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.

從前，有個叫那耳喀索斯的年輕人，他由于太自戀，愛上了自己在水中的倒影，最終在顧影自憐中抑郁死去。在其他一些古希臘神話故事版本中，那耳喀索斯變成了一朵花，就是如今我們所說的水仙，或叫水仙花。

就如同水仙花一樣，自戀癥也一直不斷地在現(xiàn)代文明中“綻放”?！白耘摹币辉~被《牛津英語詞典》評為2013年度詞匯。自己給自己畫像留影——這原是失意藝術家才會去做的事——現(xiàn)在卻成為了風靡全球的個人消遣。

最近幾周，我們看到“冰桶挑戰(zhàn)”風靡世界，但是事實顯示，參加挑戰(zhàn)的人中只有不到一半捐了款。因此，對于某些人來說，這真的是為了提高人們對“漸凍癥”的認識嗎？還是說，這只是自我推銷的伎倆而已？

幾年前撰寫《自戀流行病》一書時，我們并沒有估計到這些變化的厲害程度。自戀已經(jīng)成為了文化的一部分，以至于一項新研究發(fā)現(xiàn)，人們只要回答一個問題，就可以判斷自己是否自戀：在多大程度上你同意這種說法：“我是一個自戀者?！保ㄗⅲ鹤詰僭谶@里的意思是自我中心、自我關注和自負。）

但是心理學上的自戀則更為復雜——更令人困惑——并不是一個簡單的問題就能夠斷定的。自戀分為三種類型。不作區(qū)分地討論自戀是很有問題的。

浮夸型自戀是一種開朗的、外向的自戀類型。表面富有魅力、內(nèi)里貪污腐敗的領導、不忠的前伴侶或是饑渴媒體目光的名人，往往屬于浮夸型自戀。這些自戀的個體相信自己比其他人更聰明、更好看和更重要。因而，自然理應得到特殊的待遇。這并不意味著所有的浮夸型自戀者都是些自大煩人的家伙。他們也有可愛、討人喜歡（特別是在第一次約會或是求職面試的時候）、好玩的一面。只不過，缺點是，自戀者與他人的關系常常缺乏情感上的溫暖與關懷。

我們通常使用性格測試來研究浮夸型自戀。最普遍使用的“自戀型人格測試”題目如下：

只要有機會，我就會炫耀。

我喜歡看鏡子里的自己。

如果由我統(tǒng)治世界，世界會變得更美好。

脆弱型自戀是自戀的第二種類型。比起浮夸型自戀，脆弱型自戀較難察覺。脆弱型自戀者認為自己有權享受特殊待遇和榮耀時刻，但實際上他們不甚自信，通常也不屬典型的外向型人格。想象有這么個人，他住在媽媽家的閣樓小房子里，每天晚上都在看《X音素》，相信自己會是下一位歌唱名人。不幸的是，他并沒有勇氣去做這件事，反而慢慢變成了一名網(wǎng)絡黑子。

這里我們使用了來自于《過度敏感性自戀量表（簡稱HSNS）》中的幾個題目來測量脆弱型自戀：

受到嘲諷或者是聽到別人輕蔑的言論之后我的感情很容易受傷。

當別人帶著一身麻煩來找我，占用我時間或是尋求我同情的時候，我心里會暗暗地覺得膩煩氣悶。

像大多數(shù)的人格特征一樣，這兩種自戀型人格也有著不同的水平。大多數(shù)人處于中等水平，還有一些人處于較高或者較低的水平。通俗地說，水平高的人就稱為“自戀型人格”，就像高度內(nèi)向的人就稱為“內(nèi)向型人格”一樣。但是事實是，高低水平之間并沒有明顯的分界線。

第三種自戀型人格是極端的自戀，會造成屬臨床病征的嚴重問題，干擾私人生活：導致婚姻破裂、朋友盡失和事業(yè)無法步入正軌。這種情況下，自戀會被診斷為一種人格障礙——自戀型人格障礙（簡稱為NPD）。自戀型人格障礙包含了浮夸型自戀和脆弱型自戀兩種人格特征。

自戀或者是自戀型人格障礙能夠被改變嗎？這個問題沒有簡單的答案。對于浮夸型自戀，我通常的方法是使用“心肺復蘇術”。實踐關懷和同情；做你所熱衷而不是讓你受人矚目的事情；對自己的成功和失敗負起責任。對于脆弱型自戀，我會建議在這個單子上多做些能減少壓抑和焦慮的事情。培養(yǎng)歸屬感或者朋友圈；參加體育鍛煉；或者是練習冥想。

對于自戀型人格障礙，并沒有經(jīng)過科學驗證的針對性治療方法。相反，我們證明有效的治療方法少之又少。這些包括認知行為療法、基于正念療法、心理動力學療法和從傳統(tǒng)療法中抽取的圖式療法。但是，有兩點需要注意。第一，患有自戀型人格障礙的人通常不愿意接受治療，因為他們認為自己沒問題，有問題的是其他人。第二，臨床醫(yī)生要讓自戀型人格障礙患者堅持治療，這是很具挑戰(zhàn)性的。

自戀者越來越多，尤其是以浮夸型自戀和自戀型人格障礙的形式。本世紀頭十年，美國大約有三分之二的大學生自戀水平高于上世紀80年代的學生平均水平；年輕人的自戀水平約是年長者的三倍之多。但是，我仍然樂觀地認為人們可以改變，只要他們有充足的動機，使用正確的方法，并且清楚意識到自己面對的哪一種類型的自戀。