Narcissistic Vulnerability and Addiction

• Published date: 01 October 2016
• Author: Sofia Triliva,Paraskevi Karakoula
• Date: 01 October 2016
• DOI: 10.1177/0022042616659761
• Subject Matter: Articles

Journal of Drug Issues

2016, Vol. 46(4) 396 –410

© The Author(s) 2016

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DOI: 10.1177/0022042616659761

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Article

Narcissistic Vulnerability and

Addiction: Findings From a

Study of People in Treatment

Paraskevi Karakoula1 and Sofia Triliva1

Abstract

The main body of research on addiction and pathological narcissism has focused on the study

of their co-occurrence by applying Diagnostic and Statistical Manual of Mental Disorders (DSM)

definitions for these clinical phenomena or by assessing trait narcissism in substance-dependent

populations. Clinically informed comprehensive conceptualizations of narcissism which focus

on its phenomenological range from vulnerability to grandiosity have not been applied in

studying the specific narcissistic disturbances that underlie the relationship between these

comorbid conditions. Aiming to examine this relationship, this study compared the presence

of pathological narcissism, and more specifically narcissistic grandiosity and vulnerability, in

substance-dependent individuals in treatment with individuals from the general population.

Comparisons indicate that substance-dependent individuals experience significant narcissistic

disturbances more likely related to vulnerability than grandiosity. Shame, rage, and self-esteem

contingent upon external validation comprise the intrapsychic and interpersonal vulnerability.

Implications for the clinical conceptualization of pathological narcissism as well as for substance

dependence treatment interventions are discussed.

Keywords

pathological narcissism, substance dependence, vulnerability, grandiosity

Introduction

Personality factors and characteristics have been implicated in addiction, and the relationship

between addiction and pathological narcissism has been highlighted in clinical theory and prac-

tice. More specifically, substance abuse and dependence have been described or interpreted as

expressions of a need to experience grandiose self-states (Kernberg, 1975; Ronningstam, 2005),

as efforts to regulate self-esteem and affect (Ronningstam, 2005; Treece & Khantzian, 1986), as

efforts to manage narcissistic rage (Dodes, 1990) and recover from shame (Ulman & Paul, 2006;

Wurmser, 1974), and also as a restoration of narcissistic homeostasis following a narcissistic

injury or blow (McDougall, 1984, 1986; Wurmser, 1974). Substance use and abuse have, also,

been associated with feelings of emptiness and boredom that pertain to the narcissistic tendencies

of seeking artificial chemical stimulation (Kernberg, 2009). More importantly, addiction has

1University of Crete, Rethymnon, Greece

Corresponding Author:

Paraskevi Karakoula, Chrissippou 43A, 11631 Athens, Greece.

Email: evi_karakoula@yahoo.gr

659761JODXXX10.1177/0022042616659761Journal of Drug IssuesKarakoula and Triliva

research-article2016