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Narcissism and Alcohol

Article Overview

  • There are two types of narcissists: grandiose and vulnerable
  • Narcissistic personality disorder leans on the grandiosity and attention-seeking aspects of narcissism.
  • Alcoholics can develop narcissistic traits. Narcissists can become alcoholics. 
  • Narcissism and alcoholism share similar qualities like being entitled, self-centered, defensive, and dishonest. 
  • Many alcoholics are not narcissistic when they’re sober. A narcissist’s behavior is constant, whether or not they drink.
  • There’s no significant link between narcissistic personality disorder and substance use relapse. But when a narcissist relapses, they may hide or deny it. 
  • Treating alcoholism and narcissistic personality disorder at the same time will decrease the chances of relapse. 

What is Narcissistic Personality Disorder?

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

  1. Grandiose or overt narcissism: A socially dominant interpersonal style. Grandiose narcissists are usually arrogant, manipulative, self-assured, or aggressive.
  2. Vulnerable or covert narcissism: A neurotic-antagonistic style. Vulnerable narcissists may be overly sensitive, insecure, defensive, and anxious because of an underlying shame. They also have fragile self-esteem.

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

The Link Between Narcissism and Alcohol

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

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How Does Alcohol Affect a Narcissist?

Pathological narcissism (both grandiose and vulnerable types) is also associated with alcoholism. 

In a study of college students:5

  • Grandiose narcissism appears to be a positive predictor of alcohol misuse. In grandiose narcissists, alcohol use can enhance their grandiosity. They will deny that they have a drinking problem. They will insist that their drinking behavior is normal. They may even be proud of it, especially if it makes them stand out. 
  • Vulnerable narcissism is a risk factor for future alcohol-related problems. Vulnerable narcissists usually hide an underlying shame. They will use alcohol as a coping mechanism, which makes them prone to addiction. However, unlike grandiose narcissists, they are likely to admit that they have an alcohol problem. 

Alcoholism & Its Symptoms

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

  1. Drinking more than intended
  2. Inability to stop drinking once started 
  3. Excessive alcohol craving 
  4. Spending too much time drinking
  5. Drinking interferes with family, job, or school
  6. Developed alcohol tolerance 
  7. Continue drinking even though it causes troubles
  8. Continue drinking even though it causes depression, anxiety, other health problems 
  9. Avoid other activities to drink
  10. Getting involved in harmful situations due to drinking
  11. Experiencing withdrawal symptoms 

Depending on the number of met criteria, the severity of a person’s alcohol use disorder will be classified as: 

  • Mild: 2 to 3 symptoms
  • Moderate: 4 to 5 symptoms
  • Severe: 6 or more symptoms

10 Ways Narcissists and Alcoholics are Similar

Narcissists and alcoholics share common characteristics:7

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1. Driven by Cravings 

Alcohol addiction involves cravings, tolerance, and withdrawal. 

Narcissists thrive on attention, and they like the feeling of superiority. 

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2. Entitled and Self-centered

Narcissists believe relationships are all about them. 

Alcoholics believe that drinking comes first, even at the expense of the needs of their loved ones.

3. Blame Others

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.

4. Avoid or Hide Shame

Narcissists avoid shame. Instead, they shame other people for their wrongdoings. 

Alcoholics avoid and hide any underlying shame through drinking.

5. Opportunistic

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. 

6. Defensiveness

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.

7. Dishonesty

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.  

8. Refusal to Self-reflect

Narcissists dislike self-reflection. 

Similarly, alcoholics avoid reflecting on their insecurities and lack of self-esteem by drinking.

9. Arrogant and Manipulative Behavior

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. 

10. Destructive Behavior

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.

Differences Between Alcoholism and Narcissism

Even though narcissism and alcoholism share similarities, the two are still different and separate conditions. 

For example, narcissists and alcoholics differ in terms of:

  • Display of behavior: Many alcoholics are not narcissistic when they’re sober. They may actually be empathic. A narcissist’s behavior is constant, whether or not they use alcohol.
  • Admitting mistakes: Alcoholics may not recognize a mistake because they don’t remember it. Narcissists will constantly refuse to admit an error because they don’t want to face criticism.
  • Need for change: A person fighting alcoholism will realize they need to change. Narcissists are always unwilling to admit that they need to change.
  • Other people’s impression: People close to an alcoholic may notice any behavior change. People close to narcissists may feel the person’s behavior is never changing.

Dual Diagnosis Treatment (Alcoholism and Narcissistic Personality Disorder)

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. 

Is Someone With Narcissistic Personality Disorder More Likely to Relapse?

There appears to be no significant relationship between narcissistic personality disorder and substance use relapses.

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. 

Treatments include behavioral therapies and medications. There are support groups for emotional and social support. They are also places where people share tips on how to deal with both conditions.

Seek treatment and support if you or someone you know has alcohol use and narcissistic personality disorders. 

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Updated on March 27, 2022
9 sources cited
  1. Yakeley, Jessica. “Current Understanding of Narcissism and Narcissistic Personality Disorder.BJPsych Advances vol. 24,5 :305-315.
  2. Jauk, Emanuel, and Raoul Dieterich. “Addiction and the Dark Triad of Personality.Frontiers in Psychiatry, September 17, 2019.
  3. Raskin, Robert, and Howard Terry. “A Principal-Components Analysis of the Narcissistic Personality Inventory and Further Evidence of Its Construct Validity.J Pers Soc Psychol vol. 54,5 :890-902. 
  4. Mitra, Paroma, and Dimy Fluyau. “Narcissistic Personality Disorder.” 2021 May 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. 
  5. Welker, Logan E et al. “Grandiose and vulnerable narcissism: Associations with alcohol use, alcohol problems and problem recognition.Journal of American college health : J of ACH vol. 67,3 : 226-234.
  6. Understanding Alcohol Use Disorder.National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, U.S. Department of Health and Human Services.
  7. Neuharth, Dan. “10 Ways Narcissists and Alcoholics Are Similar.Psychology Today, December 24, 2020.
  8. Dual Diagnosis.” MedlinePlus, U.S. National Library of Medicine. 
  9. Gaber, Osama Hasan, and Mohamed Elsaed Abelfatah. “Relationship between Personality Disorders and Relapses among Sample of Substance Abuse Patients.” J Psychol Clin Psychiatry vol. 6,6 :00381.

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