Psychiatry & Psychology? Narcissism & Attention-Seeking Personality Disorders-They Are More Common Than You Think!

UPDATE: 2nd November 2009

"St Catharines ttcs" commented in this blogpost as follows:

"Funny reading your blog. "Birds of a feather flock together", as the old saying goes. Studing human nature has been my thing for some time; so that wood perhaps put us in the same boat, maybe at different ends, but the same boat.If you are tryung to sell yourself or somthing you should perhaps try not using so many "I's". It reall take away from what you are trying get across. When ever I write, 1 "I" is aloud, thats it. If it can't be done with more than one "I". It is scraped. It is muck more enjoyable to write and at the same time making it a little more challenging. Good rant though!"

My reply was:

"Touché Catherine. Using the "I" word does make me seem narcissistic huh. I too am very self-conscious about using "I" for your same reason but in this case, it was intentional to show it was just my opinion as a layman.

No, not trying to sell myself or anything; just a salesman's rant ;o)

Being on different sides of the same boat is good; perhaps it would keep the boat on even keel. Cheers!"

She has a very good point so I must concede by re-writing the original stuff in blue as follows (without a single "I"):

To me, psychiatry and psychology are not exact science. As a layman, who can blame me for thinking that at best, they are a result of extensive statistical analyses and at the very least, they are based on armchair research and postulations that require further experimental testing; case in point being Mr. Maslow. Judging from the movies (what else!), diagnoses are mainly symptomatic based and treatments seem to lay somewhere between lobotomy or Prozac and a sympathetic ear.

Many non-medical people probably share this "narrow" perception and there is not much a psychiatrist can show me that will make me change my opinion. Yet, having always been interested in human behavior the quest for that elusive formula to help me fathom the human psyche continues.

My cynical view is that qualitative techniques in psychiatry are at best "guesswork" and quantitative methods are fallible; certainly not enough to classify me as demented. It is all so easy to classify a person who exhibits extreme behavior that strongly deviates from accepted social norms as being mad but what about cases that are not so obvious? This should be the real area that the psychiatrist is supposed to earn his spondoolies.

But wait a minute! Most of us with some intelligence and diligence (especially through self-study and discussion) can also guess with a great degree of accuracy another individual's behavior patterns. Most of us can lay claim to some common sense and intuition that excludes us from having to consult psychiatrists or psychologists for that matter; we can still function effectively in a social environment!

For example, having learned to recognize character and behavior patterns in people enables me to be rather categorical in slotting all and sundry into neat "mental pigeonholes". Getting to know an individual better merely makes me put him into another pigeonhole or leave him where he is. Though still a long way from being able to attach exact labels to the "categories", nor is it my intention to do so (that would make it no different from formal psychiatry), this simple method is effective enough for me to reasonably predict behavior and reactions to a satisfactory degree of accuracy. With that, it is not a problem for me to operate effectively in my immediate environment.

As mentioned earlier, notwithstanding what my thoughts on the field of psycho analysis are, it does not preclude me from still trying to learn more about the human mind and corresponding human behavior. Trawling the Net for interesting articles and logical explanations is still a favorite pastime and having found one such article on narcissism and attention-seeking personality disorder (which indeed seems rather common; most of us can recognize it in ourselves or in those around us in various degrees but perhaps not in the extreme), sharing it here would be appropriate:

****************************************************

I do not suppose psychiatry and psychology are exact science. As a layman, I am tempted to think that at best, they are a result of extensive statistical analyses and at the very least, they are based on armchair research and postulations that require further experimental testing; case in point being Mr. Maslow. Judging from the movies (what else!), diagnoses are mainly symtomatic based and treatments seem to lay somewhere between lobotomy or Prozac and a sympathetic ear.

I am sure many non-medical people share this "narrow" perception and I dare say, there is not much a psychiatrist can show me that will make me change my opinion. Yet, since I can remember I have always been interested in human behavior and looking for that elusive formula that can help me fathom the human psyche.

Being the cynic, I tend to view qualitative techniques in psychiatry as "guesswork" and quantitative methods as being fallible; certainly not enough to classify me as demented. It is all so easy to classify a person who exhibits extreme behavior that strongly deviates from accepted social norms as being mad but what about cases that are not so obvious? I suppose that is the real area that the psychiatrist is supposed to earn his spondoolies.

But wait a minute! Most of us with some intelligence and dilligence (especially through self-study and discussion) can also guess with a great degree of accuracy another individual's behavior patterns. Most of us can lay claim to some common sense and intuition that excludes us from having to consult psychiatrists or psychologists for that matter; we can still function effectively in a social environment!

For example, I have learned to recognize character and behavior patterns in people around me and have become rather categorical in slotting all and sundry into neat "mental pigeonholes". Getting to know an individual better merely makes me put him into another pigeonhole or leave him where he is. Though I am still a long way from being able to attach exact labels to the "categories", nor do I intend to (that would make it no different from formal psychiatry), I have found this simple method effective for me to reasonably predict behavior and reactions to a satisfactory degree of accuracy. With that I can operate effectively enough in my immediate environment.

As I mentioned earlier, notwithstanding what I think of the field of psycho analysis, it does not preclude me from still trying to learn more about the human mind and corresponding human behavior. I still trawl the Net for interesting articles and logical explanations and I found one such article on narcissism and attention-seeking personality disorder which I think is rather common. Indeed, most of us can recognize it in ourselves or even those around us in various degrees and probably not in the extreme. I would like to share this article as follows:

(A) Narcissistic Personality Disorder
The serial bully displays behaviour congruent with many of the diagnostic criteria for Narcissistic Personality Disorder. Characterised by a pervasive pattern of grandiosity and self-importance, need for admiration, and lack of empathy, people with narcissistic personality disorder overestimate their abilities and inflate their accomplishments, often appearing boastful and pretentious, whilst correspondingly underestimating and devaluing the achievements and accomplishments of others.
Often the narcissist will fraudulently claim to have qualifications or experience or affiliations or associations which they don't have or aren't entitled to. Belief in superiority, inflating their self-esteem to match that of senior or important people with whom they associate or identify, insisting on having the "top" professionals or being affiliated with the "best" institutions, but criticising the same people who disappoint them are also common features of narcissistic personality disorder.

Narcissists react angrily to criticism and when rejected, the narcissist will often denounce the profession which has rejected them (usually for lack of competence or misdeed) but simultaneously and paradoxically represent themselves as belonging to the profession they are vilifying.

Fragile self-esteem, a need for constant attention and admiration, fishing for compliments (often with great charm), an expectation of superior entitlement, expecting others to defer to them, and a lack of sensitivity especially when others do not react in the expected manner, are also hallmarks of the disorder. Greed, expecting to receive before and above the needs of others, overworking those around them, and forming romantic (sic) or sexual relationships for the purpose of advancing their purpose or career, abusing special privileges and squandering extra resources also feature.

People with narcissistic personality disorder also have difficulty recognizing the needs and feelings of others, and are dismissive, contemptuous and impatient when others share or discuss their concerns or problems. They are also oblivious to the hurtfulness of their behavior or remarks, show an emotional coldness and a lack of reciprocal interest, exhibit envy (especially when others are accorded recognition), have an arrogant, disdainful and patronizing attitude, and are quick to blame and criticize others when their needs and expectations are not met.
The DSM-IV Diagnostic Criteria for Narcissistic Personality Disorder are:A pervasive pattern of grandiosity, need for admiration, lack of empathy, as indicated by at least five of:
1. a grandiose sense of self-importance
2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. believes that he or she is "special" and can only be understood by, or should associate with, other special or high-status people (or institutions)
4. requires excessive admiration
5. has a sense of entitlement, i.e. unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
6. is interpersonally exploitative, ie takes advantage of others to achieve his or her own ends
7. lacks empathy and is unwilling to recognize or identify with the feelings and needs of others
8. is often envious of others or believes that others are envious of him or her
9. shows arrogant, haughty behaviors or attitudes

(B) Attention-seeking personality disorders, victim syndrome, insecurity and centre of attention behaviorDrama queens, saviors, rescuers, feigners and attention-seekers
The need for attention
Human beings are social creatures and need social interaction, feedback, and validation of their worth. The emotionally mature person doesn't need to go hunting for these; they gain it naturally from their daily life, especially from their work and from stable relationships. Daniel Goleman calls emotional maturity emotional intelligence, or EQ; he believes, and I agree, that EQ is a much better indicator of a person's character and value than intelligence quotient, or IQ.
The emotionally immature person, however, has low levels of self-esteem and self-confidence and consequently feels insecure; to counter these feelings of insecurity they will spend a large proportion of their lives creating situations in which they become the centre of attention. It may be that the need for attention is inversely proportional to emotional maturity, therefore anyone indulging in attention-seeking behaviors is telling you how emotionally immature they are.

Attention-seeking behavior is surprisingly common. Being the centre of attention alleviates feelings of insecurity and inadequacy but the relief is temporary as the underlying problem remains unaddressed: low self-confidence and low self-esteem, and consequent low levels of self-worth and self-love.

Insecure and emotionally immature people often exhibit bullying behaviors, especially manipulation and deception. These are necessary in order to obtain attention which would not otherwise be forthcoming. Bullies and harassers have the emotional age of a young child and will exhibit temper tantrums, deceit, lying and manipulation to avoid exposure of their true nature and to evade accountability and sanction. This page lists some of the most common tactics bullies and manipulators employ to gain attention for themselves. An attention-seeker may exhibit several of the methods listed below.
Attention seeking methods
Attention-seeking is particularly noticeable with females so I've used the pronoun "she". Males also exhibit attention-seeking behavior.

Attention seekers commonly exploit the suffering of others to gain attention for themselves. Or they may exploit their own suffering, or alleged suffering. In extreme forms, such as in Munchausen Syndrome By Proxy, the attention-seeker will deliberately cause suffering to others as a means of gaining attention.
The sufferer: this might include feigning or exaggerating illness, playing on an injury, or perhaps causing or inviting injury, in extreme cases going as far as losing a limb. Severe cases may meet the diagnostic criteria for Munchausen Syndrome (also know as Factitious Disorder). The illness or injury becomes a vehicle for gaining sympathy and thus attention. The attention-seeker excels in manipulating people through their emotions, especially that of guilt. It's very difficult not to feel sorry for someone who relates a plausible tale of suffering in a sob story or "poor me" drama.
The savior: in attention-seeking personality disorders like Munchausen Syndrome By Proxy (MSBP, also known as Factitious Disorder By Proxy) the person, usually female, creates opportunities to be centre of attention by intentionally causing harm to others and then being their saviour, by saving their life, and by being such a caring, compassionate person. Few people realise the injury was deliberate. The MSBP mother or nurse may kill several babies before suspicions are aroused. When not in saviour mode, the saviour may be resentful, perhaps even contemptuous, of the person or persons she is saving.
The rescuer: particularly common in family situations, she's the one who will dash in and "rescue" people whenever the moment is opportune - to herself, that is. She then gains gratification from basking in the glory of her humanitarian actions. She will prey on any person suffering misfortune, infirmity, illness, injury, or anyone who has a vulnerability. The act of rescue and thus the opportunities for gaining attention can be enhanced if others are excluded from the act of rescue; this helps create a dependency relationship between the rescuer and rescued which can be exploited for further acts of rescue (and attention) later. When not in rescue mode, the rescuer may be resentful, perhaps even contemptuous, of the person she is rescuing.
The organiser: she may present herself as the one in charge, the one organising everything, the one who is reliable and dependable, the one people can always turn to. However, the objective is not to help people (this is only a means to an end) but to always be the centre of attention.
The manipulator: she may exploit family relationships, manipulating others with guilt and distorting perceptions; although she may not harm people physically, she causes everyone to suffer emotional injury. Vulnerable family members are favourite targets. A common attention-seeking ploy is to claim she is being persecuted, victimised, excluded, isolated or ignored by another family member or group, perhaps insisting she is the target of a campaign of exclusion or harassment.
The mind-poisoner: adept at poisoning peoples' minds by manipulating their perceptions of others, especially against the current target.
The drama queen: every incident or opportunity, no matter how insignificant, is exploited, exaggerated and if necessary distorted to become an event of dramatic proportions. Everything is elevated to crisis proportions. Histrionics may be present where the person feels she is not the centre of attention but should be. Inappropriate flirtatious behaviour may also be present.
The busy bee: this individual is the busiest person in the world if her constant retelling of her life is to be believed. Everyday events which are regarded as normal by normal people take on epic proportions as everyone is invited to simultaneously admire and commiserate with this oh-so-busy person who never has a moment to herself, never has time to sit down, etc. She's never too busy, though, to tell you how busy she is.
The feigner: when called to account and outwitted, the person instinctively uses the denial - counterattack - feigning victimhood strategy to manipulate everyone present, especially bystanders and those in authority. The most effective method of feigning victimhood is to burst into tears, for most people's instinct is to feel sorry for them, to put their arm round them or offer them a tissue. There's little more plausible than real tears, although as actresses know, it's possible to turn these on at will. Feigners are adept at using crocodile tears. From years of practice, attention-seekers often give an Oscar-winning performance in this respect. Feigning victimhood is a favourite tactic of bullies and harassers to evade accountability and sanction. When accused of bullying and harassment, the person immediately turns on the water works and claims they are the one being bullied or harassed - even though there's been no prior mention of being bullied or harassed. It's the fact that this claim appears only after and in response to having been called to account that is revealing. Mature adults do not burst into tears when held accountable for their actions.
The false confessor: this person confesses to crimes they haven't committed in order to gain attention from the police and the media. In some cases people have confessed to being serial killers, even though they cannot provide any substantive evidence of their crimes. Often they will confess to crimes which have just been reported in the media. Some individuals are know to the police as serial confessors. The false confessor is different from a person who make a false confession and admits to a crime of which they are accused because of emotional pressure and inappropriate interrogation tactics.
The abused: a person claims they are the victim of abuse, sexual abuse, rape etc as a way of gaining attention for themselves. Crimes like abuse and rape are difficult to prove at the best of times and their incidence is so common that it is easy to make a plausible claim as a way of gaining attention.
The online victim: this person uses Internet chat rooms and forums to allege that they've been the victim of rape, violence, harassment, abuse etc. The alleged crime is never reported to the authorities, for obvious reasons. The facelessness and anonymity of the Internet suits this type of attention-seeker.
The victim: she may intentionally create acts of harassment against herself, eg send herself hate mail or damage her own possessions in an attempt to incriminate a fellow employee, a family member, neighbour, etc. Scheming, cunning, devious, deceptive and manipulative, she will identify her "harasser" and produce circumstantial evidence in support of her claim. She will revel in the attention she gains and use her glib charm to plausibly dismiss any suggestion that she herself may be responsible. However, a background check may reveal that this is not the first time she has had this happen to her.

In many cases the attention-seeker is a serial bully whose behaviour contains many of the characteristics listed under the profile of a serial bully, especially the Attention-Seeker. The page on Narcissistic Personality Disorder may also be enlightening, as may be the page on bullies in the family.

Feigning victimhood is common to serial bullies and this aspect comes to the fore in most cases once the bully has been held accountable and he or she cannot escape or rely on their support network. The tactic of denial followed by immediate counterattack followed by feigning victimhood is described on the serial bully page.
Attention seeking and narcissism
Like most personality disorders, narcissism occurs to different degrees in different people and reveals itself in many ways. Many business leaders exhibit narcissism, although when present in excess, the short-term benefits are outweighed by long-term unsustainability which can, and often does, lead to disaster.

The need for attention is paramount to the person with narcissistic personality disorder, and he or she will do anything to obtain that attention. Over the last two years, the fastest growing sector for calls to the UK National Workplace Bullying Advice Line has been from the charity/voluntary/not-for-profit sector. In most (although not all) cases, the identified serial bully is a female whose objective is to demonstrate to the world what a wonderful, kind, caring, compassionate person she is. Bold pronouncements, a prominent position, gushing empathy, sitting on many committees for good causes, etc all feature regularly.

However, staff turnover is high and morale low amongst those doing the work and interacting with clients. In each case, the relief of other people's suffering changes from an objective and instead becomes a vehicle for gaining attention for oneself. In some situations, more money is spent on dealing with the consequences of the serial bully's behaviour (investigations, grievance procedures, legal action, staff turnover, sickness absence etc) than is spent on clients