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The term “narcissism” should not be confused with “egocentrism.” People who are egocentric believe they are the center of attention, and they are limited in their perspective with respect to themselves and others. In other words, they only see things from their point of view and do not really consider others’ viewpoints on a subject. They can be rather difficult to get along with and appear to be very stubborn. Their anxiety comes from worrying about other people’s opinions of them, even though these “opinions” are not based on fact but rather on the egocentric person’s assumptions about how others view them. People who are egocentric are unable to see your point of view, and this can raise problems in interpersonal relationships when partners or colleagues cannot see eye-to-eye.

Narcissists, on the other hand, do see your point of view but they would rather that you follow their viewpoint. Depending on the level of narcissism, they may get annoyed, angry or enraged if you don’t agree and follow along. Strictly speaking, narcissism is defined as an “excessive or erotic interest in oneself and one’s physical appearance.” It’s more about indulging in one’s own appearance, talents or other desirable attributes and receiving praise for those traits.

Here are some ways to spot narcissistic tendencies:

Chronically late to everything, a behavior which is reinforced if people don’t speak up

Getting recognition is more than just a desire; it’s a need

Craving to be in the spotlight

Exaggerated sense of ego; appearance of self-confidence

Feeling insignificant if they go unnoticed

Grandiose/exaggerated view of one’s own attractiveness, talents, and attributes

Sense of entitlement to special treatment

Lack of empathy, shame and remorse for one’s exploitative actions toward others

Disregard for those who don’t show praise or admiration for them

When does narcissism actually become a disorder?

Narcissistic Personality Disorder (NPD) is different from narcissism in that NPD is classified as a mental illness under the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). To be diagnosed for NPD, one must meet five or more of the following criteria:

Sense of identity is largely defined by others. Individuals with NPD look to others to help define and shape them. Their self-esteem is at the mercy of how others respond, positively or negatively, to their exaggerated sense of self

Their behavior is geared toward gaining approval from others.

They set unreasonably high standards in order to feel exceptional

They are often unaware of their own motivations

They are out of touch with the emotions and needs of others around them

They only care about others’ reactions that concern them

They overestimate or underestimate their effect on others

There is little genuine interest in others. Relationships are mostly one-sided

People with NPD look to relationships to fill an inner void

Their feelings of superiority and entitlement are overt or covert

They are obvious in their excessive attempts to seek attention and validation

Persons with NPD suffer significant relational impairments and dysfunction in their daily lives. Underneath the layer of narcissistic tendencies is the fragile ego that’s easily bruised by criticism, even if it’s constructive criticism coming from someone with good intentions. When they don’t feel accepted, they shy away and alienate themselves from those who “see through them,” and their low self-esteem worsens with social alienation, which leads to depression and anxiety. Their attention-seeking behaviors are enduring and persistent across times and situations; they aren’t just narcissistic once in a while. They are narcissistic all the time. They constantly surround themselves with people who will stroke their ego because their self-esteem depends on it. Their sense of security is contingent upon their ability to control and manipulate others to forward their agenda.

How does Narcissistic Personality Disorder tie in with alcohol and drug abuse?

Substance use can either to serve to heighten one’s grandiose sense of self or to numb out the pain of depression and anxiety. Protecting one’s ego from the harms of the world is a tedious task as NPD sufferers constantly dodge people and situations that make them feel underappreciated and threatened. The pressure of hiding from exposure as a fraud or repressing unwanted feelings leads to drug and alcohol abuse; the link between increased rates of substance use disorders and narcissistic traits are noted in the journal Alcoholism Treatment Quarterly.

Find dual diagnosis treatment for NPD and addiction

Individuals with NPD usually enter substance abuse treatment during the advanced stages of their addiction, because their egos are often too fragile to seek early intervention. Family members have a very difficult time convincing a loved one with NPD to go into treatment because the personality disorder makes it nearly impossible for the loved one to see or admit that there’s a problem. In such cases, it’s best to rely on an experienced addiction professional for intervention assistance.

About the Author

DR. RUTA STERNBERGS, Ed. D,. Psy. D., CADC-II

Dr. Sternbergs is one of New Method Wellness’s longest serving therapist. She started her career as a registered nurse (RN), which lead to her interest in the psychological needs of individuals. She received her doctorate in Counseling Psychology from Boston University, where she was asked to co-evaluate their inaugural Master’s Program Specializing in Counseling Women. Ruta also completed the requirements for her Doctor of Psychology degree (Psy.D.) from the American Behavioral Studies Institute. For the past several years, she has been an active member of the Trauma Intervention Program (TIP) of Orange County. She has discovered that her true calling is in the field of addiction recovery. “I cannot think of any other disease that has such a profound impact on so many.” She considers it to be an honor to connect and work with clients as they embark on their personal recovery journey. Ruta enjoys her family, friends and all creatures, big or small.