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Dr. Mark
Dr. Mark, Psychotherapist
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Experience:  Dr. Mark is a PhD in psychology in private practice
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Does narcissistic disorder occur in families? OKMH0213100

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Does narcissistic disorder occur in families?

Hi! I believe I can be of help with this issue.


Our current understanding of Narcissistic Personality Disorder (NPD) is that it forms between infancy and childhood, inclusive. It is understood to be a defect in healthy relationship with the primary caretaker, usually the mother. This is most often considered to mean either too overbearing and over-caring a mother or a too distant and detached mother. However, there are many other considerations involved besides just the relationship with mother. As such, our understanding is that NPD is not a heritable disorder, it is not transmitted genetically, and thus doesn't run in families.


There are many different levels of severity of NPD. And each person is different from the next. So not every person who is narcissistic will be identical, though the disorder has common traits, as I'm sure you've come to recognize.


It is very difficult for people to imagine how pervasive NPD is. They tend to keep doing things with the narcissist as if he or she's normal. Then they get burned and they are very hurt. The person with NPD will alternate charm and invective.


Let's use a parable of a house. You understand personality as being an open plan. There is the main big room where everything in the personality is and there are some smaller rooms off the main room, but they all have open doorways so that there is a unity there. If a person reacts from one of those smaller areas in his personality, it is coherent with the rest of the house, it fits into the decorating scheme of the main room, etc. It's all unified.


Someone with NPD isn't like that. He has different closed rooms. When he says something to you, it responds to some need and "truth" of a certain room. When he wants something else, it responds to a different room that contains that "truth". They don't have to agree for him to feel he is being okay and truthful. Because they are responding to different needs in him. Like different closed rooms.



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