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The language in criteria above is based on or summarized from:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition (DSM IV-TR). Washington, DC: American Psychiatric Association.
Sam Vaknin. (1999, 2001, 2003). Malignant Self Love - Narcissism Revisited, fifth revised printing. Prague and Skopje: Narcissus Publication.
("Malignant Self Love - Narcissism Revisited" http://www.geocities.com/vaksam/faq1.html )
I. PATHOLOGICAL NARCISSISM OVERVIEW
Whether narcissism and its pathology are results of genetic programming (see Anthony Benis and others) or of dysfunctional families and faulty upbringing or of anomic societies and disruptive socialization processes - is still an unresolved debate. The scarcity of scientific research, fuzziness of diagnosic criteria and differential diagnoses make it unlikely that this will be settled soon one way or other.
It is psychoanalytic belief that we are all Narcissists at an early stage of our lives. As infants and toddlers we all feel that we are center of Universe, most import ant, omnipotent and omniscient beings.
At that phase of our development, our parents are perceived by us to be mythical figures, immortal and awesomely powerful, there solely to cater to our needs, to protect and nourish us.
Both Self and others are viewed immaturely, as idealizations. This, in psychodynamic models, is called phase of "primary" narcissism.
Inevitably, inexorable processes and conflicts of life erode these perceptions and reduce ideal into the real.
Adaptation is a process of disillusionment. If this process is abrupt, inconsistent, unpredictable, capricious, arbitrary and intense - injuries sustained by infant's tender, budding, self-esteem, are severe and, often, irreversible. Moreover, empathic support of our caretakers (the Primary Objects, parents) is crucial. In its absence, our sense of self-worth and self-esteem in adulthood tends to fluctuate, to alternate between over-valuation (idealization) and devaluation of both Self and others. Narcissistic adults are widely thought to be result of bitter disappointment, of radical disillusionment in significant others in their infancy. Healthy adults accept their self-limitations (the boundaries and limitations of their selves). They accept disappointments, setbacks, failures, criticism and disillusionment with grace and tolerance. Their self-esteem is constant and positive, not substantially affected by outside events, no matter how severe.
Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, United Press International (UPI) and eBookWeb and the editor of mental health and Central East Europe categories in The Open Directory, Suite101 and searcheurope.com.
Visit Sam's Web site at http://samvak.tripod.com