自恋没药治，相处需谨慎

Does this sound like anyone you know?

这些描述听上去像不像你认识的某人？

- Highly competitive in virtually all aspects of his life, believing he (or she) possesses special qualities and abilities that others lack; portrays¹ himself as a winner and all others as losers.

—— 在人生的方方面面都很争强好胜，总觉得他（她）拥有什么特别的能力和品质是别人没有的；总表现得好像个赢家，其他人都是输家。

- Displays a grandiose² sense of self, violating social norms, throwing tantrums, even breaking laws with minimal³ consequences; generally behaves as if entitled to do whatever he wants regardless of how it affects others.

—— 表现出超强的自我意识，违背社会规范，脾气暴躁，即使违犯法律也没有严重后果，平时表现得好像自己有特权做任何事，不管对别人会有什么影响。

- Shames or humiliates⁴ those who disagree with him, and goes on the attack when hurt or frustrated⁵, often exploding with rage.

—— 羞辱那些有不同意见的人，如果自己感觉受伤害或是受到挫折，经常愤怒地爆发，攻击对方。

- Arrogant⁶, vain and haughty⁷ and exaggerates his accomplishments⁸; bullies⁹ others to get his own way.

—— 傲慢、虚荣、自大，会夸大自己的成就，威吓别人按自己说的做。

- 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.

—— 为了个人利益而撒谎或扭曲事实，责怪他人，或为自己的错误找借口，无视或改造威胁到自己形象的事实，拒绝听建立在事实基础上的辩论。

These are common characteristics of extreme narcissists as described by Joseph Burgo, a clinical psychologist, in his book “The Narcissist¹⁰ You Know.” While we now live in a culture that some would call narcissistic¹¹, 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.

这就是临床心理学家约瑟夫·伯戈(Joseph Burgo)在他的《你身边的自恋者》(The Narcissist You Know)中称为极端自恋者的人表现出的一些普遍特征。尽管有人把我们今天所处的文化称为自恋文化，成千上万人不停地自拍，没完没了地发tweet，把自己做的一切都晒到YouTube和Facebook上去，然而伯戈描述的那种极端的自恋者完全是另一路人。他们在自己选择的领域内可能极为成功，但是也非常难以相处或合作。

Of course, nearly all of us possess one or more narcissistic trait without crossing the line of a diagnosable disorder¹². And it is certainly not narcissistic to have a strong sense of self-confidence based on one’s abilities.

当然，我们所有人都有一两种自恋的特质，不过不会严重到被临床诊断为心理失调的程度。对自己的能力感到强烈自信，这当然也不属于自恋之列。

“Narcissism¹³ 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 diagnosis¹⁴ of narcissistic personality disorder, as defined by the American Psychiatric Association.

“自恋的程度和级别有很多种，”伯戈医生说，至于那些被他称为极端自恋者的名人，他并不愿按照美国精神病学会的诊断标准，仓促给他们贴上自恋型人格的特定标签。

The association’s diagnostic manual lists a number of characteristics that describe narcissistic personality disorder, among them an impaired¹⁵ ability to recognize or identify with the feelings and needs of others, grandiosity¹⁶ and feelings of entitlement, and excessive attempts to attract attention.

该学会的诊断手册列举了一系列自恋型人格失调的特点，其中包括辨识他人感受和需求的能力受损、自大、感觉自己享有特权，以及过分努力地吸引关注。

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.”

罗马元认知人际治疗所(Center for Metacognitive Interpersonal Therapy)的贾恩卡洛·迪马齐奥(Giancarlo Dimaggio)为《精神病时报》(Psychiatric Times)撰文写道，“自恋型人格失调的人有攻击性，喜欢自夸，会夸大他们自己的表现，责怪他人拖了自己后腿。”

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 conceited¹⁷ or pretentious¹⁸. They tend to monopolize¹⁹ conversations, belittle²⁰ those they consider inferior, insist on having the best of everything and become angry or impatient if they don’t get special treatment.

根据梅奥诊所(Mayo Clinic)的说法，有自恋型人格失调的人把自己想得极为重要，因而把自己捧上神坛，认为自己比其他人更有价值。他们给人以自负或装腔作势的印象。他们倾向于垄断谈话，贬低他们认为不如自己的人，坚持自己什么事都要优先，如果没有受到特殊对待就会感到愤怒或不耐烦。

Underlying²¹ their overt²² behavior, however, may be “secret feelings of insecurity, shame, vulnerability and humiliation,” Mayo experts wrote. To ward²³ off these feelings when criticized, they “may react with rage or contempt and try to belittle the other person.”

然而，在他们外表的行为之下，可能是“隐秘的不安全感、羞耻感、脆弱感和耻辱感”，梅奥的专家们写道。在受到批评时，为了抵抗这些感受，他们可能会“用愤怒、蔑视和试图贬低他人作为回应”。

Dr. Burgo, who sees clients by Skype from his home in Grand Lake, Colo., noted²⁴ that many “grandiose narcissists are drawn²⁵ to politics, professional sports, and the entertainment industry because success in these fields allows them ample opportunity to demonstrate their winner status and to elicit²⁶ admiration²⁷ from others, confirming their defensive²⁸ self-image as a superior being.”

伯戈医生在科罗拉多州格兰德莱克家中通过Skype接待病人，他指出，“很多夸张的自恋者都进入了政治、职业体育与娱乐业，因为这些领域内的成功可以令他们有充分机会去展示自己的赢家身份，获取他人的崇拜，巩固自己作为一个优越个体的防御型自我形象。”

The causes of extreme narcissism are not precisely²⁹ 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.

极端自恋的成因尚不完全为人们所知。有理论认为与家庭教育有关。父母过分强调儿童的特长，批评他的恐惧和失败，导致孩子想要表现得完美，并需要持续吸引关注。

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 trauma³⁰ or loss,” like parental³¹ 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.”

伯戈医生写道，尽管自恋无法和某一种特定的家庭背景挂钩，但是“有数量惊人的极端自恋者曾经经历过早期的创伤或损失”，诸如父母遗弃等等。他描述的若干著名自恋者，包括兰斯·阿姆斯特朗(Lance Armstrong)在内，他们的家庭生活都历过“多次婚姻失败、极度贫困，以及身体和情感暴力”。

As a diagnosable personality disorder, narcissism occurs more often in males than females, often developing in the teenage years or early adulthood³² 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 disorders³³. One study from Italy found that narcissistic personality traits were present in as many as 17 percent of first-year medical students.

作为一种可诊断的人格失调，自恋在男性中比在女性中更为高发，通常是在青少年和成年初期开始发展，随着年龄增长走向极端。它在人口中的发病率约为0.5%，6%涉及违法的人群都有精神或情感失调方面的问题。一项意大利的研究表明，多达17%的一年级医学专业学生有自恋人格的特征。

As bosses and romantic partners, narcissists can be insufferable, demanding perfection, highly critical and quick to rip apart the strongest of egos³⁴. Employee turnover³⁵ in companies run by narcissists and divorce rates in people married to them are high.

作为老板或恋人，自恋者可能会令人难以忍受、要求对方表现完美、吹毛求疵，很快便会摧毁对方最强烈的自尊。在自恋者管理的公司里，人员流动很快；婚姻中一方是自恋者的，离婚率也很高。

“The best defense³⁶ 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 sane³⁷ and reasonable” rather than engaging them in “battles they’ll always win.”

“对于选择留下的雇员来说，最佳的防御就是维护老板的自尊，避免和他们冲突，”伯戈医生在采访中说。对于遭遇极端自恋者的人，他给出的一般性建议是：“保持清醒理智”，而不是“把他们卷入他们总会赢的争斗中去”。

Despite their braggadocio³⁸, extreme narcissists are prone³⁹ to depression, substance abuse and suicide when unable to fulfill⁴⁰ their expectations and proclamations of being the best or the brightest.

尽管他们经常自吹自擂，但极端自恋者在无法满足自我期待，无法成为自己公开宣布的那种最优秀，最聪明的人时，也会倾向于抑郁、滥用药物和自杀。

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.”

这种人格失调是可以治疗的，但是疗法生效缓慢，也并不容易。这些失调患者有可能是遇到无法克服的人生危机，才会寻求治疗。“他们一定要到因为自己的破坏性行为而跌倒谷底，毁掉人生中所有重要的关系，才会寻求治疗，”伯戈医生说。“然而，这种情况并不经常发生。”

No drug can reverse a personality disorder. Rather, talk therapy can, over a period of years, help people better understand what underlies⁴¹ their feelings and behavior, accept their true competence⁴² and potential, learn to relate more effectively with other people and, as a result, experience more rewarding relationships.

没有任何药物能够扭转人格失调。然而，谈话疗法在坚持数年之后，可以帮助人们更好地理解潜伏在他们的情感与行为之下的东西，更好地接受自己真正的能力与潜力，学习更有效地与他人打交道，从而体验更美好的人际关系。