With that said, there are challenges to delivering appropriate care for the dual diagnosis. For AUD to be diagnosed, a person must meet one of four possible criteria for alcohol misuse, three of seven possible criteria for alcohol dependence, and two of 12 possible criteria for AUD symptoms. Alcohol use disorder is a alcoholism treatment type of substance use disorder where a person cannot control or stop their alcohol use. NPD and AUD frequently co-exist and can increase the effects of each other. People with a pattern of narcissism often turn to alcohol to reinforce a false sense of grandiosity. People with alcohol use disorder, also known as alcoholism, can display patterns of narcissism, including self-absorption and an underlying craving for admiration.
Understanding the Nature of Alcoholic Narcissism
Individuals with a NPD feel they can only be understood by special people. These individuals have a lack of concern for the well-being of others or how others may be affected by their actions. When AUD and NPD occur together, it can increase a person’s hostility and aggression. This can make treatment more challenging than it would be to treat each issue separately. The number of criteria a person meets determines whether they have AUD, and if so, the severity of the condition.
Narcissism vs. narcissistic personality disorder
In order to receive a diagnosis of NPD, someone needs to display the above symptoms over are all alcoholics narcissists several years. A 2018 study found that people with personality disorders were more likely to have AUD at some point in their lives. According to the National Institute of Mental Health, 22.6% of people with a personality disorder also have a substance use disorder (SUD), which can include alcohol use.
Can Alcoholism Cause Heart Attack? Uncovering the Hidden Risks and Prevention Strategies
Avoid enabling the alcoholic narcissist’s destructive behaviors by refusing to make excuses for their actions. According to some of my clients who’ve had experience with alcoholic narcissists, they might tell a few select half-truths when drunk and even reveal something of their underlying insecurities. Furthermore, as alcohol reduces inhibitions, it may exacerbate other narcissistic behaviors, such as heightened self-absorption, denial, delusions of grandeur, and destructive tendencies. When drunk, a narcissist may use their charm to seduce individuals, pushing boundaries and engaging in risky behaviors to feed their need for attention and excitement. Another reason narcissists are at risk of becoming addicted to alcohol is that they believe they’re impervious to its negative effects.
What to know about narcissism and alcoholism
- According to a 2023 report from the Substance Abuse and Mental Health Services Administration (SAMHSA), two out of every three (66.5%) adults who ever had a mental health issue considered themselves to be recovering or in recovery.
- People with AUD may be unable to reduce or stop drinking despite experiencing the negative effects of alcohol or a desire to quit.
- Moderators such as positive or negative affect or reward sensitivity might affect the strength of the associations found in this study.
- At Step 2 the types of narcissism, vulnerable and grandiose, were simultaneously entered into the model.
- Third, this study differentially evaluated the relationship between grandiose and vulnerable narcissism and alcohol outcomes.
- A grandiose narcissist may drink to show off and gain admiration from their peers, while a vulnerable narcissist may use alcohol as a coping mechanism to overcome their insecurities.
Findings suggest that having higher scores of entitlement rage was directly positively related to more alcohol-related problems, but was negatively related to heavy-episodic drinking. How entitlement-rage may or may not be an externalizing symptom of a prospective internalizing trait remains unclear. Future investigations may wish to include some internalizing precursors to entitlement-rage, such as perfectionism, to further develop a model of how entitlement plays a role in alcohol-related problems. These mixed findings call for further research into entitlement and its correlates.
Why do Narcissists Drink Alcohol?
- Methods such as cognitive behavioral therapy, dialectical behavior therapy, and schema therapy can be helpful to address the similarities and differences between the two conditions.
- Their insecurity and low self-esteem might lead them to expect bad situations to occur.27 It is also possible that vulnerable narcissists expect problems to happen to them based on their previous experiences with alcohol problems.
- According to a 2019 study in Behavioral Medicine, 40.6% of NPD have substance use problems.
- Narcissistic personality disorder can be one of the more challenging mental health conditions to treat.
- Alcohol can influence narcissistic behaviors, such as arrogance, self-importance, and feelings of superiority that aren’t otherwise present when sober.
If alcohol misuse begins to impact your life, health, or safety, you might have AUD. Although alcohol misuse and AUD can cause someone to display narcissist-like behavior, this behavior might change when they’re sober or in recovery. Narcissists hate rejection and are liable to respond aggressively or use manipulation to make you change your mind.
Overlapping treatment options
A dry drunk has stopped drinking but hasn’t yet dealt with the issues that caused their alcohol dependence. They have yet to confront the shame, guilt, or past trauma that drew them to alcohol in the first place, so are at risk of relapsing. When intoxicated, they may use alcohol to dominate others, manipulate situations, or maintain a sense of superiority.
- NPD and AUD frequently co-exist and can increase the effects of each other.
- Participating in self-help groups such as 12-step programs provides a platform for individuals to share their experiences, gain strength, and attain sobriety.
- Recognizing these links traits may enable individuals to seek appropriate help in managing these conditions.
- They may refuse to acknowledge the impact of their actions on others, instead choosing to blame others for their problems.
- Alcohol addiction exacerbates these traits and further impairs their rational thinking and self-awareness, making them prone to aggressive behaviors.
- Karen Horney (1937) theorized that the narcissist’s self-esteem is never strong because it is never based on genuine accomplishments.
How can someone support a loved one who is struggling with both narcissism and alcoholism?
Alcohol can influence narcissistic behaviors, such as arrogance, self-importance, and feelings of superiority that aren’t otherwise present when sober. People can misuse alcohol without having AUD or being addicted to alcohol. They might infrequently have bouts of excessive drinking, for example, but find that it doesn’t affect their life and that it’s easy to cut back on alcohol (or to stop drinking entirely). Alcohol misuse refers to situations where you drink excessively or when you drink alcohol when it’s harmful – for example, when you’re pregnant or when you have a medical condition that makes alcohol consumption dangerous. Many people use the terms “alcohol use disorder” and “alcohol misuse” interchangeably, but they refer to two different things. The combination of a self-obsessed narcissist who never considers your feeling and an alcoholic who blames their need to drink on you can quickly destroy the strongest bond.
