Narcissistic Personality Disorder in Practice

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               Today, we are going to discuss one of the unique and interesting disorders. This disorder's name is Narcissistic Personality Disorder. Narcissistic personality disorder is defined as a type of people are ''self-centered'' are always want and grab the attention of others.

Narcissistic Personality Disorder

             If I define Narcissistic Personality Disorder in my own words, I would say it is a condition many people talk about, but very few truly understand. This disorder is famous and has been widely studied, but many people do not even realize when they or others show narcissistic traits. I am not a professional yet, but during my learning phase, I have already met such types of people around me. First of all, narcissistic people are involved in these things, not all, but some basic which you easily notice and identify in narcissistic people.

Traits of Narcissistic People

Traits of Narcissistic People

1-They are exaggerated, which means that they are more important compared to another person.

2- They feel you ''they are very Special or unique ''.

3- They are given self-importance, which means that they are king or queen of this world.

4- They are showing you that they know about everything that you don't know. But reality is totally different. which you are, and I know. 

5-Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

6- Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.

7- Need Constant admiration. which they want every time, admiration for your every small thing, which does not make sense.

How do we diagnose Narcissistic people?

        If a person shows five or more out of the nine symptoms listed in the DSM-5, they can be diagnosed with Narcissistic Personality Disorder. Often, individuals are not aware of their own behaviors or how much these traits affect their lives.

Real Life Experience Example:

            During my undergraduate studies, I visited a substance abuse hospital, where I met different types of patients. This visit gave me valuable practical exposure and helped me understand how to take history and interact with clients.

            In total, I collected history from 14 clients. One client, in particular, sat in front of me while I kept my handbag carefully, and I started taking his history by asking questions.

            This client was using drugs and also showed narcissistic traits. When I asked why he came for treatment, he said: Not because of drugs, I just came to meet them. I am very busy. He also claimed to be a mathematics professor (Grade 21) at a boys' college, but when I asked him to solve a calculation, he could not answer.

When I asked about the reason for his drug use, he said:

  • A girl betrayed him.

  • He had conflicts with his father, who he claimed was a businessman.

  • He said his father forced him to marry an “ugly woman,” while he considered himself very handsome.

            Later, the psychologist told us that these claims were false. He was not a professor, his father was not a businessman, and in reality, his wife had divorced him. At the end, he even asked my colleague (the psychologist) if she would visit him daily, showing his manipulative and attention-seeking behavior.

            This case gave me a practical understanding of how substance abuse and personality disorders can overlap, and how clients sometimes create false stories to maintain a grand self-image.

My Point of view:

        This case helped me realize how narcissistic traits can look very different in real life than in textbooks. the client showed denial, exaggeration, and false self-image, which became clearer when combined with substance use. I learned that as future professionals, we should not only focus on what clients say but also observe behavior and verify information. Most importantly, I understand that empathy and professional boundaries are both necessary when working with such complex cases.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Ronningstam, E. (2016). Narcissistic personality disorder: A clinical perspective. Oxford University Press.

Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. Guilford Press.

Momna Bashir 

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