自戀沒藥治 相處需謹慎大綱

Does this sound like anyone you know?

這些描述聽上去像不像你認識的某人？

- Highly competitive in virtually all aspects of his life, believing he (or she) possesses special qualities and abilities that others lack; portrays himself as a winner and all others as losers.

—— 在人生的方方面面都很爭強好勝，總覺得他（她）擁有什麼特別的能力和品質是別人沒有的；總表現得好像個贏家，其他人都是輸家。

- Displays a grandiose sense of self, violating social norms, throwing tantrums, even breaking laws with minimal consequences; generally behaves as if entitled to do whatever he wants regardless of how it affects others.

—— 表現出超強的自我意識，違背社會規範，脾氣暴躁，即使違犯法律也沒有嚴重後果，平時表現得好像自己有特權做任何事，不管對別人會有什麼影響。

- Shames or humiliates those who disagree with him, and goes on the attack when hurt or frustrated, often exploding with rage.

—— 羞辱那些有不同意見的人，如果自己感覺受傷害或是受到挫折，經常憤怒地爆發，攻擊對方。

- Arrogant, vain and haughty and exaggerates his accomplishments; bullies others to get his own way.

—— 傲慢、虛榮、自大，會誇大自己的成就，威嚇別人按自己說的做。

- Lies or distorts the truth for personal gain, blames others or makes excuses for his mistakes, ignores or rewrites facts that challenge his self-image, and won’t listen to arguments based on truth.

—— 爲了個人利益而撒謊或扭曲事實，責怪他人，或爲自己的錯誤找藉口，無視或改造威脅到自己形象的事實，拒絕聽建立在事實基礎上的辯論。

These are common characteristics of extreme narcissists as described by Joseph Burgo, a clinical psychologist, in his book “The Narcissist You Know.” While we now live in a culture that some would call narcissistic, with millions of people constantly taking selfies, spewing out tweets and posting everything they do on YouTube and Facebook, the extreme narcissists Dr. Burgo describes are a breed unto themselves. They may be highly successful in their chosen fields but extremely difficult to live with and work with.

這就是臨牀心理學家約瑟夫·伯戈(Joseph Burgo)在他的《你身邊的自戀者》(The Narcissist You Know)中稱爲極端自戀者的人表現出的一些普遍特徵。儘管有人把我們今天所處的文化稱爲自戀文化，成千上萬人不停地自拍，沒完沒了地發tweet，把自己做的一切都曬到YouTube和Facebook上去，然而伯戈描述的那種極端的自戀者完全是另一路人。他們在自己選擇的領域內可能極爲成功，但是也非常難以相處或合作。

Of course, nearly all of us possess one or more narcissistic trait without crossing the line of a diagnosable disorder. And it is certainly not narcissistic to have a strong sense of self-confidence based on one’s abilities.

當然，我們所有人都有一兩種自戀的特質，不過不會嚴重到被臨牀診斷爲心理失調的程度。對自己的能力感到強烈自信，這當然也不屬於自戀之列。

“Narcissism exists in many shades and degrees of severity along a continuum,” Dr. Burgo said, and for well-known people he cites as extreme narcissists, he resists making an ad hoc diagnosis of narcissistic personality disorder, as defined by the American Psychiatric Association.

“自戀的程度和級別有很多種，”伯戈醫生說，至於那些被他稱爲極端自戀者的名人，他並不願按照美國精神病學會的診斷標準，倉促給他們貼上自戀型人格的特定標籤。

The association’s diagnostic manual lists a number of characteristics that describe narcissistic personality disorder, among them an impaired ability to recognize or identify with the feelings and needs of others, grandiosity and feelings of entitlement, and excessive attempts to attract attention.

該學會的診斷手冊列舉了一系列自戀型人格失調的特點，其中包括辨識他人感受和需求的能力受損、自大、感覺自己享有特權，以及過分努力地吸引關注。

Dr. Giancarlo Dimaggio, of the Center for Metacognitive Interpersonal Therapy in Rome, wrote in Psychiatric Times that “persons with narcissistic personality disorder are aggressive and boastful, overrate their performance, and blame others for their setbacks.”

羅馬元認知人際治療所(Center for Metacognitive Interpersonal Therapy)的賈恩卡洛·迪馬齊奧(Giancarlo Dimaggio)爲《精神病時報》(Psychiatric Times)撰文寫道，“自戀型人格失調的人有攻擊性，喜歡自誇，會誇大他們自己的表現，責怪他人拖了自己後腿。”

According to the Mayo Clinic, people with a narcissistic personality disorder think so highly of themselves that they put themselves on a pedestal and value themselves more than they value others. They may come across as conceited or pretentious. They tend to monopolize conversations, belittle those they consider inferior, insist on having the best of everything and become angry or impatient if they don’t get special treatment.

根據梅奧診所(Mayo Clinic)的說法，有自戀型人格失調的人把自己想得極爲重要，因而把自己捧上神壇，認爲自己比其他人更有價值。他們給人以自負或裝腔作勢的印象。他們傾向於壟斷談話，貶低他們認爲不如自己的人，堅持自己什麼事都要優先，如果沒有受到特殊對待就會感到憤怒或不耐煩。

Underlying their overt behavior, however, may be “secret feelings of insecurity, shame, vulnerability and humiliation,” Mayo experts wrote. To ward off these feelings when criticized, they “may react with rage or contempt and try to belittle the other person.”

然而，在他們外表的行爲之下，可能是“隱祕的不安全感、羞恥感、脆弱感和恥辱感”，梅奧的專家們寫道。在受到批評時，爲了抵抗這些感受，他們可能會“用憤怒、蔑視和試圖貶低他人作爲迴應”。

Dr. Burgo, who sees clients by Skype from his home in Grand Lake, Colo., noted that many “grandiose narcissists are drawn to politics, professional sports, and the entertainment industry because success in these fields allows them ample opportunity to demonstrate their winner status and to elicit admiration from others, confirming their defensive self-image as a superior being.”

伯戈醫生在科羅拉多州格蘭德萊克家中通過Skype接待病人，他指出，“很多誇張的自戀者都進入了政治、職業體育與娛樂業，因爲這些領域內的成功可以令他們有充分機會去展示自己的贏家身份，獲取他人的崇拜，鞏固自己作爲一個優越個體的防禦型自我形象。”

The causes of extreme narcissism are not precisely known. Theories include parenting styles that overemphasize a child’s special abilities and criticize his fears and failures, prompting a need to appear perfect and command constant attention.

極端自戀的成因尚不完全爲人們所知。有理論認爲與家庭教育有關。父母過分強調兒童的特長，批評他的恐懼和失敗，導致孩子想要表現得完美，並需要持續吸引關注。

Although narcissism has not been traced to one kind of family background, Dr. Burgo wrote that “a surprising number of extreme narcissists have experienced some kind of early trauma or loss,” like parental abandonment. The family lives of several famous narcissists he describes, Lance Armstrong among them, are earmarked by “multiple failed marriages, extreme poverty and an atmosphere of physical and emotional violence.”

伯戈醫生寫道，儘管自戀無法和某一種特定的家庭背景掛鉤，但是“有數量驚人的極端自戀者曾經經歷過早期的創傷或損失”，諸如父母遺棄等等。他描述的若干著名自戀者，包括蘭斯·阿姆斯特朗(Lance Armstrong)在內，他們的家庭生活都歷過“多次婚姻失敗、極度貧困，以及身體和情感暴力”。

As a diagnosable personality disorder, narcissism occurs more often in males than females, often developing in the teenage years or early adulthood and becoming more extreme with age. It occurs in an estimated 0.5 percent of the general population, and 6 percent of people who have encounters with the law who have mental or emotional disorders. One study from Italy found that narcissistic personality traits were present in as many as 17 percent of first-year medical students.

作爲一種可診斷的人格失調，自戀在男性中比在女性中更爲高發，通常是在青少年和成年初期開始發展，隨着年齡增長走向極端。它在人口中的發病率約爲0.5%，6%涉及違法的人羣都有精神或情感失調方面的問題。一項意大利的研究表明，多達17%的一年級醫學專業學生有自戀人格的特徵。

As bosses and romantic partners, narcissists can be insufferable, demanding perfection, highly critical and quick to rip apart the strongest of egos. Employee turnover in companies run by narcissists and divorce rates in people married to them are high.

作爲老闆或戀人，自戀者可能會令人難以忍受、要求對方表現完美、吹毛求疵，很快便會摧毀對方最強烈的自尊。在自戀者管理的公司裏，人員流動很快；婚姻中一方是自戀者的，離婚率也很高。

“The best defense for employees who choose to stay is to protect the bosses’ egos and avoid challenging them,” Dr. Burgo said in an interview. His general advice to those running up against extreme narcissists is to “remain sane and reasonable” rather than engaging them in “battles they’ll always win.”

“對於選擇留下的僱員來說，最佳的防禦就是維護老闆的自尊，避免和他們衝突，”伯戈醫生在採訪中說。對於遭遇極端自戀者的人，他給出的一般性建議是：“保持清醒理智”，而不是“把他們捲入他們總會贏的爭鬥中去”。

Despite their braggadocio, extreme narcissists are prone to depression, substance abuse and suicide when unable to fulfill their expectations and proclamations of being the best or the brightest.

儘管他們經常自吹自擂，但極端自戀者在無法滿足自我期待，無法成爲自己公開宣佈的那種最優秀，最聰明的人時，也會傾向於抑鬱、濫用藥物和自殺。

The disorder can be treated, though therapy is neither quick nor easy. It can take an insurmountable life crisis for those with the disorder to seek treatment. “They have to hit rock bottom, having ruined all their important relationships with their destructive behavior,” Dr. Burgo said. “However, this doesn’t happen very often.”

這種人格失調是可以治療的，但是療法生效緩慢，也並不容易。這些失調患者有可能是遇到無法克服的人生危機，纔會尋求治療。“他們一定要到因爲自己的破壞性行爲而跌倒谷底，毀掉人生中所有重要的關係，纔會尋求治療，”伯戈醫生說。“然而，這種情況並不經常發生。”

No drug can reverse a personality disorder. Rather, talk therapy can, over a period of years, help people better understand what underlies their feelings and behavior, accept their true competence and potential, learn to relate more effectively with other people and, as a result, experience more rewarding relationships.

沒有任何藥物能夠扭轉人格失調。然而，談話療法在堅持數年之後，可以幫助人們更好地理解潛伏在他們的情感與行爲之下的東西，更好地接受自己真正的能力與潛力，學習更有效地與他人打交道，從而體驗更美好的人際關係。