Anatomy of a Narcissist: Looking Beyond the DSM-5 Definition -

First published on Psychology Today, March 25, 2023.

To understand the trauma narcissists induce in others, we often focus on their external behaviors and how those behaviors affect the people around them. But what is really going on in the narcissistic personality? Let’s take a deep dive into the anatomy of the narcissist, beyond the superficial traits listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

Anatomy of a Narcissist

Narcissistic personality disorder is a mental illness rooted in identity and self-esteem instability primarily resulting from insecure attachment with caregivers in infancy and childhood. There may be genetic predispositions to narcissistic defenses in a child that get activated by alienating experiences in the environment.

Looking closely at the narcissistic personality, we find many developmental deficits and defensive compensations, including emotional splitting, distorted object (other) relations, poor individuation, emotional alienation, grandiose delusions, envy and victimhood, dependency on external sources of self-esteem, reactivity, self-referentiality, cognitive distortions, willful denial and projection, immorality, relational antagonism, and masking.

1. Inner Splitting

At the core of narcissism is emotional splitting of the self between two distorted extremes: the worthless inferior self and the special superior self. One way of understanding narcissism is as an inferiority complex managed through a compensatory superiority complex. Narcissistic people work constantly to repress awareness of the inferior self and to inflate and elevate the superior self. They suffer from internal vacillations between these two states, particularly when under stress, and they subject others to the same idealizing and devaluing vacillations.

2. Unrealistic/Unintegrated Object (Other) Relations

Narcissistic children who get stuck in emotional splitting are not able to attain whole object (other) relations and object (other) constancy, psychological milestones that involve integrating and sustaining awareness of realistic positive and negative aspects of the self and others. As a result, narcissists see themselves and those around them in binary all-good or all-bad terms and experience out-of-sight out-of-mind inconstancy in their relationships.

3. Lack of Individuated Identity/Emptiness

Narcissists lack an individuated sense of identity and struggle with destabilizing feelings of self-doubt and emptiness. This is usually the result of having been emotionally neglected and treated as an extension of the idealized or devalued projections of narcissistic parents. Narcissistic people often spend their lives trying on identities and/or clinging rigidly to external forms of identification.

4. Emotional Alienation/Lack of Empathy

Lacking a stable sense of self and empathetic connection with those around them, narcissists are emotionally alienated from themselves and others. Their basic distrust leads them to avoid vulnerability, which they regard as weakness, and view relationships as struggles for dominance and control rather than opportunities for interpersonal growth and intimacy.

5. Delusional Grandiosity

The flip side of narcissistic emptiness and inferiority are delusions of superiority, special entitlement, and, on the more anti-social end of the narcissism spectrum, omnipotent power and control. Outsiders with the capacity for accurate reality testing will recognize the narcissist’s grandiosity as delusional, but to the narcissist it feels like psychic survival. This is why narcissists react with rage (overt or passive aggressive) when others do not reflect back what they wish to believe about themselves.

6. Envy/Victimhood

A dimension of narcissistic grandiosity is narcissists’ belief that they never have enough of what they deserve. This sense of unfairness and deprivation creates feelings of envy and victimization that can become central aspects of the narcissist’s identity, particularly in the more covert, vulnerable form of narcissism.

7. Externalized Self-Esteem

Narcissists lack the internal ego strength to sustain consistent feelings of self-esteem and require excessive support for their exaggerated sense of importance. This makes them highly dependent on other people and on status-enhancing externalities to process their emotions and feel good about themselves. Their need for external self-esteem management leads to inordinate demands for attention, admiration, special privileges, status, caretaking, and/or control in their relationships.

8. Dysregulation/Reactivity

Narcissists’ vulnerable self-esteem and delusional grandiosity is a perfect storm for emotional dysregulation and reactivity to disappointments, losses, slights, disagreements, and conflicts.

9. Self-Referentiality

Emotionally detached from others and constantly struggling to shore up their self-esteem, narcissistic people are hyper-fixated on themselves and extremely self-referential in how they perceive and interpret their experience and relationships.

10. Cognitive Distortions

In addition to self-aggrandizement, narcissists are prone to cognitive distortions such as catastrophizing, minimizing, personalizing, and magical thinking.

11. Denial and Projection

Denying aspects of reality and projecting our own uncomfortable feelings and behavior onto others are normal emotional defenses in childhood that narcissists continue to indulge in heavily as adults. Unlike the psychotic personality, people with a narcissistic personality can distinguish fact from fantasy and truth from lies, so their use of denial and projection involves willful choice and forms of rationalized justification.

12. Immorality

Narcissists’ fragile sense of self is a house of cards built precariously on inner splitting, delusional self-beliefs, and primitive defenses. To keep from collapsing, narcissists hold reality at a distance by avoiding self-reflection and eschewing accountability. Lacking all but a rudimentary corrective observing ego (conscience) means the narcissist operates outside of normative standards of fairness, ethics, and morality.

13. Relational Antagonism

Narcissistic personalities are relationally antagonistic, behaving competitively and exploitatively rather than cooperatively and responsibly in their relationships. Harboring delusions of entitlement and lacking the inhibiting influence of emotional empathy, narcissists habitually exploit others for physical and emotional resources and devalue, humiliate, and violate others to boost their self-esteem.

14. Masking

Narcissists’ compulsive need for attention and validation of self from others often drives them to cultivate a socially winning public persona. All but the most anti-social narcissistic people want to believe they are “good” and capable of love, and some go to great lengths to portray that image to outsiders. But whether the narcissist’s mask is based on material wealth, harsh piety, fame, good looks, charm, social connections, or professional status, it is skin deep. Beneath the mask, the narcissistic personality is unstable, alienated, deluded, interpersonally antagonistic, and morally unaccountable.

Conclusion

Narcissism is a severe mental disorder that causes the narcissistic individual suffering and has a profoundly traumatizing effect on family members, social groups, and society at large. Because narcissism is often well masked, and because narcissistic people frequently seek out positions of authority and wield power abusively, it is especially important that the psychological community, educators, the justice system, and people across all walks of life recognize its signs, call it out, and protect and support its victims.

Julie L. Hall is the author of The Narcissist in Your Life: Recognizing the Patterns and Learning to Break Free from Hachette Books.

Need support? Julie provides specialized narcissistic trauma recovery coaching to clients around the world.

References

McWilliams, N. (2020). Psychoanalytic diagnosis, second edition: Understanding personality structure in the clinical process. Guilford Publications.

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