I looked at the question of 'evil' in a previous post, but I think it's important to try to get a handle on understanding the mechanisms behind what might make one person a narcissist, but not another. If everyone who experienced pain and suffering in their life went on to develop NPD, the world would be teeming with narcissists - a dauntingly dystopian prospect indeed.
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James Fallon is an American neuroscientist who describes himself as a 'pro-social psychopath' after discovering that he has the neurological and genetic correlates of psychopathy. Brain scans of psychopaths indicate differences in neural activity and connectivity, and in key regions: the ventromedial prefrontal cortex (the part of the brain associated with feelings of empathy and guilt) and the amygdalae (the part of the limbic system that regulates feelings of fear, aggression and anxiety). Note: The amygdalae are essential to an individual's ability to feel certain emotions and to perceive them in other people.
Clearly, it is a disorder that only manifests itself in certain individuals and, I think, only under certain and quite specific circumstances. Narcissism, like most mental health disorders, does not have one definitive root cause, and it is generally accepted that many factors can lead to the onset of NPD. Often it will be a complex combination of various and varying factors, which means that making decisive conclusions about the origins of NPD (and therefore its diagnosis and prognosis) is nigh-on impossible. It is a multi-faceted condition that typically appears in people with no desire for introspection (or ability to introspect), and is therefore notoriously difficult to identify, isolate, tackle and explain.
But does NPD always derive from a wounded, broken place (whether that's a 'wounded past' or a 'broken brain')? Is it a flawed 'coping mechanism', a dramatic (and irreversible?) reaction to extreme stressors and/or a dysfunctional and damaging upbringing, or is it faulty brain wiring? Or all of the above, in varying proportions? Nobody knows for sure, but there does seem to be a correlation between trauma and the onset (or worsening) of certain undesirable personality traits or preexisting disorders. |
I maintain that narcissists are made - nobody is born a narcissist, as the characteristics go against so much of what it means to be essentially human. There is probably some sort of 'predisposal' (genetic component), as there is for certain other illnesses and disorders, both physical and mental - including depression, schizophrenia, cancer and diabetes - which typically requires a 'trigger', or series of triggers (or lifestyle choices), before the illness becomes apparent.
In his 2010 book Understanding Personality Disorders: An Introduction, Duane Dobbert writes that NPD's "etiology may lie in a combination of inheritable traits, behavioural modeling, and parenting. It is difficult, if not impossible, to identify a specific set of variables that precipitate the development of the disorder." There is compelling evidence that individuals are significantly more likely to develop narcissism if their parent has (or had) it, or if they were over-indulged/excessively praised or, conversely, abused/neglected by one or both parents. (Again, we are coming back to the importance of good parenting and healthy and secure attachment bonds.)
It is believed that up to three quarters of narcissists are male (certainly most psychopaths are male), and "utilizing the heritable traits and gender research, those males whose first-degree biological relatives, most likely their fathers, have been diagnosed with NPD, have a higher probability of developing the same disorder." But will we ever know to what extent it is hereditary, and to what extent it is a case of 'modeling' (or learned) behaviour? (The age-old nature/nurture debate.)
Looking at what causes narcissism is crucial in seeking to understand how it might feasibly be addressed, treated and cured (if at all). Addressing, treating and (hopefully, ultimately) 'curing' an illness or disorder first requires the person affected with that illness or disorder to recognise and accept that they HAVE an illness or disorder. With NPD, that very first step represents a massive and invariably insurmountable obstacle. Nobody can be cured or treated if they strenuously deny needing to be cured or treated. I have met numerous people, including psychiatrists and therapists, who are adamant that, even if the underlying cause/s of NPD can be identified in an individual case, the chances of a person with genuine NPD presenting as a 'patient' (i.e. someone who needs psychological intervention; someone who admits to being maladaptive and therefore 'imperfect') are slim to non-existent.
And this raises another important question: NPD is, by definition, a disordered (grandiose, deluded, callous, detached, deceitful, interpersonally compromised) personality. How realistic is it to expect anyone to change a fundamental aspect of their personality? And NPD is not just one singular personality flaw, of course - it is a whole host of damaging ways of relating to the world and to others.
According to Joanna Ashmun's 'halcyon' site (see 'further reading', below) , "The preferred theory seems to be that narcissism is caused by very early affective deprivation*, yet the clinical material tends to describe narcissists as unwilling rather than unable, thus treating narcissistic behaviors as volitional -- that is, narcissism is termed a personality disorder, but it tends to be discussed as a character disorder. This distinction is important to prognosis and treatment possibilities. If NPD is caused by infantile damage and consequent developmental short-circuits, it probably represents an irremediable condition. On the other hand, if narcissism is a behavior pattern that's learned, then there is some hope, however tenuous, that it's a behavior pattern that can be unlearned."
(* Affective deprivation is an interesting concept, linked to Emotional Deprivation Disorder, which can arise as the result of a lack of unconditional love in early life.)
Occasionally, psychopathy (or any of its indicators) can be precipitated by a brain injury or head trauma, for example a road traffic accident, or through drug abuse (although this presents a 'chicken or egg' dilemma: does an individual become personality-disordered because of drug abuse, or do they abuse drugs because of their personality disorder?)
The website PsychCentral sums up the contributing factors behind NPD very well (see final link under 'Further reading'): "Researchers today don’t know what causes narcissistic personality disorder. There are many theories, however, about the possible causes of narcissistic personality disorder. Most professionals subscribe to a biopsychosocial model of causation — that is, the causes of are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress). This suggests that no single factor is responsible — rather, it is the complex and likely intertwined nature of all three factors that are important. If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be “passed down” to their children." (my emphasis)
Further reading:
How I discovered I have the brain of a psychopath
http://www.vice.com/read/dr-james-fallon-makes-being-a-psychopath-look-like-fun-110
http://www.halcyon.com/jmashmun/npd/dsm-iv.html
http://baarsinstitute.com/emotional-deprivation-disorder/
The Telegraph (28th March 2016): Mental Illness mostly caused by life events and not genetics?
I have included this article because although it is not agreed that NPD, strictly speaking, constitutes a 'mental illness' in the same way that addictions, schizophrenia and depression are considered mental illnesses, it is nevertheless a severe 'disorder of the mind' manifested in profoundly deviant character, thoughts and deeds. The dispute over its status as a 'mental illness' is due to the narcissist's apparent volition and their seemingly deliberate ability to 'change masks' and modify behaviour depending on circumstance and company.
Brain abnormalities found in narcissists: A study found that people with NPD have unusual cerebral cortex thinness in the region responsible for empathy (compared to people unaffected by NPD)
See my next blog post, which further explores the 'nature/nurture' debate, The ACoN doesn't fall far from the tree?
What causes narcissism? http://psychcentral.com/disorders/narcissistic-personality-disorder-symptoms/
Video: James Fallon's Ted Talk - Exploring the mind of a killer
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