Neuroscientist on Narcissistic Personality Disorder: Berit Brogaard, DMSci, PhD
We were introduced to an article written by Dr. Berit “Brit” Brogaard by several of our listeners. Her article on Psychology Today, 12 Ways to Spot a Misogynist is one of many she’s written on the subject of Narcissistic Personality Disorder. Tune in as we discuss this multi-faceted and highly charged topic on Mental Health News Radio.
Questions and Answers with Dr. Brogaard:
What is narcissism?
In its most severe form, narcissism is a personality disorder that can be diagnosed according to the DSM. There are very specific criteria that must be satisfied for a diagnosis to occur. Narcissistic personality disorder shares features in common with histrionic personality disorder and anti-social personality disorder. One of the main differences between the characterization of narcissistic personality disorder in DSM-IV and DSM-V (the newest version of the diagnostic manual) is that the condition must affect the person’s ability to function.
In general, narcissism (whether it is an actual personality disorder or a milder case) will tend to be manifested in several of the following facets of personality:
1. A focus on themselves during conversations and other interactions.
2. Being hypersensitive to criticism, blame and insult (even friendly criticism).
3. Exhibiting a lack of remorse and gratitude.
4. Having a greater tendency to feel ashamed than feeling guilty
5. Arrogance expressed verbally or in the person’s body language
6. Being friendly and complimentary toward people who admire them
7. Retaliating against people who do not admire them or who simply do not pay attention to them.
8. Difficulties empathizing with others.
9. Believing they (or their work) are more important than they really are.
10. Exaggerating their achievements and expertise.
11. Using people for sex (or dates) without being emotionally involved.
12. Difficulties remaining in long-term relationships.
Is narcissism treatable?
It appears to be extremely difficult to treat. One reason is that narcissists rarely seek professional help, because they are in denial. Sometimes they seek therapy when they are older and lonely (and realize that life has passed them by), and talk therapy can sometimes help. Few medications have been found to be useful, although there are some who will see reduced narcissistic tendencies in response to anti-anxiety drugs, such as escitalopram (Lexapro), one of the SSRIs approved for anxiety.
What makes it so difficult to be in a relationship with a narcissist?
One of the things that makes it so difficult is that they aren’t very giving. They expect you to give and give and give to them without receiving anything back. This can manifest itself in terms of your sex life, in terms of conversations, in terms of compliments and favors, or even in terms of material gifts.
Another thing that makes it difficult is that you cannot have a real conversation with them about things you could change in your relationship. They will take every hint toward change as a criticism and act out as a result.
Yet another difficulty arises if you do not constantly admire them. If you don’t, they may start engaging in serious emotional, psychological or verbal abuse.
Perhaps the worst part about narcissists is that it will be difficult for them not to cheat on you. Infidelity is almost guaranteed with a narcissist. They use sexual achievement as a form of admiration and need the constant affirmation of other sex partners or romantic partners.
What are some of the features of verbal, emotional and psychological abuse?
In The Verbally Abusive Relationship Patricia Evans identifies 15 features of verbal abuse:
1. Withholding
Withholding is primarily manifested as a withholding of information and a failure to share thoughts and feelings. A person who withholds information refuses to engage with his partner in a healthy relationship. He does not share his feelings or thoughts. When he does share anything at all, it is purely factual or functional information of the sort his partner could have looked up on the Internet, read on his Facebook wall or figured out for herself by looking around. Examples of withholding communication that fails to engage the partner include “The car is almost out of gas,” “The keys are on the table,” and “The show is on now.”
2. Countering
Countering is a tendency to be very argumentative but not merely in political, philosophical or scientific contexts but in ordinary contexts as well. The victim of the abuse may share her positive feelings about a movie she just saw, and the abuser may then attempt to convince her that her feelings are wrong. This is an example of countering. Countering is a way of dismissing the victim’s feelings, thoughts and experiences on a regular basis.
3. Discounting
Discounting is an attempt to deny that the victim of the abuse has any right to her thoughts or feelings. It may come out as criticism but criticism of a particular kind. The abuser may tell the victim on a regular basis that she is too sensitive, too childish, has no sense of humor or tends to make a big deal out of nothing. The abuser thereby denies the victim’s inner reality, indirectly telling her that how she feels and what she experiences is wrong.
4. Verbal abuse disguised as jokes
Verbal abuse is often disguised as jokes. The abuser may say something very upsetting to the victim of the abuse and then after seeing her reaction add “It was just a joke.” Abuse is not okay in any form. Jokes that hurt are abusive.
5. Blocking and diverting
Blocking and diverting is a form of withholding but one where the abuser decides which topics are good conversation topics. An abuser practicing this form of abuse may tell the victim that she is talking out of turn or is complaining too much.
6. Accusing and blaming
Accusing and blaming are forms of abuse in which the abuser will accuse the victim of the abuse for things that are outside of her control. He might accuse her of preventing him from getting a promotion because she is overweight or ruining his reputation because she dropped out of college.
7. Judging and criticizing
Judging and criticizing is similar to accusing and blaming but also involves a negative evaluation of the partner. As Evans points out, “Most ‘you’ statements are judgmental, critical, and abusive.” Some abusive judging and criticizing “you” statements are: “You are never satisfied”, “You always find something to be upset about”, “The reason no one likes you is that you are so negative”.
8. Trivializing
Trivializing is a form of verbal abuse that makes most things the victim of the abuse does or wants to do seem insignificant. The abuser might undermine her work, her way of dressing or her choice of food.
9. Undermining
Undermining is similar to trivializing but further consists in undermining everything the victim says or suggests, making her question herself and her own opinions and interests.
10. Threatening
Threatening is a common form of verbal abuse and can be very explicit, as in “If you don’t start doing what I say, I will leave you” or more subtle, as in “If you don’t follow my advice, others will find out that you are a very unreliable person.”
11. Name calling
Name calling, too, can be explicit or subtle. Explicit name calling can consist in calling the victim of the abuse a “cunt” a “whore” or a “bitch”. But it can also be more subtle, calling the other person things that are implicitly hurtful, for instance, “You are such a victim” or “You think you are so precious, don’t you?”
12. Forgetting
The category of forgetting covers a range of issues ranging from forgetting to keep a promise to forgetting a date or an appointment. Even if the abuser really forgot, it is still abuse, because he ought to have made an effort to remember.
13. Ordering
Any form of ordering or demanding is a form of verbal abuse. It falls under the general issue of control. I have written another post about controlling people. The link is here.
14. Denial
Denial is abusive when it consists in denying bad behavior and failing to realize the consequences of one’s behavior. An abuser will find a way to justify and rationalize his behavior. This is a way of denying that he has done anything wrong.
15. Abusive anger
Abusive anger consists in any form of yelling and screaming, particularly out of context. Even yelling “shut up!” is abusive. There are other ways to deal with people who need to “shut up”. No one deserves to be yelled at.

But the narcissist will find a way to gain the power in the relationship. And his or her “ways” may mess with your brain chemistry and make you feel addicted to, or obsessed with, them. Their lack of affirmation of you may make you seek them out more, while treating every little signal they send you as a sign that they like you. It’s a natural reaction to bad boys (or bad girls).
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