Pathological Narcissism Psychosis And Delusions

Pathological Narcissism Psychosis And Delusions

One of the most critical symptoms of pathological narcissism (the Narcissistic Personality Disorder) is grandiosity.

Grandiose fantasies (megalomaniac delusions of grandeur) permeate every aspect of the narcissist’s personality.

They are why the narcissist feels entitled to special treatment, which is typically incommensurate with his actual accomplishments.

The Grandiosity Gap is the abyss between the narcissist’s self-image (as reified by his False Self) and reality.

When Narcissistic Supply is deficient, the narcissist de-compensates and acts out in a variety of ways.

Narcissists often experience psychotic micro-episodes during therapy and when they suffer narcissistic injuries in a life crisis.

But can the narcissist “go over the edge”?

Do narcissists ever become psychotic?

Pathological Narcissism Psychosis And Delusions

Some terminology first:

The narrowest definition of psychosis, according to the DSM-IV-TR, is “restricted to delusions or prominent hallucinations, with the hallucinations occurring in the absence of insight into their pathological nature.”

And what are delusions and hallucinations?

A delusion is “a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary.”

A hallucination is a “sensory perception that has the compelling sense of the reality of a true perception, but that occurs without external stimulation of the relevant sensory organ.”

Granted, the narcissist’s hold on reality is tenuous (narcissists sometimes fail the reality test). Admittedly, narcissists often seem to believe in their confabulations.

They are unaware of the pathological nature and origin of their self-delusions. They are, thus, technically delusional (though they rarely suffer from hallucinations, disorganized speech, or disorganized or catatonic behavior). In the strictest sense of the word, narcissists appear to be psychotic.

But they are not. There is a qualitative difference between benign (though well-entrenched) self-deception or even malignant con-artistry – and “losing it.”

Pathological narcissism should not be construed as a form of psychosis because:

The narcissist is usually fully aware of the difference between true and false, accurate and make-belief, the invented and the extant, correct and wrong.

The narcissist consciously chooses to adopt one version of the events and aggrandizing narrative, a fairy-tale existence, a “what-if” counterfactual life.

He is emotionally invested in his myth. The narcissist feels better as fiction than as fact – but he never loses sight that it is all just fiction.

Throughout, the narcissist is in complete control of his faculties, cognisant of his choices, and goal-orientated. His behavior is intentional and directional.

He is a manipulator, and his delusions are in the service of his stratagems. Hence his chameleon-like ability to change guises, his conduct, and his convictions on a dime.

Narcissistic delusions rarely persist in the face of blanket opposition and reams of evidence to the contrary. The narcissist usually tries to convert his social milieu to his point of view.

He attempts to condition his nearest and dearest to reinforce his delusional False Self positively. But, if he fails, he modifies his profile on the fly.

He “plays it by ear.” His False Self is extemporaneous – a perpetual work of art, permanently reconstructed in a reiterative process designed around intricate and complex feedback loops.

Though the narcissistic personality is rigid – its content is constantly in flux. Narcissists forever re-invent themselves, adapt their consumption of Narcissistic Supply to the “marketplace,” attuned to the needs of their “suppliers.”

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