Narcissism vs. Narcissistic Personality Disorder

Hello everyone, welcome to the Said in Therapy Podcast. Have you ever considered going to therapy and you ended up not going? My question is why? In my humble opinion, I believe everyone can benefit from therapy. In fact, I believe everybody should go at least once in their life.

My name is Iman Tohami, and I'm a psychologist. This podcast tells you all about everyday cases with everyday people who have everyday problems and difficulties, and sometimes they carry around really deep wounds. These are their stories.

The reason for that is that I often overthrow my decision to publish in the first place. There are many reasons for that. But one reason is I started to get a lot of feedback about my more recent episodes, which I absolutely love by the way, so please keep them coming.

And for some reason that I do understand from a professional point of view, I got a lot of questions about the episode about narcissism. The reasons for that are A, it is still not clear what narcissism is, even though the term is thrown around all over the internet.

And B, the question is, is it something that you can actually treat? So I want to dedicate this episode to the whole topic, and I want to explain a bit more to you what it means to be diagnosed with a narcissistic personality disorder.

Now I don't have a guest for this episode today thinking of it. I think we all can understand why. Not everybody is comfortable with sharing their stuff with the world. The good news is I have in fact discussed with a patient who's diagnosed with exactly this disorder, and he has given me the permission to share snippets of his story.

His name is Max. This is how we pronounce it in Germany, and it is actually important to understand that his background is German, but I will explain to you why it is so important later in that episode. But let's begin with explaining what narcissism is and what a narcissistic personality disorder is, because there is actually a difference.

It is a very fine point, but it is a very important point to make. Since everybody is throwing around this word in the internet, I want to make a clear distinction. Unlike other disorders, this one feels like a character assassination, so we have to be a little bit careful when we use it.

When we talk about MPD, there is a long list of patterns and people diagnosed with it have to display at least five out of the nine. And those patterns need to be across the board. So people with MPD cannot be just horrible to you or with you and as with the rest of the world.

They have to be horrible across the board. So when they address people, they're showing behavior or the same behavior with all people. But here's the catch. It has to involve social and occupational impairment and subjective distress. It is actually just a fancy way to say it's messing up that person's life and they suffer from their own behavior and traits.

And they're very aware of it. So this is why we don't see a lot of people with MPD. If their way of not being empathetic, of being entitled, of being grandiose, of being arrogant and superficial, if all of that is working out for them, they will not be walking around saying I have a problem.

So if they don't acknowledge that there is a problem, then they are really narcissistic, but they don't have MPD. And I want to make this very clear. They are really narcissistic, which is sort of being a jerk. And as a psychologist it is very important to say we don't diagnose people for being assholes.

We may not like them, but it is really not a reason to diagnose someone. We diagnose a person who brings in a problem that causes them suffering. It is a very important point to make. You know how many people told me and asked me to diagnose their partners MPD and how upset they were when I told them nope, I cannot do that.

It's really insane. The pattern of narcissism is absolutely awful. The pattern of narcissism is absolutely awful. I'm with you, don't get me wrong. You may be on the other end of it and receiving a lot of bullshit is generally speaking not okay.

But if this person who is treating you awful is not coming around to tell you that they have a problem, then they don't have MPD. Being near a person who is narcissistic is probably the worst type of toxic environment there is.

But I want to tell you something. For all the people out there who are dying to get a diagnosis for their partners, who cares if they are diagnosed with MPD or not? If you are in a toxic relationship, it is very important to get out of it.

Another common question I get is when does self-confidence become narcissistic? And the answer is it is very simple actually. If you are self-confident and you are healthy in your state of mind, you will understand that being self-confident doesn't mean that you have to blast your achievements on every social media platform for instance.

Self-confident people won't talk over you when you share your achievements and points of view. Self-confident people don't always need to be winning and are also fine with being second place sometimes. If you are comfortable in your sense of self, you can actually stay quiet about your achievements.

So let's get back to MPD. People with MPD suffer from their own behavior because in many ways they are deeply, deeply, deeply insecure. Many of you asked me the different types of narcissism. And once again, I have to say it is almost impossible to cover all of it in one episode only.

So I will name four and we will take it from here. The first one is toxic narcissism. Those people are often very outspoken and they have to be always right. These narcissists tend to be bullies and they invalidate people at all times.

I would say this is also the most common type of narcissism. Second one is covert narcissism. They may seem kind and sweet and very depressed sometimes, but in reality they use people for their own agenda. They often seem sad and depressed, as I said, because they believe nobody understands their greatness.

In a way you will meet one of them and you will almost feel bad for them. Ultimately, many believe the world owes them. Then you have communal narcissism. To be honest, secretly I call them the hashtag narcissists. Those are often the people who will fill their profiles with charity and volunteering posts.

To break it down easily for you, those type of people will throw a gala to get donations. But they would pay, let's say, ten thousand dollars for that gala, and then they will get maybe five thousand dollars of donations.

So when I ask them why didn't you take the money of the gala and donated it, that way you will have way way more, they will tell you, no, I need that gala. So they need to be in the center of attention.

You understand a narcissist by looking at them and seeing how they treat people they cannot use or get nothing out of them. So if a communal narcissist is, for instance, an employer, there is a good chance that he or she will treat their employees absolutely horrible.

And then the last one I will bring up for today is the benign narcissist. We probably all know someone who is that way. It is the person you know who likes to drive big cars and have expensive clothes and it's all about the superficial things in life.

And important is also to know that when someone else is not having what they're having, they're easily dismissed. You can go ahead and tell them, well, this is an awful thing to do. They might even acknowledge it, but then they will turn around and do the exact same thing again.

There are a few things all narcissists have in common. Those are lack of empathy, grandiosity, entitlement, the chronic need to seek validation from the outside, arrogance, the tendency of rage and manipulation. And these are across the board, so every narcissist will show some, if not all of these traits.

Remember Max? Let's go back to him. I mentioned him in the beginning. Max, or Max, how we call him, has been in treatment for MPD for years. Initially he came to therapy to use it as a means to prove how everybody was wrong about his behavior, and that he was actually the best at what he does.

The backstory is that Max was a politician in one of the two major parts in the German system. He was running for office how you would say in America, but ultimately he lost. Instead of moving on and trying again, he was laser focused at what went wrong and finding other people to blame.

Now what you need to understand about Germany is phrases like I am the best are not necessarily well received as in other of the world or other countries. In fact, openly bragging about accomplishments can be seen as not humble and off-putting.

That contrast to the majority of society is very, very stark. Narcissists have a particularly hard time in some parts of the world, but in the context of Germany, he needed to find other ways to put himself in the center of attention.

But ultimately what cost him the election was the fact that he had total disregard for criticism and always looked for error in someone else, even in his voters. Now I can tell you his story exactly like that because it has been years and he is in therapy for a very long time.

If I had narrated his story or parts of his story the way I do now, he'd give me a call and tell me right away how wrong I was. And he would probably try to tear me down. I must highlight though that Max is an extremely charismatic person.

The way I describe him here is very simplified and highlight his narcissistic traits on purpose. But if you would see him in real life, you wouldn't even guess that he's a narcissist. Max was and is still very successful at what he does for a living.

For him to locate his insecurities to understand that the errors made in said election were not about people around him, but in fact about him, this took years. His discomfort about the situation and the slight knowledge and acknowledgement that shone through sometimes made him qualify for MPD.

Remember, I told you, people with MPD need to be aware that something in their behavior is wrong. But those moments were, especially in the beginning, very rare. People with MPD have insecurities, and those are almost always formed in childhood.

So you must understand that narcissists and people diagnosed with MPD are in a way a product of their inner world, and they try to compensate for emptiness and insecurity with the way they behave. I know that the next question will probably be can people with MPD be cured?

It is in fact a very difficult question. You see, in the case of Max, we have seen fantastic improvements and results, but he would never come out and tell you that he is in fact the person I just described.

As he puts it, it's a diagnosis to live with, but it's nothing to get rid of. He has very good days and sometimes he has bad days. But empathy is something he really needed to learn over the years.

So in some way we can say people with MPD can change, but it takes a lot of therapy, a lot of effort, and a lot of patience.

If you have any questions or suggestions, please don't hesitate to reach out. You can find me on social media, Facebook, Twitter, Instagram. The handle is always @saidintherapy.