The Many Faces of Narcissism

Understanding the spectrum from healthy to malignant

As of late the term ‘narcissist’ has become a popular buzzword. It’s turned into a designation for aloofness, any perceived slight, and self indulgent behavior. These sweeping generalizations fail to consider the variability of personality, the impact of environment and developmental history as well as the influence of one’s personal perception. Unquestionably we need to be careful about what judgments we prematurely make about others. We need to understand what these terms mean and how they can be appropriately applied.

I find myself wondering if the reason for this trend is rooted in victims of malignant narcissists not having their reality validated. This phenomenon known as Cassandra Syndrome, is a state of madness that results when one’s truth is not believed and is in fact, chalked up as lies.

Derived from Greek mythology, the mortal Cassandra is pursued by the God Apollo. Apollo promises to bestow upon her the gift of prophecy if she agrees to take him as her lover. However, once the mentorship is finished, Cassandra refuses to give her body to him. Furious at being rejected Apollo rapes her and then levels a terrible curse upon her head. While Cassandra can still foresee the future, the curse ensures that not only will no one believe her they’ll think she’s purposely telling lies.

Indeed, as a trauma therapist in NYC, I’ve encountered numerous folks like Cassandra whose accounts of narcissistic abuse were not only discounted by friends and family members but even discredited by clinicians.

Having one’s truth believed and gleaning an understanding of one’s plight is a necessary step towards liberation. When oppression of any form is suddenly recognized, the need to heal and reclaim integrity and personal power is a life affirming impulse.

That NPD victimization has been hidden, obscured and denied explains why its sudden reveal is fueled by such intense urgency and aggression. Likewise, a constellation of symptoms including perceiving danger even when circumstances may be safe, is a byproduct of narcissistic abuse syndrome. This trauma response is fueled by persistent hyperarousal aka hypervigilence and can explain the penchant for classifying all perceived threatening behavior as narcissistic.

The critical need for answers and validation has prompted a wealth of resourceful material from survivors and clinicians, who have a personal understanding of narcissism and narcissistic abuse syndrome. It is a united effort to remove the veils of illusion and break through the abject denial that impedes survivors of narcissistic abuse from receiving the help they need.

Nevertheless, sorting through information and managing impulses is critical to responsibly navigating the spectrum of narcissism. It is also essential to personal healing and gauging what is relatively safe from what is dangerous.

Above all it is important to understand that narcissism exists on a spectrum. This means narcissism is a condition that has variability across a continuous range. Unlike the introversion-extroversion spectrum where there is a range of opposite ways of being, with traits of engagement and disengagement peppered in-between, the narcissism spectrum draws distinctions of adaptive healthy narcissism from malignant pathological states. All human beings possess some characteristics that span this continuum.

In order to understand the vast differences between healthy narcissism, narcissistic traits and narcissistic personality disorder we need to appreciate the nuances of the spectrum. How benign or destructive a narcissist is depends on where on the spectrum they land.

Freud contended in his paper ‘On Narcissism’ that primary narcissism is an essential part in normal development and is critical to one’s survival. In 1968 psychoanalyst Heinz Kohut inspired by Otto Kernberg’s theory of narcissistic personality structure, coined the term Narcissistic Personality Disorder. Like Freud he also spoke of the child’s normal narcissistic entitlement as the foundation for a healthy emerging mature self. Similarly Otto Kernberg described healthy narcissism as a cohesive integrated Self.

Healthy narcissism forms a constant, realistic self-interest, mature goals and principles, and an ability to form deep relationships. It is critical to cultivating an authentic sense of self and positive self regard.

On the other hand, those who fall into the disturbed or the malignant range of narcissism evidence an absence of empathy and an intense need for aggrandizing, attention, and admiration. The disordered narcissist harbors extreme expectations, reinforced by a deluded sense of entitlement and ‘specialness’. These character traits can result in dangerously exploitive, abusive behavior that is carried out with cunning and acumen. Many adults with NPD evidenced signs of oppositional behavior as children, foreshadowing a sociopathic disposition.

The further along on the narcissistic continuum the more the capacity for love diminishes and the greater the proclivity for domination. It is here we begin to see rigid personality traits and exploitive entitled ways of operating.

Differentiating narcissistic traits from the full blown disorder can be complex, primarily because malignant disordered narcissists are skilled at morphing into seemingly humane compassionate and loving individuals. This metamorphosis is enacted to glean supply, a term which describes the narcissist’s pursuit of forms of gratification that feed insatiable needs for attention, control and unblemished admiration. Although the personality disordered narcissist shows a persistent lack of compassion and insight, s/he has the ability to impersonate feelings so as to manipulate others and achieve desired outcomes.

Discerning how frequently, intensely and consistently narcissistic behavior occurs can help determine if one has traits or the full blown disorder. A disorder is determined by persistent and chronic symptoms. Narcissistic Personality Disorder is the form of narcissism that is deep-rooted and intractable.

Folks with traits and the disorder will both infiltrate their relational maneuvering with behaviors geared towards securing admiration and control. However, although self-centered and manipulative, the individual with traits is prone to acknowledging their shortcomings. They possess some flexibility with desiring change and may present with a tenuous capacity for insight. Folks presenting with traits as opposed to the full blown disorder can respond to in-depth psychodynamic treatment. This is a critical qualifier. They are capable of empathy, even though they are guarded, suspicious and aloof.

On the contrary, those with clinical NPD will evidence a complete lack of humility and capacity to self examine. They experience pleasure with deliberately toying with others so as to dominate and exploit. In the most extreme form, malignant narcissists are psychopaths, driven towards criminality and the urge to sadistically destroy others.

Malignant narcissists rarely enter treatment, and if they do they are court mandated or intent on resurrecting a relationship by affording the false hope that they are committed to working out difficulties in therapy. During this honeymoon phase the malignant narcissist epitomizes what the targeted supply seeks, to ensure that the target and the therapist will buy into a fictional romantic narrative that will re-establish dominion.

There are varied presentations of disordered narcissists. Some present as grandiose yet charming, others as outwardly bold and arrogant. The more covert variety can appear vulnerable and contrite and may quietly virtue signal and grandstand. The somatic narcissist will use their sexuality to manipulate supply, while the cerebral narcissist will use their intellect to procure adulation.

Whatever mask is worn, the result is the same. Victims of narcissistic abuse will evince signs of PTSD irrespective of how constitutionally strong they are and how balanced and nurturing their upbringing was.

It wasn’t until 1980 that Narcissistic Personality Disorder was officially recognized in the third edition of the Diagnostic and Statistical Manual of Mental Disorders, and criteria were established for its diagnosis. Although empirical data is sparse, NPD was said to affect only 1 percent of the population until the U.S. National Institutes of Health (NIH) conducted a study of personality disorders with 35,000 random subjects. Based on their findings, in 2008 they concluded that approximately 10% of the U.S. population has borderline and narcissistic disorders. If you factor in narcissistic traits, as opposed to just the full on disorder a much greater percentage of unhealthy narcissism is implied.

Being able to identify the gradations of narcissistic behavior from dangerous pathological behavior is a vital life skill. We all are guilty of lapsing into egoistic, self-absorbed behavior from time to time. There is a vast difference between gloating over an achievement or blathering on indulgently about a new romantic relationship, from unrepentantly inflating oneself to debase another. Situational moments of narcissism do not necessarily suggest one has intractable traits and it certainly does not imply that one is narcissistically disordered. However, when behaviors to debase and demean become routine and continue to escalate that may indeed suggest the prevalence of disordered narcissism.

As the NIH stats reveal, those with noxious narcissistic traits and the full-blown disorder live amongst us undetected. Often they are charming and highly successful. After all, it is easy to be ruthlessly ambitious when you lack a conscience.

It is our responsibility to recognize and understand who amongst us poses an actual threat, so that we can decide how and if we want to handle those we encounter who exhibit traits, and successfully dodge the possibility of being sized up as potential supply by those who present as malignant. Knowing the difference is key to discerning what can be managed and what needs to be undoubtedly shunned.