Personality, Styles and Brief Psychotherapy

By Mardi Horowitz; Charles Marmar et al. | Go to book overview

7
THE NARCISSISTIC
PERSONALITY

THIS CHAPTER will focus on a character style in which vulnerability to deflation in self-esteem, with a compensatory trend to display superiority, represents a key set of traits. An important intrapsychic component of the style is protection of self-esteem through manipulation of the meaning of actual events.


Diagnosis

In defining narcissistic personality disorders, DSM-III describes an individual who has:

... a grandiose sense of self-importance or uniqueness; preoccupation with fantasies of unlimited success; exhibitionistic need for constant attention and admiration ; characteristic responses to threats to self-esteem; and characteristic disturbances in interpersonal relationships, such as feelings of entitlement, interpersonal exploitativeness, relationships that alternate between the extremes of overidealization and devaluation, and lack of empathy.

The exaggerated sense of self-importance may be manifested as extreme self‐ centeredness and self-absorption. Abilities and achievements tend to be unrealistically overestimated. Frequently the sense of self-importance alternates with feelings of special unworthiness. For example, a student who ordinarily expects

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