NARCISSISTIC PERSONALITY DISORDER 36
Thediagnostic criterion for narcissistic personality disorder hasundergone several reviews in the Diagnostic and Statistical ManualDisorders which reflect differing theories of its origins between thelast three editions (DSM-III, DSM-IV, and DSM-V). This paper willaddress some of the theoretical contributions made by thepsychologists in shaping the current diagnosis of narcissism as apersonality disorder, with a focus on Theodore Millon and SocialLearning theories. A review of the historical background of thenarcissistic personality disorder in the context of romanticrelationships in conjunction with the rise of social media use willbe done.
Keywords:Narcissism, , RomanticRelationships, Social Media.
Narcissismwas first established in the first century from a Roman poetnarrating the story of Narcissus and Echo (Letissier, 2014). And inlater years was transformed into the vastly studied psychoanalyticword. The analysis of the narcissist personality disorder has beenapplied with increased frequency in the current times. The DSM 3categorizes the condition as a personality disorder. The theoryremains to be poorly distinct and contentious. It majorly relies ondata generated from clinical psychoanalysis and is deprived ofphenomenological citations. The goals of this paper are to diagnosethe literature significant to NPD with the aim of establishing acompound picture of the problem. Emphasis will also be put on thesocial learning theory, its evolution and application in thecontemporary society. Joined efforts to examine controversial studyand doubtful temperament have been useful to identify the relevantanalytical benchmarks and in defining areas that demand additionalresearch.
Accordingto the Diagnostic and Statistical Manual (DSM) of mental disorders,it terms the narcissistic personality disorder (NPD) as a mentalproblem where people experience magnified the sense of theirself-importance, the need for appreciation, and the lack ofcompassion for others. DSM III defines the condition as a distinctivecharacter disability. Baskin-Sommers,Krusemark, & Ronningstam (2014) suggest that narcissisticpersonality disorder is mainly connected with a collection of traitsthat weaken a person’s personal functioning. According to them,failure to show compassion for others is the primary distinctivecharacteristic of the disorder. Behindall this lies a delicate self-esteem concern that is defenseless tothe least reproach.
Thisdisorder tends to begin in early adulthood and causes many problemsto multiple personal functionalities of life including family,school, work, financial affairs, and friendships (Paris, 2014).People suffering from this condition often believe that they aresuperior and special than their colleagues and would associate withpeople who are talented or unique in one way or the other(Bouizegarene & Lecours, 2016). This association tends to boosttheir self-esteem which is presumed to be fragile hiding beneath themask of ultra-confidence. They seek to be admired and given lots ofattention in an attempt to see what other perceive highly of them.According to Hart, Adams, & Tortoriello (2017), they mayexperience difficulties enduring criticisms and may feel demeanedwhen injured in the form of criticism.
Additionalcharacteristics of NPD come with varying presentation leading todisagreement over the condition’s restrictions and diagnosticbenchmarks (Marissen et al., 2016). Narcissistic personality disorderremains to be the least researched personality disorder which appearsto be predominant, increasingly comorbid, and linked to psychosocialdisabilities (Paris, 1993). This condition may be complex to treatand can also complicate remedies for co-occurring problems. Theconcept of NPD dates back to thousands of years ago and only becameto be recognized as a disease in the last fifty years. To clearlyunderstand the notion of narcissism personality disorder, it isimportant to take a closer look at how this illness came to be.
Thestory of Narcissus originated from the Greek mythology. According toLetissier, (2014) Narcissus was a young man who was said to bebeautiful and very proud of himself. His self-love, pride, andadmiration were later found to cause his demise. He attempted to viewhis mirror image in a pool of water but unfortunately, could notfamiliarize himself with the likeness as his appearance. Narcissusbecame so smitten that he could not discontinue himself from staringat his reflection. Incapable of leaving the replication in the water,he eventually died of languor (Letissier, 2014). Numerousphilosophers have explored the utmost admiration during history. Inthe prehistoric Greece, the idea was referred to as the ‘hubris,’which implies that it is a state of excessive overconfidence andoverpowering self-importance that goes beyond the aspect of reality.
SigmundFreud Psychoanalytic Theory
Itwas until the early 1900s that the idea of narcissism was recognizedas a disorder and became the topic of scientific curiosity in thearea of psychology. It further drew interest among thepsychoanalysts. Otto Rank first published what is to be considered asthe earliest definition of narcissism where he associated it toself-importance and self-centeredness. Subsequently, Freud Sigmundused the term narcissism in his book, On Narcissism. Freud offeredthat narcissism is a typical element of one’s inner self which hedenoted as the primary narcissism to mean the drive that enduresbehind each individual’s existence predispositions. In his theoryof disposition, he infers that the sense of identity is not innatewhen a person is born. Thus, through experiences that emanate duringthe developmental stages during infancy and childhood that peopleassume the ego character.
Asa child interrelates with the outside environment, they begin toacquire common morals and standards as well as cultural prospectsthat contribute to the advancement of self-centeredness or theseamless reflection of oneself that the self-image seeks to achieve.As years progressed, several authors foreshadowed the concept of NPD.In 1925, Walder published a book reporting on an individual sufferingfrom the narcissistic personality disorder. His patient was presumedto be a scientist who displayed an attitude of superiority, lack ofempathy for others, increased obsession with self-respect, egotisticsexuality, a sense of being distinct from others, and unable to showremorse. This patient was excessively analytical, coherent, andvalued thinking for own sake over the application of scientificknowledge to humanity evolution.
Walder’sschool of thought was influential in a manner that narcissism isdefined as personality disorder these days. Another fundamentalelement of Freud’s theory is the view that, love for oneself can betransformed into another person or entity. Freud offered that bygiving away love, people exhibited decreased primary narcissismmaking them unable to develop, defend, and to safeguard themselves.To replace this premise, he alleged that by receiving love and likingin return is important. In his paper ‘on narcissism’, Freudeluded the character typology and instead pointed out that there arethose that constrain the interest by the narcissistic constancywithin which they succeeded to keep away from their self-esteemanything that would weaken it.
In1931, Freud in his paper titled the Libidinal Types sought todescribe the narcissistic personality. He defined the narcissist as aperson who is outgoing, independent, aggressive, not easily overawed,energetic, unable to commit or love in relationships, and focuses onself-protection (Baskin-Sommers, Krusemark, & Ronningstam, 2014).Freud further observed that these people frequently seek attentionand approbation, and can enthusiastically assume leadership roles.Subsequently, Wilhelm Reich went on to describe the character ofphallic-narcissistic in his book written in 1933. He believes thatnarcissists are people who display an attitude of arrogance,provocative, mildly unhappy in their relationships, superiority andpresents subordination. He was the first psychoanalyst to observethat if narcissists were "injured" or offended they turnout to be aggressive and react with unfriendly contempt.
Reich’sperception of narcissism is tangled with notions of manliness bydelineation as he views it as identification between the personalityand the phallus and suggests that this condition is more prevalentamong males than females. His thoughts on the outcomes of narcissismare not unscrupulous. However, it is dependent on the socialframework. To trace the development of the thought NPD is complicatedby the interchangeable use of the words narcissistic neuroses,schizophrenia, dementia praecox, and psychoses. Psychoanalyst AnneReich offered that narcissists are individuals whose libido isfocused on themselves at the expense of the object of love. She thenprovided that narcissistic pathology cannot be regarded as limited topsychosis and presented the compensatory narcissisticself-exaggeration in particular nonpsychotic persons.
Narcissisticpersonality disorder was first published in the literature by Kohut.Since then Kohut and Otto Kernberg remain to be the primarytheoreticians to explore the conception of NPD. In 1967, Kernbergreported a comprehensible clinical description of the narcissisticpersonality disorder. He believed that this condition was a subtypeof a disputed personality problem. In his definition, he suggesteddiagnosis on the specific observational behaviors that can be used tocategorize a person with pathological narcissistic personalitystructure. He offered that patients with this kind of problemexhibited extreme cases of grandiosity, the need for beauty andpower, self-absorption, high ambitions, and overdependence onadmiration (Zhang, et al., 2016).
Kernbergemphasized on the pathological nature of one`s inner-selfirrespective of casually adaptive behavior. This pathology presentsitself in the lack of empathy, uncertainty concerning identity,feeling of tediousness, desolation, manipulation of others, andinability to commit or love others. These defenses tend to appear intheir disdain for apprehensive attachments and averting ofadmiration. There also exists the penchant toward sexual proximity,perversions, homosexuality, substance abuse, and inclination tochange values to attain favor. Kernberg believed that people withnarcissism personality may have the capability for consistent workand may also become socially successful.
However,these individuals fail to show unpretentious professional interest.He denoted this character as being pseudo-sublimatory in an attemptto differentiate it from the established form of productivity.Kernberg further referred the narcissistic person as a child who isleft emotionally starved by an unempathetic mother and in persistentcold. Feeling loathed, the child then projects his anger at hisparents who were perceived as being depriving and aggressive. Thechild`s only defense force is to seek refuge in some part of himselfthat his parents cherished. As such, the grandiosity aspectestablished itself.
Kernbergholds that the grandiose self – a term borrowed from Kohut, isformed through blending admired characters of a child, the fantasizedform that compensated for obstruction and protected against anger andresentment, and the imaginary reflection of a caring mother. Thesestructures tend to merge in the grandiose self. The undesirableappearance of one’s self as a starved infant is separated from theprimary functioning of the self. However, an experienced eyedistinguishes its existence after the acclaim, prolonged thirst forexcitement, desolation, and boredom. Kernberg sought to preserve thebargain with established psychoanalytic philosophy, spotting theinvolvement of instinctive effort to psychopathology and notrecommending the narcissistic libido liberated from initial bodyrelations.
Kohut’sgreat theory on narcissism is based on the psychoanalytic managementof patients suffering from NPD. Just like Freud, he also believedthat narcissism was a typical and healthy part of individualdevelopment. In contrast to Freud`s thoughts, he emphasized thatnarcissism was a circumstance of undifferentiated union with a motherinstead of complete self-absorption. Narcissism served as animportant character in Kohut’s ‘self-psychology’ schoolthought. He proposed that self-absorption helped people to overpowertheir emotional state of low self-confidence and mature their innersense of identity (Banai, Mikulincer, & Shaver, 2005). From thissituation, he suggested two distinct developmental courses of focuson the self and others, which were found to contrast with Freud’seconomic libidinal model in which proposes that as love magnifies forthe other, it correspondingly declines for self. Kohut thoughts werethat these models would function autonomously from each other allthrough the life cycle and the many substantial developments anddistressing disturbances that may occur would result in varying adultpersonality behavior.
Strozieret al. (2016) Kohut`s trajectories included the grandiose self andthe idealized parent who were developed to cope when the stability ofprimary narcissism is distressed by maturational burdens andagonizing psychotic strain which occurs because the mother`s comfortsare essential inadequate and disturbing suspensions cannot be barred.An advanced sequence of the idealized parent ensues with a continuingawareness of the imperfection of one`s caregiver. This knowledgecauses the internalization of a steady conscience and sense of idealsthat we seek to attain throughout our lifespan (Zajenkowski et al.,2016).
Insome instances, the process may be disturbed prematurely by adistressing discontent in the appreciated adult. While the idealizedparent concept is looked at in admiration and what one wants tobecome the grandiose self, seeks to be admired and esteemed. Thestructure of grandiosity is composed of what is good, perfect, andsatisfying (Banai, Mikulincer, & Shaver, 2005). In the initialphases anything that seems unsatisfying, imperfect, and evil is saidto be outside of the grandiose self. The standard developmentsequence of oneself involves the disclosures to and the reception ofone`s imperfection through the loving care of the parents. In theprime of life, the grandiosity figure presents itself in the form ofcreativity, ambitions, self-esteem, enjoyment of success, wisdom,sense of humor and some aspect of disappointment marked with fury andhumiliation over one`s failures (Kohut, 2011). Kohut becameincreasingly precarious of the societal premises and religion that heattempted to overpower the appearance of self-esteem (Banai,Mikulincer, & Shaver, 2005).
He,however, assumed that there could exist an unhealthy expression ofthe magnificence self that arose when a person failed to assimilategrandiose notions of self with realistic views of their inadequacies.He found that this was caused by a disruption of primary narcissisticdevelopment through parental denunciation and intemperance (Strozieret al., 2016). When the grandiose self, fails to transform into arealistic sense, then the mature self-esteem varies between theunfounded overestimation of the self and the state of subordinationand will respond with narcissistic degradation to the disrupting ofambitions (Kahn & Rochman, 2000). Kohut laid a broad foundationfor the model of narcissistic aggression superego risk that remainsto receive support by offering that narcissistic anger would exist inresponse to injuries felt to one`s personality. Efforts are beingmade to report Kohut`s explanations by a more clinical approach andto influence focus on the healing and meta-psychological mattersinstead of on the phenomenology of the NPD.
Buber’stheory of interpersonal relationship creates a useful tool fordistinguishing hypothetical standpoints and therapeutic methodologieswithin the thought of psychology. Maurice Friedman was behind theidea of engendering a dialogue between philosophers Martin Buber andCarl Rogers. Rogers infers to his primary hypothesis that a personhas within himself/herself the resources for altering his/herattitudes, self-controlled behavior, self-concept, andself-understanding (Kahn & Rochman, 2000). These resources can,therefore, be tapped when a definable environment of psychologicaloutlook can be enhanced. Psychoanalyst Martin Buber understanding ofthe human personality was more inclined towards the view of humankindas polar. He developed the ‘I and Thou’ concept which was a newway for understanding the communication between persons by rootingthe idea of relationships and relational attitudes between twohumans.
Thetwo-word pairs are important to understanding how one communicates tothe other. The ‘I` concept cannot exist on its own and thus refersto one or the other life position that one assumes in a conversation.‘Thou` relates to the existence of distinctiveness andcomprehensiveness in a person that is the consequence of response.The ‘I and Thou` premise is a two-sided affair when two individualsenter into a discussion with their exclusive complete being. Therelationship is said to be brief, lacking perpetuity, yielding,reciprocal, and results in clarity. The concept of I-Thou incommunication is essential for the focus on the control of aconversation. It deals with the willingness of communicators to beopen to moments when people include the other person in theirexperience and listen for responses.
Hefurther offers that to confirm a person as ‘he or she is` marks theinitial stage to approving what in the existent remains hidden. Buberseems less inclined than Rogers in the postulated goodness of aperson`s trait of self-actualization perspective to influence them tothis potential. To support Buber`s philosophy, Friedman denotes thathealing does not yield the old however, it shapes the new. It doesnot approve the undesirable but counterweights with the positive(Kahn & Rochman, 2000). Both philosophers seem to have goodthoughts in that their take on Rogers permit for shadier side to thehumankind nature. Buber recognizes the human as being hypotheticallydestructive and also enhancers for growth. In his viewpoint, heconsiders confirmation as struggling with another against his/herselfin a manner to support the positive end as opposed to the negativeextreme. From Friedman`s dialogue with Rogers and Buber, it can benoted that there is a clear tussle to merge two similar beliefsstructures that contain varying assumptions concerning the philosophyof nature of humankind. This implies that two dissimilar views of thetherapeutic relationship.
Inthe late 1960s, the American Psychiatric Association published itsfirst guidebook in the second edition of Diagnostic and StatisticalManual. Shortly after, Theodore Millon put out the first movement ofa vast work which established the extensive foundation for the studyof personality and its pathology for the years to come. The authorworked to conceptualize personality disorder in the existing clinicalpractice and science. In his book the Modern Psychopathology, Millonrecommended a new categorization for mental problems which presentedan integrative, productive and fruitful theory of the personalitydisorder (Pincus, & Krueger, 2015). The inspiration for thisphilosophy was significant to institute what it would later bereferred as the Axis II of the DSM of Mental Disorders (Dorr, 1999).
Thebook served as an attempt to concentrate the contradictory pieces ofevidence and models of psychopathology to a coherent and systematicstructure. The inconsistencies, insignificances, and misperceptionsthat Millon uncovered compelled him to carry out more studies toestablish his classification of psychopathology while taking intoconsideration the biological and psychological influences. In hisbeginning section, Millon develops a principle that would permanentlymark the study of psychopathology. He sought to define pathologicalpersonality behavior as the profound embedded attributes that pervadethe features of the patterns of a person (Zhang et al., 2016). Hisoriginal eight personality prototypes were the schizoid, the evasive,the sub, gregarious, narcissistic, aggressive, resigned, and thenegativistic (Millon, 1991). These behaviors are derived fromprogressive and multifaceted interactions of the constitutionalaspects and experience.
Whendeveloped in the initial stages of life, pathological personalitypatterns occupy the new areas and disseminate within vicious groups.They tend to carry out a way of life so spontaneous and entrenched inthat the patient rarely informs its existence and traumatic outcomes.Additionally, Millon proposed pathological personality disorder canassume three differing levels of gravity intensities namely severe,moderate, and mild. A high intensity of pathological personalityreduces the essence of different temperament styles (Pincus, &Krueger, 2015). On many occasions, Millon offered that instead ofdisconnecting functions independent developments, a relativelyadvanced science of personality should be composed of fourcharacteristics that would work comprehensively together i.e.assessment, theory, clinical interventions, as well as nosology(Millon, 1991). Millon was an unrelenting champion for thesignificance of disorder of behavior in clinical experience andpractice. Many of his contributions have aided to develop, supportand to stimulate clinical and controlled status of personalityproblem.
Analysisof the Theory Background
TheodoreMillon’s theoretical approach is the chosen model for in-depthanalysis for this paper. I feel that the social learning theory ismore comprehensive and relatable to the various aspects of thecontemporary life. Millon has been regarded as one of the leadingpersonality theorists globally. His theories mainly incorporate theelements of evolutionary advancement and phases of biosocialprogression. The author’s rich, integrative, and extensivescholarly workings on personality disorder demonstrated the continuedenthusiasm to speculate to limited collected information. Someevidence that others perceive as the foundation of personalitypremise such as the system of self-report mannerism adjective wasfound to be too limiting by Millon. He alleged that inductive andempirical approaches that describe and recognize the links betweenobserved variables through statistical analysis were relevant increating a negligible methodical discipline.
Millonperceived his approach to representing the need for cohesive theoryto border practical investigation. According to Dorr, (1999) Millonconsistently argued that the categorization of psychopathologyincluding personality disorder must incorporate theories, empiricalobservations, as well as the objectives of clinical practice. Theacknowledgment that temperament and personality disorders should beunderstood in integration, and within sub-disciplinary anddisciplinary viewpoints seek to mirror Millon’s distinct abilitiesto speak and listen to as well as to work with numerous scholars. Histheoretical standpoints were mainly influenced by the different areasin which he moved. For more than four decades, Millon’s theory oftemperament and personality disorder has significantly evolved.
Togetherwith his collaborators, they have successfully developed andprolonged the original theories and published a wide variety oftextbooks, articles, chapters of books that redirect their efforts toestablish a unified science of personality and psychopathology. Theearliest theoretical suggestion of the author was founded onbiosocial learning model. The model was created based on threequestions including what are the reinforcements looking individuals,which attempts to find them, and how to work to be eligible for them(Pincus, & Krueger, 2015). The resulting model attempts torespond to these questions where Millon suggested that the soughtafter reinforcement may be the quest for pleasure and escaping agony,the reinforcement could be explored in self or others, and the personmay conduct himself/herself vigorously or passively to attain it(Dorr, 1999).
Thismodel proposes that from the knowledge of deficiencies of the threemagnitudes can be derived in a reasonable manner of the eightpersonality disorder, the combining nature, contributory conducts andthe source. The model also includes the three variations of a moreserious personality disorder. The eight patterns of personality werefound to be in change and an imbalance of three divergences whichconstitute a probable inaccuracy for the model. The four modelsgathered from the source and the nature of reinforcement included thewithdrawn, dependent, independent and the indecisive. These patternstend to interconnect with the two different models of theinstrumental behavior i.e. the vigor and passive to develop eightmodels of personality. The active and passive behavior represents the‘activopasiva’ polarity whereas the retracted, dependent,independent and the indecisive do not characterize a clear division(Dorr, 1999).
Yearslater, Millon developed a new psychiatric grouping system whichformed the basis of the Diagnostic Manual and Statistical of mentaldisorder, III. Though there existed significant differences betweenMillon’s personality and those described in the DSM-III, theconceptualization of the two philosophies was found to bewell-matched. The development of numerous axis for the DSM III with anetwork designed to approve the behavior of an individual wasaccurate to the detachment between pathological personality and otherkinds of psychopathology. Persistent efforts to improve thepsychiatric nosology contributed to the immediate review of the DSMIII (Pincus, & Krueger, 2015). The revised publicationincorporated two personality disorders i.e. the masochist and sadist.The two diagnostic categories were accommodated as per Milloncontribution which obliged him to publish a second version of theMillon Clinical Multiaxial Inventory to assess personality traits.Millon was more convinced of the application of both categories thathe added them to his model which remains in use to this day.
Theauthor further incorporated a discordant component in the newdisorders to the source and nature of reinforcement. The dissonanttemperament utilized certain circumstance to attain positivereinforcement or evade negative reinforcements, or to substituteagony with pleasure. With other elements, the dissonant personalityconstituted both the active and passive variants. Due to includingthe two new personalities, Millon sought to review their descriptionto maximize compatibility between their disposition types and thosein the revised DSM-III. Another key milestone in Millon’stheoretical expansion was when he reestablished the theory oftemperament and personality disorders to take into consideration theconceptions of growth through an evolutionary, phylogenetic, and theconcept of human development (Paris, 2015).
Thereformulated model confirms the reassessment of the profoundattributes of the humankind functioning (Dorr, 1999). The focusevolves from consciousness to the appearance of nature, scrutinizingthe collective principles generated from non-psychologicalexpressions. Each classification demonstrates cohesions in theiradaptive style (Millon, 1991). The actual differences in the adaptivesuccess and styles compare the diverse and evolving environments. Theextension of the theory to integrate the many stages of evolutionfailed to include revisions of the initial three divergences. Theevolutionary model speculates four essential developed polaritiescomposed of objectives of existence, modes of adaptation, replicationstrategies, and the process of abstraction. The personalities withdifferent disorders that were present in the numerous versions of theDSM gave rise to several disparities resulting from empiricalresearch and clinical practice and combining features of more thanone disorder (Pincus, & Krueger, 2015). Millon developed fourvariations of the avoidant personality disorder which was combinedwith the basic pattern. The differences allow clinicians todiscriminate among patients diagnosed with a similar psychologicalproblem.
Whileemploying three forms of polarity, Millon categorized each of thepersonality patterns. A personality pattern was described as beingweak, neutral, or strong on any component of the polarity. The strongpattern in any particular component does not signify good trait.Instead, it demonstrates the tendency to a style of behavior. Tosupport the classification system, Millon rejected the grouping ofthe DSM-IV. He proposed that grouping disorder by identifyingcharacteristics provides no significance envisages, relevant terms,or etiological meaning of any theoretical model. This system hascontributed greatly in regards to the theory and classification ofpersonality disorder to Millons works from 1976 to the current period(Dorr, 1999).
Thetheory has evolved to complexity as it develops in an attempt toreflect the intricacies of the human nature. The classificationsystem has also been enriched form the core categories with varyingcontributions resulting from clinical research and that they arereflected in some reformulation of the DSM (Millon, 1991). The modeland the classification premises continue to be the foundation ofMillon anticipated investigation of temperament and its pathology.The assessment and the treatment components become associated withthe previous proposition to offer operational processes of thetheoretical paradigms and guiding principle for therapeuticinterventions of personality disorder.
Millonwas committed to developing various tools to operationalizetheoretical concepts. The author’s first publication was made inthe 1970s and consequently, has developed other inventories ofpersonality and clinical research with the aim of providingoperational measures of theoretical models (Dorr, 1999). To evaluatethe validity and accuracy of Millon’s theoretical models ofpersonality, the MCMI III is deemed to be the most suitable tool formeasurement (Jankowski, 2002). The instrument is directly related tothe evaluation of the core focus of the personality disorder theoryand could also be the inventory of self-report for clinicians toexamine personality disorder of the DSM-IV.
TheMCMI III is presumed to be a reflection of Millon theoreticalconceptualization and is most useful when related to a morecomprehensive theory (Jankowski, 2002). Millon previously stated thathe perceives the term personality to denote a distinctive style ofadaptive operation displaying a certain member of species toassociate with a typical range of situations. In this manner, theprimary disposition would mirror particular modes of adaptation thatare effective in predictable settings. The personality disordersembody varying types of running out of sorts adapted attributable toinsufficiencies, disproportions and struggles on the abilities of amember to interrelate with the surroundings.
Thetool to measure typical personality is the Millon Inventory of Stylesof Personality (MIPS). The instrument was intended for use in ahealthy mature person. It has been found to efficiently evaluatevarious dimensions of characteristics of interpersonal styles thatare present in a normal population. A new perspective was establishedwithout reference to disorders: however, it considered many borrowedconcepts from the original theory of personality. A properlyelaborated theory holds that Millon takes along thestraightforwardness and precision to disseminated and non-integratedevidence. To design the MIPS tool, Millon seeks to study the patternof individualities and interpersonal styles. This inventory comeswith three sets of personality variables such as motivational goals,cognitive modes, and the interpersonal behaviors which describe andmeasures the personalities and interactive styles.
Evaluationof the theory’s Aspects that are Relevant in the Field today
TheodoreMillon is considered as one of the most prominent figures inconceptualizing and specifying personality traits and disorders inthe 20thand 21stcenturies. An influential developer of the axis II classification ofthe DSM-III, III – R, and also IV, he worked to perfect hisevolutionary model after his active contributions to the manycommittees he was involved and stayed focused on the future ofpersonality evaluation. From Millon’s evolutionary theory ofbehavior and psychopathology, the MCMI (Millon Clinical MultiaxialInventory) III tool offers an extent of temperament illnesses andclinical patterns for persons going through psychiatric and mentalassessments and treatment. The instrument was developed to performclinical evaluations to assess the axis I and II personalitydisorders and remains to be in use to the present day. The mostrecent edition of the MCMI is the MCMI IV which was published in2015. The authors of this instrument show their test as exclusivecompared to other personality tests on Millon’s evolutionarytheory.
Changesin the DSM
Theneed to classify psychological syndromes has been evident all throughthe account of psychology and medication. Up until of late, there hasbeen limited promise as to which disorders should be incorporated andthe best technique for its association. Diverse categorizationsystems have been developed for the past years and have shown tocontrast in their focus on etiology, phenomenology, and centralpatterns (Kawa & Giordano, 2012). Several structures haveintegrated a few of the diagnostic criteria while other hundreds tothousands. Since the history of classification is too extensive, thishas contributed to the constant improvement of the Diagnostic andStatistical Manual of Mental Disorders (DSM).
Thediagnostic manual of the American Psychiatric Association which is atthis time in its fifth version and perceived as the orientation forthe classification and diagnosis of mental problems has undergonenumerous evolution since its foundation the mid-1950s. The DSM wasfirst established in 1952 (Kawa & Giordano, 2012). Whethersupported as a rational gold-standard or disapproved as being narrowin range and application, its effect should not be disregarded. TheDSM has employed and remains to put forth tremendous power within thepsychiatric field and the larger part of the society. This sectionwill seek to analyze the development of DSM-III through V.
TheDSM III was put out in 1980 which represented a fundamental changefor psychiatric nosology that substantially transformed the field ofpsychology (Kawa & Giordano, 2012). The publication of theDSM-III embodied a completely new classification system that lean-tothe impact of the DSM-II. The former versions of the DSMconceptualized intellectual disorder symptoms as the expression of anunderlying subliminal conflict. Therefore, the diagnostic labelseemed meaningless without recognizing the broad circumstance of apatient’s history. When psychiatrists were obliged to make adiagnosis of similar patients using the DSM-II, their scope ofagreement were found to be slightly higher than casual (Kawa &Giordano, 2012).
Asthe fundamental role of mental health, practitioners were undergoingmajor changes, the psychologists, and the psychiatrists emphasized onthe assessment and treatment of activities than ever before. Theyfailed to accept the classification system that favored oneparticular theory of psychopathology. Rather, they sought for a modelthat was a neutral and symptom-based system that depended on a clearcriterion. To achieve this, DSM researchers introduced thedescriptive section that was present in the former systems andestablished a set of observable criteria for each disorder. For apatient to be diagnosed with a certain disorder, they had to exceed aspecific number of criteria.
Thecriteria’s specific system of the DSM-III, thus, became widespread(Kawa & Giordano, 2012). The DSM III structure was perceived as asystem that relied on neutrality, certainty, and rationality. Asignificant number of field trials were carried out before thedevelopment of DSM-III to support how the mental illnesses werecategorized into specific groups (Jankowski, 2002). This basiscontributed to the increase in the prevalence of disorders comparedto the DSM-II. Substantial trials were also carried out to helpexplain and identify the autistic condition, attention deficithyperactivity disorder, and the anxiety illness (Jankowski, 2002).Some of these disorders were added to steer research in specificareas.
Thus,DSM-III accredited that DSM was a work in progress and its constantimprovement needed the assistance of superior research scientificcommunity. Another important hallmark of the DSM-II was thedevelopment of Millon’s Multiaxial Classification System (Kawa &Giordano, 2012). Its evaluation was that each person assessed by amental health practitioner would be examined in many specificterritories. This was to ensure that clinicians did not skip criticalinformation from the fields that are believed to be relevant tomental disorders. The success of DSM III was due to the advancedmedicalization in terms of research and acceptance in the field ofpsychiatric. There existed a flare-up in the number and quality oftherapies available to treat severe mental problems includingbipolar, schizophrenia, etc.
Totest the effectiveness of the new treatments, a reliable, strict,symptom-based, and standardized classification structure was needed,and DSM III was found to fit the role flawlessly. To facilitate itssuccess, the DSM developers appointed several experts in differentfields to review the DSM III for its accuracy, clearness, anddependability (Jankowski, 2002). Given DSM III success, faults werediscovered after its release. For most disorders, the criteria setappeared to be inconsistent and unclear across various categories.Many disorders, autism, and personality illnesses were found to bedimensional and continuous in nature. DSM III diagnostic hierarchicstructure categorized severe depressive disorder above the panicdisorder which was later discovered to be unfitting. Once thelimitations of DSM-III system were acknowledged, the development ofDSM-IV was initiated (Miller, Widiger, & Campbell, 2010).
TheDSM-IV Edition in 1994 was not to characterize a shift away from thesystem used in the DSM-III. Rather, its development team was watchfulof the disturbance that the extensive changes might have on theresearch and clinical practice. They, therefore, approached theamendments from a conservative viewpoint. They also took rich placesto guarantee that the alterations they brought about were free frompartiality (Ronningstam, 2014). Every adjustment in the DSM-IV was tobe reinforced by a wide-ranging evaluation of the experiential proof.The reformulated manual incorporated three major phases i.e. thesystematic literature analysis, subordinate data reevaluation, andfiled inferences.
Eachassessment was then subjected to critiques by other team members andadvisers who were required to identify inaccuracies in the results,other preconceived notion, and possible openings. Experts were inagreement that in reality, the number of disorders observed in thepopulation has been stable. Thus, the DSM-IV was perceived as themost accurate tool that is able to distinguish the sufficientdiscrepancies. The multiaxial system of diagnosis in the DSM-IVcategory provided a broad analysis that embraces a comprehensivedepiction of the complete range of factors that compromiseintellectual status (Miller, Widiger, & Campbell, 2010). TheDSM-IV diagnosis selects disorders that reflect a patient’ssymptoms. Each analytical label is linked with a diagnostic code usedby organizations for billing and data. For each disorder, a set ofDSM-IV category specifies the symptoms and period that compromiseseach analysis.
Minorchanges were made in DSM-IV in 2000 (Kawa & Giordano, 2012).These changes comprised changes based on the new research, negligiblefaults found in the initial fourth edition of the DSM manual, tomodernize the coding system to align to the international frameworks,and to heighten the informative value of the manual by including morewriting. The weaknesses of the DSM-IV were the real reason behind thefurther development of the DSM to introduce the fifth edition(Miller, Widiger, & Campbell, 2010). The major points ofcriticisms of the fourth edition of the DSM were concerned with theclear-cut grouping of the disorders and the high rates ofpervasiveness and comorbidity. Regarding the levels of disorders,there were disapprovals on the lack of crucial diagnosis and therepeated use of the category.
Thenew version of the DSM-V issued in 2013, is the product of more thana decade of efforts by experts in every aspect of mental health(Miller, Widiger, & Campbell, 2010). Their hard work andcommitment produced an authoritative work that describes andclassifies mental problems to improve research, diagnosis, andtreatment. Mainly used by researchers and clinicians to examine andgroup mental illnesses, its criteria are found to be brief andunambiguous to foster an assessment of symptoms various clinicalsettings. The new features and improvements in DSM-V make it easy touse across all settings (Miller, Widiger, & Campbell, 2010).
Mostof the changes in the DSM-V were facilitated to characterize thesymptoms and conducts of people in search of clinical support, butDSM-IV fails to properly classify their indicators. The fifth editionDSM contains the most recent criteria for examining mental disorder,as well as a general descriptive writing which provides a sharedlanguage for clinicians to converse about their patients (Miller,Widiger, & Campbell, 2010). The international classification ofdisease incorporates the code numbers to be used in DSM-V and all itstreatments required for insurance settlement and observing diseaseand death rates by state and worldwide health organizations.
HowSocial Learning Theory is applicable to Modern Society
Peoplelearn through modeling from observing others attitudes, behaviors,and their outcomes. The traditional learning theory gave rise toAlbert Bandura’s social learning theory. Behaviorism was theresponse to psychoanalysts such as Freud and others. The behavioristsbelieved that psychology should concentrate on observable, external,and measurable themes rather than internal processes (Kolb,A., & Kolb, D., 2012).Since social learning theory focused on both the inner and externalsystems, it was perceived that the model fell between Freud’sinternal processes and Skinner external patterns (Banai, Mikulincer,& Shaver, 2005). Social learning theory seeks to explain thebehavior of people regarding continuous commonalities betweenbehavioral, environmental, and intellectual influences.
Hefurther proposed that the modeling process should integrate certainsteps including paying attention, retaining details of behavior tolearn and reproduce the conduct, a person must reproduce his/herbehavior to the modeled conduct. Lastly, there must be some form ofmotivation to drive an individual’s reproductive conduct. Sociallearning theory is extensively applied to promote the understandingof aggression and psychological disorders in the framework to modifybehavior (Paris, 2015). It is also used in the theoretical foundationfor modeling of behavior which is used in training programs.Currently, Bandura has focused his philosophies on the concept ofself-efficacy which is related to the one’s development andself-esteem (McCain & Campbell, 2016).
Inthe modern society, the most common and widespread example of thesocial learning theory is the mass media. Media has for a long timeappeared to compete with the traditional authorities of socializationthat we know like the family, school, religious bodies, and peergroups. It brings with them eye-catching models, crafted talks,vibrant storytelling characteristics concerning individuals, places,and cultural sets that help to shape the world view of the childrenand the youths(Kolb, A., & Kolb, D., 2012).Television, films, and related media attempt to exert a powerfulimpact. One significant implication is that television is influencingthe human behavior and motivations on a day to day basis.
Televisioncommercials allege that drinking certain beverages or applyingparticular body creams makes one to be popular and to earn theadmiration of beautiful persons. This tends to shape behavior asshown in the commercial and motivates one to buy the product beingadvertised. As children develop into a teenage hood, mass media helpsthem to define who they are and what they want to become. By the timethey enter middle school, they have been accustomed to thousands ofhours watching movies, television, videos, etc. Social learningtheorists are however more concerned in the way televised violence,use of alcohol affects the young population. Numerous research hasshown that mass media has increased child aggressiveness andtendencies to consume alcohol and substance abuse within theirlifespan.
Banduraand other authors have determined that mass media nurtures personalattributes and modifies the former ones based on exposure which playsa significant role in the process of social learning theory. Also,parents and teachers believe that they teach by example, in whichcase they have overlooked at how relevant, influential modelingstands (Kolb,A., & Kolb, D., 2012).Considering the concept of applying punishment, parents prevent theirchildren from hostility through facilitating spanking. Through this,it provides an excellent demonstration of the young people on how tocontrol others physically. Theorists have taught us that when we findthat we are incapable of getting rid of a child’s undesirablebehavior, we need to ask ourselves whether we unintentionally modelthe young one’s behavior.
IncreasedPrevalence of NPD due to Social Media
Theincreased use of social media has magnified in the current yearsespecially among the young population. Numerous researches have shownthat the culture of social media does indeed have a significantimpact on user’s self-esteem. In America, diagnosis and prevalenceof NPD have risen sharply for the past decade (Ronningstam, 2014).Psychologists have for a long time studied the need for people tobelong and some went on to suggest that social media offers a moresuitable way for individuals to feel right (McCain & Campbell,2016). Fitting to a certain class or crowd stimulates the expansionof a shared self-confidence.
Giventhat many researches have revealed that social media promotesnarcissistic behavior and has a negative impact on self-esteem,certain attributes have demonstrated to correlate with social mediause such as unconscientiousness and extraversion which are mostlylinked to narcissistic behavior (Zajenkowski et al., 2016).Narcissism is considered as the primary envisage of social media usefrom all other features investigated. A direct link has been reportedbetween the number of Facebook friends that a person has and thepervasiveness of social disruptive attributes that is connected withnarcissistic behaviors. In one study conducted on undergraduaterespondents, it was reported that that presented higher levels ofnarcissistic behavior were much indulged on social media platforms.
Narcissistsare mostly inclined to minor affiliations. Thus, social media helpsthem to acquire many ‘superficial’ allies. Additionally, socialmedia profiles allow users to craft an exaggerated and grandioseidentity that is parallel to the narcissistic stance. The millennialsare the most susceptible to the adverse impacts of social media(McCain & Campbell, 2016). The young people go through anarcissistic phase as they seek to establish a place in the societyand detach themselves from their parents and caregivers. Theirexperiences in this stage can be very unhealthy when magnified bysocial media. Another need for interaction through social media is toenable compare self with peers. Performing comparisons has beenthought to help in many ways including obtaining ideas or advice fromothers, making decisions, and dealing with emotions.
Socialcomparisons can be categorized as either upward or downward. Anupward comparison is where an individual compares himself/herself tothose they view to be superior. The downward comparison is where aperson compares oneself to those they view to be inferior to them.Social media tends to widen the gap of social comparing in such a waythat rather than making comparisons with those within physicalproximity, users can compare himself/herself to people across theglobe. It is apparent that social media emboldens and panders to theestablished narcissistic behavior (Paris, 2014). People are using theexternal validation on social media for a reason. As such, there isthe need to examine what is lacking at the heart of the people.
Narcissismin Romantic Relationships
Narcissismhas been found to enhance romantic success in temporary contexts andcreate problems and difficulties in long term relationships. Suchrelationships are established on a bilateral listening deficiency.According to Lavner et al. (2016) in romantic relationshipsnarcissists become attached to partners who are high in status andhave complete admiration for them and would prefer not to continuethe relationship to fulfill their need for closeness and intimacy. Inmost cases, people get attracted to narcissists in the initial andshort period because of their energy and extroversion personalitiesand after a few interactions this attraction fades away when peopleobserve how self-absorbed they are.
Astudy was conducted by Lavner and colleagues (2016) to a sample of150 couples who were newlywed. They were assessed at least six timesduring their four years of being married. The results established noclear behavior of couple`s traits for persons with high levels ofnarcissism. A hierarchical model reported that the wives narcissismresults showed a slope of marriage quality over a certain periodwhich comprised a decrease in marriage satisfaction and growth inmarital problems. The husbands` narcissistic character results hadlimited effects on marital quality. Partners have reported that therelationship can be fulfilling and exciting in the first stages butlacks intimacy and bilateral communication (Lamkin, Lavner, &Shaffer, 2017). Narcissists do not want to deal with issues in arelationship. In case issues are brought up he/she will be quick towalk away. The narcissists love to be given attention, admired,adored, romanced, the promise of true love, and the expectation thathe/she has found the partner who will put up with their weirdness.
Thenarcissist does not want to be held accountable in a relationship.They seek constant approbation and attention without investing muchto pursue someone. Once pursued, one should look to be hooked.Immediately one is groomed to be a constant source of care,affection, growth, and admiration. The part missing is that thenarcissist does not give the impression to be certain that he/she isrequired to reciprocate. With men narcissists, some women believeinto winning their man and tending to his needs. It may, therefore,be easy to coach a woman to play this role. With the womennarcissists, they seek to be the queen in the relationship and thus,look for men who will shower them with adoration and admirationwithout concern for their needs. As such, men who had narcissisticfemale caregivers may easily align with such a woman and offer tocater to their every need to keep them around. It then follows thatthey are likely to be always on the lookout for someone much superioreven when committed to a serious relationship (Wurst et al., 2016).When they are offended or hurt, they seem quite unforgiving of theact. This is attributed to their self-reported high levels ofdisplaying aggression, anger, and hostility when criticized.
Personalityis often perceived as a person’s psychological immune system. Manyof the unintegrated assessment and treatment solely focuses on theminimization of its symptoms. A more valuable approach would be toenhance the adjustment of the immune system to reduce the symptomstoday and in future. Millon inventories and intervention systems aredistinctively concentrated to this goal. Likewise, once a personalityis assumed to this focal point, there arise questions on how it canbe described and replicated in a classification structure, measured,and interposed for efficient improvement. The obligatory outlook mustbe able to intertwine the personality distinct and the cognitive,interpersonal, and biophysical components in a consistent andefficient manner. As such, Millon provided a system in hisevolutionary theory to focus on this premise.
Thesocial learning theory has contributed to too many research works.Evidence report that social learning theory and the sense ofself-efficacy creates various outcomes including smoking cessation,alcohol and substance abuse, pain tolerance, career choices,confidence, and even recovery from medical procedures. In thecontemporary society, mass media has become a powerful influence inpeople’s daily lives. The kind of models shown in media has been ofconcern to those in quest of social change like the marginalizedgroups and women. These persons have documented that televisedprograms, print media, etc. have labeled women and people of color instereotyped roles which tend to impact their sense of self-efficacy.Today, organizations are campaigning to the media to stream accuratemodels to perceive women and those from marginalized groups as beingeducated and professional. Social learning theorist will affirm thatsuch strategies will employ hope that social change will eventuallytake place.
Narcissisticrelationships are established when one or both partners struggle withthe narcissistic character. The self-esteem mentality that isenhanced by social media such as Facebook which has made people becaptivated by the appearance they show to the world. It has been saidthat narcissistic form bad relationship partners. A relationship witha narcissistic partner can be hard to handle. Most people in anarcissistic commitment usually have issues with co-dependency. Theymay tolerate multiple abuses since they do not feel confident inthemselves to be on their own (Wurst et al., 2016). It is thus,important to understand your role in a narcissistic relationship. Onemay attempt to challenge his/her partner to change their ways ofrelating. This helps to develop self-confidence and self-worth bylearning to practice self-compassion.
Millonhas occasionally expressed that consistent development of theory isimportant to understand the concept of personality. This helps toapply an efficient system, design assessment tools, and to suggest aproper line of treatment. As such, Millon theory, classification,intervention, and evaluation techniques make the pillars to enhanceclinical science (Dorr, 1999). His theory has gained much opportunityand complexity while preserving the original guidelines. Minorchanges were made to conform to the new frameworks that emerged fromresearch and clinical practice. The model classification system hasbeen enriched to incorporate new prototypes of personality. Theauthor was consistent to adopt new categories requiring furtherresearch in his model which sought to provide a more productive andillustrative of the problems of personality categorization. It is thepersonality that the theoretical paradigms applied to embody theability to observe and face the world socially, psychologically, andphysically which concerns the understanding concept.
Socialmedia activity remains to be on the increase especially among theadolescents and the youths. Since many of the Millenials are usingmuch of their time and lives attached to social media, it isessential for investigators to identify how the impact of socialmedia experience has on user’s self-confidence. It would bemotivating to observe if social media is directly linked to aparticular mental disorder such as the disorder of the narcissisticpersonality. In narcissistic relationships, empirical research mustbe enhanced to validate the mutual listening deficiency as a centerfor examining narcissism and to analyze the sufficiency ofpsychologist’s preparation in the intervention programs.
Recognizingnarcissism as a mutual listening deficit can serve as a practicalguide for couple’s therapy (Lamkin, Lavner, & Shaffer, 2017).At the same time, conflict-oriented treatment strategy can facilitateprompt and substantial declines in narcissism. People learn valuesand norms for the environment and social learning theory offers thatgrowth and development occur through experimental learning. In thecurrent world, mass media, fashion and taste organizations just tomention a few, depend greatly on the social prompting power ofmodeling. It is the hope that social learning theory research willremain in the social cognitive tradition and provide insights intothe relationship of learning theories and mass media structures.
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