Narcissistic Personality Disorder (NPD) is classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as an Axis II Cluster B Disorder. As of this writing, the American Psychiatric Association (APA) is about to modify the DSM and the methods by which individuals are diagnosed with NPD. Previously, the DSM simply defined NPD as: A pervasive pattern of grandiosity, need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts,” and further offered in its definition that in order for one to be diagnosed with NPD an individual must meet at minimum 5 of the following 9 criteria:
(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
(3) believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
(4) requires excessive admiration
(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
(8) is often envious of others or believes that others are envious of him or her
(9) shows arrogant, haughty behaviors or attitudes
According to Wikipedia, symptoms of Narcissistic Personality Disorder include but are not limited to:
- Reacts to criticism with anger, shame, or humiliation
- May take advantage of others to reach his or her own goal
- Tends to exaggerate their own importance, achievements, and talents
- Imagines unrealistic fantasies of success, beauty, power, intelligence, or romance
- Requires constant attention and positive reinforcement from others
- Easily becomes jealous
- Lacks empathy and disregards the feelings of others
- Obsessed with oneself
- Mainly pursues selfish goals
- Trouble keeping healthy relationships
- Is easily hurt and rejected
- Sets unreal goals
- Wants “the best” of everything
- Appears as tough-minded or unemotional 
Narcissists also tend to be physically attractive on first impression, giving them advantages when first meeting people.  The symptoms of Narcissistic personality disorder can be similar to the traits of individuals with strong self-esteem and confidence, differentiation occurs when the underlying psychological structures of these traits are considered pathological. Narcissists have such an elevated sense of self-worth that they value themselves as inherently better than others. Yet, they have a fragile self-esteem and cannot handle criticism, and will often try to compensate for this inner fragility by belittling or disparaging others in an attempt to validate their own self-worth. It is this sadistic tendency that is characteristic of narcissism as opposed to other psychological conditions affecting level of self-worth.
On the European side, there is a manual known as the ICD 10 which is connected to the World Health Organization (WHO). On the European side, the ICD 10 (2010) codes Narcissistic Personality Disorder under F60.8 “Other Specific Personality Disorders” and groups it with the other following ‘disorders’ based on their system:
- “haltlose” type
For general informational purposes regarding the World Health Organization and the role they play in global health issues, including mental health click [HERE]
You can access the ICD-10 directly by clicking [HERE]
Additionally, Wiki provides a very general overview; as well as, a massive list of citations at the end of their entry which one may wish to investigate further. The Wiki article on Narcissistic Personality Disorder can be accessed by clicking [HERE]
Now that you’ve had a general primer on Narcissistic Personality Disorder, “What now?” You might ask. If you are searching for information and support, more than likely, you are emotionally in a very fragile state. It is important to know the distinction between someone who is suffering from Narcissistic Personality Disorder and the wound to the victim that it creates, versus being victimized by a “Jerk.” While breaking up with a jerk is hurtful, most instances do not result in the victim struggling with symptoms that if are not Post Traumatic Stress Disorder, something very close to it. It is important to understand the dynamics involved as when dealing with NPD Abuse, recovery takes time, this is not your typical break up and there will be many stages of grief and processing to go through if you are going to survive and return to whole. While no one takes kindly to a break up and break ups are painful, a breakup with a Narcissist leaves a wound that is very devastating to the victim.
It’s important to understand the distinction between a relationship with someone who suffers from NPD vs. a jerk because you will need a very strong support system to get you through this. Due to the fact that for the most part, the general populations is unaware of this particular type of Personality Disorder or has misconceptions of what it entails, it will be difficult for friends, family and sometimes even therapists to fully understand exactly the source and the depth of the pain, emotional and mental distress you are experiencing. In some cases, there was no physical harm or blatant forms of verbal abuse…this was a covert attack although there are cases where physical and overt verbal abuse were also involved.
Sometimes the covert actions are what ultimately led to the overt actions. The first thing you must own if you believe you have been involved with a Narcissist is: You are NOT crazy…although the experience will leave you feeling like you’re teetering on the edge. Actually, you might be in a state of temporary insanity…that is the mark of the wound…the narcissist projected and engaged in various techniques to break you down.
Many of these techniques were subtle and stealth and therefore difficult to pin point. By the time we are aware that such an attack has taken place, the damage has been done, and it tends to feel as if the ‘trauma’ hits us all at once like a ton of bricks. Many victims report having felt this building up for some time but because the tactics of abuse were hard to pin point, we felt something was ‘wrong’ or ‘off’ but we dismissed it…slowly it was chipping away at our psyches and this ‘blow’ to the mind is the final result. We feel extreme sadness, pain, fear, anger, rage and shock all at once, and because we cannot articulate what exactly has happened, we feel even more trapped within ourselves. I liken it to almost feeling as if one is mute, having a desperate need to want to express one’s feelings but having no means to do so, surrounded by people who don’t know sign language and the victim is left without a voice or any other means for anyone to understand what the victim is trying to communicate. That is more or less how the experience feels initially. We are isolated in our own lack of knowledge or means of articulation for what has just transpired. Your feelings and your reactions are very normal given the ABnormal situation you’ve just survived. The journey is not for the faint of heart; however, there is no other way to survive this but to walk through this storm…giving up is not an option. If you feel suicidal, get help immediately. Call your emergency services unit – there is hope and there is healing and certainly, it is understandable given the stress you are under to feel this magnitude of distress but the narcissist or anyone else for that matter is not worth your taking your life over. As a survivor, I can tell you – I promise you…there is a light at the end of this tunnel. This distress and the magnitude of it will not last forever. YOU WILL SURVIVE – even thrive, but first you have to wade through some of the dark stuff to get to the end. It is hard work, but it is so worth it. I promise…
Hold on tight as you are in for the ride of your life; however, you are not alone and there are resources and support out there to get you through…it is important to read and research so that you can understand what this is, so that you don’t own blame for what has happened. This was not your fault and I repeat: You ARE NOT crazy.
If you have a history of childhood abuse or other traumas it is possible that this wound is not Post Traumatic Stress Disorder but Complex Post Traumatic Stress Disorder (CPTSD) and this particular event may find you experiencing more intense reactions to the abuse because not only are the recent events qualified to cause PTSD, but in addition it re-introduces previous issues that are triggering for you. Again, while this may be a very scary time for you – the thought of possibly having lost your mind can be a very scary thing…Reach out for professional help, educate yourself so that you can articulate, and read up on the various methods of healing trauma, abuse, as well as getting a grasp on NPD. Doing so will help you take an active role in healing along with your therapist as rather than he/she sitting there making assumptions, you will be able to better advocate and collaborate in your healing plan rather than sitting there and possibly being misdiagnosed. There are other conditions that may be pre-existing – some victims suffer from bi-polar disorder, depression, or other forms of mental illness and that is nothing to be ashamed of; however, when PTSD is inadequately treated, victims cannot heal and that causes additional problems that can have lifelong and possibly fatal consequences; therefore it is imperative that although struggling emotionally and psychologically at this time…you FIGHT to hold on, and you stop at nothing to educate yourself as right now at this very moment for some it may very well be on the cusp of: “Your life is in your hands.”
BUT, never fear…you CAN and WILL recover…;)