Do you know some with a personality disorder? What is a personality disorder? These maybe some questions someone may ask. Personality Disorders are mental illnesses that share numerous distinctive qualities. They contain symptoms that are long lasting and play a major role in most, if not all, aspects of a person's life.
While many disorders fluctuate in terms of symptoms presence and intensity, personality disorders typically remain quite regular. The DSM IV states, “Many highly successful individuals display personality traits that might be considered narcissistic. Only when these traits are inflexible, maladaptive, and persisting and cause significant functional impairment or subjective distress do they constitute Narcissistic Personality Disorder.” (BENJAMIN J. SADOCK, M.D, 2000). The dominance of Narcissistic Personality Disorder (NPD) is less than 1% of the general population. It is noticed in 2% to 16% of psychiatric outpatients. This disorder is more common in males (50% to 75%) than females (Long,1995-2009, year). These people lead lives that few can understand, or want to understand.
The personality disorders are not only relentless and heartless, but also very hard to cure. Most people with personality disorders, unlike other psychological disorders, can function normally in every aspect of society outside their disorder. Many leaders of negative groups appear to be examples of this particular personality disorder. Overall the characteristics of these leaders are arrogance, domineering behavior and greed. The three behaviors form the core of Narcissistic Personality Disorder. Healthy people are humble, democratic, and unselfish. Not all Narcissistic Personality Disorders are leaders of destructive groups. However, it is believed that, all leaders of truly vicious groups, exhibit extreme narcissistic traits and/or tendencies. The above listed individuals, and many others, all share in common these characteristics in an uncanny way.
The Origin
For the most part the cause of this disorder is not definitive. Like most personality disorders, there are many factors that may contribute to the development of symptoms. Because the symptoms are long lasting, the idea that symptoms begin to emerge in childhood or at least adolescence is well accepted. If a child does not receive sufficient recognition for their talents during about ages 3–7 they will never mature and continue to be in the narcissistic early development stage. Some narcissistic traits are common and a normal developmental phase. The negative consequences of the symptoms may not show themselves until adulthood. Parenting behaviors that may contribute to the disorder are: an oversensitive nature at birth, overindulgence and overvaluation by parents. By looking at the life of a child is another way to identify narcissistic traits to come or that has been developed. Children who are valued by parents as a means to regulate their own self-esteem, or receive excessive admiration that are never balanced with realistic feedback, unpredictable or unreliable care giving from parents, severe emotional abuse in childhood, being praised for perceived exceptional looks or talents by adults, and learning manipulative behaviors from parents shows parental behaviors that contribute to the disorder Some psychotherapists believe that the etiology of the disorder is, in Freudian terms the result of fixation, to early childhood development (Joseph Fernando 1998). A 1994 study by Gabbard and Twemlow reports that histories of incest, especially mother-son incest are associated with NPD in some male patients.
The symptoms
The symptoms of narcissistic personality disorder revolve around a pattern of grandiosity, need for admiration, and sense of entitlement. Often people with NPD feel excessively important and will exaggerate achievements and will accept and often demand praise and admiration despite how insignificant the achievements. They may be overwhelmed with fantasies involving unlimited success, power, love, or beauty feeling that they can only be understood by others who are like them, superior in some aspect of life. There is a sense of entitlement of being more deserving than others based solely on their superiority. Karen J. Maroda, Ph.D. states that, “The basic premise is that these individuals tend to present a history of immaturity and inadequate development with a tendency toward precocity and demonstration of unusual emotional sensitivity or other talent” (Maroda, 1987). These symptoms however, are a result of an underlying sense of inferiority and are often seen as overcompensatng. Because of this, they are often envious and even angry of others who have more, receive more respect and attention, or otherwise steal away the spotlight. In an article by Giancarlo Dimaggio entitled, Metacognition, States of Mind, Cognitive Biases, and Interpersonal Cycles(YEAR): Proposal for an Integrated Narcissism Model it states “Behind the grandiose image lies a low self-esteem, which gets unmasked when one’s environment does not furnish adequate empathic support. Self-esteem and self-image are central to narcissism (DiMaggio, 2002).” For all of the symptoms that have to be present to be diagnosed as NPD, their self-esteem has to be assured. An official diagnosis can be made by a qualified mental health specialist, and requires that the person displays 5 of the 9 symptoms identified in the DSM-IV.
1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
2. Be preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
4. Requires excessive admiration.
5. Requires excessive admiration
6. Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
7. Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
8. Lacks empathy and is unwilling to recognize or identify with the feelings and needs of others
9. Is often envious of others or believes that others are envious of him or her
10. Shows arrogant, haughty behaviors or attitudes

Practitioners must also rule out other psychiatric disorders in order to make a diagnosis. People with NPD are typically described as arrogant, conceited, self-centered, and haughty. Because they imagine themselves as superior to others, they often insist on possessing items that reflect a successful lifestyle. Despite this exaggerated self-image, they are reliant on constant praise and attention to reinforce their self-esteem. As a result, those with narcissistic personality disorder are usually very sensitive to criticism, which is often viewed as a personal attack.
Treatment

Treatment for this disorder is very rarely sought. There is a limited amount of insight into the symptoms and the negative consequences are often blamed on society. In this sense, treatment options are limited. Research has found long term insight oriented therapy to be effective; however getting the individual to commit to this treatment is a major obstacle. According to Maroda (1987) “The chief implications for treatment regarding the experience of being lost in time are recognition of the extreme difficulty that narcissistic patients have in interacting with the therapist in the present and their problems in making a real commitment to treatment.”(Maroda, 1987)
When someone has narcissistic personality disorder, a person may feel like they are the one who is mentally ill. A narcissist will manipulate just about anyone and everyone around them to maintain their own sense of worth. Though people with narcissistic personality disorder are often highly intelligent and charming, they're much like toddlers in their emotional development, insisting that they are the center of the world. NPD is a destructive, despicable and twisted illness, which affects not only the narcissist but affects and changes people who are in constant contact with the narcissist.