Narcissism: What It Is, and How It Is Diagnosed

In a recent case, an 18-year-old woman was convicted of manslaughter after she convinced her boyfriend to commit suicide via text message. As the details of the case unfolded, it became apparent she did it for the attention she’d receive upon his death, even organizing a charity softball tournament in his honor. Commenters all over the internet have called her a narcissist, but what exactly does that diagnosis entail?

Narcissism is a term that originated in ancient Greek mythology. We use it on a frequent basis to describe people who seem self-centered, but it is a multi-faceted condition. With the advent of social media, it seems to be everywhere. Facebook and Twitter give users outlets to share mundane, everyday tasks and photos for “likes” and comments. Apps like Tinder and Bumble provide a way for narcissists to showcase themselves with the best selfies, and only match with those who they deem to be on their level based on a few photos.

Narcissism has been on the rise since before social media, but it has only served to increase its prevalence in society. Not all social media users exhibit these tendencies, but those who scored higher on narcissism tests also generally were heavier social media users. Narcissism is not as severe as narcissistic personality disorder, and a high confidence level does not necessarily indicate someone is a narcissist.

Narcissism vs. Narcissistic Personality Disorder

Narcissism is commonly thought of as vanity, but it is much deeper than skin level. In addition to an obsession with physical appearance, it also is the tendency to exhibit extreme selfishness and a highly exaggerated view of one’s self and talents. The narcissist is not actually mentally ill, but is just focused on gaining power and wealth in any way possible, and has an incredibly high level of self-esteem. They will exploit others to obtain their desires and do not show any regret or remorse.

Narcissistic personality disorder (NPD), which is a clinical diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), shows itself through an inability to empathize with others and feelings of grandiosity, as well as a constant need to be admired. It is one of the 11 personality disorders recognized in the DSM-5, and can often occur along with borderline personality disorder. NPD sufferers will try to take advantage of others and act arrogantly. Their self-absorption becomes a disorder as it inhibits relationships and even their job. Many believe it manifests in a person as their inability to deal with a low self-esteem.

How They’re Diagnosed

Typically, a 40-question survey called the Narcissistic Personality Inventory is used to diagnose a person with narcissism. The higher the score, the higher the chances are they have some form of narcissism. Medical professionals will also look for typical signs and symptoms of either narcissism or narcissistic personality disorder, and may also conduct a physical exam to rule out physical issues that may cause a problem.

Treatment Options for Narcissism

Typically, narcissism is treated by a therapist or counselor. The therapist needs to work to create a therapeutic relationship with the narcissist. By doing this, it forces them to practice respect and collaboration, something most narcissists are not good at doing. Narcissists manifest their behavior in different ways, whether it be through abuse, manipulation, criticizing or acting entitled. Therapists collaborate with the person to break through these behaviors and get to the root of the problem. Narcissists don’t show vulnerability often, so it may take a while and several sessions to reach for a way to assist them in ending their behavior.

Once the therapist has gotten through to them, they should set up a recovery plan so the client can identify their narcissistic behavior and how to stop it.

Treatment Options for Narcissistic Personality Disorder

NPD is more difficult to treat, as it requires long-term outpatient care with psychotherapy, or talk therapy, conducted by a psychiatrist. Psychotherapy can help a person with NPD learn to manage relationships and understand why their emotions function in that way. This therapy can take many years as it targets a change in personality traits. Some may benefit from group sessions, while others may need more intensive one-on-one counseling.

No medication is used to treat NPD specifically, but sometimes medication is also needed to manage anxiety issues or depression. In some severe cases, it may be untreatable.

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