Secession, National Sovereignty, and Territorial Integrity

I. Introduction

On February 17, 2008, Kosovo became a new state by seceding from Serbia. It was the second time in less than a decade that Kosovo declared its independence.

Pundits warned against this precedent-setting event and foresaw a disintegration of sovereign states from Belgium to Macedonia, whose restive western part is populated by Albanians. In 2001, Macedonia faced the prospect of a civil war. It capitulated and signed the Ohrid Framework Agreement.

Yet, the truth is that there is nothing new about Kosovo’s independence. Macedonians need not worry, it would seem. While, under international law, Albanians in its western parts can claim to be insurgents (as they have done in 2001 and, possibly, twice before), they cannot aspire to be a National Liberation Movement and, if they secede, they are very unlikely to be recognized.

To start with, there are considerable and substantive differences between Kosovo’s KLA and its counterpart, Macedonia’s NLA. Yugoslavia regarded the Kosovo Liberation Army (KLA or UCK, in its Albanian acronym) as a terrorist organization. Not so the rest of the world. It was widely held to be a national liberation movement, or, at the very least, a group of insurgents.

Between 1996-9, the KLA maintained a hierarchical operational structure that wielded control and authority over the Albanians in large swathes of Kosovo. Consequently, it acquired some standing as an international subject under international law.

Thus, what started off as a series of internal skirmishes and clashes in 1993-5 was upgraded in 1999 into an international conflict, with both parties entitled to all the rights and obligations of ius in bello (the law of war).

I. Insurgents in International Law

Traditionally, the international community has been reluctant to treat civil strife the same way it does international armed conflict. No one thinks that encouraging an endless succession of tribal or ethnic secessions is a good idea. In their home territories, insurgents are initially invariably labeled as and treated by the “lawful” government as criminals or terrorists.

Paradoxically, though, the longer and more all-pervasive the conflict and the tighter the control of the rebels on people residing in the territories in which the insurgents habitually operate, the better their chances to acquire some international recognition and standing. Thus, international law actually eggs on rebels to prolong and escalate conflicts rather than resolve them peacefully.

By definition, insurgents are temporary, transient, or provisional international subjects. As Antonio Cassese puts it (in his tome, “International Law”, published by Oxford University Press in 2001):

“…(I)nsurgents are quelled by the government, and disappear; or they seize power, and install themselves in the place of the government; or they secede and join another State, or become a new international subject.”

In other words, being an intermediate phenomenon, rebels can never claim sovereign rights over territory. Sovereign states can contract with insurrectionary parties and demand that they afford protection and succor to foreigners within the territories affected by their activities. However, this is not a symmetrical relationship. The rebellious party cannot make any reciprocal demands on states. Still, once entered into, agreements can be enforced, using all lawful sanctions

Third party states are allowed to provide assistance – even of a military nature – to governments, but not to insurgents (with the exception of humanitarian aid). Not so when it comes to national liberation movements.

II. National Liberation Movements in International Law

According to the First Geneva Protocol of 1977 and subsequent conventions, what is the difference between a group of “freedom fighters” and a national liberation movement?

A National Liberation Movement represents a collective – nation, or people – in its fight to liberate itself from foreign or colonial domination or from an inequitable (for example: racist) regime. National Liberation Movements maintain an organizational structure although they may or may not be in control of a territory (many operate in exile) but they must aspire to gain domination of the land and the oppressed population thereon. They uphold the principle of self-determination and are, thus, instantaneously deemed to be internationally legitimate.

Though less important from the point of view of international law, the instant recognition by other States that follows the establishment of a National Liberation Movement has enormous practical consequences: States are allowed to extend help, including economic and military assistance (short of armed troops) and are “duty-bound to refrain from assisting a State denying self-determination to a people or a group entitled to it” (Cassesse).

As opposed to mere insurgents, National Liberation Movements can claim and assume the right to self-determination; the rights and obligations of ius in bello (the legal principles pertaining to the conduct of hostilities); the rights and obligations pertaining to treaty making; diplomatic immunity.

Yet, even National Liberation Movements are not allowed to act as sovereigns. For instance, they cannot dispose of land or natural resources within the disputed territory. In this case, though, the “lawful” government or colonial power are similarly barred from such dispositions.

III. Internal Armed Conflict in International Law

Rebels and insurgents are not lawful combatants (or belligerents). Rather, they are held to be simple criminals by their own State and by the majority of other States. They do not enjoy the status of prisoner of war when captured. Ironically, only the lawful government can upgrade the status of the insurrectionists from bandits to lawful combatants (“recognition of belligerency”).

How the government chooses to fight rebels and insurgents is, therefore, not regulated. As long as it refrains from intentionally harming civilians, it can do very much as it pleases.

But international law is in flux and, increasingly, civil strife is being “internationalized” and treated as a run-of-the-mill bilateral or even multilateral armed conflict. The doctrine of “human rights intervention” on behalf of an oppressed people has gained traction. Hence Operation Allied Force in Kosovo in 1999.

Moreover, if a civil war expands and engulfs third party States and if the insurgents are well-organized, both as an armed force and as a civilian administration of the territory being fought over, it is today commonly accepted that the conflict should be regarded and treated as international.

As the Second Geneva Protocol of 1977 makes crystal clear, mere uprisings or riots (such as in Macedonia, 2001) are still not covered by the international rules of war, except for the general principles related to non-combatants and their protection (for instance, through Article 3 of the four 1949 Geneva Conventions) and customary law proscribing the use of chemical weapons, land and anti-personnel mines, booby traps, and such.

Both parties – the State and the insurrectionary group – are bound by these few rules. If they violate them, they may be committing war crimes and crimes against humanity.

IV. Secession in International Law

The new state of Kosovo has been immediately recognized by the USA, Germany, and other major European powers. The Canadian Supreme Court made clear in its ruling in the Quebec case in 1998 that the status of statehood is not conditioned upon such recognition, but that (p. 289):

“…(T)he viability of a would-be state in the international community depends, as a practical matter, upon recognition by other states.”

The constitutional law of some federal states provides for a mechanism of orderly secession. The constitutions of both the late USSR and SFRY (Yugoslavia, 1974) incorporated such provisions. In other cases – the USA, Canada, and the United Kingdom come to mind – the supreme echelons of the judicial system had to step in and rule regarding the right to secession, its procedures, and mechanisms.

Again, facts on the ground determine international legitimacy. As early as 1877, in the wake of the bloodiest secessionist war of all time, the American Civil War (1861-5), the Supreme Court of the USA wrote (in William vs. Bruffy):

“The validity of (the secessionists’) acts, both against the parent State and its citizens and subjects, depends entirely upon its ultimate success. If it fail (sic) to establish itself permanently, all such acts perish with it. If it succeed (sic), and become recognized, its acts from the commencement of its existence are upheld as those of an independent nation.”

In “The Creation of States in International Law” (Clarendon Press, 2nd ed., 2006), James Crawford suggests that there is no internationally recognized right to secede and that secession is a “legally neutral act”. Not so. As Aleksandar Pavkovic observes in his book (with contributions by Peter Radan), “Creating New States – Theory and Practice of Secession” (Ashgate, 2007), the universal legal right to self-determination encompasses the universal legal right to secede.

The Albanians in Kosovo are a “people” according to the Decisions of the Badinter Commission. But, though, they occupy a well-defined and demarcated territory, their land is within the borders of an existing State. In this strict sense, their unilateral secession does set a precedent: it goes against the territorial definition of a people as embedded in the United Nations Charter and subsequent Conventions.

Still, the general drift of international law (for instance, as interpreted by Canada’s Supreme Court) is to allow that a State can be composed of several “peoples” and that its cultural-ethnic constituents have a right to self-determination. This seems to uphold the 19th century concept of a homogenous nation-state over the French model (of a civil State of all its citizens, regardless of ethnicity or religious creed).

Pavkovic contends that, according to principle 5 of the United Nations’ General Assembly’s Declaration on Principles of International Law Concerning Friendly Relations and Co-operation Among States in Accordance With the Charter of the United Nations, the right to territorial integrity overrides the right to self-determination.

Thus, if a State is made up of several “peoples”, its right to maintain itself intact and to avoid being dismembered or impaired is paramount and prevails over the right of its constituent peoples to secede. But, the right to territorial integrity is limited to States:

“(C)onducting themselves in compliance with the principle of equal rights and self-determination of peoples … and thus possessed of a government representing the whole people belonging to the territory without distinction as to race, creed, or colour.”

The words “as to race, creed, or colour” in the text supra have been replaced with the words “of any kind” (in the 1995 Declaration on the Occasion of the Fiftieth Anniversary of the United Nations).

Yugoslavia under Milosevic failed this test in its treatment of the Albanian minority within its borders. They were relegated to second-class citizenship, derided, blatantly and discriminated against in every turn. Thus, according to principle 5, the Kosovars had a clear right to unilaterally secede.

As early as 1972, an International Commission of Jurists wrote in a report titled “The Events in East Pakistan, 1971”:

“(T)his principle (of territorial integrity) is subject to the requirement that the government does comply with the principle of equal rights and does represent the whole people without distinction. If one of the constituent peoples of a state is denied equal rights and is discriminated against … their full right of self-determination will revive.” (p. 46)

A quarter of a century later, Canada’s Supreme Court concurred (Quebec, 1998):

“(T)he international law right to self-determination only generates, at best, a right to external self-determination in situations … where a definable group is denied meaningful access to government to pursue their political, economic, social, and cultural development.”

In his seminal tome, “Self-Determination of Peoples: A Legal Appraisal” (Cambridge University Press, 19950, Antonio Cassese neatly sums up this exception to the right to territorial integrity enjoyed by States:

“(W)hen the central authorities of a sovereign State persistently refuse to grant participatory rights to a religious or racial group, grossly and systematically trample upon their fundamental rights, and deny the possibility of reaching a peaceful settlement within the framework of the State structure … A racial or religious group may secede … once it is clear that all attempts to achieve internal self-determination have failed or are destined to fail.” (p. 119-120)

V. The Cases of Kosovo and Western Macedonia

In former Yugoslavia (SFRY), Kosovo was an autonomous province within the Socialist Republic of Serbia. The Albanians in Yugoslavia were not recognized as a “people” (narod), merely as a “nationality” (narodnost).

In January 1990, the Constitutional Court of SFRY ruled illegal a unilateral secession from the Yugoslav Federation. The right to secede belonged to “the peoples of Yugoslavia and their socialist republics (and autonomous provinces)”. Kosovo was an autonomous province, but the Albanians were not a “people”. Indeed, in a later decision, dealing specifically with Kosovo’s first declaration of independence, the Constitutional Court spoke:

“(O)nly peoples of Yugoslavia had the right of self-determination.”

Western Macedonia has always been an integral part of the Republic of Macedonia within the SFRY. It had never acquired the status of an autonomous province, let alone a Republic. Albanians in Macedonia are a minority. They are well-represented in government and law enforcement and have equal access to education and the institutions of the State. Their rights are guaranteed by multiple constitutional, legal, and international instruments. They have no leg to stand on if they choose to unilaterally secede from Macedonia (for instance, in order to join Kosovo).

The Albanians of western Macedonia may, however, successfully secede from Macedonia within the framework of a realignment of borders between Serbia, Kosovo, Albania, Macedonia, and, perhaps, Greece, and Bulgaria. While Macedonia is extremely unlikely to welcome such a move, it may be coerced into acquiescence by the international community. Macedonia was strong-armed into the Ohrid Framework Agreement in 2001. There is no guarantee that this scenario will not repeat itself.

Macedonia should urgently adopt steps to change the demographic composition of its western territories. This is not without precedent. Israel has done the same in its northern territory (the Galilee), Poland with its Ukrainian borderlands, Germany in its east, the USA in its “wild” West.

Macedonia should offer economic incentives to anyone willing to relocate from the rest of its territory to its west: jobs, free land and agricultural inputs, subsidized credits, housing, infrastructure, and educational opportunities. The government should move many of its ministries, agencies, and facilities from Skopje to western Macedonia.


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And Then There Were Too Many

The Conclave of Exclaves

Burning the Oil – Development and Ethnic Tensions

The Cost of Unification – German Lessons for Korea

White Farms, Black Farmers

The Self-Appointed Altruists

The Semi-failed State

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On the Incest Taboo

“…An experience with an adult may seem merely a curious and pointless game, or it may be a hideous trauma leaving lifelong psychic scars. In many cases the reaction of parents and society determines the child’s interpretation of the event. What would have been a trivial and soon-forgotten act becomes traumatic if the mother cries, the father rages, and the police interrogate the child.”

(Encyclopedia Britannica, 2004 Edition)

In contemporary thought, incest is invariably associated with child abuse and its horrific, long-lasting, and often irreversible consequences. Incest is not such a clear-cut matter as it has been made out to be over millennia of taboo. Many participants claim to have enjoyed the act and its physical and emotional consequences. It is often the result of seduction. In some cases, two consenting and fully informed adults are involved.

Many types of relationships, which are defined as incestuous, are between genetically unrelated parties (a stepfather and a daughter), or between fictive kin or between classificatory kin (that belong to the same matriline or patriline). In certain societies (the Native American or the Chinese) it is sufficient to carry the same family name (=to belong to the same clan) and marriage is forbidden.

Some incest prohibitions relate to sexual acts – others to marriage. In some societies, incest is mandatory or prohibited, according to the social class (Bali, Papua New Guinea, Polynesian and Melanesian islands). In others, the Royal House started a tradition of incestuous marriages, which was later imitated by lower classes (Ancient Egypt, Hawaii, Pre-Columbian Mixtec). Some societies are more tolerant of consensual incest than others (Japan, India until the 1930’s, Australia).

The list is long and it serves to demonstrate the diversity of attitudes towards this most universal of taboos. Generally put, we can say that a prohibition to have sex with or marry a related person should be classified as an incest prohibition.

Perhaps the strongest feature of incest has been hitherto downplayed: that it is, essentially, an autoerotic act.

Having sex with a first-degree blood relative is like having sex with oneself. It is a Narcissistic act and like all acts Narcissistic, it involves the objectification of the partner. The incestuous Narcissist over-values and then devalues his sexual partner. He is devoid of empathy (cannot see the other’s point of view or put himself in her shoes).

For an in depth treatment of narcissism and its psychosexual dimension, see these (click on the links):

Narcissistic and Psychopathic Parents and Their Children

Narcissistic Personality Disorder (NPD) and Pathological Narcissism FAQs

Personality disorders FAQs

Paradoxically, it is the reaction of society that transforms incest into such a disruptive phenomenon. The condemnation, the horror, the revulsion and the attendant social sanctions interfere with the internal processes and dynamics of the incestuous family. It is from society that the child learns that something is horribly wrong, that he should feel guilty, and that the offending parent is a defective role model.

As a direct result, the formation of the child’s Superego is stunted and it remains infantile, ideal, sadistic, perfectionist, demanding and punishing. The child’s Ego, on the other hand, is likely to be replaced by a False Ego version, whose job it is to suffer the social consequences of the hideous act.

To sum up: society’s reactions in the case of incest are pathogenic and are most likely to produce a Narcissistic or a Borderline patient. Dysempathic, exploitative, emotionally labile, immature, and in eternal search for Narcissistic Supply – the child becomes a replica of his incestuous and socially-castigated parent.

If so, why did human societies develop such pathogenic responses? In other words, why is incest considered a taboo in all known human collectives and cultures? Why are incestuous liaisons treated so harshly and punitively?

Freud said that incest provokes horror because it touches upon our forbidden, ambivalent emotions towards members of our close family. This ambivalence covers both aggression towards other members (forbidden and punishable) and (sexual) attraction to them (doubly forbidden and punishable).

Edward Westermarck proffered an opposite view that the domestic proximity of the members of the family breeds sexual repulsion (the epigenetic rule known as the Westermarck effect) to counter naturally occurring genetic sexual attraction. The incest taboo simply reflects emotional and biological realities within the family rather than aiming to restrain the inbred instincts of its members, claimed Westermarck.

Though much-disputed by geneticists, some scholars maintain that the incest taboo may have been originally designed to prevent the degeneration of the genetic stock of the clan or tribe through intra-family breeding (closed endogamy). But, even if true, this no longer applies. In today’s world incest rarely results in pregnancy and the transmission of genetic material. Sex today is about recreation as much as procreation.

Good contraceptives should, therefore, encourage incestuous, couples. In many other species inbreeding or straightforward incest are the norm. Finally, in most countries, incest prohibitions apply also to non-genetically-related people.

It seems, therefore, that the incest taboo was and is aimed at one thing in particular: to preserve the family unit and its proper functioning.

Incest is more than a mere manifestation of a given personality disorder or a paraphilia (incest is considered by many to be a subtype of pedophilia). It harks back to the very nature of the family. It is closely entangled with its functions and with its contribution to the development of the individual within it.

The family is an efficient venue for the transmission of accumulated property as well as information – both horizontally (among family members) and vertically (down the generations). The process of socialization largely relies on these familial mechanisms, making the family the most important agent of socialization by far.

The family is a mechanism for the allocation of genetic and material wealth. Worldly goods are passed on from one generation to the next through succession, inheritance and residence. Genetic material is handed down through the sexual act. It is the mandate of the family to increase both by accumulating property and by marrying outside the family (exogamy).

Clearly, incest prevents both. It preserves a limited genetic pool and makes an increase of material possessions through intermarriage all but impossible.

The family’s roles are not merely materialistic, though.

One of the main businesses of the family is to teach to its members self control, self regulation and healthy adaptation. Family members share space and resources and siblings share the mother’s emotions and attention. Similarly, the family educates its young members to master their drives and to postpone the self-gratification which attaches to acting upon them.

The incest taboo conditions children to control their erotic drive by abstaining from ingratiating themselves with members of the opposite sex within the same family. There could be little question that incest constitutes a lack of control and impedes the proper separation of impulse (or stimulus) from action.

Additionally, incest probably interferes with the defensive aspects of the family’s existence. It is through the family that aggression is legitimately channeled, expressed and externalized. By imposing discipline and hierarchy on its members, the family is transformed into a cohesive and efficient war machine. It absorbs economic resources, social status and members of other families. It forms alliances and fights other clans over scarce goods, tangible and intangible.

This efficacy is undermined by incest. It is virtually impossible to maintain discipline and hierarchy in an incestuous family where some members assume sexual roles not normally theirs. Sex is an expression of power – emotional and physical. The members of the family involved in incest surrender power and assume it out of the regular flow patterns that have made the family the formidable apparatus that it is.

These new power politics weaken the family, both internally and externally. Internally, emotive reactions (such as the jealousy of other family members) and clashing authorities and responsibilities are likely to undo the delicate unit. Externally, the family is vulnerable to ostracism and more official forms of intervention and dismantling.

Finally, the family is an identity endowment mechanism. It bestows identity upon its members. Internally, the members of the family derive meaning from their position in the family tree and its “organization chart” (which conform to societal expectations and norms). Externally, through exogamy, by incorporating “strangers”, the family absorbs other identities and thus enhances social solidarity (Claude Levy-Strauss) at the expense of the solidarity of the nuclear, original family.

Exogamy, as often noted, allows for the creation of extended alliances. The “identity creep” of the family is in total opposition to incest. The latter increases the solidarity and cohesiveness of the incestuous family – but at the expense of its ability to digest and absorb other identities of other family units. Incest, in other words, adversely affects social cohesion and solidarity.

Lastly, as aforementioned, incest interferes with well-established and rigid patterns of inheritance and property allocation. Such disruption is likely to have led in primitive societies to disputes and conflicts – including armed clashes and deaths. To prevent such recurrent and costly bloodshed was one of the intentions of the incest taboo.

The more primitive the society, the more strict and elaborate the set of incest prohibitions and the fiercer the reactions of society to violations. It appears that the less violent the dispute settlement methods and mechanisms in a given culture – the more lenient the attitude to incest.

The incest taboo is, therefore, a cultural trait. Protective of the efficient mechanism of the family, society sought to minimize disruption to its activities and to the clear flows of authority, responsibilities, material wealth and information horizontally and vertically.

Incest threatened to unravel this magnificent creation – the family. Alarmed by the possible consequences (internal and external feuds, a rise in the level of aggression and violence) – society introduced the taboo. It came replete with physical and emotional sanctions: stigmatization, revulsion and horror, imprisonment, the demolition of the errant and socially mutant family cell.

As long as societies revolve around the relegation of power, its sharing, its acquisition and dispensation – there will always exist an incest taboo. But in a different societal and cultural setting, it is conceivable not to have such a taboo. We can easily imagine a society where incest is extolled, taught, and practiced – and out-breeding is regarded with horror and revulsion.

The incestuous marriages among members of the royal households of Europe were intended to preserve the familial property and expand the clan’s territory. They were normative, not aberrant. Marrying an outsider was considered abhorrent.

An incestuous society – where incest is the norm – is conceivable even today.

Two out of many possible scenarios:

1. “The Lot Scenario”

A plague or some other natural disaster decimate the population of planet Earth. People remain alive only in isolated clusters, co-habiting only with their closest kin. Surely incestuous procreation is preferable to virtuous extermination. Incest becomes normative.

Incest is as entrenched a taboo as cannibalism. Yet, it is better to eat the flesh of your dead football team mates than perish high up on the Andes (a harrowing tale of survival recounted in the book and eponymous film, “Alive”).

2. The Egyptian Scenario

Resources become so scarce that family units scramble to keep them exclusively within the clan.

Exogamy – marrying outside the clan – amounts to a unilateral transfer of scarce resources to outsiders and strangers. Incest becomes an economic imperative.

An incestuous society would be either utopian or dystopian, depending on the reader’s point of view – but that it is possible is doubtless.


Also Read

Sex or Gender

The Narcissist’s Family

The Roots of Pedophilia

The Pathology of Love

The Natural Roots of Sexuality

Parenting – The Irrational Vocation

Ethical Relativism and Absolute Taboos

Narcissistic Personality Disorder (NPD) at a Glance

What is Pathological Narcissism?

Click HERE to learn more about Narcissism

Pathological narcissism is a life-long pattern of traits and behaviours which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition.

As distinct from healthy narcissism which we all possess, pathological narcissism is maladaptive, rigid, persisting, and causes significant distress, and functional impairment.

Pathological narcissism was first described in detail by Freud in his essay “On Narcissism” (1915). Other major contributors to the study of narcissism are: Melanie Klein, Karen Horney, Franz Kohut, Otto Kernberg, Theodore Millon, Elsa Roningstam, Gunderson, and Robert Hare.

What is Narcissistic Personality Disorder (NPD)?

The Narcissistic Personality Disorder (NPD) (formerly known as megalomania or, colloquially, as egotism) is a form of pathological narcissism. It is a Cluster B (dramatic, emotional, or erratic) personality disorder. Other Cluster B personality disorders are the Borderline Personality Disorder (BPD), the Antisocial Personality Disorder (APD), and the Histrionic Personality Disorder (HPD). The Narcissistic Personality Disorder (NPD) first appeared as a mental health diagnosis in the DSM III-TR (Diagnostic and Statistical Manual) in 1980.

Diagnostic Criteria

The ICD-10, the International Classification of Diseases, published by the World Health Organisation in Geneva [1992] regards the Narcissistic Personality Disorder (NPD) as “a personality disorder that fits none of the specific rubrics”. It relegates it to the category “Other Specific Personality Disorders” together with the eccentric, “haltlose”, immature, passive-aggressive, and psychoneurotic personality disorders and types.

The American Psychiatric Association, based in Washington D.C., USA, publishes the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Text Revision (DSM-IV-TR) [2000] where it provides the diagnostic criteria for the Narcissistic Personality Disorder (301.81, p. 717).

The DSM-IV-TR defines Narcissistic Personality Disorder (NPD) as “an all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts”, such as family life and work.

The DSM specifies nine diagnostic criteria. Five (or more) of these criteria must be met for a diagnosis of Narcissistic Personality Disorder (NPD) to be rendered.

[In the text below, I have proposed modifications to the language of these criteria to incorporate current knowledge about this disorder. My modifications appear in bold italics.]

[My amendments do not constitute a part of the text of the DSM-IV-TR, nor is the American Psychiatric Association (APA) associated with them in any way.]

[Click here to download a bibliography of the studies and research regarding the Narcissistic Personality Disorder (NPD) on which I based my proposed revisions.]

Proposed Amended Criteria for the Narcissistic Personality Disorder

  • Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognised as superior without commensurate achievements);
  • Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
  • Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
  • Requires excessive admiration, adulation, attention and affirmation – or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);
  • Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favourable priority treatment;
  • Is “interpersonally exploitative”, i.e., uses others to achieve his or her own ends;
  • Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
  • Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;
  • Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.

Prevalence and Age and Gender Features

According to the DSM IV-TR, between 2% and 16% of the population in clinical settings (between 0.5-1% of the general population) are diagnosed with Narcissistic Personality Disorder (NPD). Most narcissists (50-75%, according to the DSM-IV-TR) are men.

We must carefully distinguish between the narcissistic traits of adolescents – narcissism is an integral part of their healthy personal development – and the full-fledge disorder. Adolescence is about self-definition, differentiation, separation from one’s parents, and individuation. These inevitably involve narcissistic assertiveness which is not to be conflated or confused with Narcissistic Personality Disorder (NPD).

“The lifetime prevalence rate of NPD is approximately 0.5-1 percent; however, the estimated prevalence in clinical settings is approximately 2-16 percent. Almost 75 percent of individuals diagnosed with NPD are male (APA, DSM IV-TR 2000).”

From the Abstract of Psychotherapeutic Assessment and Treatment of Narcissistic Personality Disorder By Robert C. Schwartz,Ph.D., DAPA and Shannon D. Smith, Ph.D., DAPA (American Psychotherapy Association, Article #3004 Annals July/August 2002)

Narcissistic Personality Disorder (NPD) is exacerbated by the onset of aging and the physical, mental, and occupational restrictions it imposes.

In certain situations, such as under constant public scrutiny and exposure, a transient and reactive form of the Narcissistic Personality Disorder (NPD) has been observed by Robert Milman and labelled “Acquired Situational Narcissism”.

There is only scant research regarding the Narcissistic Personality Disorder (NPD), but studies have not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to it.

Comorbidity and Differential Diagnoses

Narcissistic Personality Disorder (NPD) is often diagnosed with other mental health disorders (“co-morbidity”), such as mood disorders, eating disorders, and substance-related disorders. Patients with Narcissistic Personality Disorder (NPD) are frequently abusive and prone to impulsive and reckless behaviours (“dual diagnosis”).Narcissistic Personality Disorder (NPD) is commonly diagnosed with other personality disorders, such as the Histrionic, Borderline, Paranoid, and Antisocial Personality Disorders.

The personal style of those suffering from the Narcissistic Personality Disorder (NPD) should be distinguished from the personal styles of patients with other Cluster B Personality Disorders. The narcissist is grandiose, the histrionic coquettish, the antisocial (psychopath) callous, and the borderline needy.

As opposed to patients with the Borderline Personality Disorder, the self-image of the narcissist is stable, he or she are less impulsive and less self-defeating or self-destructive and less concerned with abandonment issues (not as clinging).

Contrary to the histrionic patient, the narcissist is achievements-orientated and proud of his or her possessions and accomplishments. Narcissists also rarely display their emotions as histrionics do and they hold the sensitivities and needs of others in contempt.

According to the DSM-IV-TR, both narcissists and psychopaths are “tough-minded, glib, superficial, exploitative, and unempathic”. But narcissists are less impulsive, less aggressive, and less deceitful. Psychopaths rarely seek narcissistic supply. As opposed to psychopaths, few narcissists are criminals.

Patients suffering from the range of obsessive-compulsive disorders are committed to perfection and believe that only they are capable of attaining it. But, as opposed to narcissists, they are self-critical and far more aware of their own deficiencies, flaws, and shortcomings.

Clinical Features of the Narcissistic Personality Disorder

The onset of pathological narcissism is in infancy, childhood and early adolescence. It is commonly attributed to childhood abuse and trauma inflicted by parents, authority figures, or even peers. Pathological narcissism is a defense mechanism intended to deflect hurt and trauma from the victim’s “True Self” into a “False Self” which is omnipotent, invulnerable, and omniscient. The narcissist uses the False Self to regulate his or her labile sense of self-worth by extracting from his environment narcissistic supply (any form of attention, both positive and negative).There is a whole range of narcissistic reactions, styles, and personalities – from the mild, reactive and transient to the permanent personality disorder.

Patients with Narcissistic Personality Disorder (NPD) feel injured, humiliated and empty when criticized. They often react with disdain (devaluation), rage, and defiance to any slight, real or imagined. To avoid such situations, some patients with Narcissistic Personality Disorder (NPD) socially withdraw and feign false modesty and humility to mask their underlying grandiosity. Dysthymic and depressive disorders are common reactions to isolation and feelings of shame and inadequacy.

The interpersonal relationships of patients with Narcissistic Personality Disorder (NPD) are typically impaired due to their lack of empathy, disregard for others, exploitativeness, sense of entitlement, and constant need for attention (narcissistic supply).

Though often ambitious and capable, inability to tolerate setbacks, disagreement, and criticism make it difficult for patients with Narcissistic Personality Disorder (NPD) to work in a team or to maintain long-term professional achievements. The narcissist’s fantastic grandiosity, frequently coupled with a hypomanic mood, is typically incommensurate with his or her real accomplishments (the “grandiosity gap”).

Patients with Narcissistic Personality Disorder (NPD) are either “cerebral” (derive their Narcissistic Supply from their intelligence or academic achievements) or “somatic” (derive their Narcissistic Supply from their physique, exercise, physical or sexual prowess and romantic or physical “conquests”).

Patients with Narcissistic Personality Disorder (NPD) are either “classic” (meet five of the nine diagnostic criteria included in the DSM), or they are “compensatory” (their narcissism compensates for deep-set feelings of inferiority and lack of self-worth).

Some narcissists are covert, or inverted narcissists. As codependents, they derive their narcissistic supply from their relationships with classic narcissists.

Treatment and Prognosis

The common treatment for patients with Narcissistic Personality Disorder (NPD) is talk therapy (mainly psychodynamic psychotherapy or cognitive-behavioural treatment modalities). Talk therapy is used to modify the narcissist’s antisocial, interpersonally exploitative, and dysfunctional behaviors, often with some success. Medication is prescribed to control and ameliorate attendant conditions such as mood disorders or obsessive-compulsive disorders.

The prognosis for an adult suffering from the Narcissistic Personality Disorder (NPD) is poor, though his adaptation to life and to others can improve with treatment.

Bibliography

  • Goldman, Howard H., Review of General Psychiatry, fourth edition, 1995. Prentice-Hall International, London.
  • Gelder, Michael, Gath, Dennis, Mayou, Richard, Cowen, Philip (eds.), Oxford Textbook of Psychiatry, third edition, 1996, reprinted 2000. Oxford University Press, Oxford.
  • Vaknin, Sam, Malignant Self Love – Narcissism Revisited, eighth revised impression, 1999-2006. Narcissus Publications, Prague and Skopje.

Read More:

The Narcissist – A Case Study

Who is a Narcissist?

Narcissistic Personality Disorder – Diagnostic Criteria

Narcissistic Personality Disorder – Prevalence and Comorbidity

Narcissistic Personality Disorder – Clinical Features

Narcissist vs. Psychopath

The Inverted Narcissist