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Narcissistic Personality Disorder and Autism (1):

Overlapping symptoms and differences



Narcissistic Personality Disorder (NPD) and ASD are two distinct condition. However, they share certain symptomatology that can lead to difficulties in differentiating between the two.


NPD


Note: The term "narcissism" comes from the Greek myth of Narcissus, a guy who fell in love with his own reflection in a pool of water. While the concept has been around for centuries, it wasn't officially recognized as a personality disorder until the 20th century.


Narcissistic Personality Disorder is characterised by a pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, and lack of empathy. Individuals with NPD constantly seek attention and admiration from others, often becoming envious or resentful when they perceive others as superior. Some of the main features of NPD are:


  • A grandiose sense of self-importance: they expect to be recognized as superior, exaggerating their talents and achievements. They believe that they can be understood only by special and unique people and are furious to be associated with others whom they deem ‘unworthy’, e.g.,: “I don’t want my name to be in the list with …”

  • A sense of entitlement: they expect automatic compliance with their demands, beliefs, etc. They jump on the bandwagon of whatever they think will bring them ‘deserved’ recognition and furiously fight their ‘case’, imagining that without them it would have never been achieved.

  • Arrogant, haughty behaviours and attitudes.

  • Interpersonal exploitative behaviour: they manipulate, exploit and take advantage of others to achieve their own ends.

  • Impaired ability to recognize or identify with the feelings and needs of others; lack of empathy for people who do not support their grandiose self-image; over- or underestimate of own effect on others.

  • Difficulty to maintain a stable sense of self-identity; fluctuations in self-esteem: exaggerated self-appraisal may be inflated or deflated, so they may have an excessive need for validation to boost their fragile self-esteem.

  • They get their feelings hurt easily by the slightest criticism. The individual with NPD is capable of rageful outbursts and/or violence at the slightest provocation (Webb et al. 2005); they see offence anywhere even if the wording of the statement is slightly ‘wrong’, e.g., “I am always polite and ethical but this shameful so-and-so insulted me [he didn’t], he defamed my character [he didn’t], he said that I am a liar! [he didn’t] Apologize!”


A pathological narcissistic personality tends to be organised around feelings of shame, envy, and a fundamental sense of entitlement that covers an underlying sense of deficiency. Pathological narcissism is generally a compensatory arrogance covering an internal emptiness. Often the sense of failure (narcissistic injury) is expressed as rage, which serves to protect a very low self-esteem and ego strength (McWilliams 1994).


The effects of NPD extend far beyond individual distress and can have a significant impact on interpersonal relationships, work environments, and society as a whole. Individuals with NPD often struggle with maintaining meaningful and fulfilling relationships due to their self-centredness and lack of empathy. In workplaces, their manipulative and exploitative behaviours can result in a toxic environment and hinder teamwork and productivity. On a societal level, the rise of social media and the culture of self-promotion may exacerbate narcissistic tendencies in individuals and contribute to the prevalence of NPD.


Unfortunately, NPD is very hard to treat, and in most cases any treatment is unsuccessful, if the person him/herself is unwilling to recognise their problems and is not prepared to deal with them. NPD develops over time, typically beginning quite early in childhood; the characteristics of this disorder once developed are resistant to change, regardless of what kind of interventions are attempted (Webb et al.2005).


ASD

ASD is a group of heterogeneous disorders/ conditions associated with difficulties in social interaction, communication, sensory problems and restricted, repetitive and stereotyped patterns of behaviour, interests and activities with a wide range of symptoms and severity levels.


Overlaps and Distinctions between NPD and ASD/1

While both NPD and ASD/1 (former Asperger syndrome - AS) can involve issues with social interaction and communication, the driving factors behind these difficulties are distinct.

  • In NPD, the focus lies in self-centeredness, an exaggerated self-importance and a need for admiration, while AS is characterized by differences in processing social cues, social reciprocity and symbolic communication.

  • Unlike AS, individuals with NPD are very good at manipulating people for their own advantage – they will ‘perform’ differently in different situations, e.g., “acknowledging” their lack of qualifications and knowledge in certain area – ‘It’s over my head’, but then confidently adding that experts are ‘wrong’ and shouldn’t be trusted’.

  • The superficial similarity lies in their difficulty in recognizing and responding to the emotional and relational needs of others. However, the underlying motivations and expressions of these traits differ significantly between NPD and ASD. AS individuals may struggle with recognition of conventional expressions of emotions but they genuinely care about others' feelings while those with NPD are often oblivious to the harm they cause, they are on the mission to ‘save the world’/ ‘defend autistics’ from ‘unethical NTs’ or ‘other (less important) autistics’, etc.

  • Both AS and NPD people are rigid in their behaviours and insist on sameness of the situations, but AS persons do it because they usually impelled to follow their own path rather than trying to force those around them to become the supporting staff to their ‘one-man show’, while NPD individuals create ‘scripts’ for those around them and react very badly when people do not behave according to their plan for them (Webb et al. 2005).

  • Both AS and NPD individuals exhibit self-absorption and intense interests, but the motivations and behaviours associated with these traits differ significantly between the two groups: AS individuals immerse themselves in their interests to gain a deep understanding, often focusing intensely on specific topics regardless of social appropriateness; while NPD individuals use their interests to assert their perceived superiority over others. They may resort to tactics such as projecting their negative views onto others, while ‘stealing’ their opponent’s views and presenting them as their own – thus winning the argument (who would fight against their own views?) that started very differently (with the NPD person expressing negative views). Besides, AS are likely to be truly competent in their special area (Webb et al. 2005), while NPD persons are often superficial: they tend to disguise their incompetence with ‘verbal storm’ using many words but actually saying very little.

  • Unlike AS people who have realistic self-esteem and a strong sense of genuine confidence in their abilities, those with NPD attempt to hide their sense of deficiency and low self-esteem under the cover of arrogance (Web et al. 2005).

Paula Jacobsen (2003), a psychotherapist, provides a good illustration of the differences between children with Asperger syndrome and those with NPD, whose behaviours (on the surface) look very similar:


Eric, a five-year-old child’s “early developmental milestones were normal except language development, which was precocious, and [delayed] social development… He did not play well with other children. [He benefitted from] structured learning which was easy for him, but he did not develop friendships. […]

Eric had a greatly exaggerated sense of superior abilities. He was enraged by a perceived failure in his own performance, because he experienced this as a narcissistic injury and could not tolerate it. No amount of understanding of the situation was useful. Eric wanted to demonstrate his superiority, and he wanted admiration.

He was very aware of his anger and his tantrums at the time and afterwards. He could easily describe what he had felt and done, and he saw his behaviour as a reasonable response to his situation…” (Jacobsen 2003).


Children with AS are very different, though their issues (e.g., anger) look similar to those with NPD:


Matt was a bright, verbal seven-year-old who had long [meltdowns]. He was overwhelmed by sensory stimuli, such as sounds, lights, odours, and textures. Matt was unable to control his behaviour when he felt overwhelmed. He was unable to examine what had happened afterwards… He had no idea of what he sounded like… of how long his tantrums [meltdowns] were…

Matt did not want to behave that way, although he continued for years to struggle with [meltdowns], particularly in certain situations, situations that felt overwhelming to him… He was oblivious to his own behaviour as well as its effect on others” (Jacobsen 2003).


Thus, while NPD and ASD may share similarities, a deeper understanding reveals significant distinctions in the underlying motivations and behaviours of individuals with these disorders. It is crucial to approach each condition with sensitivity and awareness of these differences in order to provide appropriate support.




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