(2023-09-01) What Is Narcissism Science Confronts A Widely Misunderstood Phenomenon

What Is Narcissism? Science Confronts a Widely Misunderstood Phenomenon. Up to 6 percent of the U.S. population, mostly men, is estimated to have had narcissistic personality disorder during some period of their lives. And the condition manifests in confoundingly different ways

review paper on diagnosing the disorder

Clinicians note several dimensions on which narcissists vary

What these seeming opposites have in common is an extreme preoccupation with themselves.

Now brain science is contributing to a better understanding of narcissism.

vulnerability indeed seems to be the hidden underside of grandiosity.

What makes narcissism particularly complex is that it may not always be dysfunctional.

Then there is “pathological” narcissism, characterized by an inability to maintain a steady sense of self-esteem.

Narcissistic personality disorder is a subtype of pathological narcissism in which someone has persistent, long-term issues.

In the 1960s and 1970s psychoanalysts Heinz Kohut and Otto Kernberg sketched what’s now known as the “mask model” of narcissism. It postulated that grandiose traits such as arrogance and assertiveness conceal feelings of insecurity and low self-esteem

some psychiatrists contended that the vulnerability criteria overlapped too much with those of other personality disorders. Borderline personality disorder (BPD), in particular

Subsequent versions of the DSM therefore placed even more weight on grandiose features

In the early 2000s Aaron Pincus, a clinical psychologist at Pennsylvania State University, noticed that this focus on grandiosity did not accurately represent what he was seeing in narcissistic patients

**researchers have found that both dimensions of narcissism are linked to what psychologists call “antagonism,” which includes selfishness, deceitfulness and callousness. But grandiosity is associated with being assertive and attention seeking, whereas vulnerability tends to involve neuroticism and suffering from anxiety, depression and self-consciousness.
Clinicians’ evaluations, as well as studies in the wider population, support the idea that narcissists oscillate between these two states.

But Josh Miller, a psychologist at the University of Georgia, and others entirely reject the idea that grandiose individuals are concealing a vulnerable side. Although grandiose people may sometimes feel vulnerable, that vulnerability isn’t necessarily linked to insecurities, Miller argues. “I think they feel really angry because what they cherish more than anything is a sense of superiority and status—and when that’s called into question, they’re going to lash back,” he adds.

These differences in perspective may arise because different types of psychologists are studying different populations

Most narcissists who seek help are generally more vulnerable

To him, that means clinics might not be the best place to study narcissism—at least not its grandiose aspect. It’s “a little bit like trying to learn about a lion’s behavior in a zoo,” he says.

The unwillingness to seek therapy is especially true of “malignant narcissists,”

Research with identical and nonidentical twins suggests that narcissism may be at least partially genetically heritable, but other studies indicate that dysfunctional parenting might also play a significant role.

Grandiosity may derive from caregivers holding inflated views about their child’s superiority, whereas vulnerability may originate in having a caregiver who was cold, neglectful, abusive or invalidating. (why not both?)

In a study published in 2015, researchers at the University of Michigan recruited 43 boys aged 16 or 17 and asked them to fill out the Narcissism Personality Inventory, a questionnaire that primarily measures grandiose traits. The teenagers then played Cyberball

Cyberball tests how well people deal with social exclusion. Participants are told that they’re playing with two other people, although they are actually playing with a computer

virtual players begin by tossing the ball to everyone but later pass it just between themselves—cutting the participant out of the game.

The teenagers with higher levels of grandiose narcissism turned out to have greater activity in the so-called social pain network than those with lower scores

the researchers did not find differences in the boys’ self-reports of distress

The bodies of narcissists bear evidence of elevated stress. Studies indicate that men with more narcissism have higher levels of the stress hormone cortisol than those with less narcissism

Such findings suggest that “vulnerability is always there but maybe not always expressed,”

these studies are far from the last word on the matter: many of them have a small number of subjects, and some have reported contradicting findings

To date, there have been no randomized clinical trials for treatments specific for narcissistic personality disorder