Church Leaders and Narcissism

For those of you who've been following the Mars Hill dialogue, here's some interesting info from Wikipedia on Narcissistic Personality Disorder, submitted without comment: (link)

DSM Criteria
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:[1]

has a grandiose sense of self-importance
is preoccupied with fantasies of unlimited success, power, brillance, beauty, or ideal love
believes that he or she is "special" and unique
requires excessive admiration
has a sense of entitlement
is interpersonally exploitative
lacks empathy
is often envious of others or believes others are envious of him or her
shows arrogant, haughty behaviors or attitudes
(see also: Full list in DSM-IV-TR)

- Lifetime prevalence is estimated at 1% in the general population and 2% to 16% in clinical populations. 50 to 75% of those with this diagnosis are men.

- Hypothetical Causes

The etiology of this disorder is unknown, but, according to Groopman and Cooper[3], factors identified by researchers as possibly contributing to this disorder include:

An oversensitive temperament at birth
Overindulgence and overvaluation by parents
Valued by parents as a means to regulate their own self-esteem
Excessive admiration that is never balanced with realistic feedback
Unpredictable or unreliable caregiving from parents
Severe emotional abuse in childhood
Being praised for perceived exceptional looks or talents by adults
Learning manipulative behaviors from parents
Some narcissistic traits are common and a normal developmental phase. When these traits are compounded by a failure of the interpersonal environment and continue into adulthood they may intensify to the point where NPD is diagnosed. It has been suggested that NPD may be exacerbated by the onset of aging and the physical, mental, and occupational restrictions it imposes

Pathological narcissism occurs in a spectrum of severity. In its more extreme forms, it is narcissistic personality disorder. NPD is considered to result from a person's belief that he or she is flawed in a way that makes the person fundamentally unacceptable to others. This belief is held below the person’s conscious awareness; such a person would typically deny thinking such a thing, if questioned. In order to protect themselves against the intolerably painful rejection and isolation that (they imagine) would follow if others recognised their supposedly defective nature, such people make strong attempts to control others’ view of them and behaviour towards them.

Psychologists commonly believe that pathological narcissism results from an impairment in the quality of the person’s relationship with their primary caregivers, usually their parents, in that the parents were unable to form a healthy, empathic attachment to them. This results in the child conceiving of themselves as unimportant and unconnected to others. The child typically comes to believe that he or she has some defect of personality which makes them unvalued and unwanted.

Narcissistic Personality Disorder (NPD) is isolating, disenfranchising, painful, and formidable for those diagnosed with it and often those who are in a relationship with them. Distinctions need to be made among those who have NPD because not each and every person with NPD is the same. Even with similar core issues, the way in which one's individual narcissism manifests itself in his or her relationships varies.

To the extent that people are pathologically narcissistic, they can be controlling, blaming, self-absorbed, intolerant of others’ views, unaware of others' needs and of the effects of their behavior on others, and insistent that others see them as they wish to be seen. They may also 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. (For example, a narcissistic father who was a lawyer demanded that his son, who had always been treated as the "favorite" in the family, enter the legal profession as well. When the son chose another career, the father rejected and disparaged him.)

These traits will lead overly narcissistic parents to be very intrusive in some ways, and entirely neglectful in others. The children are punished if they do not respond adequately to the parents’ needs. This punishment may take a variety of forms, including physical abuse, angry outbursts, blame, attempts to instill guilt, emotional withdrawal, and criticism. Whatever form it takes, the purpose of the punishment is to enforce compliance with the parents' narcissistic needs.

People who are overly narcissistic commonly feel rejected, humiliated and threatened when criticised. To protect themselves from these dangers, they often react with disdain, rage, and/or defiance to any slight criticism, real or imagined. To avoid such situations, some narcissistic people withdraw socially and may feign modesty or humility.

Though individuals with NPD are often ambitious and capable, the inability to tolerate setbacks, disagreements or criticism, along with lack of empathy, make it difficult for such individuals to work cooperatively with others or to maintain long-term professional achievements. With narcissistic personality disorder, the person's perceived fantastic grandiosity, often coupled with a hypomanic mood, is typically not commensurate with his or her real accomplishments.

The exploitativeness, sense of entitlement, lack of empathy, disregard for others, and constant need for attention inherent in NPD, adversely affects interpersonal relationships. Individuals with NPD frequently select as mates, and engender in their children, "co-narcissism," which is a term coined to refer to a co-dependent personality style similar to co-alcoholism and co-dependency. Co-narcissists organize themselves around the needs of others. They feel responsible for others, accept blame readily, are eager to please, defer to others’ opinions, and fear being considered selfish if they act assertively.

- Theories on Narcissistic personality disorder and shame
It has been suggested that Narcissistic personality disorder may be related to defenses against shame.

Gabbard suggested NPD could be broken down into two subtypes. He saw the "oblivious" subtype as being grandiose, arrogant and thick skinned and the "hypervigilant" subtype as easily hurt, oversensitive and ashamed.

He suggested that the oblivious subtype presents a large, powerful, grandiose self to be admired, envied and appreciated, which is the antithesis of the weakened and internalised self that hides in a generic state of shame, in order to fend off devaluation, whereas the hypervigilant subtype, far from fending off devaluation, is obsessed with it, neutralising devaluation by seeing others as unjust abusers.

Jeffrey Young, who developed Schema Therapy, also links shame to NPD. He sees the so-called Defectiveness Schema as a core schema of NPD, next to the Emotional Deprivation and Entitlement Schemas. The Defectiveness Schema is compensated with three Schema Modes (coping strategies):

Surrender: Choose critical partners and significant others; puts him- or herself down.
Avoidance: Avoids sharing "shameful" thoughts and feelings with partners and significant others due to fear of rejection.
Overcompensation: Behaves in a critical or superior way toward others; tries to come across as perfect.
Note that an individual with this schema might not employ all three schema modes.


- Treatment and prognosis
Though there is controversy in the profession, most psychiatrists and psychologists regard NPD as a relatively stable condition when experienced as a primary disorder. James F. Masterson's A Therapist's Guide to the Personality Disorders: The Masterson Approach outlines a prominent approach to healing NPD, while discusses a continuum of severity and the kinds of therapy most effective in different cases. Typically, as narcissism is an ingrained personality trait, rather than a chemical imbalance, medication and therapy are not very effective in treating the disorder. Schema Therapy, a form of therapy developed by Jeffrey E. Young that integrates several therapeutic approaches (psychodynamic, cognitive, behavioral etc.), also offers an approach for the treatment of NPD.

It is unusual for people to seek therapy for NPD. Subconscious fears of exposure or inadequacy are often met with defensive disdain of therapeutic processes.

Pharmacotherapy is rarely used. In a review of the literature, one patient responded to Wellbutrin.

Because NPD contributes to negative, stressful life experiences characterized by the mental health field as "clinically significant distress" or "impairment", co-existing conditions of depression and anxiety are typical.

Comments

Anonymous said…
thanks for a really helpful account of NPD!
Charlie said…
Sounds about right. It's definately centred around feelings of shame, abandonment and repressed neediness.

Having tried almost every therapy going, I'm finding group analytic work extremely helpful. Can be painful at times though.

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