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The History of Narcissistic Personality Disorder

A Closer Look at the Myth and History Behind the Disorder

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Narcissus

The mythological Narcissus depicted by the artist Michelangelo Caravaggio.

Image from the Wikimedia Commons

As defined by the Diagnostic and Statistical Manual of Mental Disorders, narcissistic personality disorder (NPD) is a pervasive disorder characterized by symptoms that include grandiosity, an exaggerated sense of self-importance and a lack of empathy for others. Like other types of personality disorders, narcissistic personality disorder involve a longer term pattern of behaviors and thoughts that cause problems in multiple life areas including work, family and friendships.

An estimated one percent of U.S. adults are thought to have NPD, although many romantic partners, parents, children, family members, co-workers and friends are thought to be directly affected by this disorder as well.

Uncovering the Origins of Narcissistic Personality Disorder

While the concept of narcissism dates back thousands of years, narcissistic personality disorder only became a recognized illness within the last 50 years. In order to better understand how psychologists and researchers view NPD, it is essential to take a closer look at how this personality disorder came to be.

Freud and Psychoanalytic View of Narcissism

Narcissistic personality disorder has its earliest roots in ancient Greek mythology. According to the myth, Narcissus was a handsome and proud young man. Upon seeing his reflection on the water for the first time, he became so enamored that he could not stop gazing at his own image. He remained at the water's edge until he eventually wasted to death.

The concept of excessive self-admiration has also been explored by various philosophers and thinkers throughout history. In the past, the idea was known as hubris, a state of extreme arrogance and haughtiness that often involves being out of touch with reality. It wasn't until fairly recently that the notion of narcissism as a disorder became a subject of scientific interest in the field of psychology.

During the early 1900s, the topic of narcissism started to attract interest in the growing school of thought known as psychoanalysis. Austrian psychoanalyst Otto Rank published one of the earliest descriptions of narcissism in 1911, in which he connected it to self-admiration and vanity.

In 1914, the famous Sigmund Freud published a paper titled On Narcissism: An Introduction. Freud suggested that narcissism is actually a normal part of the human psyche. He referred to this as primary narcissism, or the energy that that lies behind each person's survival instincts. In Freud's theory of personality, people are born without a basic sense of self. It is only through the experiences that occur during infancy and early childhood that people gain what is known as ego, or a sense of self. As children interact with the outside world, they begin to learn social norms and cultural expectations leading to the development of an ego idea, or a perfect image of oneself that the ego strives to attain.

Another important part of Freud's theory is the idea that this love of one's self could be transferred onto another person or object. By giving away love, Freud suggested that people experienced diminished primary narcissism, leaving them less able to nurture, protect and defend themselves. In order to replenish this capacity, he believed that receiving love and affection in return was vital.

The Recognition of Narcissism as a Disorder

During the 1960s and 1960s, psychoanalysts Otto Kernberg and Heinz Kohut helped spark more interest in narcissism. In 1967, Kernberg introduced the term "narcissistic personality structure." He developed a theory of narcissism that suggested three major types: normal adult narcissism, normal infantile narcissism and pathological narcissism

In 1968, Kohut first introduced the term "narcissistic personality disorder" and went on to take some of Freud's earlier ideas about narcissism and expand upon them. Narcissism played an important role in Kohut's theory of self-psychology, which suggested that narcissism allows people to suppress feelings of low self-esteem and develop a sense of self.

In 1980, disorder was officially recognized in the third edition of the Diagnostic and Statistical Manual of Mental Disorder and criteria were established for its diagnosis. The upcoming edition of the DSM-5, due for publication in 2013, has removed five of the ten personality disorders that are in the current edition of the manual, including narcissistic personality disorder. The decision to exclude the disorder has caused some controversy, particularly among psychologists working with clients suffering from narcissistic personality disorder.

References:

American Psychiatric Association. (2000). Narcissistic personality disorder. Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR)

Flanagan, L.M. (1996). The theory of self psychology. In (Eds.) Berzoff, J., Flanagan, L.M., & Hertz, P. Inside out and outside in. New Jersey:ason Aronson Inc.

Kohut, Heinz, (1971). The Analysis of the Self. New York: International Universities Press.

Livesley, W. J. (1995). The DSM-IV personality disorders. The Guilford Press.

Zanor, C. (2010). The fate that narcissists will hate: Being ignored. The New York Times. http://www.nytimes.com/2010/11/30/health/views/30mind.html?_r=1

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