As a teenager, Leigh Anne had moved from one group of close friends to the next in rapid succession. She found herself in repeated conflicts with others, and each time, she believed she’d been the victim of the other person’s ignorance or lack of insight. Occasionally she grew friendly with someone who possessed some quality or object that Leigh Anne desired, and always these were the relationships she was interested in maintaining. When a slightly older friend received her driver’s license, Leigh Anne expected to be driven to and from school, and anywhere else she wanted to go—even though this friend lived miles away. When another friend was nominated prom queen, Leigh Anne tried to stay close, hoping to receive some notoriety for having such a popular “best friend,” but her attempts were eventually thwarted by her jealousy. For these reasons and others, high school had not gone as well as Leigh Anne might have hoped. Still, when she got to college, she invented stories about how amazing her high school years had been. She claimed to have been exceedingly popular and happy, and to have a group of “followers” still vying for contact with her. She invented a story about having been prom queen to prove her tale as much as to receive extra validation. She invented loads of boyfriends and never told the truth about the terrible fights she’d had with numbers of “ex-friends.” There was a period when Leigh Anne stopped showing up to classes, yet she expected her professors to forgive her missing test scores on the basis of her beauty and charm. Not receiving her wish, she grew indignant and threatened at least one professor with a formal grievance for being “unfair and prejudicial” in her case. Her old “mean girl” tactics still in place, she began a rumor about the professor that she hoped would cost him his job. After graduation, Leigh Anne landed a job at a great law practice, but unhappy with her entry level status and pay, she demanded to be given higher level paralegal duties. At first she was charming and persuasive, but when the firm did not comply—Leigh Anne had neither the training nor experience—she quit in a storm and even wrote bogus negative reviews online about the firm’s partners. Leigh Anne met a wealthy man (she’d always said she would “marry rich”) and in the weeks before their marriage, her wedding planner quit. He claims to have done so because Leigh Anne was “the worst bridezilla” he’d ever had to work with. Her husband, a somewhat docile man, eventually despaired of his wife’s frequent rages and her lack of gratitude, and he filed for divorce. By the age of 35, Leigh Anne had embarked on another disastrous marriage, had fired four therapists, and had become embroiled in a lawsuit with her neighborhood’s HOA before symptoms she believed were depression finally compelled her to take her issues seriously and commit to therapy. Narcissism Defined Do you tend to have strong personality clashes with others? Are you convinced others are completely in the wrong when such clashes occur? Do you believe strongly in your own talents, your own specialness? Do you just know that you are more intelligent than most people, more attractive, more charming, more superior? Do you expect favorable treatment—even special treatment—from everyone from the grocery clerk to your company’s executive staff? Is it hard for you to understand (or consider) what others might be feeling and why? Do you seek the attention and admiration of others, even expect it? If you answered ‘yes’ to most of these, you might be a narcissist. In Greek mythology, Narcissus, the son of a god and a nymph, was a hunter who was lauded for his beauty. According to the legend, Narcissus believed absolutely in his beauty and uniqueness, and was terribly proud. Seeing Narcissus’ pride and the way he scorned all who admired him, the goddess Nemesis lured Narcissus to a pool of water. When he saw his own reflection, he fell madly in love. So in love, he was unable to leave, and eventually died. The term narcissism evolved as a term to describe someone who is egotistical, overly proud, entitled, vain and selfish. A Disorder of Narcissism Narcissistic personality disorder (NPD) means more than possessing some of the traits of narcissism. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth revision (DSM-5), lists the criteria for NPD this way: “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: 1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements). 2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. 3. 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). 4. Requires excessive admiration. 5. Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations. 6. Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends. 7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.” NPD is believed to occur in less than 1 percent of the population, and occurs more frequently in men than women. NPD symptoms tend to get better as a person gets older, especially by the 40s and 50s, but its symptoms can be extreme in younger years. Often, other psychiatric disorders co-occur with NPD (i.e., bipolar illness, depressive disorders, anxiety disorders and substance related disorders). Most people who have NPD do not seek treatment; those who do so typically arrive in therapy after their disorder has created considerable life strain and dysfunction. This was the case for Leigh Anne. Through her treatment for NPD—which includes long-term psychotherapy with an experienced therapist and may include certain medications to help with the worst symptoms—she began to gain life skills to help her attempt to walk in others’ shoes and to forecast how others are likely to feel about and respond to her behaviors. With the considerable desire for self-improvement, as well as the goal of having a happier life, Leigh Anne has made good strides in her progress.