. Alvarez et al. found that facial resemblance between couples was a strong driving force among the mechanisms of assortative mating: human couples resemble each other significantly more than would be expected from random pair formation.[45] Since facial characteristics are known to be inherited, the "self seeking like" mechanism may enhance reproduction between genetically similar mates, favoring the stabilization of genes supporting social behavior, with no kin relationship among them.

Narcissistic supply
Main article: Narcissistic supply

Narcissistic supply is a concept introduced into psychoanalytic theory by Otto Fenichel in 1938, to describe a type of admiration, interpersonal support or sustenance drawn by an individual from his or her environment and essential to their self-esteem.[46] The term is typically used in a negative sense, describing a pathological or excessive need for attention or admiration in codependents and the orally fixated, that does not take into account the feelings, opinions or preferences of other people.[47]

Narcissistic rage and narcissistic injury
Main article: Narcissistic rage and narcissistic injury

Narcissistic rage is a reaction to narcissistic injury, which is a perceived threat to a narcissist's self-esteem or self-worth. Narcissistic injury and narcissistic scar are terms used by Sigmund Freud in the 1920s. Narcissistic wound and narcissistic blow are other, almost interchangeable, terms.[48]

The term narcissistic rage was coined by Heinz Kohut in 1972. Narcissistic rage occurs on a continuum from aloofness, to expressions of mild irritation or annoyance, to serious outbursts, including violent attacks.[49]

Narcissistic rage reactions are not limited to personality disorders. They may also be seen in catatonic, paranoid delusion, and depressive episodes.[49] It has been suggested that narcissists have two layers of rage. The first layer of rage can be thought of as a constant anger towards someone else, with the second layer being a self-aimed anger.[50]

Narcissistic defenses
Main article: Narcissistic defenses

Narcissistic defenses are those processes whereby the idealized aspects of the self are preserved, and its limitations denied.[51] They tend to be rigid and totalitarian.[52] They are often driven by feelings of shame and guilt, conscious or unconscious.[53]

Narcissistic abuse
Main article: Narcissistic abuse

Narcissistic abuse was originally just defined as a specific form of emotional abuse of children by narcissistic parents – parents who require the child to give up their own wants and feelings in order to serve the parent's needs for esteem.[54] The term emerged in the late twentieth century due to the works of Alice Miller and other Neo-Freudians, rejecting psychoanalysis as being similar to the poisonous pedagogies.[55]

Self-help culture assumes that someone abused by narcissistic parenting as a child likely struggles with codependency issues in adulthood. An adult who is or has been in a relationship with a narcissist likely struggles with not knowing what constitutes a "normal" relationship.[56]

In recent years the term has been applied more broadly to refer to any abuse by a narcissist including in adult to adult relationships.[57]

Types

Masterson's subtypes (exhibitionist and closet)

In 1993, James F. Masterson proposed two categories for pathological narcissism, exhibitionist and closet.[58] Both fail to adequately develop an age- and phase- appropriate self because of defects in the quality of psychological nurturing provided, usually by the mother. The exhibitionist narcissist is the one described in DSM-IV and differs from the closet narcissist in several important ways. The closet narcissist is more likely to be described as having a deflated, inadequate self-perception and greater awareness of emptiness within. The exhibitionist narcissist would be described as having an inflated, grandiose self-perception with little or no conscious awareness of the emptiness within. Such a person would assume that this condition was normal and that others were just like him. The closet narcissist seeks constant approval from others and appears similar to the borderline in the need to please others. The exhibitionist narcissist seeks perfect admiration all the time from others.

Millon's variations

In 1996 Theodore Millon identified four variations of narcissist.[11] Any individual narcissist may exhibit none or one of the following:

Acquired situational narcissism

Acquired situational narcissism (ASN) is a form of narcissism that develops in late adolescence or adulthood, brought on by wealth, fame and the other trappings of celebrity. It was coined by Robert B. Millman, professor of psychiatry at the Weill Cornell Medical College of Cornell University. ASN differs from conventional narcissism in that it develops after childhood and is triggered and supported by the celebrity-obsessed society. Fans, assistants and tabloid media all play into the idea that the person really is vastly more important than other people, triggering a narcissistic problem that might have been only a tendency, or latent, and helping it to become a full-blown personality disorder. "Millman says that what happens to celebrities is that they get so used to people looking at them that they stop looking back at other people."[59] In its presentation and symptoms, it is indistinguishable from narcissistic personality disorder, differing only in its late onset and its support by large numbers of others. "The lack of social norms, controls, and of people telling them how life really is, also makes these people believe they're invulnerable,"[60] so that the person with ASN may suffer from unstable relationships, substance abuse and erratic behaviour. A famous fictional character with ASN is Norma Desmond, the main character of Sunset Boulevard.

Codependency
Main article: Codependency

Codependency is a tendency to behave in overly passive or excessively caretaking ways that negatively impact one's relationships and quality of life. Narcissists are considered to be natural magnets for the codependent. Rapport identifies codependents of narcissists as "co-narcissists".[61]

Collective or group narcissism
Main article: Collective narcissism

Collective narcissism (or group narcissism) is a type of narcissism where an individual has an inflated self-love of his or her own ingroup, where an "ingroup" is a group in which an individual is personally involved.[62] While the classic definition of narcissism focuses on the individual, collective narcissism asserts that one can have a similar excessively high opinion of a group, and that a group can function as a narcissistic entity.[62] Collective narcissism is related to ethnocentrism; however, ethnocentrism primarily focuses on self-centeredness at an ethnic or cultural level, while collective narcissism is extended to any type of ingroup beyond just cultures and ethnicities.[62][63]


Conversational narcissism

Conversational narcissism is a term used by sociologist Charles Derber in his book, The Pursuit of Attention: Power and Ego in Everyday Life. Derber observed that the social support system in America is relatively weak, and this leads people to compete mightily for attention. In social situations, they tend to steer the conversation away from others and toward themselves. "Conversational narcissism is the key manifestation of the dominant attention-getting psychology in America," he wrote. "It occurs in informal conversations among friends, family and coworkers. The profusion of popular literature about listening and the etiquette of managing those who talk constantly about themselves suggests its pervasiveness in everyday life." What Derber describes as "conversational narcissism" often occurs subtly rather than overtly because it is prudent to avoid being judged an egotist. Derber distinguishes the "shift-response" from the "support-response," as in the following two hypothetical conversation fragments:

John: I'm feeling really starved.
Mary: Oh, I just ate. (shift-response)
John: I'm feeling really starved.
Mary: When was the last time you ate? (support-response)

Cultural narcissism

In The Culture of Narcissism, Christopher Lasch defines a narcissistic culture as one where every activity and relationship is defined by the hedonistic need to acquire the symbols of wealth,[64] this becoming the only expression of rigid, yet covert, social hierarchies. It is a culture where liberalism only exists insofar as it serves a consumer society, and even art, sex and religion lose their liberating power. In such a society of constant competition, there can be no allies, and little transparency. The threats to acquisitions of social symbols are so numerous, varied and frequently incomprehensible, that defensiveness, as well as competitiveness, becomes a way of life. Any real sense of community is undermined—or even destroyed—to be replaced by virtual equivalents that strive, unsuccessfully, to synthesize a sense of community.

Destructive narcissism

Destructive narcissism is the constant exhibition of numerous and intense characteristics usually associated with the pathological narcissist but having fewer characteristics than pathological narcissism.[65]

Malignant narcissism
Main article: Malignant narcissism

Malignant narcissism, a term first coined in a book by Erich Fromm in 1964,[66] is a syndrome consisting of a cross breed of the narcissistic personality disorder, the antisocial personality disorder, as well as paranoid traits. The malignant narcissist differs from one suffering from narcissistic personality disorder in that the malignant narcissist derives higher levels of psychological gratification from accomplishments over time (thus worsening the disorder). Because the malignant narcissist becomes more involved in this psychological gratification, in the context of the right conditions, the narcissist is apt to develop the antisocial, the paranoid, and the schizoid personality disorders. The term malignant is added to the term narcissist to indicate that individuals with this disorder have a severe form of narcissistic disorder that is characterized also by features of paranoia, psychopathy (anti-social behaviors), aggression, and sadism according to Kernberg and colleagues.[67]

Medical narcissism

Medical narcissism is a term coined by John Banja in his book, Medical Errors and Medical Narcissism.[68][69] Banja defines "medical narcissism" as the need of health professionals to preserve their self-esteem leading to the compromise of error disclosure to patients. In the book he explores the psychological, ethical and legal effects of medical errors and the extent to which a need to constantly assert their competence can cause otherwise capable, and even exceptional, professionals to fall into narcissistic traps. He claims that:

...most health professionals (in fact, most professionals of any ilk) work on cultivating a self that exudes authority, control, knowledge, competence and respectability. It's the narcissist in us all—we dread appearing stupid or incompetent.

In the workplace
Main article: Narcissism in the workplace

Narcissism as a personality trait, generally assessed with the Narcissistic Personality Inventory, is related to some types of behavior in the workplace. For example, individuals high in narcissism inventories are more likely to engage in counterproductive work behavior (CWB, behavior that harms organizations or other people in the workplace).[70] Although individuals high in narcissism inventories might engage in more aggressive (and counterproductive) behaviors, they mainly do so when their self-esteem is threatened.[71] Thus narcissistic employees are more likely to engage in CWB when they feel threatened.[72] Individuals high in narcissism have fragile self-esteem and are easily threatened. One study found that employees who are high on narcissism are more likely to perceive the behaviors of others in the workplace as abusive and threatening than individuals who are low on narcissism.[73]

The narcissistic manager will have two main sources of narcissistic supply: inanimate – status symbols like company cars, company-issued smartphone or prestigious offices with window views; and animate – flattery and attention from colleagues and subordinates.[74]:143 Teammates may find everyday offers of support swiftly turn them into enabling sources of permanent supply, unless they are very careful to maintain proper boundaries.[74]:143, 181 The need to protect such supply networks will prevent the narcissistic managers from taking objective decisions;[75] while long-term strategies will be evaluated according to their potential for attention-gaining for the manager themself.[74]:122 Organizational psychologist Alan Downs wrote a book in 1997 describing corporate narcissism.[76] He explores high-profile corporate leaders (such as Al Dunlap and Robert Allen) who, he suggests, literally have only one thing on their minds: profits. According to Downs, such narrow focus actually may yield positive short-term benefits, but ultimately it drags down individual employees as well as entire companies. Alternative thinking is proposed, and some firms now utilizing these options are examined. Downs' theories are relevant to those suggested by Victor Hill in his book, Corporate Narcissism in Accounting Firms Australia.[77]

Primordial narcissism

Psychiatrist Ernst Simmel first defined primordial narcissism in 1944.[78] Simmel's fundamental thesis is that the most primitive stage of libidinal development is not the oral, but the gastrointestinal one. Mouth and anus are merely to be considered as the terminal parts of this organic zone. Simmel terms the psychological condition of prenatal existence "primordial narcissism." It is the vegetative stage of the pre-ego, identical with the id. At this stage there is complete instinctual repose, manifested in unconsciousness. Satiation of the gastrointestinal zone, the representative of the instinct of self-preservation, can bring back this complete instinctual repose, which, under pathological conditions, can become the aim of the instinct. Contrary to Lasch, Bernard Stiegler argues in his book, Acting Out, that consumer capitalism is in fact destructive of what he calls primordial narcissism, without which it is not possible to extend love to others.[79] In other words, he is referring to the natural state of an infant as a fetus and in the first few days of its life, before it has learned that other people exist besides itself, and therefore cannot possibly be aware that they are human beings with feelings, rather than having anything to do with actual narcissism.

Sexual narcissism

Sexual narcissism has been described as an egocentric pattern of sexual behavior that involves an inflated sense of sexual ability and sexual entitlement. In addition, sexual narcissism is the erotic preoccupation with oneself as a superb lover through a desire to merge sexually with a mirror image of oneself. Sexual narcissism is an intimacy dysfunction in which sexual exploits are pursued, generally in the form of extramarital affairs, to overcompensate for low self-esteem and an inability to experience true intimacy.[80] This behavioral pattern is believed to be more common in men than in women and has been tied to domestic violence in men and sexual coercion in couples.[81][82] Hurlbert argues that sex is a natural biological given and therefore cannot be deemed as an addiction. He and his colleagues assert that any sexual addiction is nothing more than a misnomer for what is actually sexual narcissism or sexual compulsivity.[83] While Hurlbert writes mainly of sexual narcissism in men, Schoenewolf (2013) describes what he calls "gender narcissism" which occurs in both males and females who compensate for feelings of sexual inadequacy by becoming overly proud and obsessed with their masculinity or femininity.[84]

Narcissistic parents
Main article: Narcissistic parents

Narcissistic parents demand certain behavior from their children because they see the children as extensions of themselves, and need the children to represent them in the world in ways that meet the parents' emotional needs. This parenting 'style' most often results in estranged relationships with the children, coupled with feelings of resentment and self-destructive tendencies.[61] They would intentionally create a situation to collect Narcissistic supply.

Narcissistic leadership
Main article: Narcissistic leadership

Narcissistic leadership is a common form of leadership. The narcissism may be healthy or destructive although there is a continuum between the two. A study published in the journal Personality and Social Psychology Bulletin suggests that when a group is without a leader, a narcissist is apt to take charge. Researchers found that people who score high in narcissism tend to emerge as group leaders.[85]

In culture and society
According to recent cultural criticism, Narcissus has replaced Oedipus as the myth of our time. Narcissism is now seen to be at the root of everything from the ill-fated romance with violent revolution to the enthralled mass consumption of state-of-the-art products and the 'lifestyles of the rich and famous'.

Jessica Benjamin (2000), "The Oedipal Riddle," p. 233[86]

Some critics contend that pop culture has become more narcissistic in recent decades.[87] This claim is supported by scholarship indicating some celebrities hire "fake paparazzi",[88] the frequency with which "reality TV" programs populate the television schedules,[87] and the growth of an online culture in which digital media, social media and the "will-to-fame" are generating a "new era of public narcissism [that] is mutating with new media forms."[89] In this analysis, narcissism, rather than being the pathologized property of a discrete personality type, has been asserted as a constituent cultural feature of an entire generation since the end of World War II.[90][91][92]

Supporting the contention that American culture has become more narcissistic and that this is increasingly reflected in its cultural products is an analysis of US popular song lyrics between 1987 and 2007. This found a growth in the use of first-person singular pronouns, reflecting a greater focus on the self, and also of references to antisocial behavior; during the same period, there was a diminution of words reflecting a focus on others, positive emotions, and social interactions.[93][94] Similar patterns of change in cultural production are observable in other Western states. A linguistic analysis of the largest circulation Norwegian newspaper found that the use of self-focused and individualistic terms increased in frequency by 69 per cent between 1984 and 2005 while collectivist terms declined by 32 per cent.[94] References to narcissism and self-esteem in American popular print media have experienced vast inflation since the late 1980s.[94] Between 1987 and 2007 direct mentions of self-esteem in leading US newspapers and magazines increased by 4,540 per cent while narcissism, which had been almost non-existent in the press during the 1970s, was referred to over 5,000 times between 2002 and 2007.[94]

Cross-cultural studies of differences in narcissism are rare. Instead, as there is a positive association between narcissism and individualism and a negative one between it and collectivism, these traits have been used as proxies for narcissism in some studies.[95] This approach, however, risks the misapplication of the concepts of individualism and collectivism to create overly-fixed, "caricature-like",[96] oppositional categories.[97] Nonetheless, one study looked at differences in advertising products between an individualistic culture, America, and a collectivist one, South Korea. In American magazine advertisements, it found, there was a greater tendency to stress the distinctiveness and uniqueness of the person; conversely the South Korean ones stressed the importance of social conformity and harmony.[95] This observation holds true for a cross-cultural analysis across a wide range of cultural outputs where individualistic national cultures produce more individualistic cultural products and collectivist national cultures produce more collectivist national products; these cultural effects were greater than the effects of individual differences within national cultures.[95]

In fiction
  • Maisie Farange, in Henry James' novel What Maisie Knew (1897), is neglected by her vain and self-absorbed parents. After her parents divorce, find new partners, and ultimately cheat again on their new partners, Maisie finally decides to move in with the morally strong family maid.
  • Mavis Gary, Charlize Theron's character in Young Adult (2011), who conspires to return to her hometown to steal back her high school sweetheart, despite his being married with a child, embodies many narcissistic traits–including the emptiness she feels when she is not receiving attention or praise from her writing.
  • Jay Gatsby, the eponymous character of F. Scott Fitzgerald's novel The Great Gatsby (1925), "an archetype of self-made American men seeking to join high society", has been described as a "pathological narcissist" for whom the "ego-ideal" has become "inflated and destructive" and whose "grandiose lies, poor sense of reality, sense of entitlement, and exploitive treatment of others" conspire toward his own demise.[98]
  • Gordon Gekko, the fictional character in the film Wall Street (1987) and its sequel Wall Street: Money Never Sleeps (2010),[99] has become a symbol in popular culture for unrestrained greed and self-interest (with the signature line, "Greed, for lack of a better word, is good"), often in fields outside corporate finance.
  • Charles Foster Kane, a fictional character and the subject of Orson Welles' film Citizen Kane (1941), which explores the life of the titular character, who is widely believed to be based on the publishing tycoon William Randolph Hearst. Welles played Kane (receiving an Oscar nomination) in addition to producing, co-writing, and directing the film, while Buddy Swan played Kane as a child. In 1871, Kane's mother puts him under the guardianship of a New York City banker named Walter Parks Thatcher, who raises him in luxury. As an adult, Kane takes control of a newspaper, which he uses to advance businesses in which Kane holds stock. Kane also hires staff members away from the rival Chronicle newspaper, regarding them as collectibles. To finance the fledgling Inquirer, Kane uses his personal resources, which allowed him to operate it, even at a million dollar annual loss, for decades.
  • In George R. R. Martin's A Song of Ice and Fire series and its television adaptation, Game of Thrones:
    • The Lannisters have been deemed a "family of narcissists".[100] Licensed Mental Health Counselor (LMHC) Colleen Jordan has said the incestuous twins Cersei and Jaime have a combination of borderline personality disorder and narcissistic personality disorder, and their younger brother Tyrion is an alcoholic narcissist.[101][100] Additionally, a clinical psychologist posted as Redditor Rain12913: "People seem to be falling into the trap of thinking that Cersei really does genuinely love her brother and her (late) children. While she certainly says that she does quite a bit, and while her behaviour may seem to suggest that she does, it is highly unlikely that such a narcissistic character is capable of true love."[102] About the family's patriarch, Jordan observes that "Tywin Lannister is actually the worst of them".[100]
    • Of Lord Petyr Baelish (nicknamed "Littlefinger") Jordan observes: "If you look at Littlefinger, we know he's not remotely personally interested in Lysa, but he likes the attention. And he needs her. Narcissists use people for functions, which he does.".[100]
  • Suzanne Stone-Maretto, Nicole Kidman's character in the film To Die For (1995), wants to appear on television at all costs, even if this involves murdering her husband. A psychiatric assessment of her character noted that she "was seen as a prototypical narcissistic person by the raters: on average, she satisfied 8 of 9 criteria for narcissistic personality disorder... had she been evaluated for personality disorders, she would receive a diagnosis of narcissistic personality disorder".[103]

See also

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Further reading
  • Blackburn, Simon, Mirror, Mirror: The Uses and Abuses of Self-Love (Princeton, NJ: Princeton University Press, 2014)
  • Brown, Nina W., Children of the Self-Absorbed: A Grown-up's Guide to Getting over Narcissistic Parents (2008)
  • Brown, Nina W., The Destructive Narcissistic Pattern (1998)
  • Golomb, Elan, Trapped in the Mirror – Adult Children of Narcissists in their Struggle for Self (1995)
  • Hotchkiss, Sandy; Masterson, James F., Why Is It Always About You? : The Seven Deadly Sins of Narcissism (2003)
  • Lavender N. J.; Cavaiola, A. A., The One-Way Relationship Workbook: Step-By-Step Help for Coping with Narcissists, Egotistical Lovers, Toxic Coworkers & Others Who Are Incredibly Self-Absorbed (2011)
  • Lowen, Alexander, Narcissism: Denial of the True Self (1984)
  • Lunbeck, Elizabeth, The Americanization of Narcissism (Cambridge, MA: Harvard University Press, 2014)
  • Malkin, Craig, Rethinking Narcissism, Harper Wave 2016
  • McFarlin, Dean, Where Egos Dare: The Untold Truth About Narcissistic Leaders – And How to Survive Them (2002)
  • Morrison, Andrew P., Essential Papers on Narcissism (Essential Papers in Psychoanalysis) (1986)
  • Morrison, Andrew P., Shame: The Underside of Narcissism (1997)
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