Jean Twenge, author of "The Narcissism Epidemic," said one of the great myths about narcissism is that it's a mask for insecurity.
"Deep down inside, narcissists think they're awesome," Twenge said. Efforts to mitigate narcissism by boosting a person's ego is "like suggesting to a fat person that they eat more doughnuts," she said.
Other psychologists disagree.
Wendy Behary, director of the Cognitive Therapy Center of New Jersey and author of "Disarming the Narcissist," released last year, said that underneath narcissists' bravado is a high degree of insecurity often stemming from parents who pressured them to excel at everything.
"The message they get is that just being who you are isn't good enough; you have to achieve, you have to be extraordinary," said Behary, who specializes in treating narcissists. "They feel they have to show off to prove themselves."
Chicago psychoanalyst Frank Summers, who specializes in character disorders and agrees that narcissism is rooted in a feeling of defectiveness, said you can identify narcissists by how they handle disappointment.
Summers said he had one patient who would fly into a rage whenever he was criticized at work. Another patient would crumble into self-doubt when the man she was seeing didn't call her when he was supposed to. Narcissists are, in a way, addicted to affirmation from others, Summers said, so they suffer inordinately when they don't get it.
"To feel disappointed is normal, but to have your sense of self deflated? That's not normal," Summers said.
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