By Renee Kohanski, MD
NORWICH, CT — What a narcissist! How many times have we heard this of late? With the fury of the elections upon us and certainly with the richness of material to draw upon, the subject of narcissistic personality is as much a part of daily conversation in the talk radio business as is corporate debt. That being said, the autistic spectrum disorders we are all blessed and cursed with are varying degrees of narcissism.
Or are we?
Let me take you into the world of pathological narcissism, “healthy narcissism” and contrast it to high self-esteem. You may consider where you are in this range and where is the figure upon whom you are commenting? In a society that has become consumed with the need for exhibitionistic/voyeuristic self-expression and self-validation it may be hard to remember a spectrum exists. For you, maybe a spectrum doesn’t exist. Life is simply black and white and what I am saying makes no sense at all.
Regardless, first the pathological: People with narcissistic personality disorder are characterized by feelings of self-importance that are excessive to the situation. They have a sense of entitlement and grandiosity for that which is not earned. There is a need for constant admiration and a constant, almost obsessive seeking of approval from others. They have a sense of privilege in life but have done nothing which entitles them to this privileged belief.
In a hypothetical example, say you find yourself waiting patiently at your local obscenely priced café bistro. You are just about to tell Emanuel, your favorite barista, your order (we’ll not comment for the moment about what this hypothetical might imply about you) when some hurried, well-dressed man, you’ve never met, rushes the line. He pushes through the crowd right in front of you, barks his orders gruffly, shouting into his cell phone as he throws money on the counter. You roll your eyes but do nothing. On another occasion you might have challenged this person, or other customers could have objected, but that’s quite irrelevant for our purposes right now. This hypothetical man continues to exist in this situation whether you object here or not. So, what gives him the right to cut to the front of the line? That’s so unfair! And the truth is, absolutely nothing gives him the right to do this, it is completely unfair and this is the life of the narcissist. Generally if it’s pathological and there’s no true talent, it will catch up with him and be his destruction. Not to worry if you did nothing in this situation, generally these people cause their own demise. Just try not to marry or employ them. If you do, exit as soon as you realize your peril.
These folks have a strong need for admiration, but lack the ability to empathize with others. They constantly seek to be the center of attention often at the expense of others, most frequently family members. As tempting as it may be to quickly label some of our more colorful, current-day, newsworthy individuals narcissists, do they really fulfill all these criteria? Do you?
Now let’s compare this to high self-esteem. Self-esteem is your overall opinion of yourself and how you fit in the world. Self-esteem is when you appreciate all that you are including your strengths, the special qualities that make you distinctly you and distinctly special, in conjunction with your human foibles. High self-esteem can be said to be the healthy cousin to narcissism. Abraham Maslow is the guru psychologist of self-esteem. His terminologies have made their way into common day lexicons when we talk about of the “hierarchy of needs.” High positive self-esteem allows a person to achieve the Maslowian highest level of maturity and that is, self-actualization. According to Maslow, “What a man can be, he must be.”
So we circle back to our so-called narcissistic personality disorder, narcissism and self-esteem. All artificial constructs anyway. Let me throw some questions for you to think about both for yourself and for your guests. Consider another hypothetical – an altruistic one. One that is positive for humanity; be it a small-level contribution at your child’s school or a larger community level such as building a hospital. A legitimate conversation could be had to say that an individual with the highest level of self-esteem would do such a project anonymously, because his self-esteem is intact and does not require admiration of others to be complete. Could be true, but not 100%. Even those with mature self-esteem from time to time appreciate acknowledgement. Contrast this with an individual who needs to constantly be told how wonderful he (or she) is for having done such a thing. Isn’t he a narcissist? Not exactly, he actually did something worthy of praise, but the constant need for the praise speaks to something. And lastly, what about the person who has accomplished wonderful things and some not so wonderful things? What if he has the need to constantly tell you about all the wonderful things he has done? Is he a narcissist? I don’t know. You decide.
Renee Kohanski, MD is a Board Certified Psychiatrist with Added Qualifications in Forensic Psychiatry., practicing for over 25 years. She is a regular contributor to TALKERS and has been heard across the nation on television and radio. Dr. Kohanski maintains a private practice in southeastern Connecticut and has provided expert witness testimony in hundreds of criminal and civil cases. She is available for commentary and can be reached at 860-334-4576.