Narcissistic Personality (NPD) and Historical Personality (HPD) are both personality disorders of Cluster B. These personality disorders are characterized by the following:
- Thinking and behavior patterns that look unstable or unpredictable
- Actions or thoughts that others consider dramatic
- Thinking and behavioral plans that look overly emotional for a particular situation
- The behaviors are persistent and rigid and lead to harm and anxiety
Some mental health experts consider HPD and NPD to be the most similar of the four personality disorders of Cluster B. Similarities between these conditions may include attention seeking behaviors, bullying that is often inappropriate, behavior that seems shallow or unfounded. for approval and admiration from others.
Some researchers have even suggested that HPD is an NPD event rather than a single condition, but Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines HPD as a separate diagnosis. However, both conditions or any combination of personality disorders can occur and this can sometimes complicate the diagnosis.
Some people believe that those with personality disorders will never change their behavior. It is true that these behavioral traits are often less directly responsive to treatment than symptoms of other mental health conditions, but treatment is still possible.
What is the difference between a personality disorder and a narcissistic personality disorder?
These two conditions may appear similar, but differ in different ways.
Estimates show that HPD only occurs in about 1.8% of people, while NPD is more common. Diagnostic criteria may vary and actual prevalence is unknown for some, but recent estimates suggest that approximately 5% of the general population could meet NPD diagnostic criteria. Among those diagnosed with NPD, between 50 and 75% are men. Research shows that HPD is more commonly diagnosed in women.
Ability to display sympathy
A key feature of NPD is the failure to show empathy for the feelings of others. Lack of empathy, however, is not a prime feature of historical personality. The behavior of people with HPD may seem shallow or selfish at times.
A study from 2018 shows that people with any cluster Personality disorder can have a difficult time identifying emotions – those of others as well as their own. The inability to clearly identify emotions can make it challenging to know when to offer compassion or support, which could seem like a lack of sympathy.
Different types of attentive behavior
Generosity, or feelings of superiority or excessive self-reliance, is a prime feature of narcissism. This trait is not an important feature of other personality disorders. People who have NPDs believe very much about themselves and their abilities and may, from this superiority, tend to separate from others in a group. People living with HPD, on the other hand, tend to want to belong and match.
This desire to participate and endorse marks another distinction between narcissistic and historical personality disorders. Both involve a deep need for attention, and people living in any situation can manipulate others to get that attention. People with NPD need more than just attention. They need admiration, praise and recognition.
People with HPD may be less concerned about the kind of attention they receive and allow them to see in a sensitive or even negative way, as long as their attention is focused. They are more likely to have a low sense of self-esteem and to seek approval from others to increase their self-esteem.
With HPD, trying to pay attention can seem overly emotional or dramatic. People living with this condition can easily get upset and move quickly between moods. This extreme sentiment, characteristic of historical personality, has less to do with narcissism. People with narcissism tend to have less emotion and tend to be more reserved and self-sufficient.
Why do these differences matter?
Narcissism and historical personality affect personal relationships and general well-being in various ways. Both issues are characterized by unstable or diminished personal relationships. People with HPD may struggle to be emotionally intimate with others, while those with NPD are more likely to cause significant emotional damage.
The words and actions of people with NPD are often bad, as they generally do not deal with the feelings of others. In relationships, people with narcissism may require a full focus on their own needs and feelings. A partner who tries to share emotions or find their own needs will usually face emotional rejection or complete withdrawal. The narcissistic person may accuse the partner of being selfish or not caring enough about them.
Narcissism can be difficult to do well in the workplace, as fear of shame or failure can lead people with NPD to quit their jobs when faced with criticism. They also tend to react with anger or contempt when faced with embarrassment or criticism. Persistent feelings of shame can lead to withdrawal or depression. Other issues related to narcissism are substance abuse and anorexia.
People with HPD can struggle in relationships for a variety of reasons. The desire for satisfaction and excitement can lead to boredom in long-term relationships and can often look for new partners. Historical personality is also characterized by a tendency to consider relationships more intimate than they actually are. Having to deal with the true nature of a relationship can lead to discomfort.
In relationships, people with HPD are often very dependent on partners and can act in manipulative ways to attract attention or comfort. However, people with HPD can and do show empathy and compassion for the needs and emotions of others. They may become depressed and empty when they lack attention or love and make suicidal gestures or threats to increase the attention or care they receive.
Because people living with HPD often struggle with boredom, they may struggle to keep the same job and change jobs or careers often. They may be more successful in jobs that are less common and involve different tasks.
Physical symptoms and conversion disorder often occur with HPD. People living with the condition may appear to have poor health or report a variety of health symptoms to get attention, but they may also actually experience health symptoms.
Existing research on both situations suggests that people with HPD are more likely to eventually receive help, either for depression or anxiety symptoms or when their behavior causes difficulties such as friendship or relationships. Behaviors related to historical personality are more likely to improve than those associated with narcissism.
Treatment for HPD and NPD
Personality disorders are diagnosed when patterns of behavior are rigid and persistent for a long time. Some people believe that those with personality disorders will never change their behavior. It is true that these behavioral traits are often less directly responsive to treatment than symptoms of other mental health conditions, but treatment is still possible.
For treatment to succeed, a person must be able to recognize harmful patterns of behavior and want to make changes. People with HPD and NPD often do not feel they need treatment and cannot seek treatment on their own. It can be especially difficult for people with narcissism to understand how their actions harm others, so that they see nothing wrong in their behavior.
Research on the treatment of narcissism is very limited, as people with narcissism rarely seek treatment. When they do, treatment can help them to understand how their behavior affects others. Skills training can teach you how to connect with people in positive ways and how to accept and deal with personal imperfections, failures and criticism from others. The root cause of NPD is often a deep sense of self-esteem and low self-esteem, so when treatment can address these concerns, certain narcissistic-related behaviors may improve.
Shape therapy is a specific approach that has shown promise in the treatment of narcissism. This approach helps people identify and deal with inappropriate patterns or patterns that affect their behavior. Through treatment, people may be able to heal these patterns and learn to meet their needs in healthier ways that do not cause harm.
Many approaches can benefit the treatment of historical personality. Therapy often focuses on helping people develop self-esteem and learning to respond to emotional needs in healthier ways.
Cognitive behavioral therapy can help people learn to trigger thoughts that lead them to desire attention and replace the behaviors that seek attention with other actions. Psychodynamic therapy can help people understand the reasons behind the interpersonal challenges they face, which can contribute to positive change. Family counseling can also help, as the involvement of loved ones in counseling can help people realize the impact their behavior has on others. Skills training and group therapy help people learn to relate to others who face similar challenges.
In some cases, counseling for couples can help people with personality disorders deal with relationship problems. But keep in mind that narcissism, in particular, often involves patterns of deception, manipulation and emotional abuse, and many therapists do not recommend counseling for abusive relationships. It is important to deal with and change long-term forms of manipulation and other harmful behaviors first. Good progress in individual therapy may indicate that counseling can help in the future.
Treatment usually deals with issues such as depression, anxiety or substance abuse. Some people may also have more than one personality disorder. If this is the case, a combination of treatment approaches can be very useful. If it is not possible to address all of the concerns that they present at the same time, the treatment generally aims to address the most serious or harmful issue first and then continue to help the individual work through other challenges.
I get help
The traits of any personality disorder can lead to serious emotional distress and affect your life, relationships, and the people around you. If you or a loved one has signs of a personality disorder, contact a qualified counselor today. Treatment is the best way to treat symptoms and learn new methods of treatment and behavior.
The stigma surrounding personality disorders can be discouraging. You may have heard that some therapists will not work with people living with a personality disorder, especially narcissistic personality disorder.
Contrary to what many people think, personality disorders are curative and there are specialist therapists who can provide support. If you want to make a difference in your life, start your search for a trained, compassionate therapist at GoodTherapy.
- American Psychiatric Society. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.
- Behary, W. T., & Dieckmann, E. (2013). Shape therapy for pathological narcissism: The art of adaptive repatriation. In J. S. Ogrodniczuk (Ed.), Understanding and curing pathological narcissism (pp. 285-300). Washington, DC, USA: American Psychological Society.
- Caligor, E., Levy, K. N., & Yeomans, F. E. (2015, April 30). Personality Disorder: Diagnostic and Clinical Challenges. American Journal of Psychiatry, 172(5). Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14060723?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&.
- Dieckmann, E., & Behary, W. (2015). Shape Therapy: An Approach to Treating Narcissistic Personality Disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26327479
- Ekselius, L. (2018). Personality disorder: A disease in disguise. Upsala Journal of Medical Sciences, 123(4). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327594
- Historical personality disorder. (2018, January 23). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9743-histrionic-personality-disorder
- Mayo Clinic staff. (2016, September 23). Personality disorders. Retrieved from https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463
- Mayo Clinic staff. (2017, November 18). Narcissistic personality disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662
- Ritzl, A., Csukly, G., Balázs, K., & erhgerházi, A. (2018, September 13). Deficits in facial recognition and alexithymia in borderline, narcissistic and historical personality disorders. Psychiatric Research, 270. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30248486
- Theatrical drama against personality disorder disorder. (2018, July 18). Newport Academy. Retrieved from https://www.newportacademy.com/resources/mental-health/histrionic-personality-disorder-inteenteen
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