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Narcissistic Personality Disorder (NPD) | Dr. William Winter is a child and adolescent psychiatrist.
Will Winter, MD, FAAP
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"But enough about me, let's talk about you... what do you think about me?"
from the movie, "Beaches" (1988)

This disorder has to do with a preoccupation with oneself. Many of us may spend more time than is necessary in this capacity- For example, how much time do you spend looking at your own profile page on Facebook?

However, the focus on oneself in this disorder is all consuming and therefore dysfunctional. People with Narcissistic Personality Disorder (NPD) keep friends who are like cheerleaders. Those with NPD may exaggerate their achievements or talents to keep the admiration going.

If a friend stops admiring and complimenting, he's in danger of being dumped immediately. People with NPD are exquisitely sensitive to criticism. If criticized, they may react severely, i.e. with rage or shame.
Narcissistic Personality Disorder (NPD) is similar to Borderline Personality Disorder (BPD) in that the root of both is low self-esteem. The difference between BPD and NPD is that in BPD, attention in any form is needed and accepted. In NPD, attention, in the form of admiration specifically, is required.

Interestingly, people with a healthy sense of self-esteem need not bring attention to themselves. It is the ones that lack it who need your attention.

Because relationships are built on the faculty of giving (not just taking), those with NPD may not have relationships that most of us would find satisfying. However, they may still have relationships. For example, 2 people with NPD may pair off together because each may estimate the other as handsome/beautiful and therefore will make him/ her look good. The connection is superficial and, one would imagine that if 2 people with NPD were to marry (which happens), each would live their own lives. Basic relationship skills like compromise or ability to emotionally support the other on occasion may not be available to this type of couple. Finally, children of such a couple might end up with significant psychological issues as a result of their parents being too self-absorbed to raise them.

People with NPD may be professionally successful and may appear successful in every other way. This may be, in part, because they will make every effort to be perceived as such. Regardless, at the end of the day, the number of real friends/ relationships they will have will be few, if any.

People with NPD will not seek help for this condition because they will not recognize that this way of functioning is unusual, abnormal or problematic. But, they will sometimes present for supportive therapy and help with associated problems, i.e. anxiety, depression, anger issues, etc. These may result from work, relationship and family problems.