Delusions, Pathological Narcissism, and Psychosis

Excessive self-importance is a hallmark of narcissistic personality disorder, a form of pathological narcissism. All parts of a narcissist's character are characterized by grandiose imaginations, which are actually megalomaniac delusions of grandeur. The narcissist's sense of entitlement to preferential treatment, often out of proportion to his actual achievements, stems from these things. The chasm that separates the narcissist's actual self from his idealized version of himself—his false self—is called the grandiosity gap.

When there is a shortage of narcissistic supply, the narcissist will act out in various ways in order to compensate. During therapy or after suffering narcissistic damage during a life crisis, narcissists frequently have psychotic micro-episodes. Are narcissists capable of "going over the edge"? Is psychosis a possible outcome for narcissists?

First, a few terms:

The DSM-IV-TR states that severe psychosis is "limited to delusions or prominent hallucinations, with the hallucinations occurring in the absence of insight into their pathological nature" as its most stringent description.

And what exactly are hallucinations and delusions?

A misunderstanding is "a false belief based on an incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary.".

A lucid dream is a "sensory perception that has the compelling sense of reality of a true perception but that occurs without external stimulation of the relevant sensory organ.".

To be fair, narcissists don't always succeed when tested with reality. It is true that narcissists tend to believe in the fictions they create for themselves. Although they rarely have hallucinations, disorganized speech, or disorganized or catatonic behavior, they are technically delusional since they do not know the pathological nature or origin of their self-delusions. It would appear that narcissists are insane in the most literal sense of the term.

Yet that is not the case. "Losing it" is markedly different from benign (albeit deeply ingrained) self-deception or even malicious con-artistry.

It is incorrect to classify pathological narcissism as a psychosis due to:

True and untrue, real and make-believe, imagined and existing, and right and wrong are concepts that narcissists typically have little trouble distinguishing. The narcissist willfully lives out one version of events, whether it's an inflated storyline, a make-believe world, or a "what-if" hypothetical life. His personal myth has a strong emotional impact on him. Never losing sight of the truth that it is all fabrication, the narcissist feels better as fiction than as fact.
Every step of the way, the narcissist is completely self-aware, purposeful, and in command of his own abilities. He moves in a deliberate and purposeful manner. When it comes to his manipulative strategies, his delusions serve him well. This explains his remarkable capacity to adopt many personas, alter his behavior, and change his beliefs at the drop of a hat.
Even when confronted with overwhelming facts and widespread resistance, narcissistic beliefs rarely last. Typically, the narcissist will attempt to persuade those around him to see things from his perspective. In an effort to bolster his illusory false self, he tries to influence those closest to him. On the other hand, he swiftly adjusts his profile if he doesn't succeed. The individual "plays it by ear." . His False Self is an ever-evolving piece of art, created in real time through a series of iterative processes built around sophisticated feedback loops.
The narcissistic personality may be inflexible, yet its contents are always changing. In order to meet the demands of their "suppliers," narcissists are always inventing new ways to consume narcissistic supply. Just like the great performers that they are, they connect with their "audience" and provide them with what they desire and anticipate. In terms of extracting and consuming human reactions, they are efficient tools.

The endless pursuit of perfection leaves narcissists bereft of allegiance, principles, doctrines, beliefs, connections, and convictions. Negative or positive, their addiction to human attention is their sole limitation.

On the other hand, psychotics can't shake their convictions about who they are and where they fit in the universe. When confronted with facts that could disprove their illusions, they choose to disregard them. Under the influence of their troubled thoughts, individuals eventually start acting dysfunctionally.

Because their unstable sense of self-worth is so dependent on other factors, narcissists can't afford to isolate themselves. Because of this reliance, they are extremely sensitive and watchful, ready to respond to any new information. They are always active, in an ego-syntactic way, reorganizing their self-delusions to integrate new facts.

For this reason, a "diminished capacity" (insanity) defense based on narcissistic personality disorder is inadequate. In order to keep their disordered, borderline-psychotic mentality in check, narcissists constantly seek out, absorb, and revel in reality. No narcissist, no matter how insane, lacks morality, purpose, or control over their own body or behavior.