Co-morbidity
Narcissistic personality disorder can occur in combination with any other personality disorder.Most often it is linked to the so-called histrionic (hysterical/hysterical) personality disorder. (typical example here: the behavior of an actress whose new film was torn apart by the professional critics). Often the constant “fight against the world” can even develop symptoms of a real depression.
Causes
One of the main theories (Millon and Davis 1996) concerning the development of pathological narcissism is that the parents’ educational style is seen as very decisive. If a wrong model is exemplified by the parents (one or both parents themselves narcissistic), the child can be misshapen at a very early age. Also, “wrong encouragement” can influence the development of a narcissistic disorder.
Parents who teach their children at an early age that they are “better than others” distort the actual perception of their own achievements at an early age. Often enough these children become outsiders because of their strange parents and the even stranger beliefs they are taught. This in turn causes children to hear from their parents that the other children are jealous that you are better than them.
This further promotes the development of intolerance and misperception of oneself. This leads to permanent conflicts with the environment, which in turn can lead to a depressive or aggressive course. Another theory according to Kernberg (1976) states that narcissistic personality disorder is directly related to borderline personality disorder. In his opinion, borderline personality disorder is the more severe form of narcissistic disorder. According to Kernberg, this disorder has better “defense mechanisms”, so that e.g. the emotional fluctuations do not break through as strongly as in the borderline disorder.
Therapy
The form of therapy of choice is psychotherapy. There are different starting points: If, as mentioned above, depression develops, drug treatment with antidepressants may be indicated.
- Behavioral therapy: Behavioral therapy works primarily on the patient’s deficits in dealing with other people.
It focuses on the necessary empathy, the right social interaction and the fear of negative evaluation. Role plays and video recordings are used for example.
- Depth Psychological Therapy:Depth psychology is primarily about confronting and working with the patient’s defense mechanisms (e.g. “Why do you have to overestimate yourself? “How do you feel about feelings such as anger, envy and aggression?
)
- Counseling and Coaching: The so-called coaching, i.e. very practical tips in dealing with other people and in dealing with special problems, is an effective way of treatment in narcissism. (However, this is by no means true for all mental disorders! )
