Self-awareness and introspection in Narcissistic Personality Disorder (NPD)

Answer: Narcissism defi nes the narcissist’s waking moments and his nocturnal dreams. It is all-pervasive. Everything the narcissist does is motivated by it. Everything he avoids is its result. Every utterance, decision, his very body language are all manifestations of narcissism. It is rather like being abducted by an alien and ruthlessly indoctrinated ever since. The alien is the narcissist’s False Self a defence mechanism constructed in order to shield his True Self from hurt and inevitable abandonment.

Citation: Vaknin S (2021) Self-awareness and introspection in Narcissistic Personality Disorder (NPD). Ann Psychiatry Treatm 5(1): 019-022. DOI: https://dx.doi.org/10.17352/apt.000026 I never said that narcissists cannot CHANGE -only that they cannot HEAL. There is a huge difference between behavior modifi cation and a permanent alteration of the psychodynamic landscape. Narcissistic behavior CAN be modifi ed using a cocktail of talk therapy, conditioning, and medication. I have yet to encounter a healed narcissist.
The emphasis in therapy is thus more on accommodating the needs of those nearest and dearest to the narcissistspouse, children, colleagues, friends -than on "treating" the narcissist. If the narcissist's abrasiveness, rage, mood swings, reckless and impulsive behaviors are modifi ed -those around him benefi t most. This, as far as I am concerned, is a form of social engineering.

One last hope
Narcissism (though rarely) does tend to ameliorate with age and many forms of pathological narcissism are reactive and transient (Millman, 1989;Ronningstam and Gunderson, 1996).

Introspection in Pathological Narcissism
Are narcissists capable of introspection? Can they distinguish their False Self from who they really are? Can this help them in the therapeutic process?
A passage by Nathan Salant-Schwartz from "Narcissism and Character Transformation". Jungian parlance aside, the author seems to be describingrather poetically -the basic relationship between the True Self and the False Self. No theoretician has ignored this dichotomy, most basic to malignant narcissism. The True Self is synonymous with the [Freudian] Ego. It is shrivelled, dilapidated, stifl ed and marginalised by the False Self. The narcissist draws no distinction between his Ego and his Self. He is incapable of doing so. He relegates his Ego functions to the outside world. His False Self is an invention and the refl ection of an invention.
Narcissists, therefore, do not "exist". The narcissist is a loose coalition, based on a balance of terror, between a sadistic, idealised Superego and a grandiose and manipulative False Ego. These two interact only mechanically. Narcissists are Narcissistic Supply seeking androids. No robot is capable of introspection, not even with the help of mirroring.
Narcissists often think of themselves as machines (the "automata metaphor"). They say things like "I have an amazing brain" or "I am not functioning today, my effi ciency is low." They measure things, constantly compare performance.
They are acutely aware of time and its use. There is a meter in the narcissist's head, it ticks and tocks, a metronome of selfreproach and grandiose, unattainable, fantasies.
The narcissist likes to think about himself in terms of automata because he fi nds them to be aesthetically compelling in their precision, in their impartiality, in their harmonious embodiment of the abstract. Machines are so powerful and so emotionless, not prone to be hurting weaklings.
The narcissist often talks to himself in third person singular. He feels that it lends objectivity to his thoughts, making them appear to be emanating from an external source.
The narcissist's self-esteem is so low that, to be trusted, he has to disguise himself, to hide himself from himself. It is the narcissist's pernicious and all-pervasive art of un-being.
Thus, the narcissist carries within him his metal constitution, his robot countenance, his superhuman knowledge, his inner timekeeper, his theory of morality and his very own divinity -himself. Narcissists often go through "soul searching". But they do so only in order to optimize their performance, to maximize the number of sources of narcissistic supply, and to better manipulate their environment. They regard introspection as an inevitable and intellectually enjoyable maintenance chore.
The introspection of the narcissist is emotionless, akin to an inventory of his "good" and "bad" sides and without any commitment to change. It does not enhance his ability to empathize, nor does it inhibit his propensity to exploit others and discard them when their usefulness is over. It does not tamper his overpowering and raging sense of entitlement, nor does it defl ate his grandiose fantasies.
The narcissist's introspection is a futile and arid exercise at bookkeeping, a soulless bureaucracy of the psyche and, in its own way, even more chilling that the alternative: a narcissist blissfully unaware of his own disorder. As a prolonged, incomprehensible, unpredictable, frequently terrifying and deeply saddening nightmare. This is a result of the functional dichotomy -fostered by the narcissist himself -between his False Self and his True Self. The latterthe fossilised ashes of the original, immature, personality -is the one that does the experiencing. The False Self is nothing but a concoction, a fi gment of the narcissist's disorder, a refl ection in the narcissist's hall of mirrors. It is incapable of feeling, or experiencing. Yet, it is fully the master of the psychodynamic processes which rage within the narcissist's psyche.

Inner experience of the narcissist
This inner battle is so fi erce that the True Self experiences it as a diffuse, though imminent and eminently ominous, threat.
Anxiety ensues and the narcissist fi nds himself constantly ready for the next blow. He does things and he knows not why or wherefrom. He says things, acts and behaves in ways, which, he knows, endanger him and put him in line for punishment.
The narcissist hurts people around him, or breaks the law, or violates accepted morality. He knows that he is in the wrong and feels ill at ease on the rare moments that he does feel. He wants to stop but knows not how. Gradually, he is estranged from himself, possessed by some kind of demon, a puppet on invisible, mental strings. He resents this feeling, he wants to rebel, he is repelled by this part in him with which he is not acquainted. In his efforts to exorcise this devil from his soul, he dissociates.
An eerie sensation sets in and pervades the psyche of the narcissist. At times of crisis, of danger, of depression, of failure, and of narcissistic injury -the narcissist feels that he is watching himself from the outside. This is not an out-of-body experience. The narcissist does not really "exit" his body. It is just that he assumes, involuntarily, the position of a spectator, a polite observer mildly interested in the whereabouts of one, Mr. Narcissist.
It is akin to watching a movie, the illusion is not complete, neither is it precise. This detachment continues for as long as the narcissist's ego-dystonic behaviour persists, for as long as the crisis goes on, for as long as the narcissist cannot face who he is, what he is doing and the consequences of his actions.
Since this is the case most of the time, the narcissist gets used to seeing himself in the role of the protagonist (usually the hero) of a motion picture or of a novel. It also sits well with his grandiosity and fantasies. Sometimes, he talks about himself in the third person singular. Sometimes he calls his "other", narcissistic, self by a different name.
He describes his life, its events, ups and downs, pains, elation and disappointments in the most remote, "professional" and coldly analytical voice, as though describing (though with a modicum of involvement) the life of some exotic insect (echoes of Kafka's "Metamorphosis").
The metaphor of "life as a movie", gaining control by "writing a scenario" or by "inventing a narrative" is, therefore, not a modern invention. Cavemen narcissists have, probably, done the same. But this is only the external, superfi cial, facet of the disorder.
The crux of the problem is that the narcissist really FEELS this way. He actually experiences his life as belonging to someone else, his body as dead weight (or as an instrument in the service of some entity), his deeds as a-moral and not immoral (he cannot be judged for something he didn't do now, can he?).
As time passes, the narcissist accumulates a mountain of mishaps, confl icts unresolved, pains well hidden, abrupt separations and bitter disappointments. He is subjected to a constant barrage of social criticism and condemnation. He is ashamed and fearful. He knows that something is wrong but there is no correlation between his cognition and his emotions.
He prefers to run away and hide, as he did when he was a child. Only this time he hides behind another self, a false one.
People refl ect to him this mask of his creation, until even he believes its very existence and acknowledges its dominance, until he forgets the truth and knows no better. The narcissist is only dimly aware of the decisive battle, which rages inside him. He feels threatened, very sad, suicidal -but there seems to be no outside cause of all this and it makes it even more mysteriously menacing.
This dissonance, these negative emotions, these nagging anxieties, transform the narcissist's "motion picture" solution into a permanent one. It becomes a feature of the narcissist's life. Whenever confronted by an emotional threat or by an existential one -he retreats into this haven, this mode of coping.
He relegates responsibility, submissively assuming a passive role. He who is not responsible cannot be punished -runs the subtext of this capitulation. The narcissist is thus conditioned to annihilate himself -both in order to avoid (emotional) pain and to bask in the glow of his impossibly grandiose fasntasies.
This he does with fanatic zeal and with effi cacy.
Prospectively, he assigns his very life (decisions to be made, judgements to be passed, agreements to be reached) to the False Self. Retroactively, he re-interprets his past life in a manner consistent with the current needs of the False Self.
It is no wonder that there is no connection between what the narcissist did feel in a given period in his life, or in relation to a specifi c event -and the way he sees or remembers these later on. He may describe certain occurrences or phases in his life as "tedious, painful, sad, burdening" -even though he experienced them entirely differently at the time.
The same retroactive colouring occurs with regards to people. The narcissist completely distorts the way he regarded certain people and felt about them. This re-writing of his personal history is aimed to directly and fully accommodate the requirements of his False Self.
In sum, the narcissist does not occupy his own soul, nor does he inhabit his own body. He is the servant of an apparition, of a refl ection, of an Ego function. To please and appease his Master, the narcissist sacrifi ces to it his very life. From that moment onwards, the narcissist lives vicariously, through the good offi ces of the False Self.
Throughout, the narcissist feels detached, alienated and estranged from his (False) Self. He constantly harbours the sensation that he is watching a movie with a plot over which he has little control. It is with a certain interest -even fascination -that he does the watching. Still, it is mere, passive observation.
Thus, not only does the narcissist relinquish control of his future life (the movie) -he gradually loses ground to the False Self in the battle to preserve the integrity and genuineness of his past experiences. Eroded by these two processes, the narcissist gradually disappears and is replaced by his disorder to the fullest extent.
Pathological narcissism is a defense mechanism intended to isolate the narcissist from his environment and to shield him from hurt and injury, both real and imagined. Hence the False Self -an all-pervasive psychological construct which gradually displaces the narcissist's True Self. It is a work of fi ction intended to elicit praise and defl ect criticism.
The unintended consequence of this fi ctitious existence is a diminishing ability to grasp reality correctly and to cope with it effectively. Narcissistic Supply replaces genuine, veritable, and tested feedback. Analysis, disagreement, and uncomfortable facts are screened out. Layers of bias and prejudice distort the narcissist's experience.
Yet, deep inside, the narcissist is aware that his life is an artifact, a confabulated sham, a vulnerable cocoon. The world inexorably and repeatedly intrudes upon these ramshackle battlements, reminding the narcissist of the fantastic and feeble nature of his grandiosity. This is the much-dreaded Grandiosity Gap.
To avoid the agonizing realization of his failed, defeatstrewn, biography, the narcissist resorts to reality-substitutes.
The dynamics are simple: as the narcissist grows older, his Sources of Supply become scarcer, and his Grandiosity Gap yawns wider. Mortifi ed by the prospect of facing his actuality, the narcissist withdraws ever deeper into a dreamland of concocted accomplishments, feigned omnipotence and omniscience, and brattish entitlement.
The narcissist's reality substitutes fulfi ll two functions. They help him "rationally" ignore painful realities with impunity -and they proffer an alternative universe in which he reigns supreme and emerges triumphant.
The most common form of denial involves persecutory delusions. I described these elsewhere: "(The narcissist) perceives slights and insults where none were intended. He becomes subject to ideas of reference (people are gossiping about him, mocking him, prying into his affairs, cracking his e-mail, etc.). He is convinced that he is the centre of malign and mal-intentioned attention. People are conspiring to humiliate him, punish him, abscond with his property, delude him, impoverish him, confi ne him physically or intellectually, censor him, impose on his time, force him to action (or to inaction), frighten him, coerce him, surround and besiege him, change his mind, part with his values, even murder him, and so on." The narcissist's paranoid narrative serves as an organizing principle. It structures his here and now and gives meaning to his life. It aggrandizes him as worthy of being persecuted.
The mere battle with his demons is an achievement not to be sniggered at. By overcoming his "enemies", the narcissist emerges victorious and powerful.
The narcissist's self-infl icted paranoia -projections of threatening internal objects and processes -legitimizes, justifi es, and "explains" his abrupt, comprehensive, and rude withdrawal from an ominous and unappreciative world . The narcissist's pronounced misanthropy -fortifi ed by these oppressive thoughts -renders him a schizoid, devoid of all social contact, except the most necessary.
But even as the narcissist divorces his environment, he remains aggressive, or even violent. The fi nal phase of narcissism involves verbal, psychological, situational (and, mercifully, more rarely, physical) abuse directed at his "foes" and "inferiors". It is the culmination of a creeping mode of psychosis, the sad and unavoidable outcome of a choice made long ago to forego the real in favor of the surreal.