A pattern of traits and behaviours which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition.

Most narcissists (50-75%, according to the 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 the 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 the 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 the mild, reactive and transient to the permanent personality disorder. Narcissistic Supply is outside attention - usually positive (adulation, affirmation, fame, celebrity) - used by the 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, the compensatory narcissist covers up in his haughty behaviour for a deep-seated deficit in self-esteem, and the inverted type is a co-dependent who caters to the 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, the International Classification of Mental and Behavioural Disorders, published by the World Health Organisation in Geneva [1992] regards Narcissistic Personality Disorder (NPD) as “a personality disorder that fits none of the specific rubrics”. It relegates it to the category “Other Specific Personality Disorders” together with the eccentric, “haltlose”, immature, passive-aggressive, and psychoneurotic personality disorders and types.

The American Psychiatric Association, based in Washington D.C., USA, publishes the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Text Revision (DSM-IV-TR) [2000] where it provides the diagnostic criteria for the Narcissistic Personality Disorder.

The DSM defines NPD as “an all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts.”

The DSM specifies nine diagnostic criteria. For NPD to be diagnosed, five (or more) of these criteria must be met.

[In the text below, I have proposed modifications to the language of these criteria to incorporate current knowledge about this disorder. My modifications appear in bold italics.]

[My amendments do not constitute a part of the text of the DSM-IV-TR, nor is the American Psychiatric Association (APA) associated with them in any way.]

[Click here to download a bibliography of the studies and research regarding the Narcissistic Personality Disorder (NPD) on which I based my proposed revisions.]

Proposed Amended Criteria for the Narcissistic Personality Disorder

Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognised as superior without commensurate achievements);

Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;

Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);

Requires excessive admiration, adulation, attention and affirmation - or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);

Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favourable priority treatment;

Is “interpersonally exploitative”, i.e., uses others to achieve his or her own ends;

Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;

Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;

Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.

Too soon for lunch and hungry after a spin through town on my bike, I spied a Dunkin Donuts and stopped for a break. To while the time, I brought along my graphic arts workbook. Next to me two stools away sat an old man, dressed in scruffy, rough clothing, craning his head to get a better look at my workbook. I asked him if he would like to see it and he slid over eagerly.

He introduced himself as Henry and revealed that he worked as a graphic designer in New York in the fifties. Though his wife died of cancer twenty years ago, he continued to live in their house, alone except for two stray cats. He offered to show me some of his graphic art that he saved.

So the following Saturday I rode over to his house. I stood transfixed in the path to the front door. Surrounding me were weeds head high, rubble strewn across the brick path as if it were a forest floor. I carefully made my way through treacherous rose thorns, stickers and assorted junk to rickety stairs leading to a small porch. At one end sat a large wooden chest and an old doorless refrigerator at the other. These signs of neglect failed to prepare me for the unimaginable scene inside the house.

Inside, Henry led me through a dark hall through an archway leading to the living room/dining room, apologizing all the way for the mess. And what a mess! Covering the floor were newspapers, Victorian bric-a-brac of every description. More appalling was the inch-thick layer of dust covering every unused surface. Framed art filled every square inch of wall space, festooned with trailing spider webs and glass hiding under a layer of grime. It would take at least twenty years of neglect for this amount of dirt to accumulate!

Henry shuffled over to a low, homemade bookshelf and retrieved a large scrap album bursting with paper. Henry lovingly turned each page, reminiscing how and for whom he created each piece. I learned that many a nineteen forty- six Macy ad came from his brushes.

In the center of the room sat a large oak drafting bench with an angled work top and adjustable shelves underneath. Dozens of brushes, pencils, and assorted drafting tools sat waiting on its surface. I’m sure none of them had been used for two or three decades. Nearby on a small table sat a new looking portable typewriter with a partially typed sheet of paper in the carriage. While Henry went to fix us a cup of coffee, I sneaked a peek at the first paragraph. It seemed to be the beginning of his memoirs, featuring his experiences repairing the old Morris Canal in the fifties. The grammar and sentences flowed quite well, but the typing was littered with mis-strikes and typing errors.

One cat wound his body around my legs and another peeked with one eye from the kitchen. After coffee, I offered to help clean up, curious about the rest of the house. Following Henry into the kitchen, he proudly pointed to the new refrigerator in the middle of one wall in front of the two windows. It turned out that his oldest son had it delivered one day. I gathered that his son only visited his Dad once a year to see how he was doing.

During the next three weeks, I started to help Henry make his kitchen more livable. I painted the cabinets, threw out the forty-year-old spices, washed the dishes (most of which lay congealed in a pantry sink. The back door was completely blocked with junk, his garbage being carried out through the front door and onto the porch. Henry wasn’t too concerned with the unsanitary conditions, but would rather have me fix up some of his treasures. Like a two foot long sailing ship he and his son made together. It needed major repairs and re-rigging. So I took it home and worked on it for a couple of weeks. He cried when I gave it to him. Henry showed signs of dementia, forgetting to eat and being confused with time and the days of the week. A neighbor finally contacted a free lunch program which would supply Henry with at least one good meal per day.

During the rest of the summer, I enjoyed repairing various things around the house. One interesting project was the restoration of an old Gibson mandolin. Missing were the strings, the bridge, a tuning knob and pieces of mother-of-pearl decorations. Henry told me a story how he saw it in a pawn shop window and bought it for ten dollars. I placed it exactly where it was on the wall over the book shelf, gleaming with new varnish and looking as it must have looked in 1888 when it was new. Throughout the house were samples of Henry’s wife’s hobby — collecting Victorian paraphernalia. Old dolls, boxes, hand-made toys and antique books of every description were piled on every surface.

Henry died at ninety-two, six years ago. The house still stands as it was, dilapidated and run down. Everything was left as it was except for a few things his son took away — the mandolin, the Boston rocker and the model ship. Nobody cared for this kind old man who missed his dead wife to the point of barely existing. How many poor souls are there out in the world with no-one to share a life with? I’ll miss him.

Writing soothes my soul.

Change hits hard, fast, and often. It shifts our focus, changes our direction and alters our plans. Change leaves us stumped by questions we’re not prepared to answer and searching for questions that we never thought to ask. Left on the road, between what we were once sure of and the indecision of which way to go, a problem awaits to be solved.

Problems Begin with One Unanswered Question

Hearing the word problem, we automatically think of some catastrophic event requiring kick-off meetings, project teams, and an all-out hunt for the illustrious root cause. Usually, however, problems are much more subtle than that. They move in quietly, riding the coattails of change or they drag change along, bringing it to our doorsteps. Problems both follow and precede change. Most problems don’t need a grand introduction. All we need to is to look for them, wait for them, and prepare for them. They are always there, just beneath the surface. And before they took a life of their own, even those problems with the deepest roots usually started simply enough as an unanswered question.

What issues currently have your organization tied up in knots? What was the last problem that you attempted to solve? What was the last problem that you ignored?

Problems don’t need official-sounding names and formally outfitted team leaders wearing colored belts. Problems are not only exposed through formal processes but are revealed in a moment of curiosity. Just around the corner of expectation and at the intersection of “why; why not; and if not me, who?” is a chance for every employee to positively influence the course of events.

The following is a case in point of a problem in the making:

Friday morning a shipment of boxes was delivered to a distribution warehouse in a small North Carolina town. As had happened on many Friday mornings before, Jason Checkins received the shipment and pointed to the area where the pallets should be placed. As the boxes were stacked, Jason noticed that the boxes all had yellow stickers. He thought that it was odd and wondered to himself, “Why don’t these boxes have the blue labels that they normally do?” He thought about it for a moment and moved on. He never mentioned the blue labels to anyone in the facility until the following Friday, a week later.

What Happens to a Problem Deferred?

Problems often come first in unseen whispers. They are more than headaches to avoid; they are signals of things to come - flashes of lights drawing us to attention and calling us to action. Before we can resolve them, we have to increase our ability to predict them, sense them, see them, and examine them.

When I think of organizational problem solving, it brings a poem written by Langston Hughes, “What Happens to a Dream Deferred?”. We sense that something may be wrong, but we stand back. We watch and we wait to see what is going to happen. We watch the market; we see the effects on our competitors and our suppliers. We watch what’s happening around us, to our employees, and to our co-workers. We read the headlines and hear the news of industry fallout and thousands of jobs being lost. Still we fail to consider what those signs might mean for us. Only rarely do we look for opportunities to make a difference.

Pointing his pen at the corporation, today Mr. Hughes might ask:

What happens to a problem deferred?
Does it dry up
like a raisin in the sun?
Or fester like a sore–
And then run?
Does it stink like rotten meat?
Or crust and sugar over–
like a syrupy sweet?
Maybe it just sags
like a heavy load.
Or does it explode?

Problems Don’t Just Go Away. You don’t usually have six months to form an assessment committee or three months to train all your people. You can’t afford to lose time pretending that the problem does not exist, or even one day wondering why someone else has not taken action. It is the job of every person in the company to do what he can, when he can–and hopefully before it is too late.

To read the complete article please go to: http://www.changethis.com/21.ThinkingThrough

Valarie is CEO of Think 6 Results — a knowledge broker passionate about learning and improving performance in organizations. She’s a writer, presenter, and executive coach on a mission to get every employee and organization focused on and thinking about the SIX business driving goals that matter.

The complete Thinking Through Problem Solving article is found at http://www.changethis.com/21.ThinkingThrough.

Contact Valarie at washington@think6results.com or by calling 630-705-1189. Visit us at http://www.Think6Results.com.