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The Narcissism Spectrum


Let’s talk narcissism. Thanks to social media, the term "narcissism" has become a hot topic over the past several years. So much so that we've begun to conclude that anyone who is rude and self-focused must be narcissistic.

When we are rude towards others, it's often easy to identify the external triggers. My boss is frustrating me, nothing is going my way, I am overworked, I didn't get enough sleep, I'm hangry, etc. But when someone else is rude towards us, whether cutting us off on the freeway or not saying excuse me when they bump into us, we often say to ourselves, "that person is such an asshole." More often than not, we attribute someone else's behavior to internal factors related to their personality ("he must be an asshole"), and not to the external factors we attribute to our own rude behavior ("I'm having a bad day").

How then, do we distinguish pathological narcissism from a) someone with a low stress tolerance who externalizes frustrations, or b) someone who is just rude and careless towards others?

Narcissism exists on a spectrum from least extreme to most extreme.  I visualize this spectrum as the least harmful to others to the most harmful to others.  On the left end (least harmful) is complete selflessness, or caring about the needs of others more than the needs of the self.

The middle of the spectrum, the necessary form of narcissism (such as self-love, self-focus and self-directed behaviors), allow us to reach goals and meet our own needs.  This can be harmful if it is done at the expense of someone else.  


The majority of people oscillate between selflessness and necessary narcissism. A healthy balance is key.

Somewhere in the middle-right of the spectrum sit the two subtypes of pathological narcissism (PN): grandiose and vulnerable.  

Grandiose: “I am the best in the world!” 

This is represented by the DSM-5 diagnosis of narcissistic personality disorder.  Think: grandiosity, a lack of empathy, a need for admiration and recognition, a sense of entitlement, fantasies of success and power, a belief that everyone admires them the way they admire themselves... you get the picture. Their initial self-confidence can be very charming and attractive. However, they are out of touch with the limits of their capabilities and may deflect and blame others for their own inadequacies. Grandiose PN is a well-established defense mechanism to either a) hide core shame and worthlessness or b) avoid the reality that they are just like everyone else. 

Vulnerable: “The world is against me! I am the victim!”

This subtype is not recognized by the DSM-5.  It involves the same grandiosity, lack of empathy, sense of entitlement, need for admiration and fantasies of success and power.  But what makes it different is that these individuals do NOT appear grandiose.  They often appear shy, fragile, maybe even sweet.  Unlike grandiose PN, they do not feel admired as much as they admire themselves.  They fear criticism and are hyper-sensitive to how others treat them (often misinterpreting the intentions of others) but are unaware of how their own behavior is perceived (which requires empathy).  As a result, they often play the victim and struggle with regulating emotions, often turning towards others for validation. This subtype may be related to borderline personality disorder but without the repeated threats of suicide and self-harm behaviors (1).  Just like grandiose PN, vulnerable PN is a well-established defense mechanism to protect themselves from their core shame and emptiness.  

On the right end (most harmful) sits malignant narcissism: “The world owes me!”

Think of Hitler.  Malignant narcissism is a combination of grandiose narcissism and antisocial personality disorder with a sprinkle of sadism (feeling pleasure from the suffering of others).  Malignant narcissists are often impulsive, lack remorse and are fueled by revenge against narcissistic injury (a threat to their fragile self (core shame), hidden behind the narcissistic defense mechanism) (2).  

Of course, these descriptions are not comprehensive, and individuals may not fit neatly in any description.  Some people may possess both grandiose and vulnerable PN or switch between the two depending on their phase in life.  The idea behind this post is to give you a fundamental understanding of pathological narcissism so that you can begin to recognize it in your own life.  




Resources:

1. Miller, J. D., Lynam, D. R., Vize, C., Crowe, M., Sleep, C., Maples-Keller, J. L., Few, L. R., & Campbell, W. K. (2018). Vulnerable narcissism is (mostly) a disorder of neuroticism. Journal of Personality, 86(2), 186-199. https://doi.org/10.1111/jopy.12303

2. Goldner-Vukov, M., & Moore, L. J. (2010). Malignant narcissism: From fairy tales to harsh reality. Psychiatria Danubina, 22(3), 392-405. https://doi.org/10.1159/000492228 #Narcissism #Therapy

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