Musings - and interpersonal maelstroms - of the Complexities of Narcissistic Personality Disorder (NPD)

This post has been a long time coming, and one in which I’ve wanted to be careful in its curation, both in its tone and content.


“You’ll write about this one day, y’know? And you should. You should share your experience. ’Cause you were fucking unlucky. And who knows? Somebody else might be as desperate and lonely as you were.” - A dear, wise friend of mine.


Mental illness is vast. We as a society are so conditioned to equate discussions of mental health with that of anxious stirrings, dips in mood, and agitations of routine. Rarely ever do we venture beyond the clipped, controlled horizon of the known.


That’s because mental illness can be inexorably daunting to talk about. It’s psychosis and breakdowns and hallucinatory voices. It’s cutting and throwing chairs and risk of sectioning. It’s abusive behaviour, not only to yourself but potentially others. It’s messy and it’s nasty and it is, understandably so, still a mystery to society’s neurotypical attitude.


As such, the illnesses that we normally fail to be exposed to tend to appear the most malignant in nature. This is a natural part of the human condition: the things we know the least about, tend to be hotly pursued by a susurrating, menacing undercurrent of fear and uncertainty. The following article details my own experiences with a partner, who, unbeknownst to me until later down the line, would be described as suffering from Narcissistic Personality Disorder, or abbreviated as NPD. 

It should be noted that if you’re expecting a disparaging, one-note essay on how narcissists are evil or monstrous or diabolical, then I suggest you turn away. NPD is a relatively new illness in the realms of psychology, in addition to being a complex one.

Can it procure a great deal of social distress? Yes. Can people who suffer from the condition hurt those around them? Also, yes. However the same can be said for many of the mental illnesses we face in today’s mainstream realm, today, too. I know that my own toxic behaviour in the past manifested from unhealed, sickly parts of my psyche - and it was only through radical honesty, therapy and medication that I was able to start to do the work on it.

 Perhaps, by bringing more awareness to potentially damaging behaviours and understanding how a person requires treatment, we can reduce the pain and despair faced by people in these circumstances.

I hope to bring more awareness to the symptoms and potential ramifications it brings to interpersonal relationships - as well as assuring those who suffer from dealing with its consequences that they are not alone, and that there are toolkits at our disposal.


NPD is a truly difficult illness - and yes, it can make relationships of all kinds particularly tricky. But I believe there needs to be a better conversation out there on the Internet towards the condition. The stigma and understanding surrounding it can already by pretty generic and outlandish.

WHAT IS NPD?

Many people confuse Narcissistic Personality Disorder with being self-centred; lacking self-awareness; vainness, or perceived superiority. Of course, these are all symptoms within the spectrum of narcissism - and we all exhibit and own traits of narcissism within us, which may be exacerbated during different times of our lives - but NPD describes a pattern of behaviour throughout a long period of time - think, throughout adolescence and adulthood.

According to the DSM, NPD is described as a Cluster-B disorder. This group of illnesses is often outlined by dramatic, overly emotional or unpredictable thinking or behaviour and interactions with others. It may include: antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.

These disorders are particularly difficult to diagnose - and should be verified with caution. The above symptoms can all be associated with mood disorders such as anxiety, depression, or bipolar, and treatment will, of course, vary if this is the case.

Which means no silly social media-armchair diagnoses; no name-calling or random assumptions. It means going to a professional, providing evidence for interactions and interpersonal experiences, and allowing them to explore possible hypotheses towards the behaviour. 

NPD is a severe, destructive illness, both for the sufferer and their surrounding loved ones. Unlike the generic statements scattered around the ‘Gram in memes and cringe quotations, it is particularly rare: approximately 0.5% of the population must endure it, with the majority of sufferers being male. This does not exempt women from having the condition, it must be noted. Many times during this period of distress I have looked back and asked myself, “do I have this illness?” which was an interesting concept to explore in therapy. (Turns out, I just have good ol’ fashioned bipolar II and a variant of PTSD.)

Experts aren’t fully certain what predisposes people to the illness, but many figure that it’s at least partly genetic, but mostly experiential. This normally manifests in the form of ongoing or impactful trauma, or as a result of parenting methodologies (either overindulgent, defining the child as “special” or “superior”, or downright neglectful) in addition to some implications of neurophysiological differences. The insular cortex, the region of the brain where, essentially, our empathy may be activated, has shown to foster little activity in sufferers compared to those who do not have the illness, and those who suffer may also have fewer mirror neurons overall, for example.

Overall, symptoms are an ingrained, long-term pattern, which may include the following:


  • Having a hyperbolic sense of self-importance.

  • Having a sense of entitlement and require constant, excessive admiration

  • Expecting to be seen as superior even without achievements that warrant said image

  • Exaggerating achievements, accolades and talents

  • Being preoccupied with fantasies about success, power, brilliance, beauty or the “dream partner"

  • Believing they are superior and can only associate with certain people - or choose to surround themselves with people they deem “inferior” to feel better about themselves

  • Taking control of conversations and belittle or look down on people they perceive as inferior

  • Expecting special favours and unquestioning compliance with their expectations

  • Taking advantage of others to get what they want

  • Having an inability or unwillingness to acknowledge or recognise the needs and feelings of others

  • Being envious of others and believe others envy them

  • Behaving in an arrogant or haughty manner, coming across as conceited, boastful and pretentious

  • Insisting on having the best of everything — for instance, the best car, best lifestyle, or office


Again, we’ll all partake in these actions in *some capacity* during stints in our lives. This is normal. Being a bit of an ass every now and then is human, and acts as great capacity for learning and growth. Further, as narcissism as a trait is a spectrum, it’s perfectly healthy to exhibit some of these behaviours in a non-extreme, softened way. There is an evolutionary advantage to being self-interested, after all.

NPD, on the other hand, is much more vociferous and pernicious. It stains the decades of a person’s life, inculcated in pain and shame and trauma and the inability to let go of that inner self-critic. It is an extreme, detrimental pattern of behaviour that can be seen across the span of a lifetime. People with the illness may come across as extremely confident, perhaps arrogant, cocky, aggressive and full of life; but underneath this all is an exceptionally fragile ego, terrified of vulnerability, accepting imperfection, and refusing to acknowledge responsibility to avoid the pit of self-loathing that would then take place.

So, odds are, your uncle or your ex or that girl you just don’t get on well with at work don’t suffer from the condition - they might just be a bit unaware of dickish behaviours. This illness is serious business, both for the sufferer and their surrounding circle.

It’s best not to diagnose - or self-diagnose - blindly.


WHAT’S THE “WHY” BEHIND THE ILLNESS?


As well-evolved social animals, we come equipped with the capacity to develop our own Jiminy Cricket, that evaluated our behaviours accordingly.

For instance, we forget to pay that person back, or we lash out after a long day, or don’t see our friend like we promised - our internal guiding voice chastises this, and encourages us to do better.

Likewise, a promotion at work, volunteering at a charity, or setting time aside to be with our parents would warrant a more positive appraisal.


This Jiminy Cricket gets nourished during our childhoods, based upon our relationship with our parents, our genetic temperament, and our own understanding of what was deemed worth of praise or criticism during that timespan.


We want the Jimmy Cricket to be realistic: unabashed in praise when we do the right thing, but not afraid of inducing shame or guilt when we make a mistake. This Jiminy Cricket would be sensible, imparting appropriate reactions for a given behaviour, ensuring it’s all nice and proportionate. 


In essence, our Jiminy Cricket acts as a parental role when we begin to live independently as our own agents.


This is where it gets tricky with NPD sufferers.


Their Jiminy Cricket, beyond their cultivated idea of Self and formulaic arrogance, is incredibly harsh and devaluing. This voice will be quick to criticise and wary of appraisal. Any mistake in this Cricket’s eyes is worthy of extreme, harsh punishment.


Imagine you had this horrible, poisonous, terrifying voice punishing you for being less than the perfect Self. Frightening, right? 


People with the condition will try to avoid any responsibility for anything that goes wrong in order to avoid this evil, nasty Cricket. To avoid this potential breakdown and spiralling into self-loathing, they project the blame and their own imperfections onto somebody else. 


For example, in the average domestic problem, rather than saying “When this happens/when this actions undertaken, I feel x and y”, somebody with NPD might constantly lie to keep up their projected Self, or be more inclined to engage in the following, without any willingness to change their communication style:


“You always play the victim.”

“You’re so selfish. Why can’t you see my needs instead of only yours?”

“If you weren’t like this/hadn’t done X, we’d never have this problem.”

“You never/always do x.”

“Nah, this is just you. You’ll never change.”

“This is just classic you.”

“You’re a worthless piece of shit.”

“I’m sorry you feel that way."

“You’re a bitch.


Notice how this places all of the onus on you, rather than create a productive atmosphere to solve interpersonal differences, whereupon each individual - or perhaps only one - may shoulder responsibility adeptly and safely.


In my past experience, for instance, absolutely everything was my fault: according to them, my anxiety and depression meant that I was constantly playing the victim, (which I’ve no doubt came across that way) and the more I tried to voice my own feelings and emotions, the needier I got. 


I was constantly accused of being manipulative, which to all of my loved ones around me - previous partners included - seemed extraordinarily bizarre. It was a pretty new, hot take on the block. Accused of this, whilst consistently being lied to. It was quite the confusion.


No doubt my emotional upset and distress manifested poor behaviour, and was my own ego crying out for nurturing and care. And I constantly apologised - which, in of itself can be manipulative, unbeknownst to me at the time. My emotional state and my behaviour were worsening as I felt progressively less mentally safe. In the end, my horror and fear of being this person meant that, conveniently, in order not to “manipulate” them, I ended up shrinking and shrinking and staying silent and inexpressive for fear of being this image of a selfish bitch that was being created.


Invariably, repressed feelings always come out, in some shape or form, as even more desperate and uncontrolled than before. As begging, pain, and crying. Overt neediness and codependence. It was obviously hurtful, and something I was never proud of: I became somebody completely alien to the Sophie I knew before, and the Sophie I strive to be. 


I felt like I was going truly insane. The entire process was one of the most painful things I have ever undergone.


And whilst the pain still smarts to this day, one of the things I have learnt in my therapy work is that the affliction runs just as deep for the person with the condition - it merely manifests itself in other ways. Of course, as with any mental illness, for each sufferer, it presents itself diversely. But we can certainly look at the average, and make conclusions from the data.


Each time someone who has NPD berates or criticises you, that is a form of self-protection.

Each time they turn and twist things back onto you, again, that is a form of avoiding their own pain.

Each time they avoid responsibility, that is them showing themselves to be terrified of facing old wounds and coming to terms with trauma and a spiteful inner critic.


This is not to excuse toxic, poor, or potentially abusive behaviour from any ill individual - but it does explain it. With knowledge comes power, and it’s something I wish I had during this time, to prevent my own emotional reactivity and melodrama.

Because of their torrid Jiminy Cricket, an NPD-sufferer who hasn’t done the healing work may choose to project the traits that they’re deeply ashamed of onto you, or attempt to shift all blame and responsibility as far away from themselves as possible. The tragic reality is that this situation cannot be solved by logic or by arguing about who is right or wrong - I remember feeling like I was on an emotional rollercoaster, or slamming my head against the wall, repeatedly. This type of back-and-forth has nothing to do with external circumstance or fairness. It is about the preservation of self-esteem. To avoid self-blame, and by extension, the haunting chasm of their own inner emotional turmoil. 

This can be a tricky component of the illness. If you avoid self-blame or responsibility, you’ll never pick up on a problematic pattern in your life, and therefore will never go to therapy to actively do the work. This is one of the reasons the illness can cause havoc to surrounding loved ones - and may mean being mindful of certain symptoms if they cannot be objective.

 When NPD sufferers imagine accepting responsibility or blame for an event, however harmless it may ultimately be, they unconsciously fear the psychological equivalent of a thousand knives being harpooned into their chest, by both you and their unforgiving inner voice. Therefore, they project their own self-criticism onto you and then see you as the problem to escape this distress


There are a couple of things that can be done when it comes to reducing reactivity in interactions with a sufferer. The fundamental key is to shift from discussing who is to blame and focus on making that person more comfortable - for them to feel safe.


Method 1—“The Empathy Diet”


This technique was one of James F. Masterson’s interventions that he trained professionals to use to help people with NPD feel understood. In this method, we ignore the notion of blame and who is right and wrong, and instead we use empathy and patience to capture the emotion that the person is feeling.

People with NPD find empathy and feeling understood, alongside the absence of judgement, very soothing. Most grew up without ever experiencing empathy from their caregivers. That is why their inner voice is so harsh. Through regular viewing of patience and empathy and soothing, the individual soon finds “mirroring” this way of communication to become easier, and is able to connect through a “diet” of learned connection.



Case study 1

Sarah is getting ready and leaves a necklace on the floor. Adam comes home and accidentally steps on it. He starts berating Sarah.

 I can’t believe that you leave shit lying on the floor! This is all your fault! You never pay enough attention to what you are doing!


Sarah knows that the necklace was only on the floor for a minute, whilst she was adjusting her makeup. She knows that there's two people involved in this outcome. She also knows that it is fruitless to argue with him about it. If she protests, it will just lead to arduous, painful arguing. So, she empathically tries to “mirror” back to Adam what she thinks he is feeling.


That must have been really painful for you when the necklace was there on the floor, making a mess. I can understand how frustrated you were by it being there. You just wanted peace and comfort and to have your surroundings respected.


NPD sufferers find empathy and feeling understood, coupled with the absence of judgement, very healing. Most grew up without ever experiencing empathy from their caregivers, or the sense that they are special or superior - this is why their inner voice is so hypercritical.


Method 2 - “Teamwork makes the Dream Work”


Ignoring unfair criticisms, as painful as it can be, is another way of establishing productive communication: in other words, emphasising the fact that you are both a team, rather than placing blame on one another.


Case study 2


Adam blames Sarah for leaving the necklace on the floor. Sarah swiftly tidies the area up and does not protest his tone of voice. This is all done calmly, matter-of-fact, and not reacting to Adam’s own projections.


The key component here is that Sarah is not holding Adam accountable for his reaction; thus, over a long span of time, he may slowly begin to internalise a new model of how to handle mistakes without blaming anyone. He realises it is safe to make mistakes, and gradually, trusts Sarah’s intentions rather than assume she is nasty and manipulative.


Adam may have the capacity in the future to still blame, project, and devalue her character in parts due to his condition, but he will slowly come to understand that she is not purposefully or maliciously trying to “undo” him. Further, with healing, therapy, and potential medication, this will be diminished even further.


This is a huge turning point in his Adam’s understanding of interpersonal relationships: that he can feel hurt by Sarah, yet know she is not intentionally trying to harm him, and establishing a healthy, less black-and-white view of her personhood. Again, this will help him feel safe, become more vulnerable, and be more mindful in how he approaches problems between the two of them.


Both of these methods can be done - but it does mean that at times, you may have to orientate yourself as more of a psychotherapist in the interplay, rather than a child or sibling or friend or partner. This piece is not to tell people to run away from NPD sufferers, nor dismissing their own experience or telling them to “get on with it” - rather, it’s there to make people more aware of the backdrop to the condition, providing an emotional toolbox for both parties, and giving people the options for action if this is the path they choose to take.


Looking back, there’s no way in hell that I had the emotional toolkit nor the maturity to handle such a massive, trauma-based reaction. I was the match to their gasoline - and probably triggered all kinds of nasty, unpleasant sensations which made me wholly unsupportive in my endeavours throughout the partnership. Whilst I regret this, I know I did my best, and further research puts me in a much better position for any future scenarios in any personal interactions that could ensue.


Knowing what I know now, would I date somebody if I was aware that they dealt with this condition? The answer, as a mental health advocate and mindful of my own shortcomings, is a unconditionally yes. I now have better awareness of my own codependency, and continue to improve the shadowy bits about myself which I choose to actively integrate. I am more aware of how to make a sufferer feel safe and supported, as opposed to simply focus on my own pain. If the individual in question is willing to heal and work on themselves as I am with my own “stuff”, the decision is easy. Relationships are a journey, and I’ve gained a much deeper understanding about who I am, my own needs, and what I need to heal, through this unique pain.


Was it painful? Exceptionally. Would it be painful again? Knowing the condition’s implications, I can imagine so. But anyone who dates me with my own mental illness will recognise how difficult to love I may be. I can only imagine the deepest, unconscious loneliness one may face dealing with this trauma and fear of vulnerability. And so, I refuse to discriminate.