我们都是自恋狂?
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There was once a young man named Narcissus who was so 1）vain that he fell in love with his own reflection in the water and died. In some versions of the mythological tale from Ancient Greece， Narcissus was transformed into a flower that today carries the name narcissus， or daffodil.
Like the flower， narcissism has continued to flourish in modern culture. “Selfie” was awarded word of the year in 2013 by the Oxford Dictionary. Capturing an image of oneself―once the 2）purview of 3）despondent artists―has become an international pastime.
In recent weeks， we’ve seen the Ice Bucket challenge thrive， but it has been revealed that less than half of people doing the challenge are actually donating. So， for some， is it really about awareness for ALS or selfpromotion？
When we wrote The Narcissism Epidemic a few years ago we didn’t predict the extent of these changes. Narcissism has become such a part of culture that a new study found people could report their own narcissism simply by answering a question： To what extent do you agree with this statement： “I am a narcissist.” （Note： The word“narcissist” means egotistical， self-focused， and vain.）
But narcissism is more complicated―and confusing―than a single question can capture. There are really three types of narcissism. Problems arise when people discuss narcissism without identifying the form.
4）Grandiose narcissism is the outgoing， extraverted form. When you look at 5）charismatic but corrupt leaders， unfaithful ex-partners or media hungry celebrities you are often seeing grandiose narcissism in action. The narcissistic individual believes he or she is smarter， better looking and more important than others. And， of course， deserves special treatment for this fact. This does not mean that grandiose narcissists are all 6）pompous bores. They can be very charming， likable （especially on first dates or job interviews） and fun to be around. On the 7）flip side， narcissistic relationships are often not very emotionally warm or caring.
When we measure grandiose narcissism for research we typically use personality tests. The most popular of these， the Narcissistic Personality Inventory， has items like：
I 8）am apt to show off if I get the chance.
I like to look at myself in the mirror.
If I ruled the world it would be a much better place.
9）Vulnerable narcissism is the second flavour of narcissism. It is harder to see than grandiose narcissism. Vulnerable narcissists think they are entitled to special treatment and greatness but actually have low self-esteem and are not typically extraverted. Imagine someone living in his mum’s attic. He spends his evenings watching 10）X Factor believing he should be the next celebrity singing act. Unfortunately， he lacks the confidence to do it and instead becomes an internet troll.
Here are a couple items from the Hypersensitive Narcissism Scale（HSNS） that we use to measure vulnerable narcissism：
My feelings are easily hurt by ridicule or the 11）slighting remarks of others.
I am secretly “put out” or annoyed when other people come to me with their troubles， asking me for my time and sympathy.
Like most personality traits， these two forms of narcissism have different levels. Most people are in the middle and there are some people who are higher and lower. 12）Colloquially people who have high levels of narcissism are called “narcissists” in the same way people with high levels of introversion are called“introverts”. But the reality is that no bright line separates the highs from the lows.
The third form of narcissism occurs when narcissism is extreme and causes clinically significant problems in a person’s life―marriages fall apart， friends are lost， careers get derailed. When this occurs narcissism can be diagnosed as a personality disorder， narcissistic personality disorder （also known as NPD）. NPD contains a mix of both grandiose and vulnerable narcissism.
Can you change narcissism or NPD？ There is no simple answer to this. For grandiose narcissism， my usual formula is 13）CPR. Practice caring and compassion； do what you are passionate about rather than what gets you attention； and take responsibility for your mistakes as well as successes. For vulnerable narcissism， I would supplement this list with practices that reduce depression and anxiety. Cultivate a sense of belonging or a friendship network； engage in physical exercise； or practice a form of meditation.
For NPD， there is no single， scientifically verified treatment of choice. Instead， we have limited evidence that many treatments work. These include cognitive behavioral therapies， mindfulness based therapies， psychodynamic therapies， and therapies like schema therapy that draw from multiple traditions. But there are two 14）caveats. First， people with NPD are often unwilling to enter treatment because in their mind they do not have a problem―everyone else does. Second， it is challenging for clinicians to keep individuals with NPD in treatment.
Narcissism is increasing， notably in the form of grandiose narcissism and NPD. About two thirds of college students in America in the 2000’s had narcissism scores higher than the average student in the 1980’s， and the lifetime rate of NPD symptoms in young people is about three times higher than in seniors. Still， I remain optimistic that people can change if they are motivated， have the right tools， and know what type of narcissism they are dealing with.
从前，有个叫那耳喀索斯的年轻人，他由于太自恋，爱上了自己在水中的倒影，最终在顾影自怜中抑郁死去。在其他一些古希腊神话故事版本中，那耳喀索斯变成了一朵花，就是如今我们所说的水仙，或叫水仙花。
就如同水仙花一样，自恋症也一直不断地在现代文明中“绽放”。“自拍”一词被《牛津英语词典》评为2013年度词汇。自己给自己画像留影――这原是失意艺术家才会去做的事――现在却成为了风靡全球的个人消遣。
最近几周，我们看到“冰桶挑战”风靡世界，但是事实显示，参加挑战的人中只有不到一半捐了款。因此，对于某些人来说，这真的是为了提高人们对“渐冻症”的认识吗？还是说，这只是自我推销的伎俩而已？
几年前撰写《自恋流行病》一书时，我们并没有估计到这些变化的厉害程度。自恋已经成为了文化的一部分，以至于一项新研究发现，人们只要回答一个问题，就可以判断自己是否自恋：在多大程度上你同意这种说法：“我是一个自恋者。”（注：自恋在这里的意思是自我中心、自我关注和自负。）
但是心理学上的自恋则更为复杂――更令人困惑――并不是一个简单的问题就能够断定的。自恋分为三种类型。不作区分地讨论自恋是很有问题的。
浮夸型自恋是一种开朗的、外向的自恋类型。表面富有魅力、内里的领导、不忠的前伴侣或是饥渴媒体目光的名人，往往属于浮夸型自恋。这些自恋的个体相信自己比其他人更聪明、更好看和更重要。因而，自然理应得到特殊的待遇。这并不意味着所有的浮夸型自恋者都是些自大烦人的家伙。他们也有可爱、讨人喜欢（特别是在第一次约会或是求职面试的时候）、好玩的一面。只不过，缺点是，自恋者与他人的关系常常缺乏情感上的温暖与关怀。
我们通常使用性格测试来研究浮夸型自恋。最普遍使用的“自恋型人格测试”题目如下：
只要有机会，我就会炫耀。
我喜欢看镜子里的自己。
如果由我统治世界，世界会变得更美好。
脆弱型自恋是自恋的第二种类型。比起浮夸型自恋，脆弱型自恋较难察觉。脆弱型自恋者认为自己有权享受特殊待遇和荣耀时刻，但实际上他们不甚自信，通常也不属典型的外向型人格。想象有这么个人，他住在妈妈家的阁楼小房子里，每天晚上都在看《X音素》，相信自己会是下一位歌唱名人。不幸的是，他并没有勇气去做这件事，反而慢慢变成了一名网络黑子。
这里我们使用了来自于《过度敏感性自恋量表（简称HSNS）》中的几个题目来测量脆弱型自恋：
受到嘲讽或者是听到别人轻蔑的言论之后我的感情很容易受伤。
当别人带着一身麻烦来找我，占用我时间或是寻求我同情的时候，我心里会暗暗地觉得腻烦气闷。
像大多数的人格特征一样，这两种自恋型人格也有着不同的水平。大多数人处于中等水平，还有一些人处于较高或者较低的水平。通俗地说，水平高的人就称为“自恋型人格”，就像高度内向的人就称为“内向型人格”一样。但是事实是，高低水平之间并没有明显的分界线。
第三种自恋型人格是极端的自恋，会造成属临床病征的严重问题，干扰私人生活：导致婚姻破裂、朋友尽失和事业无法步入正轨。这种情况下，自恋会被诊断为一种人格障碍――自恋型人格障碍（简称为NPD）。自恋型人格障碍包含了浮夸型自恋和脆弱型自恋两种人格特征。
自恋或者是自恋型人格障碍能够被改变吗？这个问题没有简单的答案。对于浮夸型自恋，我通常的方法是使用“心肺复苏术”。实践关怀和同情；做你所热衷而不是让你受人瞩目的事情；对自己的成功和失败负起责任。对于脆弱型自恋，我会建议在这个单子上多做些能减少压抑和焦虑的事情。培养归属感或者朋友圈；参加体育锻炼；或者是练习冥想。
对于自恋型人格障碍，并没有经过科学验证的针对性治疗方法。相反，我们证明有效的治疗方法少之又少。这些包括认知行为疗法、基于正念疗法、心理动力学疗法和从传统疗法中抽取的图式疗法。但是，有两点需要注意。第一，患有自恋型人格障碍的人通常不愿意接受治疗，因为他们认为自己没问题，有问题的是其他人。第二，临床医生要让自恋型人格障碍患者坚持治疗，这是很具挑战性的。
自恋者越来越多，尤其是以浮夸型自恋和自恋型人格障碍的形式。本世纪头十年，美国大约有三分之二的大学生自恋水平高于上世纪80年代的学生平均水平；年轻人的自恋水平约是年长者的三倍之多。但是，我仍然乐观地认为人们可以改变，只要他们有充足的动机，使用正确的方法，并且清楚意识到自己面对的哪一种类型的自恋。