Definition of Narcissistic Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorders fourth edition, DSM 5, a widely used manual for diagnosing mental disorders, defines narcissistic personality disorder (in Axis II Cluster B) as:

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 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 others are envious of him or her

9. Shows arrogant, haughty behaviors or attitudes

10. Often mild to moderate paranoia, that others are out to do him in.

11. Predominant “name dropper” boasting or suggestion association with people or affiliations of importance.

***The Narcissist after a Break-Up:
Breaking up with a narcissist is an emotional roller coaster. If you have read other articles or received support from a therapist on how to break up with a narcissist, you will know that the only viable way to do this is with No Contact.

However, this causes the narcissist to experience “withdrawal” from not having enough ‘narcissistic supply’. In his frantic desire to gain a “fix” of narcissistic supply, he will respond in one of two ways.

He will either leave, with no remorse or shame for the abuse he has imposed, and seek out a new source of supply or he will immediately swing back into pursuit mode, with the singular goal of winning you back. A narcissist does not want to be alone and he constantly needs someone to validate him.

Sticking to your guns of No Contact will initially anger and threaten the narcissist, so expect some new craziness to emerge. The narcissist is relentless when it comes to securing his sources, and he will use all kinds of manipulative behavior to draw you back into the relationship. He may romance you, seduce you, and charm you just like he did in the beginning.

If that doesn’t work he will resort to more drastic measures such as threatening suicide or saying “he cannot live without you”. The narcissist will return to see if he can still get his fix from you, or even create supply through your reactions.

The narcissist isn’t ignorant about the pain he’s caused, he just doesn’t care. As long as you react-in any way-the narcissist will always come back (whenever there is a lapse in whatever supply he’s replaced you with).

Do not underestimate the patience of the narcissist; he will wait to come back until the most convenient time to return. He will return without offering an apology or explanation.

He will come back to get the thrill he wants … the thrill of power- of conquering and controlling. When his narcissistic supplies run out, rest assured, he will be knocking at your door.

The narcissist will dig deep into his ‘bag of tricks’ to re-conquer his perceived opponent. He will be capable of unthinkable and egregious behavior because your initiative of No Contact has upset him to the very core.

His nastiness can range from simple verbal attacks to being downright destructive. Do not underestimate him and be prepared for anything – despite how well you think you may know them.

However, if he knows that you have figured him out, he will not want to be around you for fear that you will tell people the truth. He is less likely to contact you after the break-up.

Most likely the individual with NPD will move on quickly. NPD has no conscience, hence his ability to move on quickly to seek a new victim with more supply.

The Boomerang:
Prepare yourself for continued conflict after the break-up for he will fight the decision tooth and nail.

The narcissist will be worried about how you will make them look plus the added effort of having to find another person to abuse. He may suddenly soften toward you, he may seem sweet and probably even claim that he will change for you.

A narcissist will try to talk his way back in the door claiming unfinished business or the need to talk. He will try manipulating you back into the relationship. A narcissist will come back like a boomerang. Even after they accept the break-up, they will show up with gifts at your door. They will want to talk fondly of the relationship. They will want to control what you say to others about why you broke up. They need to be in control and they need to still come out looking like a hero.

Perhaps the most confusing and difficult thing when being involved with a narcissist is the crazy- making cycles of breaking up followed by the “highs” of making up.

It is an inevitable process that comes with the territory of a narcissistic relationship. A narcissist will leave you only to return back to the relationship; he will hurt you deeply and then come back on bended knee and beg forgiveness; he will spend excessive amounts of time trying to convince you to give him another chance, only to revert back to his old ways as soon as he realizes you have once again committed to him.

Narcissists take advantage of your good nature and they know how to get you to feel sorry for them. At first he will show acts of being loving, compassionate and supportive; he will promise to change and he has a natural ability to fake tears and emotion.

He may acknowledge the error of his ways and promise it will never happen again. The conquest of getting you back is like a drug to him; the narcissist is a junkie when it comes to obtaining his sources of supply.

He needs his fix whether it comes from new narcissistic sources of supply or old sources.
These boomerang cycles and the conquests make him feel alive and give him a thrill.

This is why the narcissist will use every known lure, going to great lengths to reel you back in again, only to immediately revert back to his old behavior after he has succeeded.

Realize, too, that any type of reaction from you is considered narcissistic supply; your reaction whether positive or negative is irrelevant. If he can’t get a good response from you, he will try to elicit a bad response … any reaction from you gives him his fix. Do not feed his addiction.

Quick “Fix”:
It doesn’t matter if your relationship lasted months or years, the narcissist believes he will always own you and that he will always have control over you.

He is arrogant and truly believes that all people he is, or was, close to can still be manipulated despite the passing of time

They will ignore the boundaries that you try to set. Giving these emotional predators the benefit of the doubt or forgiveness is like giving them the rope to hang their victims. They prey on individuals that are forgiving or are romantics.

Most victims of a narcissist want to believe this boomerang behavior is based upon genuine desire to be back in a relationship with them and wanting the relationship to work.

Unfortunately, a narcissist is only returning back to the relationship to get a “quick fix” on his addiction.

The narcissist will put on a great act and use his best performance to lure you in and conquer you once more. As time passes, the way he treats you and the cycles of idealization and de-valuation begin to re-establish themselves. This process continues on, even during the break- up stages. If you validate him by reacting to him in any way, shape, or form, he’s got his fix and will move on to the next best supply.

You may feel intoxicated by his change of heart and behavior and take him back but the minute he realizes that he has you again he will immediately revert back to his old cruel behavior. It’s a mind game and the only reason the narcissist continues to come back is to ensure that he still has you right where he wants you- where he can control you.
In summary, expect continued craziness after a breakup; given time the ensuing craziness will subside to a more manageable level if you do not take him back.

When the narcissist finds a more reliable source of supply, he will skip off without hesitation and show no signs of remorse, guilt or shame. You on the other hand, are left heart- broken as well as emotionally and mentally exhausted.

You will need to remind yourself that narcissists are incapable of change, and that they are incapable of genuinely loving anyone. If you take them back after the break-up, the roller-coaster ride will be ongoing and the boomerang cycles will continually repeat.

Break free by sticking with No Contact and get support from those who have also been through it (support group) or from an NPD experienced therapist.


We ALL are ONE!! We have ALL met one!!!

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About Dr. Rex

I'm originally from Puerto Rico. I was born in Santurce and raised in Rio Piedras. Have lived in Florida since 1999. I have a doctorate degree in Medicine; completed in 1976. My Internal Medicine specialty was completed in 1979. Worked for Puerto Rico's health system until 1985. At this time, I'm happily retired after working for the federal government for almost 28yrs. I want to offer any knowledge that I have to anyone "out there" who is interested. My views are liberal in almost every sense. My knowledge is "eclectic" - a bit of everything. Music and reading are my passion. Blogging has also become a very interesting endeavor. Metaphysical topics attract me. I'm interested in news reporting human issues like injustice, discrimination and abuse - the "wrongly" affected. My intention is to bring this knowledge to an understandable level and to help anyone in need. I'm open to questions and will answer them to the best of my ability. Currently working on an enterprise whose main mission will be to bring peoples of all walks of life together. To be one .... since we ALL are ONE!! The future looks bright and promising!!!

2 thoughts on “MEDICAL CORNER …. NPD!

  1. Pingback: You cannot change what you refuse to confront. | Life is meant for LIVING!

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