Living with pathological narcissism: a qualitative study

Abstract

Background: Research into the personality trait of narcissism have advanced further understanding of the pathological concomitants of grandiosity, vulnerability and interpersonal antagonism. Recent research has established some of the interpersonal impacts on others from being in a close relationship with someone having such traits of pathological narcissism, but no qualitative studies exist. Individuals with pathological narcissism express many of their difficulties of identity and emotion regulation within the context of significant interpersonal relationships thus studying these impacts on others is warranted. Method: We asked the relatives of people high in narcissistic traits (indexed by scoring above a cutoff on a narcissism screening measure) to describe their relationships (N = 436; current romantic partners [56.2%]; former romantic partners [19.7%]; family members [21.3%]). Participants were asked to describe their relative and their interactions with them. Verbatim responses were thematically analysed. Results: Participants described 'grandiosity' in their relative: requiring admiration, showing arrogance, entitlement, envy, exploitativeness, grandiose fantasy, lack empathy, self-importance and interpersonal charm. Participants also described 'vulnerability' of the relative: contingent self-esteem, hypersensitivity and insecurity, affective instability, emptiness, rage, devaluation, hiding the self and victimhood. These grandiose and vulnerable characteristics were commonly reported together (69% of respondents). Participants also described perfectionistic (anankastic), vengeful (antisocial) and suspicious (paranoid) features. Instances of relatives childhood trauma, excessive religiosity and substance abuse were also described. Conclusions: These findings lend support to the importance of assessing the whole dimension of the narcissistic personality, as well as associated personality patterns. On the findings reported here, the vulnerable aspect of pathological narcissism impacts others in an insidious way given the core deficits of feelings of emptiness and affective instability. These findings have clinical implications for diagnosis and treatment in that the initial spectrum of complaints may be misdiagnosed unless the complete picture is understood. Living with a person with pathological narcissism can be marked by experiencing a person who shows large fluctuations in affect, oscillating attitudes and contradictory needs.

It's Not That Great Anymore: The Central Role of Defense Mechanisms in Grandiose and Vulnerable Narcissism

“…Not rarely treatment courses of narcissistic patients end with unpleasant surprises and sudden dropouts, fights, or an inability to end the treatment and separate from the therapist (8). Overall, our findings extend recent studies showing the interpersonal burden pathological narcissism places on relationships, both in daily life (92) and in clinical settings (93). These challenging interpersonal patterns are visible in treatment complications like drop-outs (4), the need for tact and sensitivity and therapist's adaptiveness when dealing with problematic relationship patterns (94), underlying shame (95) and the need for the therapist to turn to both fragile vulnerable aspects and provocative grandiose aspects of pathological narcissism (96).…”

Self-serving social strategies: A systematic review of social cognition in narcissism

“…where skills are applied excessively). In the case of NPD, some characteristics such as excessive jealousy and paranoia (Day et al, 2020), could arise in association with over-mentalizing, rather than a reduction in social reasoning. Envy may result from the comparison between one's own and another person's mental state.…”

Narcissistic traits in young people and how experiencing shame relates to current attachment challenges

“…Research using measures of implicit self-esteem and implicit shame have found a relation with grandiose narcissism [ 34 , 97 , 98 ]. Moreover, informant reports of narcissism traits which partially overlap with self-reports, also highlight a dismissive yet affirmation needing stance towards others as a feature of grandiose narcissism [ 99 – 101 ]. Why those with higher grandiosity may potentially dismiss emotions such as shame and attachment anxieties requires further research, but it may be due to a self-presentation of a “false” positive self as described in the clinical literature [ 102 ].…”