Impaired self-mentalizing may underlie emotional dysregulation in vulnerable narcissists

Pathological narcissism has long been linked to emotional dysregulation. Now, a study published in Personality and Mental Health reveals that individuals with narcissistic vulnerability struggle to regulate their emotions, and this difficulty may stem from an impaired ability to understand their own thoughts and feelings. These findings highlight self-mentalizing as an important factor in managing the emotional challenges faced by vulnerable narcissists.

Pathological narcissism is generally understood through two primary expressions: grandiose narcissism and vulnerable narcissism. Grandiose narcissism is often associated with an inflated sense of self-importance, entitlement, and a need to dominate or exploit others to maintain a sense of superiority. Individuals with grandiose narcissism often appear confident, charismatic, and self-assured, but underneath this facade, they rely on external validation to reinforce their exaggerated self-image.

In contrast, vulnerable narcissism is marked by hypersensitivity to criticism, feelings of inadequacy, and a tendency toward shame and insecurity. Rather than projecting confidence, individuals with vulnerable narcissism may appear anxious, depressed, or socially withdrawn. They still crave validation and recognition but are often overwhelmed by feelings of worthlessness and self-doubt.

The motivation behind the study was to investigate how these two forms of pathological narcissism are related to emotional regulation difficulties, particularly in clinical populations. Emotion regulation refers to how individuals manage and respond to their emotional experiences. Previous research has shown that individuals with pathological narcissism struggle to regulate their emotions. However, much of this research has been conducted on general populations, leaving a gap in understanding how these dynamics play out in clinical settings, where individuals are already experiencing emotional dysregulation.

The researchers also wanted to explore the role of mentalizing—specifically, the ability to reflect on one’s own emotions (self-mentalizing) and others’ emotions (other-mentalizing)—in the relationship between pathological narcissism and emotional regulation. By focusing on mentalizing, the study aimed to uncover whether difficulties in reflecting on one’s own emotional states might explain why individuals with narcissistic traits struggle to manage their emotions.

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To explore these relationships, the researchers conducted a study on 183 patients who were being treated at an outpatient center specializing in emotional regulation disorders. These patients had various psychological conditions, including borderline personality disorder, attention deficit hyperactivity disorder, and emotion regulation difficulties, all of which could impact their narcissistic traits and mentalizing abilities.

The participants completed several standardized assessments to measure different aspects of their psychological functioning. Pathological narcissism was evaluated using two scales: the Pathological Narcissism Inventory (which measures both grandiosity and vulnerability) and the Narcissistic Personality Inventory (which focuses on grandiosity). Emotional regulation was assessed with the Difficulties in Emotion Regulation Scale, which examines different aspects of emotional control, such as awareness and acceptance of emotions, impulse control, and access to emotion regulation strategies.

Mentalizing abilities were measured using the Mentalization Scale, which assesses the ability to understand one’s own emotions (self-mentalizing), others’ emotions (other-mentalizing), and the motivation to engage in mentalizing. The researchers also considered the patients’ symptoms of borderline personality disorder and attention deficit hyperactivity disorder, given their known impact on both narcissism and emotional regulation.

The researchers found that narcissistic vulnerability was strongly associated with difficulties in emotional regulation. Patients who scored high in narcissistic vulnerability were more likely to struggle with managing their emotions, particularly in situations where they felt their self-esteem was threatened. These individuals had difficulty controlling their impulses, accepting their emotions, and accessing effective strategies for regulating their emotional states.

Interestingly, the researchers found that this relationship between narcissistic vulnerability and emotional regulation was mediated by self-mentalizing. In other words, individuals who were less able to reflect on and understand their own mental states tended to have more difficulties regulating their emotions. This suggests that improving self-mentalizing abilities could potentially help individuals with narcissistic vulnerability manage their emotions more effectively.

On the other hand, narcissistic grandiosity showed a more nuanced relationship with emotional regulation and mentalizing. While grandiosity was initially associated with both difficulties in emotional regulation and self-mentalizing, these associations disappeared when the researchers accounted for other psychological conditions, such as borderline personality disorder and attention deficit hyperactivity disorder. This suggests that these comorbid conditions may play a larger role in the emotional difficulties of individuals with grandiose narcissism than grandiosity itself.

However, the researchers did find that narcissistic grandiosity was positively associated with other-mentalizing, meaning that individuals who displayed grandiose narcissism were better at understanding the mental states of others. This is a surprising finding, as grandiosity is often associated with a lack of empathy. It may be that these individuals are more skilled at reading others’ emotions in a way that allows them to manipulate social situations for their own benefit.

It is important to note, however, that the cross-sectional design of the study, which involves collecting data at a single point in time, limits the researchers’ ability to determine whether one variable directly causes changes in another. Without tracking participants over time, it’s unclear whether difficulties in mentalizing lead to emotional dysregulation in individuals with pathological narcissism or if the emotional regulation challenges contribute to impairments in mentalizing. Longitudinal studies would be needed to establish a clearer cause-and-effect relationship between these factors.

The study, “Association between pathological narcissism and emotion regulation: The role of self-mentalizing?” was authored by Martin Blay, Margaux Bouteloup, Miguel Duarte, Roland Hasler, Eleonore Pham, Rosetta Nicastro, Marlène Jan, Martin Debbané, and Nader Perroud.