Narcissism: From when on the personality trait becomes pathological – Health


Selfish, conceited, narcissistic.

I think that’s how most people would describe narcissists.

People like that are just craving attention and admiration.

They’re also often ambitious.

In fact, they are often in leadership positions – and do outstanding work.

And they are very confident in themselves.

But such a personality style is not necessarily pathological.

No compassion, fear of criticism: people with narcissistic personality disorders make themselves big and others small.

Experts explain what characterizes the disorder and where therapies can be applied.

Narcissistic people are considered to be self-indulgent and self-admiring.

This usually characterizes a person who is strongly self-absorbed and pays less attention to others.

However, this character trait must be distinguished from narcissistic personality disorder.

At what point does narcissism become a disease?

One person in a hundred develops a narcissistic personality disorder
When narcissism is pathological

“To a certain extent, narcissism is just another term for a healthy pursuit of self-esteem,” says the Hamburg psychiatrist and psychotherapist Prof.

Claas-Hinrich Lammers.

However, narcissistic personality disorder is said to exist when narcissism leads to suffering on the part of the affected person and his or her environment.

Lammers estimates that about one percent of the population has a narcissistic personality disorder.

Those affected have an excessive but at the same time unstable self-esteem.

They try to compensate for this through exaggerated and reality-distorting self-representation.

They tend to overestimate their competences and achievements.

“They increase their self-esteem by having an exaggerated sense of entitlement,” says Lammers.

Narcissists crave attention

People with this disorder place themselves above others.

Specifically, they try to dominate and control others and to minimize or devalue their achievements and achievements.

“Such behaviour inevitably leads to conflicts,” says Prof.

Sabine Herpertz, Director of the Department of General Psychiatry at the University Hospital of Heidelberg.

They show little sympathy or interest in others.

If their wishes are not fulfilled, criticism hails.

If failures occur, they react with anger, aggression or pejorative statements.

“Those affected only have an interest in others if they contribute to the achievement of their goals or if they meet with admiration from others,” explains Claas-Hinrich Lammers.

This leads to a dilemma, according to Lammers: As little as people with narcissistic personality disorder show interest in other people, they are dependent on their attention and admiration in order to stabilise their self-esteem.

Starting therapy can be difficult.

“Therapists often need a lot of time to even get to the patient,” says Claas-Hinrich Lammers.

At first, pathological narcissists treat them in the same way as they treat other people in their environment: they want to demonstrate their superiority by devaluing their counterpart.

“A big problem is that those affected often have very little awareness of their illness,” says Sabine Herpertz, who sits on the board of the DGPPN (German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology).

People suffering from narcissistic personality disorders often first seek psychotherapy because of secondary diseases such as depression, eating disorders or addiction.

This is how a psychological strain arises: firstly from the tensions and conflicts with others.

And secondly, from the ever-widening gap between reality on the one hand and a demanding attitude and self-idealisation on the other.

If those affected are put in their place, they can fall into existential crises.

WashingtonNewsday Health


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I am The Washington Newsday correspondent. I cover general science and Nasa news. I have been in the Science Desk's Technology Beat since joining Washington Newsday in 2018. You can contact me at [email protected]

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