Grandiose and Vulnerable Narcissism: Associations with Alcohol Use, Alcohol Problems and Problem Recognition PMC

The complete sonnets and poems of Shakespeare recanted the Greek story of Narcissus, who fell in love with his own reflection, while ignoring a chance for a real relationship. Psychoanalysts as early as Sigmund Freud described a developmental stage in children in which their egos lack concern for anyone else’s needs, which he referred to as primary narcissism. According to Freud, individuals severely traumatized during this developmental period never leave the ego-driven state, even as adults, leaving them incapable of caring for others. Karen Horney theorized that the narcissist’s self-esteem is never strong because it is never based on genuine accomplishments. Heinz Kohut wrote about individuals whose needs were not met in childhood and escape from bad inner negativity into idealized objects outside of themselves. Otto Kernberg believed narcissism depends upon the affirmation of others and the acquisition of desirable objects. In sum, narcissists have been characterized as developmentally stunted in their concern for the well-being of other people in their lives. Grandiose narcissism appears to be a positive predictor of alcohol misuse.

Narcissists and alcoholics can become highly defensive if you question their actions or point out their unhealthy behaviors. Both may sulk, become non-communicative, or lash out at you for pointing out the faults and dysfunction they desperately seek to deny or hide. Narcissism involves difficulty accepting fault for one’s mistakes. People with narcissism usually have incorrect perceptions about their life and what people think of them. They may believe that only their narcissism and alcohol abuse version of reality is accurate and are often unconcerned with the damage that their arrogant and manipulative behavior does to other people. When narcissism is combined with the cravings and impulses of alcoholism, this behavior only worsens. AA and other 12-step programs can also provide a valuable added layer of peer support for people quitting or cutting back on their drinking. Exact outcome data is hard to determine due to the anonymity of the programs.

How are Narcissistic Personality Disorder and Substance Abuse Connected?

In some cases, they want to show off by drinking as much as possible. When drunk, they have an easier time seeing themselves as smarter and more powerful than everyone else. But that also means that both conditions can be treated through similar approaches. After going through a detox program, an alcoholic narcissist can receive talk therapy. Denial manifests for alcoholics in many ways, such as saying they can stop drinking anytime they want, lying about when they drank, or refusing to acknowledge that their drinking has costs. Narcissism is partially a self learned-behavior and can also partially be a genetic trait.

These plans incorporate various therapies and aftercare programs that address both alcohol abuse and a mental health condition. Maintaining relationships and careers can be challenging when someone has either narcissism or alcoholism, because the two conditions often cause arrogance, manipulation, belligerent behavior, and lack of empathy. When somebody is dealing with both narcissism and alcoholism, it can become difficult to even convince them that they have an issue. Exhibiting narcissistic behavior when drunk doesn’t necessarily mean a person has narcissistic personality disorder. Alcohol can influence narcissistic attitudes, including arrogance, self-importance, and an inflated self-esteem or feelings of superiority that aren’t otherwise present when sober.

Interpersonal analysis of grandiose and vulnerable narcissism

In addition, the defense mechanisms of narcissists and the power of addiction for alcoholics make it difficult for either to sustain long-term authentic relationships. Lacking empathy and feeling superior, narcissists feel they have the right to do whatever they want, despite the rules or costs to others. By the same token, alcoholics become highly resourceful at procuring drink. In a sense, addictions such as alcohol are narcissistic acts — putting a drug above all else, no matter what the cost to others. Researchers have suggested that due to the link between personality disorders and AUD, it’s important for healthcare providers to screen for both disorders when one is present. Treating NPD can be challenging and may require long-term therapy, but working alongside healthcare professionals can help people reduce symptoms. With treatment, those with NPD can live healthy lives with positive relationships. According to a 2018 article, due to the common co-occurrence of personality disorders and AUD, it is important that substance misuse services screen for personality disorders and vice versa. When people have a mental health condition that co-occurs with a substance misuse disorder, such as AUD, doctors may refer to this as dual diagnosis.

In these cases, the right type of professional assistance is vital for both intervention and treatment. As a result of self-centeredness and denial, alcoholics can behave in manipulative ways. Like narcissists, they may threaten harm to themselves or others if they don’t get what they want. They may pretend to be nice for a short while to get other people to leave them alone.

Reach out to one of our addiction specialists for alcohol treatment help today. Individuals with narcissistic personalities tend to seek admiration from others while ensuring to maintain an emotional distance from them. If someone with NPD begins to feel threatened or as if someone is getting too close to them, their narcissistic behavior will intensify. Oftentimes, this behavior either irritates or offends the individual, creating the space the person of concern desired. Additionally, a narcissist will often blame others for their anger, allowing them to disregard reality and preserve their elevated sense of self. Narcissists who are also alcohol addicts tend to be even more emotionally reactive. They will likely become extremely angry if you bring up their drinking. Helping a narcissist with an addiction is a greater challenge because of their unwillingness to admit any problems with themselves or their behavior.

Little is known about narcissism and drinking in college students, a population that is at high risk for alcohol-related problems. No studies examined associations between narcissism and alcohol problems, problem expectancies, problem evaluation and readiness to change. Narcissism is a personality trait that in some people can be part of narcissistic personality disorder and alcoholism is a substance use disorder, but the two are linked and share similar qualities. Narcissists can become alcoholics and alcoholics can be particularly narcissistic when drunk. People who display addictive behaviors in addition to narcissistic traits may require a substance abuse treatment program that is equipped to treat co-occurring disorders. Individuals suffering from both conditions must receive treatment for their NPD and addiction simultaneously.

Verywell Health’s content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Although Sober House people with AUD may relapse or have treatment setbacks, they can recover from the disorder. Learning healthy coping strategies can help them remain sober when they face triggers.

Narcissists are almost always unwilling to admit that they need to change, or that their actions have caused harm. Ria Health offers several FDA-approved medications for alcohol use disorder. When combined with counseling, this approach is proven highly effective. Excessive drinking has numerous impacts on your body and mind, ranging from mild to severe.