Narcissistic Personality Disorder

Dr. Lorin Bradbury, author of "Treasures from an Old Book, Ancient Wisdom for a Modern World".

by Dr. Lorin Bradbury

Question: What does narcissistic personality disorder look like?

Answer: Personality disorders often overlap with one another, and therapists recognize what is often referred to as a budding personality disorder when behaviors trend in a certain direction, but there are not enough symptoms to make a diagnosis. According to the fifth edition of the Diagnostic and Statistical Manual (DSM-5), Narcissistic personality disorder (NPD) is characterized by the presence of five or more of the following symptoms:

•Has an inflated sense of self-importance

•Is preoccupied with fantasies of success, power, brilliance, beauty, or ideal love

•Believes that he or she is “special” and can only be understood by other special or high-status people

•Requires excessive admiration

•Possesses a sense of entitlement

•Takes advantage of others

•Lacks empathy 

•Is often envious of others or believes others are envious of him or her

•Behaves in an arrogant, egotistical, or haughty way

Individuals who meet the criteria for a diagnosis of NPD are often described by others as being very self-absorbed or egotistical. Those close to these individuals may describe them as narcissistic, or self-centered, or self-absorbed, but until these behaviors (symptoms) significantly interfere with relationships, occupation, or other important aspects of life, the disorder usually goes undiagnosed. Many experts believe those symptoms reflect a need to compensate for an underlying poor sense of self-worth.

To my knowledge, there are no empirically supported treatments for NPD, however, it has been suggested that there is enough similarity between NPD and Borderline Personality Disorder (BPD) that Dialectical Behavioral Therapy may be beneficial. Rather than trying to find treatment for this kind of individual, you might look for literature on how react and not react to such individuals. Try to avoid playing into their games.

Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to [email protected]

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