Narcissistic Personality Disorder (NPD) has been described as “the last station on the train to hell” (Payson, The Wizard of Oz and Other Narcissists: Coping with the One-Way Relationship in Work, Love, and Family, (2002)). Some would go further: It is hell. Anyone who has dealt with a relative or friend afflicted with Narcissistic Personality Disorder (NPD) is aware of the damage done by these malignant people upon those around them. Very rarely do they have insight or any willingness to change.

The features of narcissistic Personality Disorder, according to the most recent
Diagnostic and Statistical Manual of Mental Disorders (DSM 5) include the following:

Significant impairments in personality functioning manifest by:
Impairments in self functioning (a or b):

Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem.

Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high in order to see oneself as exceptional, or too low based on a sense of entitlement; often unaware of own motivations.

AND

Impairments in interpersonal functioning (a or b):

Empathy: Impaired ability to recognize or identify with the

feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others.

Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others‟ experiences and predominance of a need for personal gain

Pathological personality traits in the following domain: 1. Antagonism, characterized by:

a. Grandiosity: Feelings of entitlement, either overt or covert;

self-centeredness; firmly holding to the belief that one is better than others; condescending toward others.

b. Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking.

C. The impairments in personality functioning and the individual‟s personality trait expression are relatively stable across time and consistent across situations.

The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual‟s developmental stage or socio-cultural environment.

The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).

The central defect of narcissism is not putting oneself first, though this is a prominent feature of the disorder. The central defect is rather the wholesale embrace of a lie–the embrace and promotion of the “false self”, a distorted image which is protected ruthlessly. It should be noted, that the lie is first and foremost directed to oneself. The embrace of the lie is also at the root of the ill promulgated by narcissists.

A view from the inside can be found in this “letter from a narcissist’s true self” (available from an online forum at Psych Forums):

You can never get through to my true self because the lies I tell are nearly impenetrable. I have lied so often and for so long that I myself have come to believe my own lies. I am a walking lie. That is the truth.

Psychiatrist and famed author M. Scott Peck shocked many when he wrote, “I now know that Satan is real. I have met it.” He dealt with a subset of people with NPD in his book People of the Lie, in which he proposed that a certain subcategory of them be termed “evil”. He has related that one can define “evil” as “live” spelled backwards–“evil” is the opposite of “live”, or it is that which kills life.

Among the many tales in this book he recounted how a set of parents gave the grieving brother of a suicide victim a grisly present one Christmas–the very gun used in the suicide. They either didn’t care how this would affect him, or wanted to send him a message. For the most part in Peck’s encounters, evil people are of the banal sort, harming only those around them. They may appear normal, often even poised and highly successful. They go to church (and are often leaders there). But they can devastate the lives of those who are around them.

Whereas “God is love”, the malignant narcissist offers only a pretense of love. As Peck says:

Those who are evil are masters of disguise; they are not apt to wittingly disclose their true colors–either to others or to themselves. (p 104)
Because they are such experts at disguise, it is seldom possible to pinpoint the maliciousness of the evil. The disguise is usually impenetrable. (p 76).
Naturally, since it is designed to hide its opposite, the pretense chosen by the evil is most commonly the pretense of love. (p 106)

Victims of narcissism aren’t the only ones to taste Hell. The pain comes around to the person with NPD as well. Narcissism is a double edged sword. The lie is first directed at oneself. It is rare to hear a narcissist complain, but I did run across this post, from a self aware person with NPD:

Here is a comment from the other side. I have narcissistic personality disorder and have lost just about everything important. My adult children have distanced themselves. My wife has filed for divorce. Yes, I have screwed up just about everything. Fortunately, only 1% of the population has NPD. I wish I didn’t.
(From “Lament of a Lonely Narcissist” in a Psychology Today blog by Randi Kruger).

Among the pictures of Hell that have been proffered, one that intrigues me comes from Tim Keller:
We know how selfishness and self-absorption leads to piercing bitterness, nauseating envy, paralyzing anxiety, paranoid thoughts, and the mental denials and distortions that accompany them. Now ask the question” “What if when we die we don’t end, but spiritually our life extends on into eternity?”
Hell, then, is the trajectory of a soul, living a self-absorbed, self-centered life, going on and on forever. (Keller, Reason to Believe p.79)

May God free us from such a trajectory. Let us shun evil and embrace life. As Jesus taught: “I came that they might have life, and have it more abundantly”.