NARCISSISM

The term “narcissism” has been seemingly embraced by the general public and incorporated into everyday language. Usually, its use refers to those who hold a sense entitled. But narcissism in medical terms is much more than this mere description.
Narcissistic individuals have a grandiose sense of self. They hold a sense of entitlement believing that they are superior to others. Constantly motivated to establish superiority, they tend to overestimate their accomplishments and competencies (Daig, Klapp, & Fliege, 2009).Morf & Rhodewalt's (2001) dynamic self-regulatory processing model describe it as “an ongoing personality process (rather than a static condition) organized around the chronic goal of creating, maintaining, and further enhancing grandiose self views” (as cited in Thomaes, Bushman, De Castro, & Stegge, 2009, p. 1234). Social interactions are used as opportunities to obtain admiration yet, the process often backfires because people are often turned off to this type of behavior and the narcissist ends up repeating the cycle in constant pursuit of external validation to self esteem. Narcissists come off as arrogant, selfish, and self absorb in need of constant admiration and external validation.
Theories of Development
Although diagnosing minors with narcissism is discouraged, many mental health professionals agree that narcissistic tendencies are established well before adulthood (Thomaes, et al., 2009). It is important to note that while adult narcissism is well documented and researched, lack of empirical evidence exist of this in childhood and adolescents ( Thomaes, et al., 2009). In the analysis of narcissistic tendencies and its onset, experts look into normal childhood development for insight.
According to Thomaes, et al. (2009) prior to eight years of age, children do not possess the necessary cognitive skills to “consciously and intentionally reflect upon themselves” indicating that self esteem and self worth is not developed at this point (p. 1236). It is then theorized that age eight is the point where manifestations of narcissistic tendencies onsets.There are basically four reasons for this premises. First, self-reflection and self-esteem emerges at this age. Second, from this age upwards, children and adolescents become self conscious of how they are viewed by others. Third, children at this stage are particularly sensitive to two emotions closely associated with self esteem: shame and humiliation.
Lastly, children and adolescents at this age tend to engage in “impression management” behaviors to influence others opinion of them ( Thomas, et al., 2009, p. 1236). Along with theories of the onset of narcissistic behaviors are theories of why narcissism emerges. Two theories have been cited as possible explanations: temperamental factors and socializing experiences. The innate factor of temperament is passed from parent to child through genetics and is seen to influence personality. Dispositions are physiologically based with brain networks influencing internal responses and thus external ones as well. The amygdala and hypothalamus, areas of the brain responsible for emotion, facilitates in these responses when regulating neurotransmitters such as serotonin and dopamine (Thomas, et al., 2009). Basically, what is being indicated is that individuals have predisposition in innately behaving in certain ways depending on genetic influences predetermined before birth. It is then theorized that narcissistic individuals are likely those who have inherited a generally neuro-biological sensitivity to positive stimuli which is exacerbated by external environmental conditions.
Socializing experiences contributing to this maladaptive behavior are mainly attributed to parenting. One theories content that overvaluation and overindulgence are the culprits that lead to raising children with narcissistic predispositions. This parenting instills the grandiose self views and sense of entitlement associated with narcissism. Another theory lies on parental coldness, indifference, and lack of support and empathy combined with extremely high expectations encourages “inflated, narcissistic self-views to protect themselves against feelings of rejection and worthlessness” ( Thomaes, et al., 2009, p. 1240).
Working with Narcissism
It was previously thought of that low self esteem is a significant risk factor for
aggression. In fact, recent incidents of school shootings have had the U.S Department of Education include low self esteem as one of the warning signs of destructive behavior(Thomaes, Bushman, Stegge, & Olthof, 2008). A recent study by Thomaes, et al. (2008) found the opposite as true. In a study conducted on adolescents on aggression and narcissistic behavior, it was found that children that tested high in high self views were more prone to aggressive behavior. Furthermore, threats to pride, reputation, and self-esteem, especially when involving public exposure is a good predictor of this aggression and is well supported and documented in empirical research in narcissistic adults. Shame induced aggression serves as protective function in preventing further damage to sense of self (Thomaes, et al2008).Consequently, working with a client with narcissistic tendencies can be intimidating and unnerving. An article written by Pat McDonald (2011) illustrates this point. She cites a casestudy involving a narcissistic patient named Robin who was difficult to the point of hostile in his interactions with clinic staff. He shouted at the nurses and went into a “a narcissistic rage” when he did not get what he demanded. McDonald points out how important it is understanding the motivation behind these chaotic and seemingly unpredictable behavior.Mainly, she stresses that insecurity and fear is behind the difficult behavior and that compassion and understanding goes a long way in helping a narcissistic patient. This is especially true when the patient has a physical illness. McDonald also stresses setting boundaries. Be friendly and concerned yet professional at the same time.
Conclusion
Narcissistic behaviors have seem to be prevalent in today's society as senses of
entitlement is being looked upon more favorably as ever before. In spite of this change in American mentality, mental health professionals are well aware how damaging this can be to individuals and those around him. Narcissistic dispositions has been theorized to manifest during the ages of eight years of age and onward. It is further theorized that the root of narcissistic tendencies lie in temperament and parenting style during childhood development. As mental health professionals it is important to know what characterizes this maladaptive mechanism. Individuals with narcissism tend to be aggressive when pride, self-esteem, and reputation is threatened. Understanding the underlying causes and feelings of the manifested
behavior helps us feel the compassion and understanding needed to in turn help them.


References
Daig, I., Klapp, B. F., & Fliege, H. (2009). Narcissism predicts therapy outcome in
psychosomatic patients. Journal of Psychopathology and Behavioral Assessment, 31(4),
368-377. Retrieved from http://search.proquest.com/docview/622254918 ?
accountid=34899
MacDonald, P. (2011). Narcissistic personality disorder: The journal for nurses in general
practice. Practice Nurse, 41(1), 16. Retrieved from
http://search.proquest.com/docview/855003066 accountid=34899 ?
Thomaes, S., Bushman, B. J., d Castro, Bram Orobio, & Stegge, H. (2009). What makes
narcissists bloom? A framework for research on the etiology and development of
narcissism. Development and Psychopathology, 21(4), 1233-1247. Retrieved from
http://search.proquest.com/docview/742989934?accountid=34899
Thomaes, S., Bushman, B. J., Stegge, H., & Olthof, T. (2008). Trumping Shame by Blasts of
Noise: Narcissism, Self-Esteem, Shame, and Aggression in Young Adolescents. Child
Development, 79(6), 1792-1801. doi:10.1111/j.1467-8624.2008.01226.x