Narcissism – The disease that’s all about “me.” - (8/27/2019)

By Dr. Ron Gasbarro

The technician asked the pharmacist why he looked so glum. “My mom died yesterday. My brother called me last night.” “Are you going to her funeral?” the tech asked. “We never had much of a relationship. She constantly berated me. Nothing was ever good enough. Everything was about her,” explained the pharmacist. “But, I met your mom once. She was very charming!” said the tech. “She was good at fooling many people,” he said. The pharmacist continued, “She put me through hell. I was so confused. I went through substance abuse, anxiety, and depression. I could never figure out what I did wrong…why she didn’t love me.” “Wow! A mother putting a son through all that,” the tech replied. “It is a tragedy in my life,” he said. “But as I told my brother when I learned of her death, ‘Problem solved.’”

What is narcissism? Also called by the psychiatric term, Narcissistic Personality Disorder (NPD) is a mental condition in which people have an inflated sense of their importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others, according to the Mayo Clinic. However, behind this facade of pathological confidence lies a fragile self-esteem that is vulnerable to the slightest criticism. NPD causes problems in many areas of life, such as relationships, work, school, and financial affairs. People with NPD may be generally unhappy and even angry when they are not bestowed the special favors or admiration they believe they deserve. They may find their relationships unfulfilling, and others may not enjoy being around them.

Yes, the disorder can cripple those around the narcissist. The foundation of narcissistic abuse is emotional manipulation. The person pushes you to your limit. Then, just before you have had enough, the charm oozes out. She loves you when you want to leave, but ignores you when you stay. The recipient of narcissistic abuse typically believes he is, at times, crazy, not deserving and not worthy of love or concern. That is exactly what nourishes the narcissist. Their twisted power is gained by making others feel insecure.

While mental health experts have never agreed on the cause of NPD, various factors may be associated with the development of this disease. Experiences that may cause NPD include severe emotional abuse in childhood; unpredictable or negligible neglect by caregivers in childhood; excessive pampering or praise in childhood; excessive criticism for poor behaviors in childhood; an oversensitive temperament at birth; and/or genetic abnormalities affecting psychobiology – the link between brain and behavior.

The mainstay of treatment for NPD is psychotherapy. The patient needs to understand his behavior and how it affects others. Group therapy can be beneficial in terms of support and feedback from the psychologist and others within the group. No drugs exist that can cure NPD. However, the patient may have overlapping psychiatric conditions that can be helped with pharmacotherapy. These include depression, anxiety, transient psychosis, mood swings, and poor impulse control. Ironically, the person with NPD thinks nothing is wrong with her. Therefore, she needs no treatment. The narcissist, such as the pharmacist’s mother, will likely carry her affliction to her grave, without ever realizing how it had eroded the quality of her life and lives of those around her.

The pharmacist said to the tech, “It was hard enough living in a house run by a narcissist. Imagine living in an entire country run by a narcissist. What a mess that would be!”

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Read more at


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