Identifying and Understanding the Narcissistic Personality

Identifying and Understanding the Narcissistic Personality

Identifying and Understanding the Narcissistic Personality

Identifying and Understanding the Narcissistic Personality

Synopsis

Narcissists have been much maligned, but according to clinicians who study personality, there are many productive narcissists who succeed spectacularly well in life because they can articulate a vision and make others follow. Elsa Ronningstam, who has been studying and treating narcissists for20 years, presents a balanced, comprehensive, and up-to-date review of our understanding of narcissistic personality disorder, explaining the range from personality trait, which can be productive, to full-blown disorder, which can be highly destructive. Through fascinating case histories,Ronningstam shows us the inner life of narcissists, the tug of war that exists within them between self-confidence and arrogance on the one hand and painful shame and insecurity on the other. It is the first integrated clinical and empirical guide to assist clinicians in their work withnarcissistic patients.

Excerpt

Over the past century numerous studies on narcissism and narcissistic disorders have added to our present understanding of these conditions. Although there is by now a general agreement about the dynamics and features of pathological narcissism and narcissistic personality disorder (abbreviated NPD throughout this volume), there are still different and contradictory opinions about conceptualization and clinical descriptions of these conditions. The complex nature of pathological narcissism and the challenges involved in treating narcissistic patients have been major contributing factors. The official diagnostic system, Axis II of The Diagnostic and Statistical Manual of Mental Disorders (4th ed. and 4th ed. text revision; American Psychiatric Association, 1994, 2000; abbreviated DSM-IV throughout this volume), has presented some limitations in capturing personality pathology and reflecting the clinicians'usage of personality disorder diagnosis. This has been particularly consequential for diagnosing patients with narcissistic disorders. People with pathological narcissism that range beyond the DSM-IV criteria set, or people who have less extensive or less overt narcissistic disorders or who may show (even severe) pathological narcissism that is more specifically situational or contextually determined (e.g., expressed only within the marriage or in the workplace), tend to be overlooked and not correctly identified. In addition, the definitions and dynamic meaning and expressions of several of the characteristics for pathological narcissism are vague, and the vicissitudes in interpersonal interactions, self-esteem fluctuations, and affect dysregulation have until recently remained a relatively unexplored area.

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