Hello this is Dr. Grande. Today's question is: "What are the emotional processing abilities...
We would see with narcissistic personality disorder?"
Now this is an area that's been researched... somewhat. I wouldn't say a lot, but somewhat.
And we know a lot of interesting information about how
narcissistic personality disorder or NPD can present.
Now, much of this information regarding emotional processing is consistent with
the symptom criteria we see for NPD in the Diagnostic and Statistical Manual.
The first area I'll cover with the emotional processing of NPD is a condition known as
alexithymia.
Now this is a condition we sometimes see with narcissistic personality disorder and other mental health disorders.
Now, alexithymia is a condition where an individual has difficulty identifying their own feelings,
and difficulty differentiating their feelings from bodily sensations.
Also, individuals with alexithymia have difficulty identifying feelings in other people.
Now we have other research on NPD that indicates that
many individuals with NPD failed to recognize disgust and fear in other people.
And they tend to have a negative reaction
when they see something that is considered normally to be happy
And they have indifference when they see a fearful or sad condition.
Now this is interesting for a variety of reasons,
but one is that many individuals with NPD have a fear of losing emotional regulation.
So fear is something they often experience,
yet there is confusion when trying to identify fear in other people.
Another item related to emotional processing with NPD is aggression.
Now aggression has an unusual place with NPD.
Sometimes we could think of the product of aggression,
when processed through narcissistic personality disorder, as positive or negative.
For example, if it's processed in a positive way
it can lead to perfectionistic tendencies.
But not overly perfectionistic. So this could be helpful
at careers, for example, and we can see an increase in competence.
Now on the destructive or negative side of aggression, of course we see
arrogance and a condescending attitude.
Another type of aggression is aggression that's pointed inward.
And of course we would normally think of this as being negative.
We see it in NPD as self-hatred and self-criticism.
And this is not something that would be necessarily observable to someone on the outside.
This is an internal process that's actually fairly common with NPD.
A lack of empathy is often associated with NPD.
It's actually one of the symptom criteria in the DSM.
But interestingly, there is a difference when we look at empathy
between cognitive empathy and emotional empathy.
And research indicates that individuals with NPD generally
have cognitive empathy that's within the normal range.
That's the same as individuals that do not have NPD.
It's the emotional empathy that appears to be compromised.
So an individual with NPD can often feel, but they don't act.
So they can in many cases understand what somebody's feeling,
but there's no movement to act on that feeling.
So this is where we see the lack of empathy.
It's really in the observable behavior rather than the cognitive process.
Another interesting item related to emotional processing in NPD is that
a number of individuals with NPD have fragile self-esteem.
Now again, when we look at the symptom criteria, this would not be obvious.
Now this self-esteem can be boosted externally.
For example: being promoted at work, or doing well at work, or receiving praise from other people.
It can also be moved downward externally; it can be negatively affected.
Someone can lose their self-esteem because they lose praise, or they lose the job, or they lose relationships.
So the self-esteem for many people with NPD is really externally controlled,
and of course this lack of internal control and being dependent on
external situations for self-esteem leads to problems.
The last item I'll cover here with NPD and emotional processing is
this term we see in the literature referred to as
an expectation of super-empathetic understanding.
This is a condition that we see
with many disorders, not just NPD,
but it is closely associated with NPD.
This is where an individual with NPD would
believe that other people automatically know how they feel,
what they're thinking, and what they expect.
So this leads to what are refered to as "silent demands."
An individual with NPD may expect people to know what they're thinking and put demands on them,
and of course those demands wouldn't be met. And this could lead to a number of
negative reactions including aggression or a drop in self-esteem.
So how does this information about emotional processing in NPD
affect the treatment that's provided to people who have narcissistic personality disorder?
Well, there are a few theories that have come out of all these different
pieces of information on emotional processing.
One is that therapy should be focused, at least in part,
on increasing an awareness of behavior, internal processes, and the patterns that individuals with NPD
sometimes can find. For example:
Being condescending, or arrogant, or that expectation that other people know what they're thinking or feeling.
So it's believed that
increasing the ability to identify feelings and being more aware our behaviors
could lead to insight that could aid in recovery.
I hope you found this description of emotional processing and NPD to be interesting. Thanks for watching.