Introduction
Narcissism has become a common word in our culture. However, it is a loaded term and sometimes a misunderstood one. Although it is familiar to hear someone say, “He’s a narcissist” or “She’s narcissistic,” the history and implications of this term are often lost. The terminology can be traced back to ancient Greece, originating with the myth of Narcissus. Today, the language of narcissism has been largely subsumed in psychological and therapeutic concepts. The most notable case is in how the Diagnostic and Statistical Manual of Mental Disorders (DSM) describes and defines narcissism. While some psychologists say that narcissism is a personality trait present in everyone on a spectrum of severity“1The New Science on Narcissism.” PsychologyToday. Dec. 4, 2020. https://www.psychologytoday.com/us/blog/the-author-speaks/202012/the-new-science-narcissism. This article will focus more specifically on what the DSM has labeled “narcissistic personality disorder” or NPD. This psychiatric label is reserved for those who exhibit abnormally high levels of narcissistic tendencies according to the description and criteria in the DSM.
Therapeutic Description of NPD
To get a good idea of how NPD is understood, consider the following definition and criteria for NPD from the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is “psychiatry’s Bible” used for categorizing and defining mental illnesses. It defines NPD as: “A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following [criteria].”2 Diagnostic and Statistical Manual of Mental Disorders, 5th ed., Washington, DC: American Psychiatric Association, 2013, 669-670. Following this definition, the DSM then lists nine criteria which either focus on (1) an excessive regard and esteem of oneself or (2) a lack of regard and disinterest in others.3The nine criteria for NPD are “1) Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements). 2) Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. 3) Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions). 4) Requires excessive admiration. 5) Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations). 6) Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends). 7) Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others. 8) Is often envious of others or believes that others are envious of him or her. 9) Shows arrogant, haughty behaviors or attitudes.” Diagnostic and Statistical Manual of Mental Disorders, 669-670.
So, what do we know thus far? Some psychologists consider narcissism a normal personality trait that everyone exhibits to one degree or another, but an abnormally high level of this trait is the basic ingredient for NPD. With this grounding the discussion, let’s consider how to think about NPD from a biblical framework.
Theological Response: The Heart of the Issue
Does the Bible say anything about narcissistic personality disorder? Not in those terms, but when considering the nine criteria of NPD, at the center of this description lies one word, pride. Although NPD does identify a problem, it fails to understand this problem according to God’s wisdom which He has revealed in Scripture (Psalm 19:7). This section identifies two primary ways NPD departs from a biblical worldview in how it describes the concept of narcissism.
First, a psychological view on NPD does not employ the biblical language of pride. Beyond being a helpful and accurate one-word synthesis of this concept, pride also demands moral responsibility and accountability of the individual. If someone has a pride issue, that person has a sin issue. Trying to describe narcissism apart from the concept of sin is ultimately unbiblical and unhelpful because it gives the impression that someone suffers from a disorder that cripples his or her ability to obey God’s commands. This leaves the individual with the illusion of being unaccountable before God. However, Scripture repeatedly warns that every person will stand before the Lord on the day of judgment and receive just commendation for how he lived his life (2 Corinthians 5:10; Revelation 20:12). As biblical counselors, we must remember that the person sitting with us in the counseling room has an eternal soul and is morally culpable before a holy God.
The second major way NPD departs from a biblical description of the problem is in how it defines the heart of the issue. This is key because the way you see the problem will determine the direction you take in seeking a solution. If NPD is at root a “personality disorder” as the DSM claims, the solution will aim at attempts to make the person more socially fit and acceptable in the eyes of man. If “narcissism” is at root a pride issue as God’s Word describes, the root issue is sin, both original sin because we are in Adam (Genesis 3:6-7; Romans 5:12), but also the individual’s personal sin (see James 4:6). This distinction is critical because when one correctly identifies the root issue, one can also offer the correct solution.
Theological Response: A Little Nebuchadnezzar
Recognizing “narcissism” as an outworking of the sin of pride enables the counselor to understand the nature of the problem from a biblical framework. The proud man has built, in the imagination of his heart, an impregnable kingdom with himself sitting on the throne. Like King Nebuchadnezzar (Daniel 4:28-30), he takes delight in all that he has and all that he is. However, he fails to understand that nothing in life has come to him apart from the hand of God, and he arrogantly ascribes any greatness or success to himself. When Nebuchadnezzar was puffed up in his pride, God humbled him by taking his kingdom from him, driving him away from society, and making him dwell with the animals (Daniel 4:31-32). Let the words of King Nebuchadnezzar, after being humbled before God, ring out as a sober warning to the proud man: “Now I, Nebuchadnezzar, praise and extol and honor the King of Heaven, for all his works are right and his ways are just; and those who walk in pride he is able to humble” (Daniel 4:37, emphasis mine).
Plan of Counseling
Although every case in counseling is different, there is a general trajectory to pursue when counseling a deeply prideful person. The first step in counseling “the narcissist” is the same as any other case: gather data. During this step, be specific and careful not to ask vague questions like “What do you do when things don’t go your way?”. A deeply prideful person is typically unwilling to admit or reveal any issues, so ask for examples and specific details from real-life situations.
The second step is to go directly to the Gospel. Biblical counselors must remember that it is impossible to change a prideful heart—and no amount of skill or techniques will either. Only the Holy Spirit can take a prideful heart and replace it with a heart capable and willing to walk in love toward God and others (Ezekiel 36:26-27; Philippians 2:3-5; Galatians 5:16; 1 John 4:7). Therefore, point the counselee to the true solution of the Gospel, even if he refuses to listen.
The third step in this plan of counseling is to clearly establish the goal of counseling and to give hope. The prideful man needs to hear that the goal of counseling has nothing to do with him and everything to do with living in a manner that will bring glory to the Father (1 Corinthians 10:31; 2 Corinthians 5:9). Further, he needs the hope that God has provided through Scripture, which contains everything he needs to live a righteous life after the manner of Christ (2 Peter 1:3). The concept of diagnosis of narcissistic personality disorder must not serve as a license to disobey Christ. Instead, we must see pride as a sin issue which highlights the necessity of Christ’s atonement. In His life, Christ modeled humility for us (Philippians 2:4-9), and in His death, He defeated sin, making it possible for us to follow in His footsteps in the power of the Spirit (1 John 4:10, 19).
Indications of Biblical Change
As counseling progresses, there are at least four marks that biblical change is taking place. First, can the counselee get on board with the goal of biblical counseling—biblical change for the glory of God? If the counselee commits to the goal of bringing glory to the Father, this may be a significant indication of heart change taking place. Second, can the counselee articulate what Christ-like humility looks like according to Philippians 2:4-11? Although intellectual understanding does not equal a changed heart, it is nevertheless hopeful progress if the counselee demonstrates a true understanding of Christ’s own humility. Third, has the counselee repented of his sin? Repentance must involve forsaking sin and pursuing the Lord. God’s solution to sin—the Gospel of Jesus Christ—always requires sinful man to relinquish his pursuit of sin and turn to Christ instead. Lastly, has the counselee committed to obeying the law of Christ? The apostle John summarizes this law as believing in Christ and loving the saints (1 John 3:23). The proud man is humbled when he acknowledges that there is a King sitting on the throne, but it is Christ, not himself. This is demonstrated practically when he is committed to obeying the law of Christ instead of serving his own law.
Conclusion
Narcissistic personality disorder is correct in seeing that a prideful person’s personality is disordered; however, it fails to adequately recognize that at the root of this problem is pride. Further, even cases of therapeutic intervention that are deemed successful ultimately fail to help the narcissist in light of eternity because only the Holy Spirit can change a prideful heart. Because of this, the measure of success in biblical counseling must not be teaching the narcissist to be nicer or to act in a socially acceptable manner. The goal in counseling is to warn the proud man of the end of his path, to present Christ as his only hope in life and death, and to plead with him to humble himself under the mighty hand of God (1 Peter 5:6).
