NPD Clinical Features: How Narcissism Presents in Practice

Clinical Features of the Narcissistic Personality Disorder

Opinions vary as to whether the narcissistic traits evident in in infancy, childhood, and early adolescence are pathological. Anecdotal evidence suggests that childhood abuse and trauma inflicted by parents, authority figures, or even peers provoke "secondary narcissism" and, when unresolved, may lead to the full-fledged Narcissistic Personality Disorder (NPD) later in life.

This makes eminent sense as narcissism is a defense mechanism whose role is to deflect hurt and trauma from the victim's "True Self" into a "False Self" which is omnipotent, invulnerable, and omniscient. This False Self is then used by the narcissist to garner narcissistic supply from his human environment. Narcissistic supply is any form of attention, both positive and negative and it is instrumental in the regulation of the narcissist's labile sense of self-worth.

Perhaps the most immediately evident trait of patients with Narcissistic Personality Disorder (NPD) is their vulnerability to criticism and disagreement. Subject to negative input, real or imagined, even to a mild rebuke, a constructive suggestion, or an offer to help, they feel injured, humiliated and empty and they react with disdain (devaluation), rage, and defiance.