Thoughts on Narcissistic Personality Disorder

Within the last year or so, Narcissistic Personality Disorder (NPD) seems to have been mentioned in various places, including the ongoing saga with Tony Jones (mentioned here).  I’ve also seen it referenced quite a lot in relation to perpetrators of abuse.  I tweeted the wonderful psychologist, Dr Kate Middleton to ask her thoughts on NPD.  She kindly emailed me some thoughts, which I then asked if I could turn into a blog.  So here is it…!

Personality disorders are quite controversial, both in their diagnosis and treatment. How and why is easiest tackled by thinking about their theoretical basis. Your personality is about how you respond to the world – the patterns of responses you have (traits) – feelings, behaviours etc. Certain traits are common patterns and thus various theories describe personality along sets of traits – some of which are well known e.g. extraversion/introversion. There are lots of theories of personality with many different traits although some (e.g. introversion/extraversion) come up in lots of theories and are more widely accepted – as well as having relatively strong biological theories supporting them.

Personality ‘disorders’ stem from an acceptance that there is a ‘normal’ – i.e. the more common, central patterns along certain traits. Beyond a point therefore we start to call some personality patterns (patterns of behaviour, feelings or emotions) ‘abnormal;’. Personality disorders in a clinical sense describe patterns which are problematic – generally because they either trigger difficult and painful emotions for the individual, or because they lead to people acting towards others in very unpleasant or upsetting ways. However the concept hangs on the acceptance of ‘normal’ verses ‘abnormal’, and of course where exactly you draw the line. For example, there have been various recent books and articles about the ‘psychopaths’ you might meet in everyday contexts like business etc – just one example where people are looking at personality characteristics in individuals who otherwise function relatively ‘normally’. There is always going to be a range across all these measures and the question is when it becomes ‘abnormal’ or something that we should view as ‘illness’ and therefore treat. And of course whether you can say someone is ‘ill’ when it doesn’t affect them – they are perfectly happy, it is just others who they hurt.

In theory personality (certainly once you reach adulthood) has a degree of ‘stability’ – although some personality disorders can worsen as people age, and some tend to improve slightly. Treatment of personality disorders aims to challenge and develop difficult patterns of behaviour, teach alternative strategies and improve awareness/insight and understanding of what these patterns are with the hope of introducing change. Sometimes drug treatment is also used, often with great effect – especially where the problem is related to emotionality (as we have some drug treatments which can reduce or moderate emotions like anxiety, depression etc). However the treatment of personality disorders is notoriously difficult and it is difficult to define ‘success’. The reality is that people with personality disorders tend to have some degree of long term difficulty, although many learn to manage their condition very well. The degree of insight – how much an individual is aware that they have this ‘problem’ and whether they view it as a problem or not – also varies a lot.

So – on to considering Narcissistic personality disorder specifically. In a nutshell this describes someone who has not moved on from the very ego-centric way of viewing the world that children have – and in fact that this has developed in a a rather unhealthy way. Someone with narcissistic personality disorder generally sees themselves as the centre of everything, and views everything from that perspective. They wish others to view them in the same way and often hold unrealistic beliefs or expectations about themselves which can even be described as illusions of grandeur. They can be very controlling and particularly emotionally manipulative as they try to make sure that everyone else maintains this illusion (for it is usually an illusion) that they are all wonderful and all powerful. Their self-belief is immense (which perhaps explains why people with elements of this personality type do extremely well in careers which require a lot of self confidence).

Thinking specifically about whether there is a link between narcissistic personality disorder and abusive behaviour, this varies a lot. In fact narcissistic personality disorder isn’t always associated with abusive behaviour – but it can be present, generally because people with narcissistic personality disorder can be so controlling and require those around them to look up to them them. This can lead them to resent anyone having other interests and sometimes be very jealous etc. One feature often linked with abusive patterns is a lack of empathy – when the individual is so persistent in only viewing things from their perspective that their awareness of the feelings of others becomes almost zero. This feature varies amongst sufferers.

A key question where personality disorders are concerned is how much we can or should ‘excuse’ bad behaviour or abusive treatment of others because of a personality disorder? It’s very hard to perceive how much insight an individual has and whether therefore these actions are a choice or something they are not able to control. A key distinction would also fall around just how marked key traits were in an individual – how far up the scale into ‘disorder’ they might be. Remember that you can see traits related to the same things we call ‘disorder’ in individuals functioning perfectly ‘normally’ in society.

Another interesting thing to consider where narcissistic personality disorder is concerned is how much it might benefit someone to show some features of this disorder at a lower level. Specifically, if you consider personality type you might need in order to be naturally drawn to be a very charismatic leader – the utter self belief and self promotion that narcissists demonstrate would certainly aid them in gaining ‘a following’. Leadership can be learned and taught – but there are clear examples of people who have naturally and instinctively been ‘drawn’ to leadership – with mixed results. Might some of those be people who would score highly on traits associated with narcissism?

In fact, on this topic it becomes really interesting to ponder how often God selected for leadership people who really didn’t want to be leaders and in that sense weren’t ‘natural’ leaders at all. Time and again God’s selected leaders disagreed and even argued with Him about their suitability for that kind of role. Might it be that some of these people were in fact such good leaders precisely because of the absence of some of these characteristics? It is my belief that when looking for leadership potential we should be careful not to only consider those who are the ‘obvious’ choices – many a successful and charismatic leader can grow out of a less clear candidate.

This subject is also interesting from a cultural perspective, when you consider how much we are encouraged to build and feed our ego and self-esteem from the modern ‘instant fix’ of social media. We’re offered such tangible and immediate ‘evidence’ of our popularity (how many likes do we get to a comment etc) – and we know that the more tangible and explicit the reward the more likely we are to pursue it. And yet God calls us to the opposite, says that if we want to be something, we should be nothing and be willing to serve. Something to pray for for our leaders who have to fight this constant tension between platform and humility.

In fact, one feature of our current culture has led some experts to question whether we might be at risk of developing a generation of people more at risk of narcissistic personality problems. As the explosion in ‘selfies’ encourages us to consider every event we experience with us at the centre, might we be learning to become more egocentric instead of less? Here’s just one example of a discussion of this question.

Ultimately in ministry (and in life in general) we must remember that there are no ‘perfect’ personalities. I am always heard saying that no personality is perfect – they all have good sides and flip sides. The key is knowing yourself well enough to know what your weak points are likely to be – the achilles heel of your own personality. It’s about understanding the push and pull of your personality – these narcissistic people will be really good at putting themselves forward, but their risk is that they will be too ego-centric, not good enough at thinking about things from other people’s perspectives etc..

So can or should we ‘excuse’ behaviour because people have a personality disorder? This is a very difficult question, but my instinct would always be to say no. Abusive behaviour is abusive behaviour and we always need to pull people up on that. However we must consider carefully the degree of insight that an individual has, and there could be situations (particularly when that person is themselves the victim of abuse etc) where some would argue that they are not – legally or ethically – responsible for their actions. This is why the aspect of treatment of personality disorders which involves improving insight – and hopefully helping people consider and take onboard the impact their behaviour has on others – is so important.

In fact for us all an essential part of growth and emotional maturity involves improved understanding and insight of both aspects – positive and negative – of our personalities, particularly the impact they might have on us or on others. This is a vital step on the journey as we work to improve ourselves, and become more like Jesus, and I applaud recent calls for leaders to work as much on their emotional maturity as they do on their spiritual life (for example, Peter Scazzero’s Emotionally Healthy Spirituality). But this can only be done from a foundation of the absolute and unconditional love that we get from God. Only by realising that we are acceptable as ourselves, with all our human weaknesses and frailties, can we take the risk of admitting and accepting that aspects of who we are may not be all that great – and allow ourselves to become vulnerable as we work to change.

To read more, check out:

The Royal College of Psychiatry notes on personality disorders.

This article looking specifically at narcissistic personality disorders.

You can tweet Kate @communik8ion and find out more about her NEW BOOK “Refuel” HERE.

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