From the Editor Beyond ‘selfies’: An epidemic of acquired narcissism Narcissism has an evil reputation. equals. They also seem to be incapable But is it justified? A modicum of of experiencing shame as they inflate their self-importance and megalomania narcissism is actually healthy. It can at the expense of those they degrade. bolster self-confidence, assertive- They cannot tolerate any success by oth- ness, and success in business and in ers because it threatens to overshadow Henry A. Nasrallah, MD their own exaggerated achievements. the sociobiology of mating. Perhaps Editor-in-Chief They can be mercilessly harsh towards that’s why narcissism as a trait has a their underlings. They are incapable of survival value from an evolutionary fostering warm, long-term loving rela- perspective. tionships, where bidirectional respect is essential. Their lives often are replete Taking an excessive number of “selfies” with brief, broken-up relationships ‘Acquired narcissism’ with a smartphone is probably the most because they emotionally, physically, or that comes from fame common and relatively benign form sexually abuse their intimate partners. of mild narcissism (and not in DSM-5, Primary NPD has been shown in can lead celebrities to yet). Narcissistic personality disorder twin studies to be highly genetic, and start believing they are (NPD), with a prevalence of 1%, is on more strongly heritable than 17 other the extreme end of the narcissism con- personality dimensions.1 It is also indeed superior to the tinuum. It has become tainted with such resistant to any effective psychother- rest of us mortals an intensely negative halo that it has apeutic, pharmacologic, or somatic become a despised trait, an insult, and treatments. This is particularly rel- even a vile epithet, like a 4-letter word. evant given the proclivity of individu- But as psychiatrists and other mental als with NPD to experience a crushing health professionals, we clinically relate disappointment, commonly known as to patients with NPD as being afflicted “narcissistic injury,” following a real with a serious neuropsychiatric disor- or imagined failure. This could lead to der, not as despicable individuals. Many a painful depression or an outburst of people outside the mental health profes- “narcissistic rage” directed at anyone sion abhor persons with NPD because perceived as undermining them, and of their gargantuan hubris, insufferable may even lead to violent behavior.2 selfishness, self-aggrandizement, emo- Apart from heritable narcissism, tional abuse of others, and irremediable there is also another form of narcis- vanity. Narcissistic personality disor- sism that can develop in some indi- To comment on this editorial or other topics der deprives its sufferers of the proso- viduals following life events. That of interest: cial capacity for empathy, which leads hazardous condition, known as henry.nasrallah them to belittle others or treat compe- “acquired narcissism,” is most often @currentpsychiatry.com tent individuals with disdain, never as associated with achieving the coveted Current Psychiatry Vol. 18, No. 8 7 From the Editor Editorial Staff status of an exalted celebrity. At risk entertainers or star athletes believe EDITOR Jeff Bauer for this acquired personality afflic- they can enunciate radical statements SENIOR EDITOR Sathya Achia Abraham tion are famous actors, singers, movie about contemporary social, political, ASSISTANT EDITOR Jason Orszt WEB ASSISTANTS directors, TV anchors, or politicians or environmental issues (at both ends Tyler Mundhenk, Kathryn Wighton (although some politicians are natu- of the debate) as though their artistic Art & Production Staff ral-born narcissists, driven to seek the success renders them wise arbiters of CREATIVE DIRECTOR Mary Ellen Niatas powers of public office), and less fre- the truth. What complicates matters ART DIRECTOR Pat Fopma DIRECTOR, JOURNAL MANUFACTURING quently physicians (perhaps because is their delirious fans, who revere and Michael Wendt the practice of medicine is not done mimic whatever their idols say (and PRODUCTION MANAGER Donna Pituras in front of spectators) or scientists their fashion or their tattoos), which Publishing Staff (because research, no matter how further intensifies the grandiosity and Sharon Finch PUBLISHER momentous, rarely procures the glam- megalomania of acquired narcissism. DIRECTOR eBUSINESS DEVELOPMENT Alison Paton our or public adulation of the enter- Celebrity triggers mindless idolatry, SENIOR DIRECTOR OF SALES Tim LaPella tainment industry). The ardent fans of fueling the narcissism of individuals CONFERENCE MARKETING MANAGER those “celebs” shower them with such who are blessed (or cursed?) with run- Kathleen Wenzler intense attention and adulation that away personal success. Neuroscientists Editor-in-Chief Emeritus it malignantly transforms previously should conduct research into how the James Randolph Hillard, MD “normal” individuals into narcissists brain is neurobiologically altered by Frontline Medical Communications who start believing they are indeed fame, but there are many more urgent SVP, FINANCE Steven Resnick “very special” and superior to the rest questions that demand their attention. VP, OPERATIONS Jim Chicca of us mortals (especially as their earn- It would be important to know if it is VP, SALES Mike Guire VP, SOCIETY PARTNERS Mark Branca ing power balloons into the millions reversible or enduring, even as fame VP, EDITOR IN CHIEF Mary Jo Dales after growing up with humble social inevitably dims. VP, EDITORIAL DIRECTOR, CLINICAL CONTENT Karen Clemments or economic roots). The pursuit of wealth and fame is VP, DIGITAL CONTENT & STRATEGY Social media has become a catalyst widely prevalent and can be healthy if Amy Pfeiffer for acquired narcissism, with millions it is not all-consuming. But if achieved PRESIDENT, CUSTOM SOLUTIONS JoAnn Wahl VP, CUSTOM SOLUTIONS Wendy Raupers of followers on Twitter, Facebook, or beyond the aspirer’s wildest dreams, VP, MARKETING & CUSTOMER ADVOCACY YouTube. Cable TV also caters to poli- he/she may reach an inflection point Jim McDonough VP, HUMAN RESOURCES & FACILITY ticians, some of whom morph into conducive to a pathologic degree OPERATIONS Carolyn Caccavelli narcissists, intoxicated with their new- of acquired narcissism. That’s what DATA MANAGEMENT DIRECTOR Mike Fritz found eminence and stature among the French refer to as “les risques du CIRCULATION DIRECTOR Jared Sonners CORPORATE DIRECTOR, RESEARCH their partisan followers, and become métier” (ie, occupational hazard). I & COMMUNICATIONS Lori Raskin genuinely convinced that they have recall reading about celebrities who DIRECTOR, CUSTOM PROGRAMS Patrick Finnegan supreme power or influence over the became enraged when a policeman In affiliation with Global Academy for masses. They get carried away with “dared” to stop their car for some Medical Education, LLC their own exaggerated self-importance driving violation, confronting the offi- PRESIDENT David J. Small, MBA as oracles of the “truth,” regardless cer with “Do you know who I am?” of how extreme their views may be. That question may be a clinical bio- Celebrity, politics, social media, and marker of acquired narcissism. 7 Century Drive, Suite 302 cable TV have converged into a com- Interestingly, several years ago, Parsippany, NJ 07054 Tel: (973) 206-3434 bustible mix, a crucible for acquired when the American Psychiatry Fax: (973) 206-9378 www.frontlinemedcom.com narcissism. Association last revised the DSM— Subscription Inquiries: An interesting feature of acquired sometimes referred to as the “bible” [email protected] narcissism is “collective narcissism,” of psychiatric nosology—it came close in which celebrities coalesce to con- to dropping NPD from its listed dis- solidate their imagined superhuman orders, but then reverted and kept Published through an educational partnership with attributes that go beyond the technical it as one of the 275 diagnostic cat- skills of their professions such as act- egories included in DSM-5.3 Had the ing, singing, sports, or politics. Thus, NPD diagnosis been discarded, one continued on page 41 Current Psychiatry 8 August 2019 From the Editor continued from page 8 wonders if the mythical god of narcis- References 1. Livesley WJ, Jang KL, Jackson DN, et al. Genetic sism would have suffered a transcen- and environmental contributions to dimensions of dental “narcissistic injury”… personality disorder. Am J Psychiatry. 1993;150(12): 1826-1831 2. Malmquist CP. Homicide: a psychiatric perspective. Washington, DC: American Psychiatric Publishing, Inc.; 2006:181-182. 3. Diagnostic and statistical manual of mental disorders, Henry A. Nasrallah, MD 5th ed. Washington, DC: American Psychiatric Editor-in-Chief Association; 2013..