The Range Of Perspectives On Narcissism

If you’ve found this blog, there is a good chance you – or someone you care about – has experienced some of the more damaging consequences of genuine narcissism.

Maybe you didn’t realize you were dealing with a narcissist at first, but the pain and damage this selfish, arrogant, condescending, and domineering person caused might have driven you to search for answers about what was going on, and how to deal with them.  As you searched online or in books, perhaps you read more about who this type of person is, and how he or she operates.  You likely have read explanations on causes, and advice on how to deal with this “narcissist.”

Those looking for help with understanding and dealing with a narcissist have typically turned to the following five sources:

    • Professional psychologists or psychiatrists
    • The pop-psychology world of books, blogs, self-help forums, etc.
    • Christian psychologists
    • Biblical counselors[i]
    • A shoulder to cry on (i.e. – a caring friend)

Of the above, by far the most commonly sought sources have been the world of pop-psychology and caring friends.  My own journey of discovery started with asking God for “help!”, but my first stop on the road was the world of pop-psychology.  However, God soon showed me that He has something to say on the subject.

The Secular Perspective on Narcissism

The Professional Psychiatry/Psychology Track

For the past several decades, the diagnostic and solution domain for dealing with narcissism has been “owned” by the world of professional psychiatry and psychology.  This is a relatively recent phenomenon.  From Hoermann, Zupanick, and Dombeck[ii]

“By the 1950’s, the concept of “character disorders” had become widely accepted within the psychoanalytic community, and psychoanalytic clinicians were distinguishing character disorders from the more severe forms of mental illnesses that cause people to lose touch with reality (i.e., to become psychotic).  But character disorders were not viewed as legitimate mental illnesses in their own right.  Instead, they were typically understood as weaknesses of character or willfully deviant behavior caused by problems in a person’s upbringing.”…..

It was not until the 1950s, with the publication of the first Diagnostic and Statistical Manual of Mental Disorders (DSM)[iii], that the character disorders became formally recognized. The original DSM, devised to reduce confusion surrounding psychiatric diagnosis and diagnostic systems prevalent at the time, defined the personality disorders as patterns of behavior that were quite resistant to change, but not connected to considerable anxiety or personal distress on part of the patient…….

In DSM II, personality disorders were described as follows, “This group of disorders is characterized by deeply ingrained, maladaptive patterns of behavior that are perceptibly different in quality from psychotic and neurotic symptoms.” (APA, DSM II, 1968, p. 41). Then each disorder was briefly described by a few short sentences. The names of these disorders, and their brief descriptions, bear only a slight resemblance to what we know today as personality disorders……

Prior to DSM III, personality disorders were only vaguely described categories that did not lend themselves to research.  However, the publication DSM III (APA, 1980) changed all that.  Personality disorders were now recognized as a distinct and separate category of disorders in their own right…….[iv]

The term “narcissistic personality structure” was introduced by Otto Kernberg in 1967[v] and “narcissistic personality disorder” was first proposed by Heinz Kohut in 1968.[vi]

Professional track limitations

Since then there has been much discussion on the definition and characteristics of Narcissistic Personality Disorder (NPD), its causes, and possible treatment.  While there is a degree of commonality regarding a description of the traits of narcissism, a precise, universally accepted definition has yet to emerge.  The causes of and solutions to narcissism, according to psychiatry, remain in the realm of the theoretical.

Beyond its commonly observable traits, the professional psychiatric world is still debating how to classify Narcissistic Personality Disorder[vii] and its associated characteristics.  There is also no clearly defined line to cross to determine if someone has NPD or not, so its diagnosis comes down to a “professional assessment”.  From the Mayo Clinic[viii]:

Diagnosis:  Some features of narcissistic personality disorder are similar to those of other personality disorders. Also, it’s possible to be diagnosed with more than one personality disorder at the same time. This can make a diagnosis of narcissistic personality disorder more challenging.  Diagnosis of narcissistic personality disorder typically is based on:

    • Signs and symptoms
    • A physical exam to make sure you don’t have a physical problem causing your symptoms
    • A thorough psychological evaluation that may include filling out questionnaires
    • Criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Treatment (Mayo):  Treatment for narcissistic personality disorder is talk therapy (psychotherapy). Medications may be included in your treatment if you have other mental health conditions.  Psychotherapy can help you learn to relate better with others, so your relationships are more intimate, enjoyable and rewarding……  Therapy can be short term to help you manage during times of stress or crisis or can be provided on an ongoing basis to help you achieve and maintain your goals. Often, including family members or significant others in therapy can be helpful.

Medications (Mayo):  There are no medications specifically used to treat narcissistic personality disorder. However, if you have symptoms of depression, anxiety or other conditions, medications such as antidepressants or anti-anxiety drugs may be helpful.

In the secular discussion of Narcissistic Personality Disorder (NPD), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association is considered “the Bible”.

Here is DSM-V’s most detailed attempt at a definition of NPD[ix]:

NPD is defined as comprising a pervasive pattern of grandiosity (in fantasy or behavior), a constant need for admiration, and a lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by the presence of at least 5 of the following 9 criteria:

    • A grandiose sense of self-importance
    • A preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
    • A belief 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
    • A need for excessive admiration
    • A sense of entitlement
    • Interpersonally exploitive behavior
    • A lack of empathy
    • Envy of others or a belief that others are envious of him or her
    • A demonstration of arrogant and haughty behaviors or attitudes

In a proposed alternative model cited in DSM-5, NPD is characterized by moderate or greater impairment in personality functioning, manifested by characteristic difficulties in 2 or more of the following 4 areas:  Identity, Self-direction, Empathy, Intimacy.  In addition, NPD is characterized by the presence of both grandiosity and attention seeking.

The fact that the DSM references an alternate model in addition to its official model, underscores their need to leave the door open to further development of their definitions of NPD.

The Popular Psychology / Self-Help Tracks

The pop-psychology track includes a myriad of pop-culture blogs, books, and articles on the subject.  This track takes its cues from the professional psychology track and expands the definition of narcissism through a group-sourced ‘echo chamber’ of personal observations and experiences.  These myriad views on what narcissism is and how to deal with it tend to converge into a commonly held conventional wisdom on narcissism.  The attraction of this track is the affirmation and the emotional support which it provides.

Many hold themselves out as experts on narcissism, from life coaches to ex-pastors to housewives to the Huffington Post and beyond.  This pop-psychology track also often takes the form of online group therapy sessions or support groups, providing positive reinforcement and sympathy – often without providing real solutions.  This “wisdom of the crowd” is found literally everywhere in cyberspace and on bookshelves.

Secular Perspectives on Possible Causes

The worlds of psychiatry and professional psychology acknowledge that they continue to wrestle with the cause of narcissism.  Here is a sample statement, from the Mayo Clinic[x].

It’s not known what causes narcissistic personality disorder. As with personality development and with other mental health disorders, the cause of narcissistic personality disorder is likely complex. Narcissistic personality disorder may be linked to:

  • Environment – mismatches in parent-child relationships with either excessive adoration or excessive criticism that is poorly attuned to the child’s experience.
  • Genetics – inherited characteristics
  • Neurobiology – the connection between the brain and behavior and thinking”

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Or, from the Australian Health Direct website[xi] which is funded, screened, and approved by the Australian Government

“As with many personality disorders, the exact cause of narcissistic personality disorder (NPD) is unknown. Biological vulnerabilities, early childhood experiences and psychological factors form a complex mixture and may all play a part.  Early childhood risk factors include:

    • insensitive parenting
    • over-praising and excessive pampering – when parents focus intensely on a specific talent or the physical appearance of their child as a result of their own self-esteem issues
    • unpredictable or negligent care
    • excessive criticism
    • abuse
    • trauma
    • extremely high expectations.
    • Other possible factors include:
      • genetic abnormalities impacting on psychobiology – the connection between brain and behavior
      • an over-sensitive temperament.

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These “answers” are attempts to connect cause with effect based on individuals whom they have observed.  Although the definitive answer to the question of what causes NPD escapes them, professionals agree that the sooner treatment begins, the better a person’s chance for an improved quality of life.  How do you treat this without clearly understanding the cause?  That kind of treatment necessarily focuses on symptoms and not core solutions.

The secular views on possible causes rest on two assumptions.  The first assumption is that external factors caused it.  The second is that it is related to the genetic makeup of the narcissist.  Both these assumptions minimize a narcissist’s personal responsibility for his actions.

There’s Another Option

In contrast to the secular approach, there is another option available in the search for answers to the thorny issues of narcissism.  This path brings God fully into the equation – the God who is the all-knowing, all-wise, all-loving Creator and designer of people, and who therefore fully knows how they work.  This option is based on God’s genuine wisdom and brings to bear His power for dealing with life’s real issues.  It is outlined in the Bible as His intricately interwoven message on everything pertaining to life.

“All Scripture is inspired by God and profitable for teaching, for reproof, for correction, for training in righteousness; so that the man of God may be adequate, equipped for every good work.”   

2 Timothy 2:16-17

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“For the Lord gives wisdom; From His mouth come knowledge and understanding.” 

Proverbs 2:6

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This track is labelled “Biblical” over “Christian”.  There’s an ongoing debate among Christian professional counselors about how much of secular psychology’s concepts, principles, and practices should be incorporated into Christian counseling.  Their positions range widely from “almost zero” to “almost everything.”  Those on the “zero” end of the spectrum term themselves “Biblical counselors” or “nouthetic counselors,” while those willing to broadly incorporate elements from the world of psychology typically still call themselves “Christian counselors.”  This debate is beyond the intention or scope of this book.  You can to develop your own view as you study further.

While the keen observational approach inherent in professional psychiatry unarguably has some  value, it misses core, key ingredients foundational to lasting solutions.  I agree with John McArthur’s statement when he says[xii]:

“I have no quarrel with those who use either common sense or social sciences as a helpful observer’s platform to look on human conduct and develop tools to assist people in getting some external controls in their behavior. That may be useful as a first step for getting to the real spiritual cure. But a wise counselor realizes that all behavioral therapy stops on the surface, far short of actual solutions to the real needs of the soul, which are resolved only in Christ.  On the other hand, I have no tolerance for those who exalt psychology above Scripture, intercession, and the perfect sufficiency of our God. And I have no encouragement for people who wish to mix psychology with the divine resources and sell the mixture as a spiritual elixir. Their methodology amounts to a tacit admission that what God has given us in Christ is not really adequate to meet our deepest needs and salve our troubled lives.”  

Common Descriptions, Different Terms

While there is a degree of common ground between the secular and Biblical approaches to narcissism – mostly in the description of narcissists and how they behave, i.e. narcissistic traits – the approaches diverge substantially in the areas of root causes, possible solutions, and ways in which “victims” should deal with these troubling people.

To simply illustrate the overlap and divergence between the different approaches, the overlapping areas in the following Venn diagram below are primarily descriptive (how do narcissists behave), and the non-overlapping areas tend toward the causal (why are narcissists the way they are) and the prescriptive (what to do about it).

Human nature has been the same since the beginning of humankind. Since the Bible speaks about the nature of man and interpersonal relationships, we should see the kind of people the secular world refers to as “narcissists” in the Bible.  By accurately identifying the terms the Bible uses to describe the people which the secular world calls narcissists, we can then study those terms for a comprehensive look at what the Bible says about narcissism.

Since the term narcissism derives from the character Narcissus in Greek mythology, and usage in the world of psychiatry only began in the early 1900’s[xiii], we would not expect the Bible to use that term.  Some of the terms the Bible regularly uses for narcissism are “insolent pride,” “proud,” “haughty,” and “scoffer”. These terms, as well as others, can be considered synonymous with narcissism.

 “Proud,” “Haughty,” “Scoffer,” are his names, who acts with insolent pride. 

Proverbs 21:24

Prior to the widespread use of the term narcissism, people commonly recognized the traits of these people by other labels, such as: megalomania, egocentricity, conceit, arrogance, haughtiness, vanity, self-absorption, etc.  We can equate the Bible’s terminology with the term narcissism used by the secular world, based on comparable descriptions of the same people.

Among many others, this equivalence in terms is illustrated in Wikipedia’s definition, which says that narcissistic traits derive from “arrogant pride:”[xiv]

“Narcissism is the pursuit of gratification from vanity, or egotistic admiration of one’s own physical or mental attributes, that derive from arrogant pride. The term originated with Narcissus in Greek mythology, who fell in love with his own image reflected in a pool of water.”

Secular vs. Biblical Perspectives

One of the differences between the secular and Biblical approaches is that the secular psych world is “outside in” – observing characteristics, grouping them, and then labeling them – whereas the Biblical approach is “inside out.”  God alone knows the heart and character of a narcissistic person.  He gives the person with that kind of heart a name and then describes that type of person and the damage they leave in their wake in cascading detail.  Here’s a simple chart illustrating these approaches:

In a sense, the secular psych world is only observing and categorizing the characteristics which God through the Bible has already defined.

There Is an Evil Underneath

While the descriptions are similar between the secular and Biblical world, God does not view “narcissism” as a mere personality disorder.  He sees narcissistic behavior as an evil that is driven by what is in a person’s heart.

But the things that proceed out of the mouth come from the heart, and those defile the man. For out of the heart come evil thoughts, murders, adulteries, fornications, thefts, false witness, slanders. 

Matthew 15:18-19[xv]

The battle is between good and evil, and it is waged at the heart level.  We can see the outward results of this battle through actions and words, but God sees directly inside.

“Man looks at the outward appearance, but the Lord looks at the heart.”

 1 Samuel 16:7

Would not God find this out? For He knows the secrets of the heart. 

Psalm 44:21

The problem’s source and solution start in the heart.  The mind simply serves the heart.  That’s one explanation for why a narcissist can appear to be self-contradictory by quickly taking the opposite position of something he just said.  His mixed signals display the mixed motives of his heart.

People who are casually around narcissists may only find them annoying.  However, those hurt by narcissists are quite aware there is something deeper – an underlying evil.  Narcissists typically don’t see themselves as evil – in fact, they usually see the contrary in themselves – but their victims are eventually forced to see them for what they are.

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[The above are slightly edited excerpts from the book, The First Will Be Last:  A Biblical Perspective On Narcissism, Davidson Publishing]

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Notes: 

[i][i]There is a difference between Christian counseling and Biblical counseling (see https://zondervanacademic.com/blog/biblical-counseling-vs-christian-counseling-whats-the-difference/ for an introduction)

[ii] https://www.mentalhelp.net/articles/the-history-of-the-psychiatric-diagnostic-system-continued.  Hoermann, PhD. Corinne E. Zupanick, Psy.D. & Mark Dombeck, PhD.

[iii] The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association.  The first edition came out in the 1950’s and fifth edition came out in 2013 . It is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. DSM contains descriptions, symptoms, and other criteria for diagnosing mental disorders.  It is for diagnostic purposes only, and does not include information or guidelines for treatment .

[iv] https://www.mentalhelp.net/articles/the-history-of-the-psychiatric-diagnostic-system-continued/

[v] Kernberg, Otto, Borderline Conditions and Pathological Narcissism, 1967

[vi] Kohut H The Psychoanalytic Treatment of Narcissistic Personality Disorders: Outline of a Systematic Approach, 1968

[vii] Narcissistic Personality Disorder in DSM-5.  Skodol, Bender, Morey

https://pdfs.semanticscholar.org/cbdf/0a480f675f00ee161499d9931ce86f754f49.pdf

[viii] Mayo Clinic:  Patient & Health Information:  Narcissistic Personality Disorder.  https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/diagnosis-treatment/drc-20366690

[ix] https://www.medscape.com/answers/1519417-101764/what-are-the-dsm-5-diagnostic-criteria-for-narcissistic-personality-disorder-npd

[x] https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662

[xi] https://www.healthdirect.gov.au/causes-of-npd

[xii] From “Counseling: How to Counsel Biblically (MacArthur Pastor’s Library)” by John F. MacArthur, Wayne A. Mack, Master’s College Faculty

[xiii] Sigmund Freud wrote the essay “On Narcissism” in 1914, see wikipedia.org/wiki/On Narcissism

[xiv] From Wikipedia (http://en.wikipedia.org/wiki/Narcissism)

[xv] See also Mark 7:21, Luke 6:45