What is NPD?

The term "narcissism" comes from a first century book (written in the year 8 AD) by the Roman poet Ovid. Metamorphoses Book III tells the mythical story of a handsome young man, Narcissus, who spurns the advances of many potential lovers. When Narcissus rejects the nymph Echo, who was cursed to only echo the sounds that others made, the gods punished Narcissus by making him fall in love with his own reflection in a pool of water. When Narcissus discovers that the object of his love cannot love him back, he slowly pines away and dies.Narcissistic personality disorder is a mental disorder characterized by a life-long pattern of exaggerated feelings of self-importance, an excessive craving for admiration, and a diminished ability to empathize with other's feelings. These personality traits are often overcompensation for a fragile ego, an intolerance of criticism, and a weak sense of self.


- Diagnostic Criteria:A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believes that he or she is “special” and unique 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 (i.e., takes advantage of others to achieve his or her own ends).
7. Lacks empathy: 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.

Dialectical behavior therapy (DBT) is a modified type of cognitive behavioral therapy (CBT). Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.DBT was originally intended to treat borderline personality disorder (BPD), but it has been adapted to treat other mental health conditions.


Mindful Skills

Observe: Observe your thoughts, feelings and experiencesDescribe: Describe your thoughts, feelings, and experiencesParticipate: Enter into the event

One-Mindfully: Do one thing at a time and completely focus on what you are doingNon-Judgmentally: Observe don't judgeEffectively: Do what works in a situation


Distress Tolerance Skills

STOP: Stop, Take a step back, Observe, Proceed MindfullyTIP: Temperature, Intense Exercise, Paced Breathing/Paired Muscle Relaxation/Progressive Muscle Relaxation (change your level of distress quickly)Distract using Wise Mind ACCEPTS: Distract yourself with Activities, Contributing, Comparisons, Emotions, Pushing away, Thoughts, SensationsSelf-Soothe: Use the senses (vision, hearing, taste, smell, touch) to soothe your physical self in order to make your emotions less painful.IMPROVE the Moment: Improve the moment with Imagery, Meaning, Prayer, Relaxation, One thing in the moment, Vacations, EncouragementPros and Cons: Examine the short term and long term pros and cons of acting and not acting on your urges/impulses using a chart.Radical Acceptance/Reality Acknowledgement: Acknowledge what is, let go of fighting or denying reality. Use TURNING THE MIND to commit to acknowledgement over and over again.


Interpersonal Effectiveness Skills

Clarified Priorities: What is most important to you in this interpersonal interaction 1) Obtaining your objective, 2) Maintaining the relationship, or 3) Maintaining your self-esteem/sense of self-worthDEAR MAN: Describe, Express, Assert, Reinforce, stay Mindful, Appear confident, Negotiate (used for saying “no” or asking for something; obtaining your objective)GIVE: Be Gentle, act/be Interested, Validate, use an Easy manner (used for maintaining a relationship)FAST: Be Fair, no Apologies, Stick to values, be Truthful (used to maintain your self-esteem/sense of self-worth)


Emotional Regulation Skills

PLEASE: Treat PhysicaL illness, balance Eating, avoid mood-Alerting drugs (as in street drugs or non-prescription drugs), balance Sleep, get ExerciseABC: Accumulate Positive Emotions/Experiences: Do pleasant things that are possible now. Make changes in your life so that positive events will occur more often.ABC: Build Mastery: Engage in activities that make you feel competent and in control.ABC: Cope Ahead: Rehearse a plan ahead of time so that you are prepared to cope skillfully with emotional situations.Opposite Action: Change emotions by acting opposite to current emotions/urges. Used for when emotions don’t fit the facts of a situation.Check the Facts: Check out whether your emotions or behavior fit the facts of the situation. Changing beliefs and assumptions to fit the facts can help you change your emotional reactions to situations.Problem Solve: When the facts themselves are the problem, solving emotional problems consistently and effectively will reduce the frequency of negative emotions and increase your sense of competency in regards to dealing with these emotions/urges.


Things that help:- Write down a list of things you don’t like about yourself and find healthy/realistic ways you can change them, if you can’t change them try to find ways to accept them
- Write down things you like about yourself!
- Practice self neutrality
- Start a gratitude journal / think of one thing you’re grateful for each day
- Practice good grooming habits
- Try to eat healthy and balanced
- Reward yourself for trying your best even when you fail
- Remind yourself that nobody is perfect and you’re not the exception
- Take your medication (if you have any)
- Meditate
- Get dressed everyday
- Get out of bed everyday
- Build a good support system (online counts)
- Use daily affirmations such as “I am not my failures” and “Its okay to not be perfect”
- Be honest with your therapist/psych
- Try to listen to others
- If you have good supports and you really want attention, just ask
- Do things you’re good at and you actually enjoy
- Practice coping skills even when you are not upset
- Apologize when you hurt someone and if you’re not good at that, practice in the mirror or with someone



Are you hydrated?
If not, have a glass of water.
Have you eaten in the past three hours?
If not, get some food — something with protein, not just simple carbs. Perhaps some nuts or hummus?
Have you showered in the past day?
If not, take a shower right now.
Have you stretched your legs in the past day?
If not, do so right now. If you don’t have the energy for a run or trip to the gym, just walk around the block, then keep walking as long as you please. If the weather’s crap, drive to a big box store (e.g. Target) and go on a brisk walk through the aisles you normally skip.
Have you said something nice to someone in the past day?
Do so, whether online or in person. Make it genuine; wait until you see something really wonderful about someone, and tell them about it.
Have you moved your body to music in the past day?
If not, jog for the length of an EDM song at your favorite tempo, or just dance around the room for the length of an upbeat song.
Have you cuddled a living being in the past two days?
If not, do so. Don’t be afraid to ask for hugs from friends or friends’ pets. Most of them will enjoy the cuddles too; you’re not imposing on them.
Have you seen a therapist in the past few days?
If not, hang on until your next therapy visit and talk through things then.
Have you changed any of your medications in the past couple of weeks, including skipped
doses or a change in generic prescription brand?

That may be screwing with your head. Give things a few days, then talk to your doctor if it doesn’t settle down.
If daytime: are you dressed?
If not, put on clean clothes that aren’t pajamas. Give yourself permission to wear something special, whether it’s a funny t-shirt or a pretty dress.
If nighttime: are you sleepy and fatigued but resisting going to sleep?
Put on pajamas, make yourself cozy in bed with a teddy bear and the sound of falling rain, and close your eyes for fifteen minutes — no electronic screens allowed. If you’re still awake after that, you can get up again; no pressure.
Do you feel ineffective?
Pause right now and get something small completed, whether it’s responding to an e-mail, loading up the dishwasher, or packing your gym bag for your next trip. Good job!
Do you feel unattractive?
Take a goddamn selfie. Your friends will remind you how great you look, and you’ll help fight society’s restrictions on what beauty can look like.
Do you feel paralyzed by indecision?
Give yourself ten minutes to sit back and figure out a game plan for the day. If a particular decision or problem is still being a roadblock, simply set it aside for now, and pick something else that seems doable. Right now, the important part is to break through that stasis, even if it means doing something trivial.
Have you over-exerted yourself lately —physically, emotionally, socially, or intellectually?
That can take a toll that lingers for days. Give yourself a break in that area, whether it’s physical rest, taking time alone, or relaxing with some silly entertainment.
Have you waited a week?
Sometimes our perception of life is skewed, and we can’t even tell that we’re not thinking clearly, and there’s no obvious external cause. It happens. Keep yourself going for a full week, whatever it takes, and see if you still feel the same way then.