The Many Faces of Narcissism (Overt, Covert, and Toxic)
The Enigma of Narcissism
The fact is, narcissists don't think there's anything wrong with themselves. They lack introspection and self-awareness, so they rarely get treatment or diagnosis. That's because unlike, say, OCD, narcissism is an egosyntonic disorder: the behaviors and traits involved are in sync with the afflicted's values and beliefs.
As a result, few narcissists are available to participate in research studies, and therefore pathological narcissism and Narcissistic Personality Disorder (NPD) are not very well researched or understood, compared to say, Borderline Personality Disorder.
Therefore, much of our understanding is based as much on prevailing theories rather as on definitive research studies.
Prevalence
It's unclear what the prevalence of NPD is, because estimates vary widely. An NIH study reports 6.2%, which seems like a good number to use, as it "falls in the middle of the broad range of estimates (0.0%–14.7%) found in previous epidemiological surveys."
Especially when you consider the possibility that vulnerable (covert) narcissists might not be included in that number (here's why), it's pretty clear that a significant portion of the population is afflicted.
Dr. Ramani Durvasula, clinical psychologist and expert on narcissism, says that in actuality, the prevalence of narcissism may be 10 to 15%, although she clarifies that that number is not limited to individuals diagnosed with NPD. That's because, as Durvasula explains, a diagnosis of any personality disorder requires that there be "clinically significant distress or impairment in social, occupational, or other important areas of functioning." And because many narcissists are rewarded for their behavior and are "winning the game," (think celebrities and and hard-charging executives), they wouldn't meet the criteria for an NPD diagnosis.
If Dr. Ramani's estimate is correct, that means there are probably more narcissists in your world than you realize, and it's worth your while to recognize who they are and understand they behave.
The Narcissism Spectrum and Co-occuring Disorders
And what's more, narcissism exists on a spectrum.
It can be described as starting with healthy narcissism; to having narcissistic traits; to mild narcissism, to more severe pathological narcissism; and culminating with malignant narcissism. NPD lives in the pathological zone, but as you will see, the diagnosis requires specific criteria that doesn't represent all types of narcissism, and can therefore be seen to represent a subset of pathological narcissism.
Much less is written about the milder narcissists. These are people that, unlike more severe narcissists, have empathy, and are generally agreeable enough to form deep relationships with, notwithstanding some mildly trouble personality traits. However, when triggered, the same narcissistic mechanisms kick in, and much to your surprise, you'll find yourself being attacked. I call these the "hidden narcissists," because even after they reveal their worst side, most people don't realize they are dealing with a narcissist.
It's important that we understand that narcissistic behavior can be milder than the extremes we hear so many stories about. Otherwise we may be overlooking subtler forms of narcissistic abuse and its victims.
Finally, NPD has a high rate of co-occurrence with other personality disorders* (63%), making it even harder to figure out what makes the exasperating person in your life tick.
Traits Common to All Three Types of Narcissists
Pathological narcissism is a complex disorder that comes in a 3 main types (and a variety of other flavors): grandiose (overt) narcissism; vulnerable (covert) narcissism, and malignant (toxic) narcissism.
The prevailing conceptualization posits that narcissists developed a fragile and shaky self-esteem in childhood, such that they need external validation to bolster it. (Their need for this validation is so paramount that the term "Supply" is used for both the validation provided and the person, or thing, providing it.) They generally achieve this validation both by lifting themselves up and putting others down.
Their need to feel that they are held in high regard is so all-consuming that it manifests as, among other things, a need to control those around them. In fact, narcissists have a strong sense of entitlement that extends to controlling others, such that they tighten their grip when the object of their control tries to act independently rather than be constrained as an extension of the narcissist.
They react poorly to perceived threats to their ego ("Narcissistic Injury") and may engage in counterattacks of various types, including devaluation, using put-downs, sarcasm, and denigration. When set off by a Narcissistic Injury, they may launch into a Narcissistic Rage with a flurry of attacks that demean and punish.
Narcissists feel threatened quite easily and are particularly hypervigilant to criticism, real or perceived.
They may be triggered by unintended slights in commonplace interactions with others. Even something so trivial as a difference of opinion may set them off. I call it the "The Narcissist's Donkey Kick." It happens that swiftly.
[Examples of narcissistic reactions: Is It Healthy, Obnoxious, Toxic or Narcissistic?]
As a result, those around the narcissist can sometimes feel like they are walking on eggshells.
Inability to Accept Blame
Narcissists do not tolerate being seen as being in the wrong.
Acknowledging a misdeed or wrong-doing, or simply a mistake or mis-step, is intolerable to the narcissist, as they equate doing wrong with being bad -- altogether rotten and worthless.
[Why this is the case: The Narcissist's Alternate Reality: How Can They Say They Didn't When Clearly They Did?]
As a result, narcissists often turn to lying to evade accountability, or even just to deflect what they perceive to be intolerable criticism. They are known to be pathological liars.
They may go a step further and engage in gaslighting (reinventing history to make you doubt your own memory and perceptions, sometimes saying you are paranoid or imagining things), projection (accusing you of behaviors or characteristics they themselves have), and blame-shifting to turn things around on you and put you on the defense. This leads to conversations that go nowhere and are, at best, frustrating and at worst, verbally and emotionally abusive.
Exploitative, Manipulative, Deceitful and Envious
In order to achieve their goals, narcissists are often interpersonally exploitative, using various forms of manipulation and deceit to get people to do their bidding.
They are often quite envious, and that envy can trigger rivalry and fuel vengeance.
Lack Empathy
They also lack emotional empathy (the ability to feel some of what the other person is feeling), although that may not be obvious, since they develop the ability to respond seemingly empathetically using cognitive empathy (the ability to understand what the other person is feeling).
Devalue Others
Because they see people in terms of where they rank in status relative to themselves, they may treat the other person along the lines of an idealize - devalue - discard cycle.
[More on this cycle: Love Bombing and Limerence, a Potent Mix: How Your Twin Flame Can Burn You]
It's important to remember that this can happen even on the milder end of the spectrum than the near-sociopaths we often hear about.
For example, Dr. Elinor Greenberg, who specializes in NPD and other personality disorders, names Archie Bunker, from the 70s hit TV show "All in the Family," as an example of a narcissist who engages in devaluing others. He frequently devalues his wife Edith ("Dingbat") even though he loves her, as well as his son-in-law Michael ("Meathead").
The Grandiose (Overt) Narcissist
While psychologists who specialize in personality disorders define at least three main types of pathological narcissism, you may only be familiar with one, grandiose (overt) narcissism, especially if you've read lists of traits that come from the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The DSM outlines a set of diagnostic criteria that skews toward grandiose narcissism. (The DSM's treatment of NPD has been widely criticized, but as a practical matter, it is used primarily for insurance and research purposes, rather than treatment.)
Grandiose narcissists are easy to spot: conceited, selfish, demanding of admiration, and with a penchant for outsized materialism or excessive vanity that can be off-putting.
Here are the DSM-5's diagnostic criteria for NPD, which best align with grandiose narcissism. In fact, there are several traits that are specific to a grandiose presentation, which I've marked with an asterisk.*
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
* Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
* Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
* Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
* Requires excessive admiration.
Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
Is often envious of others or believes that others are envious of him or her.
* Shows arrogant, haughty behaviors or attitudes.
The Vulnerable (Covert) Narcissist
These narcissists aren't called covert because they are consciously trying to hide their narcissism from view or because they abuse covertly (although they happen to do so). The term simply means that the narcissism itself, especially the grandiosity, is hidden.
Covert narcissists lack the self-confidence to put themselves out there, i.e., to be on display and demand admiration, in order to acquire the Narcissistic Supply they need to boost their fragile self-esteem. In fact, they fear being exposed as inadequate.
Instead, as Dr. Greenberg explains, they satisfy their need for admiration not be exhibiting their own qualities or acquisitions, but by aligning themselves with a person, organization, or cause that they admire, thereby boosting their self-esteem by association.
The covert narcissist is often self-effacing, generous with their time and energy, and seemingly quite empathetic.
In fact, they may be the last person you'd expect to be a narcissist for just these reasons.
They may also play the victim or take on a "less-than" role.
When defending themselves from perceived slights, they resort to passive-aggressive behaviors such as the silent treatment that seemingly come out of nowhere. Rather than use threats or violence to maintain control, they resort to manipulation in order to get their way. However, when their covert sense of superiority and entitlement is significantly threatened, they may become enraged, and resort to verbal and emotional abuse.
So let's look at the DSM-5 criteria, which best represent the grandiose narcissist, and see how they might apply to covert narcissists:
Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements). [Any grandiosity will be private and manifests more in terms of an expectation that they are to be seen as being right, which plays into the need to control other people or situations, typically through passive-aggressive means.]
Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. [Any fantasies of these types will be private and likely more modest.]
Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions). [If this manifests at all, it will be in the form of a "Woe is me; I deserved better" narrative about lost opportunities through no fault of their own, or an "I have it worse than you" pity party.]
Requires excessive admiration. [This will be satisfied instead by boosting their self-esteem by association with a person, organization or cause they admire.]
Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations). [This manifests more in terms of expecting automatic compliance with their expectations.]
Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends). [This is where the manipulation and deceit come in.]
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others. [This is true of all narcissists.]
Is often envious of others or believes that others are envious of him or her. [This is true of all narcissists, possibly worse so for covert / vulnerable narcissists.]
Shows arrogant, haughty behaviors or attitudes. [This generally does not manifest in covert narcissists.]
Although it's possible for a narcissist to flip to the other presentation for a period of time under the right circumstances, you can imagine that it's much less likely that a vulnerable (covert) narcissist would be diagnosed with NPD, since at least 5 of the 9 criteria must be met.
The Malignant (Toxic) Narcissist
It is Dr. Otto Kernberg, a psychiatrist who has dedicated his long, auspicious career to the study and treatment of severe personality disorders, who conceptualized malignant narcissism, defining it as:
A syndrome combining a narcissistic personality, egosyntonic aggression, a paranoid orientation, and antisocial behaviors, lying intermediate between the narcissistic personality and the antisocial personality.
Malignant narcissists can be either grandiose/overt or vulnerable/covert, so the word "malignant" is often used as a modifier, as in "malignant grandiose narcissist" or "malignant covert narcissist."
While the milder narcissists mainly only bite when you get in their way, malignant narcissists go on the offense. They may use a scorched earth approach to take down their perceived opponent. They will often stop at nothing and will proceed with a laser-like focus and limitless energy on taking you down.
They use manipulation and deceit to orchestrate their moves. They are conniving and may twist past events and interactions, both real and fabricated, into ammunition for a smear campaign. They may enlist the help of enablers who do their bidding, known as "Flying Monkeys," who knowingly or unknowingly collaborate in persecuting the target after being fed lies and distortions that paint the narcissist as the victim. In some case, even the target's closest friends or loved ones may "drink the kool-aid" and be poisoned against them.
Malignant narcissists experience pleasure from inflicting physical or psychological pain on the target of their wrath, with a sadistic bent that veers into sociopathy. They are highly envious, and that envy can also fuel a vengeful response.
Although they may not fear the consequences of their actions when they are on a rampage, they can also be quite paranoid, becoming convinced that they are being persecuted. This stems from the fact that they assume others have the same penchant for aggression, revenge, manipulation and deceit that they do.
Given that narcissists project their own negative characteristics and abominable actions and onto their opponents, things can get quite disturbing when you are engaged with a malignant narcissist. They can unknowingly give you a glimpse into the depravity of their inner world. (In one case, a malignant narcissist mother tried to convince her teenage daughter that her older sister was putting poison in the food she cooked for the teenage daughter and their grandmother.)
While one of the strongest examples of a malignant narcissist is Hitler, it's important to understand that there are much more subtle manifestations of malignant narcissism, which are more likely to be in your midst than you might realize. It can simply be a narcissist who constantly devalues and engages in conflict. Here's a description of what a day in a relationship with just such a malignant narcissist might be like.
But if you're unlucky enough to be involved with an extreme malignant narcissist, be prepared that if you try to take them on, the result will only be damage and devastation. Malignant narcissists, in particular, don't play fair, and their stamina for machination and conflict will likely far outrun yours.
They will not accept boundaries. The best approach is No Contact. The only way to win is to not play the game.
* The most common are Borderline Personality Disorder, 37%; Schizoid Personality Disorder, 27%; and Obsessive-Compulsive Personality Disorder, 21%. Also of interest is that 39% of those diagnosed with Borderline Personality Disorder (BPD) also had NPD. So if you're wondering whether the exasperating person in your life has NPD or BPD, be aware that there's nearly a 40% chance that they have both.
NEXT: Read about White Hat Narcissism.
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