Diseases

Narcissism: Narcissistic Personality Disorder (NPS) - causes, symptoms and therapy


"Narcissism means stagnation of personality through the persistent and fatally successful attempt to remain unchanged and childlike in a core area of ​​the soul." Ingrid Wandel & Fritz Wandel.

Narcissus is the name of a young man who, in Greek mythology, falls in love with the reflection he sees in the water. We therefore call “self-in love” people narcissistic. They exaggerate their own performance, must be the focus, they are selfish and take advantage of others.

This behavior is the leading culture of the West in late capitalism. Asserting yourself, getting to the top and appearing on talk shows is one of the goals of young people. Solidarity with the weak, or doing good in secret, is far behind on the scale. According to studies, adolescents born in the USA and Germany since 1982 are a generation that develops less and less sustainable social relationships and focuses on themselves. Scruples are a hindrance.

A society in which only material success and presence in the media counts promotes this everyday narcissism. Top politicians, some rock stars and business magnates behave like those who are typically disturbed - and are thus successful on the outside. If the behavior takes on pathological forms, it is therefore rarely seen as a disorder.

Narcissistic personality disorder symptoms

Together with histronic and dissocial personality disorder, narcissism forms the main group B among personality disorders. These disorders are characterized by the characteristics "dramatic", "emotional" and "moody". For one narcissistic disorder The following criteria must be met. The affected

  • is convinced of his own grandiosity without showing any corresponding performance,
  • fantasized about limitless success, power, fame or perfect love,
  • considers himself unique, ahead of its time as a genius and geniuses
  • craves admiration,
  • expects to be given preferential treatment, wishes to be fulfilled and has hardly any claims that can be met,
  • exploits other people in relationships to achieve their own goals,
  • is extremely vulnerable to criticism but without empathy for other people’s needs,
  • is jealous of others and assumes others to be jealous of him,
  • behaves arrogantly and presumptuously,
  • shows this behavior permanently and in different areas of life,
  • suffers from his behavior.

Healthy narcissism means the development of love for the self and thus a reasonably balanced balance of the soul. The narcissistic disorder, on the other hand, shows up as a tension between warded-off existential self-doubts and megalomania. The bloated false self must constantly affirm affected people. Excessive ambition, ruthlessness, vengefulness and exploitation of others are typical.

If they are alone, they are bored and suffer from loneliness. Old humiliations show up in the idea that "the world owes them something." Anyone who has more than them needs to be belittled.

They think that they are allowed to dispose of other people without feelings of guilt, they suck them out and let them fall - at work as in "love" relationships.

The psychoanalyst Jürg Will writes: “The radicalism, uncompromising and fearlessness with which narcissists fight and distance themselves from their enemies impresses many people as firmness and independence. Many see them as strong leaders, often martyrs, victims of their enemies, which gives them unconditional followers of those who try to identify with a narcissist from a similar structure. They take the narcissist to their idol, put themselves fully in his service, listen to him and are ready for total dedication. ”

Pathologically affected people do not know how to deal with conflicts constructively. As soon as someone criticizes them or withdraws from their influence, they lose their right to exist - in the eyes of the disturbed. The perpetrator is so alienated from his own feelings that he lacks compassion for the suffering of the victim. The inability to grieve, stand by your fears and admit weaknesses is part of the disease.

The disturbance characterizes the imagination of success and power without limits, the feeling of grandiosity, the right to be admired without having to do anything for it, the lack of empathy, arrogance and egomania - in other words a circle around the ego, with a realistic assessment has nothing to do with your own role. Those who are disturbed exploit other people, feel no pity and do not help those in need; they are extremely jealous of relationships and jealous of other people's wealth and fame. At the same time, it is difficult for them to enjoy success.

They only use other people as a canvas to represent themselves and therefore do not have relationships that are based on real exchange. They feel an inner emptiness within themselves, but often appear “seductive” in contacts with other people. However, those who are genuinely socially committed and who live in stable relationships find those affected unappealing - and wrong.

However, the patients only act charmingly to achieve a goal, otherwise they are emotionally cold. They are arrogant and hurt others. They are well aware of that.

The idea that a narcissist loves himself is wrong. His illness is the opposite of self-love. Those who are disturbed need external recognition, performance and status. Without fame, without admiration, he feels empty. He is not currently in a stable self. The external appearance covers his feeling of depression, his difficulties in perceiving his own feelings and needs. His megalomania arises from insecurity about himself. His self-esteem is unstable and therefore he feels slightly offended.

Affected people often suffer from fatigue syndrome. The reason for this is her panicky ambition and the impossible attempt to be perfect in all areas. Part of the narcissistic illness is shifting responsibility for these physical symptoms: blame is on the boss, “the idiots around me”, or the society that “does not understand his genius”. The listlessness that goes with exhaustion is experienced by narcissists as extremely stressful, even though the body “pulls the emergency brake” here.

Self and self worth

Self-esteem and self-esteem are disturbed in the sick. The feeling of self shows us our feelings, desires and needs. If it is stable, we also feel comfortable when we are alone: ​​we read the books that interest us, treat ourselves to a day in the garden or go for a walk in the forest without having to prove anything to anyone else.

The disturbed person has hardly developed his self-confidence. He feels burned out alone because of this. So he doesn't love himself, but is alienated from himself. He compensates for this estrangement by fantasies of perfection, by over-adaptation (striving) or by devaluing the achievements of others and the social environment: "The city is too small for me"; "Society is not yet ready for my thoughts".

Affected people hide this fragile self behind a facade. In doing so, they impress others, but are also dependent on their false admiration; they do not admire him, but the image that he carries outwards. His feeling for his own value depends almost exclusively on the environment. The narcissist knows this consciously or unconsciously and therefore has to produce his image again and again. His false self throws big fantasies on the market, which the admirers have to constantly confirm.

The patient is in a vicious cycle. His size fantasies result from ego weakness. As with a drug addict, he has to constantly increase the effect and at the same time feels increasingly empty. The greater the fame of his artificial figure, the more alienated he becomes from himself. The stronger the narcissistic disorder, the more he cuts off the real relationships with family or friends. Because relationships based on respect mean criticism. Real friends who know the victim's damaged self appear to him as obstacles when fleeing from himself.

The person concerned takes over his environment and thus expands his false self. He defines the other, and he has to be what the sick want him to be.

Narcissistic lies

All people are lying. Parents have secrets from their children, wives from their husbands. We could hardly cope with everyday life without little lies. With classic lies, we know that we are telling the falsehood to gain an advantage and avoid anger. Classic liars know that lies are not good. The amoral ego conflicts with the moral ego. If the inner bastard wins, we say that someone stole the wallet entrusted to us instead of losing it. We have a guilty conscience.

The narcissistic lie is completely different. The person concerned builds his external appearance on lies. He has no firm connection to the truth. This lack of truthfulness is part of his suffering, but it gives him an advantage over "normal neurotics". While classic liars know they're saying something wrong, the narcissist doesn't understand the difference between real and unreal.

"Real" is what appears useful to him in a specific situation. Those affected are not confused by contradictions in their own statements; in doing so, they surprise people with stable values ​​and norms. They don't even understand scruples, but the others unconsciously assume a moral framework that the narcissist doesn't have. He invents the truth; his lies are drafts of reality that cheat away real reality in order to maintain the "harmony" of his illusory world.

The appearance of size, independence and control must be preserved. At the beginning of relationships, those affected impress by promising their “new love” the blue in the sky. You go into this fantasy yourself, pull your partner along and abruptly break off the relationship; later they injure and devalue their counterpart when the soap bubble bursts.

Narcissistic lies are life lies to fantasize a constructed self against an oppressive reality. The narcissistic lie includes subtle insinuations as well as open threats. For example, a person affected could complain to their partner that they are constantly tired. This is not a statement about his condition, but rather suggests that those who are tired work more. He also subtly devalues ​​what the other person is doing.

The partner, i.e. the victim, often does not understand the game. Because the person concerned often "criticizes" very real points, which are also relevant in every relationship, which has its origin in respect and affection. Perhaps the partner rarely brings the garbage to the door, does not shower every day or forgets appointments. The disturbed, however, is not about criticizing behavior, but about power and control. He suggests: “You are weak, unable and lazy. It is a grace of mine to bear the hard lot of being with you. ”If the partner accepts the“ criticism ”and works on his“ weaknesses ”, the trap snaps shut. The narcissist always finds and invents new defects, the victim feels more and more worthless.

Narcissists in relationships

Those affected use various strategies to secure their power in relationships. Truth is what helps them. Therefore, they deny when they say something that is inappropriate. They represent aggressiveness as empathy, make the partner responsible for the atrocities inflicted, and disguise psychological attacks as concerns.

If the partner or child is successful, they tell about others who are more successful. Or they throw a prick in a subordinate clause. First, they are jealous of the successes of their relatives, secondly, they want to keep them small.

Affected people praise their partners, but with an undertone that suggests how much they suffer and would dispute this undertone at any time. Narcissistic mothers terrorize their children without saying a word - with looks and gestures that can "kill". At some point the child is always afraid and always feels wrong.

The disturbed are masters at rationalizing their abuse. It is hard to explain to outsiders. "Self-in love" dress injuries in public in the masks of sympathy: "The poor. Now it is becoming a social case. What should I do? ”So the narcissist devalues ​​his relatives and at the same time feels sorry for himself. Usually outsiders get a bad picture of the victim, while the perpetrator appears as an altruist.

Income affected. If the child is asked whether he wants to eat, the narcissist says yes or no. At the partner he speaks of "we" when he talks about his interests. He spreads his partner's intimacy in front of friends and strangers because he knows that they humiliate the partner first and secondly leave the disturbed as a martyr: “He has these sexual problems. I've tried everything. ”Those affected read foreign diaries and letters, and they listen to their partners for information that they can use against them.

With their children they attack the urge for independence. For example, if the adolescent asks to decide his own time, a reaction would be: "Then die in the gutter."

Such disturbed parents often divide their children between "Mummy's darling" and "Cinderella". The darling is idealized and the “Cinderella” always does everything wrong. In this way, the narcissist trains his strategy of "divide and conquer."

Narcissists only reward their partner's achievements if they can use them to put themselves at the center. Otherwise they ignore these services or reduce them in a targeted manner. If the disturbed person cannot be the center of attention, for example, he does not come to the son's high school party, or he tells how the son owes his high school diploma to the sacrifice of his father.

Sick people destroy their neighbors' success: If the “best friend” prepares for an exam, the person concerned engages him in a telephone call lasting several hours the night before; if the partner urgently needs to have a job interview, the patient starts a dispute in good time and is then "so aggrieved" that he can no longer bring him to the appointment on time. After good performances by others, narcissists distribute swipes that seem to have nothing to do with this topic. The victims only notice that they are not happy about the success.

If the partner complains that someone has treated him unfairly, the victim sides with the opponent without knowing anything about the incident. No matter what the partner does, the narcissist puts everything in a bad light.

The troubled people complain about the partner's "deficits": "Everything is so easy with others, everything is always so difficult with you;" "I don't know how I can handle it with you". Or the narcissist is alone with the partner and complains: "Nobody loves me."

Affected people rave about others in the presence of their partner so that the partner realizes how little importance they have. When the partner conveys experiences, the narcissist makes them ridiculous.

The disturbed people pathologize their relatives, especially when they confront them. They assume a "blossoming fantasy" or advise the partner (and not himself) to seek psychotherapy. They accuse critics of having no idea, claiming that they do not remember specific events, even if, for example, they are insults in emails. The patient takes away the victim's perception of reality until the victim no longer trusts his intuition and memory.

In the next step, the narcissist then reports on the victim's “mental illness” in the social environment, presenting himself as a helpless victim who does not know where this “sudden antipathy” comes from. Something is wrong with the victim, suggests the victim, and this defamation is often successful.

For example, narcissists often show their new partners the ex, who thanks to his experience is a psychological wreck, and ask the new one: "Can you imagine that I was with someone like this once?" The new one does not yet know that after some Time will be just as poor.

"Self in love" are jealous. Whenever the partner or child has something they don't have, they talk badly or try to get the same thing. They relax their daughter's lover or forbid her from wearing nice clothes. They talk to their children about their grandchildren's upbringing and poison their siblings' relationships.

Those affected lie very cleverly to outsiders. Instead of freely inventing, they reverse the victim's actions or deliberately misinterpret statements. You lie preventively. If they have just committed bad deeds, make the victim irresponsible beforehand. Or interrupt the victim when the story begins.

Narcissists involve their counterpart in a game in which the other cannot win. They contradict each other when their intent changes. If the person concerned is informed of a contradiction in his testimony, he denies that he ever said that. If he has to admit bad deeds, he includes the "admission" in "maybe", "could", "I suspect" etc. Lies are because the perpetrator knows exactly what he was doing.

For parents with this disorder, children have the purpose of worshiping them and taking care of them. That is why they keep the children waiting, assign them tasks when the children are on the go, prohibit them from playing with friends and also complain that nobody helps them. If the relatives do something on their own, the sick person sulks, becomes aggressive or "suffers" from invented diseases. If those affected grow old, they complain all the more about the pain of old age. If the neighbor has a car accident, the narcissist stages himself as "compassionate" as if he were the sufferer.

In the family, the sick person ensures that he gets the best place. He howls in the new flat until he gets the largest room. The dramaturgy is often out of proportion to the advantage achieved. If the person concerned is explicitly told that he is not allowed to bring his dog to his party, he will do just that. This is not about the specific situation, but the narcissist demonstrates that nobody has anything to forbid him.

Gifts are a hot topic for such people. If you get something for yourself, you lose control. Either they ignore it or they do it badly. Or it is a gift that confirms its own "size". Even giving is difficult for them. They either donate items that they honor themselves, such as their latest book, or something they no longer need, such as their old bike; or they buy the gift together with the recipient and buy themselves something more expensive.

Affected people show their partner how important their needs are and how void those of the partner are. When someone is in a difficult situation, the narcissist emphasizes that his is much worse. The disturbed like to "take care" of the problems of the partner; they then suggest to him how weak he is and how generous they are - and they tell him that he is in their debt.

The slightest criticism leads to outbreaks of hatred in the narcissist - right up to physical violence against your partner or your children. These attacks can only be avoided if the relatives give the victim everything he wants. Children learn to fear through cold silence or a sharp look and sometimes keep this fear for life.

Affected people abuse their children through neglect and often so skillfully that it can hardly be proven.

Sick people behave childishly if their manipulations do not work. If the partner does not work, the person concerned throws himself on the floor and shouts: "Nobody cares about me." The narcissist as an adult maintains a childish "repay the same with the same".

They manipulate their partners to get money or prestige. They withdraw money that doesn't belong to them, they break agreements, or they take child benefit.

You project. You have to do this because humans exist for them only as an extension of your ego. They locate their characteristics in the child or partner.

They never admit to having made a mistake. They don't really apologize, but mix apologies with insults and blame: "I'm sorry if you think I hurt you;" "It hurt more than you."

Those affected are very sensitive when the feelings of others are identical to their own. Otherwise they switch off their emotions. Narcissists can read the feelings of their fellow human beings and manipulate them with them. They know exactly how their threats and outbreaks work.

They create situations in which the partner can only lose. Either he has to do something that humiliates him or the patient swears revenge. The victim remains helpless in any case.

You don't ask; they demand. They don't argue; they command. If the answer is no, they press on the partner until they buckle.

Partners, children and friends are to blame for the adversity of the narcissist. If the victim beats, the partner has provoked him. If he lost his job, the "difficult children" were to blame.

They destroy the relationships in their environment. If the ex-boyfriend has a new partner, she intervenes until the relationship is broken. If the children understand each other, it splits until they quarrel. Sick people have a keen sense of cracks in the friendships of others and cheat themselves in as a supervisory authority.

Co-narcissism

Like co-alcoholics, there are co-narcissists. The patient feeds on admiration. He surrounds himself with flatterers. Partners with weak self-esteem and high ethical standards fit the narcissist like a lock to the key. They fulfill all the wishes of the person concerned and hope for the recognition that he refuses to give them.

Narcissists shy away from strong characters in relationships, because they are rarely fooled by the facade. Instead, they look for people who have adapted at the same time and have learned to serve others. They then idealize a counterpart in order to feel themselves completely. They adore their partner; the person concerned extends their false self with them. Ideal partners of the disturbed are easily unsettled. They seek to create harmony, even if the narcissist offends them severely.

Such relationships are similar to a drug addiction: the partner makes more and more efforts to satisfy the sick. But its inner emptiness is a black hole. At some point the partner breaks down.

These co-narcissists are themselves narcissistically disturbed, but they compensate for their damaged self by admiring others and also expanding their self into them. The relationship becomes a symbiosis.

A strong personality is unlikely to enter into a relationship with such people. She sees through its soap bubbles and brings the high-ups back to their true core. The person concerned will not get any further with his manipulations, and he also lacks admiration.

A person who is in balance with himself could help the narcissist and show him that social status does not mean hurting others. But the victim becomes aware of his helplessness, and that is probably why he runs away from such a relationship.

The malignant narcissism

Malignant narcissism is the most dangerous form of this mental disorder. The psychologist Otto Kernberg describes this as a narcissistic disorder that is linked to anti-social behavior and aggressive sadism. Malignant sadists feel pleasure when they torture others.

The serial killer Ted Bundy was of the malignant type. He was extremely charming and could wrap women around the finger. Then he murdered her. Even less dangerous narcissists devalue others, but in the case of the malignant patient this degradation extends to control over the life and death of the victim.

The anti-social behavior shows itself as violence in raw forms, but also in extreme exploitation. Such disturbed people are predestined to be pimps, for example.

Malignants are so dangerous because they generally distrust other people. Even as children, they experienced violence and killed their emotions.

Narcissistic personality disorder: causes

Narcissism is a normal development in childhood. The child needs the reflection from the educators. When it discovers itself as a person, it needs confirmation that it is unique and that its idiosyncrasy is loved at the same time. Only then can it recognize its limits.

However, if a child has ambitious parents, they try to form an individual image out of an individual. The real person falls into the shadow. The child learns that only external success counts; internally it remains lonely and encapsulates its feelings.

The opposite also promotes the narcissistic personality. If the parents support the narcissistic needs for too long, praise the child to heaven without a reason in reality, they make sure that the later adult does not adapt to the frustrations of life. Failure and pampering both promote a person with uncertain self-confidence who needs the confirmation of his false self by others.

The two often coincide: Parents adore gifted children and devalue them later if they do not achieve top performance in all areas. The child realizes that it is not loved for itself. The child's megalomania remains and combines with the fear of failure. The pursuit of perfection mingles with superficial contempt for the “normal people”. Better to fail terribly than to live an unnoticed life. School refusals and criminals can also suffer from the disorder. Negative recognition is better than none at all for the damaged self.

Sick people often have equally disturbed parents. Fathers who make a name for themselves at work, but are only physically present at home, or vice versa, fail at work and terrorize the family as compensation. Generally, narcissists grow up when a child cannot develop its natural needs.

But these disorders are also a social phenomenon. Young people are flooded with artificial needs and the manipulative promise that they can be fulfilled without problems. "Germany is looking for the superstar" and slim top models in dresses that cost thousands of euros suggest that young people are worth nothing without a luxury apartment, sports cars and appearances at RTL. It is difficult for parents to give their children enough self-esteem so that they do not slip into the greed for new demands.

Narcissistic personality disorder: therapy

“An elementary rule when dealing with narcissists is to respect their limits and never to press them with unconditional care or love. It is important to understand this because of the insight into the narcissistic system and not to succumb to the temptation, in the exuberance of helping, to “just so” satisfy the deep hunger that is so often felt by narcissists. ”Ingrid Wandel & Fritz Wandel

Troubled people are difficult to treat. They often seek therapy, but they usually try to perfect their denial strategy. The therapist then plays the same role for them as the partner and the public: he brings them the recognition from which they feed.

A serious need for change usually requires a high level of suffering, such as that of borderliners and depressed people. However, narcissistically disturbed people have made a life lie that serves to avoid suffering; Others suffer more from them than the narcissist admits his own suffering. In addition, her disorder promises advantages: Charismatics, politicians and pop stars testify to the success. A narcissistic lifestyle works.

A patient must therefore be prepared to forego the advantages of his false self and be satisfied with the "normalcy" of an authentic self. He must first learn that intimate relationships with other people make you happier in the long run than the “kick”. The person concerned must distrust himself and reject his strategies; this will must become so strong that it can withstand the pull of its destructive child-self.

The practitioner must be mentally stable: "What narcissists need are real experiences with people who live authenticity without hidden intentions and secret self-interest." Ingrid & Fritz Wandel

The therapist must be extremely careful. Sick people have had bad experiences, otherwise they would not have developed the disorder. The temptation is great to meet them with warmth. Das wird der Adressat in seinem Gehäuse jedoch als Schwäche auslegen und versuchen, den Therapeuten zu manipulieren – und häufig gelingt ihm das. Die verständnisvolle Spiegelung, in der er sein wahres Gesicht zeigt, fürchtet der Betroffene gerade.

Stattdessen sollte der Therapeut dem Patienten zwar wohl wollend, aber mit Distanz begegnen und seine Ausführungen analytisch begleiten. Als erstes sollte er mit dem Patienten das Selbstmitleid und die Fantasie von Grandiosität bearbeiten. Der Helfer kann dem Betroffenen die Muster der Selbsttäuschung aufzeigen. Wenn der Narzisst der Versuchung widersteht, sich selbst zu belügen, lernt er das versteckte Selbst kennen und baut es Schritt für Schritt auf. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • Ingrid Wandel und Fritz Wandel: Alltagsnarzissten. Destruktive Selbstverwirklichung im Licht der Transaktionsanalyse. Paderborn 2012
  • Berufsverbände und Fachgesellschaften für Psychiatrie, Kinder- und Jugendpsychiatrie, Psychotherapie, Psychosomatik, Nervenheilkunde und Neurologie aus Deutschland und der Schweiz: Narzisstische Persönlichkeitsstörung oft kombiniert mit weiteren Störungsbildern (Abruf: 27.08.2019), neurologen-und-psychiater-im-netz.org
  • Sonnenmoser, Marion: Narzisstische Persönlichkeitsstörung: Erkrankung mit vielen Facetten, Deutsches Ärzteblatt 12/2014, aerzteblatt.de
  • Merck & Co., Inc.: Narzisstische Persönlichkeitsstörung (NPS) (Abruf: 27.08.2019), msdmanuals.com
  • Mayo Clinic: Narcissistic personality disorder (Abruf: 27.08.2019), mayoclinic.org

ICD-Codes für diese Krankheit:F60ICD-Codes sind international gültige Verschlüsselungen für medizinische Diagnosen. You can find yourself e.g. in doctor's letters or on disability certificates.


Video: This is Narcissistic Personality Disorder (January 2022).