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In Greek mythology, a character named Narcissus fell in love with his self-reflection in a pool.
This myth was later used to describe narcissism as a personality disorder.1
Narcissism has two types, with each type having distinct characteristics:2
Narcissistic personality disorder is defined as extreme grandiosity and attention-seeking.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) focuses more on this grandiosity than the more vulnerable aspects of narcissism.
The most widely used tool for assessing narcissism is the Narcissistic Personality Inventory (NPI). It contains 40 items that describe narcissistic traits.
People with high NPI scores are initially seen as charming but later on will come across as vain.3
People diagnosed with a co-occurring disorder have a mental health disorder along with alcohol or drug use problems.
Narcissistic personality disorder is one of those conditions that can co-occur with alcoholism.
Alcoholics are not always narcissists. However, alcoholism can cause some people to develop narcissistic traits. They can become arrogant, self-centered, self-righteous, and defensive — the same qualities that also describe a narcissist.
On the other hand, having a narcissistic personality disorder can also make a person vulnerable to alcohol misuse.
When narcissism leads to alcoholism, the reason is usually due to a grandiose view of one’s self or as a coping mechanism to hide an underlying shame.2, 4
Pathological narcissism (both grandiose and vulnerable types) is also associated with alcoholism.
In a study of college students:5
Alcoholism is used to describe a person’s chemical and psychological dependence on alcohol.
It’s a progressive illness that gets worse over time. DSM-5 officially uses “alcohol use disorder” as the official term for alcoholism.
A person is diagnosed to have an alcohol use disorder if they meet at least 2 of 11 criteria of DSM-5:6
Depending on the number of met criteria, the severity of a person’s alcohol use disorder will be classified as:
Narcissists and alcoholics share common characteristics:7
Alcohol addiction involves cravings, tolerance, and withdrawal.
Narcissists thrive on attention, and they like the feeling of superiority.
Narcissists believe relationships are all about them.
Alcoholics believe that drinking comes first, even at the expense of the needs of their loved ones.
Narcissists rarely apologize for their mistakes.
Admitting mistakes is a weakness, something narcissists hate. They also blame other people for making them act as they do.
Alcoholics will give lots of excuses for their alcohol consumption. But usually, it’s not their fault.
Narcissists avoid shame. Instead, they shame other people for their wrongdoings.
Alcoholics avoid and hide any underlying shame through drinking.
Narcissists feel they can do whatever they want at the expense of other people.
Alcoholics are opportunistic and resourceful at getting their drinks, no matter the cost.
Both narcissists and alcoholics will become defensive once people confront them.
They may withdraw or be stern. They may also attack other people who point out the things they want to deny or hide.
Narcissists will lie to promote their image and avoid criticism.
Alcoholics will say they can stop drinking anytime they want. They will also deny when they had a drink or that their drinking has unhealthy consequences.
Narcissists dislike self-reflection.
Similarly, alcoholics avoid reflecting on their insecurities and lack of self-esteem by drinking.
Narcissists are arrogant and manipulative. They often show emotions designed to promote a positive image of themselves.
Alcoholics may cry over the costs of their addiction. But crying is meaningless because they still won’t stop drinking.
A narcissist exhibits destructive behavior due to a lack of empathy and authentic emotions.
Alcohol addiction affects an alcoholic’s behavior and the way they treat people.
Other people will also feel the destructive effects, as they experience arrogance, manipulation, rejection, and lack of empathy.
This makes it hard for narcissists and alcoholics to maintain relationships.
Even though narcissism and alcoholism share similarities, the two are still different and separate conditions.
For example, narcissists and alcoholics differ in terms of:
A person with a dual diagnosis has both a mental health disorder and substance use problem. The two co-occurring conditions can interact in a way that worsens their symptoms.8
Diagnosing and treating co-occurring disorders can be difficult. This is true with alcoholism and narcissistic personality disorder which have overlapping symptoms and often affect each other.
For example, alcoholism can cause people to become defensive of their addiction. This trait reveals narcissistic personality disorder.
It’s tricky to tell whether the root of the problem is narcissism or alcoholism. It will also be tricky to recommend the proper treatment.
It’s crucial to treat co-occurring disorders at the same time. Treating only one (alcoholism or narcissistic personality disorder) increases the chances of relapse.
There appears to be no significant relationship between narcissistic personality disorder and substance use relapses.9
However, when people with both alcoholism and narcissistic personality disorder start drinking again, they may hide or deny it. Or, they may feel they failed and blame others for their failure.
Therefore, simultaneous treatment of alcoholism and narcissistic personality disorder is essential. If only one condition is treated, the person’s chances of relapse will increase.
Seek treatment and support if you or someone you know has alcohol use and narcissistic personality disorders.
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