What are the biggest signs that someone has narcissistic personality disorder?
By Elinor Greenberg
I would leave the actual diagnosis of Narcissistic Personality Disorder to mental health professionals trained in this diagnostic category. One of the reasons for this is that there are three basic types of NPD—-Exhibitionist, Closet (Covert), and Toxic (Malignant). and the only one that you are likely to recognize is the classic Exhibitionist Narcissist.
Narcissistic Personality Disorder Is a Pattern
Even with the Exhibitionist Narcissist, you will have to look for the underlying motive of the behaviors and search for a pattern of behaviors that is consistent over time across different situations, with almost all people— not just one or two traits.
Here are some typical elements of the Exhibitionist Narcissist pattern that must occur together consistently over time in order to make the diagnosis:
Motive: The attempt to regulate an unstable sense of self-esteem.
The GOD Defense: This is a term that I invented that describes an essential part of the Exhibitionist Narcissist pattern whose purpose is to up-regulate self-esteem.
Grandiosity: The person overstates their capabilities. Insists that they are special, the regular rules do not apply to them, and other people must see that they are deserving of special treatment and obsequious respect.
Omnipotence: They claim to always be right and will twist the truth in an attempt to prove that. They also rewrite history to support their claim.
Devaluation: When they feel criticized they devalue other people in cruel ways. This is a strategy to position the person who criticized them as below them, which automatically makes anything that they said valueless. Exhibitionist Narcissists may also devalue other people casually to amuse themselves, or to entertain the group they are in by pointing out someone else’s flaws: “Can you believe how fat she is?” “He is so stupid, he should be afraid to talk.”
Little or No Emotional Empathy: Narcissists do not feel bad, when they make other people feel bad. This makes it more likely that they will say and do abusive things, either on purpose or accidently. It also means that they are unlikely to care very much when other people are hurt, sick, depressed, or anxious.
Lacks Whole Object Relations: This is the capacity to see people (and themselves) realistically as a mix of liked and disliked traits and abilities. Instead they view people in an either/or binary way: They are either special or worthless.
When they find a flaw in a person that they previously thought was perfect, if the person has higher status than the Narcissist, they will find a way to rationalize it away or simply ignore it. If the person is not “above” them, they will now see them as “worthless.” What they cannot do is integrate the good and the bad into one coherent picture of the person that remains relatively stable over time.
Lacks Object Constancy: Object Constancy is the ability to maintain your positive feelings towards somebody that you like while you are angry, hurt, frustrated, or disappointed with the person. Without “object constancy,” love turns to hatred which can lead to abuse.
Punchline: A good diagnosis is based on the observation over time of enduring patterns of behavior, life strategies, motives, and accompanying dysfunctions. To paraphrase Aristotle who said: One swallow does not a Summer make; simply being self-centered and wanting attention does not a Narcissist make.
