History of Narcissistic Personality Disorder

Although the current DSM-5 no longer puts personality disorders in their own category, narcissistic personality disorder (NPD) is still recognized as an important condition. It is characterized by symptoms including grandiosity, an exaggerated sense of self-importance, and a lack of empathy for others.

An estimated 1% to 6% of adults are thought to have NPD, although many romantic partners, parents, children, family members, co-workers, and friends are also directly affected by loved ones with this disorder as well.

Uncovering the Origins of Narcissistic Personality Disorder

While the concept of narcissism dates back thousands of years, narcissistic personality disorder was only recognized as an illness in the last 50 years. To better understand how psychologists and researchers view NPD, it is essential to take a closer look at how this personality disorder came to be recognized.

Narcissistic personality disorder has its earliest roots in ancient Greek mythology. According to myth, Narcissus was a handsome and proud young man. Upon seeing his reflection on the water for the first time, he became so enamored that he could not stop gazing at his own image. He remained at the water's edge until he eventually wasted to death.

It wasn't until fairly recently that the notion of narcissism as a disorder became a subject of scientific interest in the field of psychology.

During the early 1900s, the topic of narcissism began to attract interest in the growing school of thought known as psychoanalysis. Austrian psychoanalyst Otto Rank published one of the earliest descriptions of narcissism in 1911, in which he connected it to self-admiration and vanity.

Freud and the Psychoanalytic View of Narcissism

In 1914, the famous Sigmund Freud published a paper titled, On Narcissism: An Introduction. Freud proposed a rather complicated set of ideas in which he suggested that narcissism is connected to whether one's libido, the energy lying behind each person's survival instincts, is directed inward toward one's self, or outward toward others. He said infants directed all of their libido inward, a state he referred to as primary narcissism.

In Freud's model, there was a fixed amount of libido, and to the degree the energy was directed outward toward others, it diminished the amount available to one's self. An important part of Freud's theory is the idea that this love of one's self could be transferred to another person or object. By "giving away" this love, Freud suggested people experienced diminished primary narcissism. He also believed receiving love and affection in return was vital to replenishing this capacity to love and maintaining a sense of satisfaction. 

Freud's theory of personality also says a person's sense of self develops as a child interacts with the outside world and begins to learn social norms and cultural expectations. This causes the development of an ego ideal, or a perfect image of oneself the ego strives to attain.

The Recognition of Narcissism as a Disorder

During the 1950s and 1960s, psychoanalysts Otto Kernberg and Heinz Kohut sparked more interest in narcissism with their research. In 1967, Kernberg described "narcissistic personality structure." He developed a theory of narcissism that suggested three major types: normal adult narcissism, normal infantile narcissism, and pathological narcissism, which can have its own different types. 

In 1968, Kohut came to a different understanding of "narcissistic personality disorder" by examining some of Freud's earlier ideas about narcissism and expanding upon them.

In 1980, narcissistic personality disorder was officially recognized in the third edition of the Diagnostic and Statistical Manual of Mental Disorder and criteria were established for its diagnosis. There has been some debate about how to categorize personality disorders in the recent DSM-5, but narcissistic and other personality disorders remain relatively unchanged in their diagnostic criteria from previous editions.