Up Close With Dr. E

Understanding Narcissitic Personality Disorder


Take a deep breath, for you are about to plunge into the murky depths of a complex psychiatric condition known as Narcissistic Personality Disorder, or NPD. Use this map to help you navigate today’s topic:

1. Seven key questions.

2. How Burt destroyed his family.

3. Conclusion — a case of “Emotional Blindness”.

Question #1: What does the word, “narcissistic” mean? The word comes from Greek mythology, where a handsome young man named Narcissus, fell in love with his own reflection in a pool of water. A narcissist is someone who believes they are superior and special.

Question #2: What is NPD? Think of personality as the concrete foundation of a house, upon which all other structures — walls, roof — will be built. If the foundation was correctly poured, then the house will be solid and stable.

By the age of seven, your core personality — how you view yourself and others — is in place. If your foundation was poured correctly, then you can build healthy relationships. One skill needed for building relationships is the ability to “walk in the shoes of others.” This skill is called empathy.

NPD is the lack of empathy, combined with these deviant beliefs: “I am more special than you; I must always have my way; No one should ever have more of anything than me.” (Beck, A.T., 2007).

Question #3: Is NPD common? Yes. It occurs mostly in men.

Question #4: What causes NPD? Using the model of personality as a foundation poured in childhood, any event which disrupted the mother/child bond — maternal illness, separation, death, or child abuse/neglect — would be a risk factor for causing NPD.

Question #5: Is it true that NPD men often lead lives which are dangerous and destructive to their wives and children? Yes. You are about to get re-acquainted with Burt Maslam, a man who has an undiagnosed NPD.

Question #6: Is it true that Adolph Hitler and Sadam Hussein are believed to be NPD men? Yes. But it is also true that NPD men can become highly successful.

Question #7: Are there “red flags” which reveal a destructive NPD man? Yes. In his book, Dr. Yudofsky identified the following “fatal flaws”: The NPD man says to his wife, “I’m fine, you’re the problem, so you need to change, not me.” Other red flags include threats or use of physical harm and violating the law.

Let’s meet today’s cast of characters. Burt and Cindy Maslam married for 12 years, have twin daughters, Amber and Carrie. Cindy’s father, a wealthy man who owned many car dealerships, has died and Burt now runs his businesses. Suffering from the loss of her father and realizing that Burt was a wolf in sheep’s clothing, Cindy became severely depressed.

When Burt began to leave home for weeks at a time, Cindy hired a private detective who discovered that not only had Burt been unfaithful, he had stolen all her money. With professional help, Cindy learned how Burt’s mind operated.

1. Burt believes he is special. Cindy described him as “A peacock, strutting about showing off his expensive cars, houses and clothes. Look at his underwear. What kind of man would monogram his boxer shorts?” Burt saw it differently: “I work hard to give my family the best of everything.”

2. Relationships are tools. Listen how the twins described their father: Amber — “My sister and I began gymnastics at age three. We loved it. But when we turned nine, Daddy said, “gymnastics is for losers, it’s golf, tennis and swimming that counts.” Daddy stopped us from taking gymnastics so he could parade us in front of his golfing buddies.”

3. Burt led a secret life. Cindy explained, “These photos are pictures of Burt’s harem — over 20 girls.”

4. Above the law. Burt explained his illegal activities: “Show me a millionaire and I’ll show you a crook. Yes, I grab what I can, I lie, take risks, cross the line. But who do I hurt?” Cindy’s take on Burt’s law-breaking is heartbreaking: “Burt stole the twin’s college money, my inheritance, and all the money from dad’s businesses.

5. Abuse of power. Burt will destroy anyone who tarnishes his image. Cindy reported, “When I told Burt we were leaving him, he exploded: ‘I’ll destroy you; I’ll sue for custody of the twins!’

Conclusion: Research on NPD has raised this question: Is NPD a form of “emotional blindness,” where men like Burt are unable to read social cues, or see how their behavior hurts others? What do you think?


1. “Fatal Flaws”, Yudofsky, 2005.

2. “Cognitive Therapy of Personality Disorders, Beck, 2007.


Dr. Richard Elghammer contributes his column each week to the Journal Review.


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