What is Narcissism?Written by Sam Vaknin
A pattern of traits and behaviours which signify infatuation and obsession with one's self to exclusion of all others and egotistic and ruthless pursuit of one's gratification, dominance and ambition.
Most narcissists (50-75%, according to DSM-IV-TR) are men. The Narcissistic Personality Disorder (NPD) is one of a "family" of personality disorders (known as "Cluster B"). Other members of Cluster B are Borderline PD, Antisocial PD and Histrionic PD. NPD is often diagnosed with other mental health disorders ("co-morbidity") – or with substance abuse and impulsive and reckless behaviours ("dual diagnosis"). NPD is new (1980) mental health category in Diagnostic and Statistics Manual (DSM). There is only scant research regarding narcissism. But what there is has not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to NPD. It is estimated that 0.7-1% of general population suffer from NPD. Pathological narcissism was first described in detail by Freud. Other major contributors are: Klein, Horney, Kohut, Kernberg, Millon, Roningstam, Gunderson, Hare. The onset of narcissism is in infancy, childhood and early adolescence. It is commonly attributed to childhood abuse and trauma inflicted by parents, authority figures, or even peers. There is a whole range of narcissistic reactions – from mild, reactive and transient to permanent personality disorder. Narcissistic Supply is outside attention – usually positive (adulation, affirmation, fame, celebrity) – used by narcissist to regulate his labile sense of self-worth. Narcissists are either "cerebral" (derive their Narcissistic Supply from their intelligence or academic achievements) or "somatic" (derive their Narcissistic Supply from their physique, exercise, physical or sexual prowess and romantic or physical "conquests"). Narcissists are either "classic" [see definition below] or they are "compensatory", or "inverted" [see definitions here: "The Inverted Narcissist"]. The classic narcissist is self-confident, compensatory narcissist covers up in his haughty behaviour for a deep-seated deficit in self-esteem, and inverted type is a co-dependent who caters to emotional needs of a classic narcissist. NPD is treated in talk therapy (psychodynamic or cognitive-behavioural). The prognosis for an adult narcissist is poor, though his adaptation to life and to others can improve with treatment. Medication is applied to side-effects and behaviours (such as mood or affect disorders and obsession-compulsion) – usually with some success. The ICD-10, International Classification of Mental and Behavioural Disorders, published by World Health Organisation in Geneva  regards Narcissistic Personality Disorder (NPD) as "a personality disorder that fits none of specific rubrics". It relegates it to category "Other Specific Personality Disorders" together with eccentric, "haltlose", immature, passive-aggressive, and psychoneurotic personality disorders and types.
The Shattered Identity - Part IWritten by Sam Vaknin
In movie "Shattered" (1991), Dan Merrick survives an accident and develops total amnesia regarding his past. His battered face is reconstructed by plastic surgeons and, with help of his loving wife, he gradually recovers his will to live. But he never develops a proper sense of identity. It is as though he is constantly ill at ease in his own body. As plot unravels, Dan is led to believe that he may have murdered his wife's lover, Jack. This thriller offers additional twists and turns but, throughout it all, we face this question:
Dan has no recollection of being Dan. Dan does not remember murdering Jack. It seems as though Dan's very identity has been erased. Yet, Dan is in sound mind and can tell right from wrong. Should Dan be held (morally and, as a result, perhaps legally as well) accountable for Jack's murder?
Would answer to this question still be same had Dan erased from his memory ONLY crime -but recalled everything else (in an act of selective dissociation)? Do our moral and legal accountability and responsibility spring from integrity of our memories? If Dan were to be punished for a crime he doesn't have faintest recollection of committing - wouldn't he feel horribly wronged? Wouldn't he be justified in feeling so?
There are many states of consciousness that involve dissociation and selective amnesia: hypnosis, trance and possession, hallucination, illusion, memory disorders (like organic, or functional amnesia), depersonalization disorder, dissociative fugue, dreaming, psychosis, post traumatic stress disorder, and drug-induced psychotomimetic states.
Consider this, for instance:
What if Dan were victim of a Multiple Personality Disorder (now known as "Dissociative Identity Disorder")? What if one of his "alters" (i.e., one of multitude of "identities" sharing Dan's mind and body) committed crime? Should Dan still be held responsible? What if alter "John" committed crime and then "vanished", leaving behind another alter (let us say, "Joseph") in control? Should "Joseph" be held responsible for crime "John" committed? What if "John" were to reappear 10 years after he "vanished"? What if he were to reappear 50 years after he "vanished"? What if he were to reappear for a period of 90 days - only to "vanish" again? And what is Dan's role in all this? Who, exactly, then, is Dan?
II. Who is Dan?
Buddhism compares Man to a river. Both retain their identity despite fact that their individual composition is different at different moments. The possession of a body as foundation of a self-identity is a dubious proposition. Bodies change drastically in time (consider a baby compared to an adult). Almost all cells in a human body are replaced every few years. Changing one's brain (by transplantation) - also changes one's identity, even if rest of body remains same.
Thus, only thing that binds a "person" together (i.e., gives him a self and an identity) is time, or, more precisely, memory. By "memory" I also mean: personality, skills, habits, retrospected emotions - in short: all long term imprints and behavioural patterns. The body is not an accidental and insignificant container, of course. It constitutes an important part of one's self-image, self-esteem, sense of self-worth, and sense of existence (spatial, temporal, and social). But one can easily imagine a brain in vitro as having same identity as when it resided in a body. One cannot imagine a body without a brain (or with a different brain) as having same identity it had before brain was removed or replaced.