Millon's biosocial view seems to be that narcissistic children are spawned by narcissistic parents who overindulge them, giving them a sense of specialness that creates expectations about praise and subservience from others (Silverstein, 2007, p. 30). Sperry (1995) gives a good summary of various theories about NPD formation (pp. 116-118). The psychoanalytic formulation attributes NPD to an early childhood of parental overvaluation or of erratic, unreliable caretaking. This fixes the psyche in the narcissistic phase. It cannot break free of this self-image. Kohut thought that the structures of the grandiose self and the idealized parental image are not integrated in the NPD person's childhood because of environmental mirroring, echoing, and idealizing. This leads the adult from this environment repeatedly to fail to realize their goals or promise, and to the experience of shame and rage (Silverstein, 2007, p. 44). Kernberg links NPD with emotional deprivation caused by a covertly spiteful mother, which is then escaped from through some special and unique talent. Benjamin's interpersonal formulation claims that NPD sufferers are raised in environments of selfless, unconditional love and adoration, but without genuine self-disclosure. The extreme vulnerability to criticism or being ignored, and the strong wish for love and admiration, results from holding onto the expectations of others being the same adoring mother from childhood. As these views show, the family is generally considered the place where NPD begins. The parent-child relation is crucial. Unfortunately in the film, there are no memories or flashbacks. Therefore, the notion of Chad's background can only be assumed. The cognitive-behavioral theory of NPD proposed by Beck and others is similar (Beck et al., 2003, pp. 17-51). It focuses on the ways mental schemas are formed in the child or person's environment. The schemas are made up of beliefs that serve to interpret and evaluate experience. Out of the evaluative schemas come affective motives and adaptive or maladaptive strategies. The dysfunctional narcissistic beliefs at the root of the problem are caused by the interaction of genetic predispositions and the influence of others, including traumatic events. Out of this constant nature-nurture interaction develop the core beliefs and self-appraisals related to their own specialness. This is the schema of inferiority or unimportance, which manifests itself in the compensatory attitude of superiority or specialness (Beck et al., 2003, p. 249). It comes from parental messages in childhood and personal experience. Covertly there is a belief of their being unlovable and helpless (Beck et al., 2003, p. 44). Nothing in the environment serves adequately to counteract the schema. One author has pointed out the core operating schema as entitlement, emotional deprivation, and defectiveness, with secondary schemas such as unrelenting standards, subjugation, and distrust (Ronningstam, 2005, p. 22). Chad shows all of these elements, and must have had a childhood upbringing similar to this.

As a result, he was unable to integrate a healthy schema of himself and world. The grandiosity, need for achievement, and lack of empathy he developed in adulthood are compensating mechanism. They allow him to overcome an inherent low self-esteem -- self-doubt, distrust, insecurity, and unconscious fears. This low self-view is evident in his constant worry about those under him in the company taking his job and his losing his girlfriend to some other man. His critical speech and distrust toward others suggests that inside he feels inferior and is sensitive himself to criticism. This is what drives his narcissistic complex.

People with Narcissistic Personality Disorder are difficult to get into therapy. Chad displays no sign of wanting or needing intervention. Their heightened self-image and sense of pride makes them outwardly project a type of imperviousness. Often they can function in society as long as their antisocial behaviors go undetected. Chad recognizes the risky behavior of seducing someone

He reminds his accomplice Howard that it should never be discovered. If it was, perhaps he would seek counseling. It often takes some triggering event like job loss from unethical conduct to get NPD's into therapy. Using their talent often allows them to succeed in the workplace, where their personality failures may be ignored for some greater good. Rarely are they confronted by peers on their disorder. The same goes for their relationships, which simply come, go, or stay without a fuss. In other words, the likelihood of NPD's to get into therapy is low. The fact that they misperceive their own accomplishment and importance while being sensitive to criticism means that they are able to overlook the possibility that they have a problem. However, they may enter therapy as a result of exploitive abuse of power. Chad would have a chance at therapy if he ran into limitations at work that threaten his self-image -- things such as looking bad or losing a special status ("narcissistic insult"). Once in therapy, however, "they do not see their problems in ordinary terms, however, and may expect to fascinate the therapist by being a uniquely complex patient" (Beck et al., 2003, p. 242). This means that even were Chad to seek therapy, it would be difficult to work with him.
The cognitive-behavioral goal of therapy is to restructure the NPD person's personality. Davidson (2008) writes, "Cognitive therapy for personality disorder aims to modify these early maladaptive schemas" (p. 22). Identifying the schemas comes first and involves the exploration of the person's childhood and unmet needs. Then work can be done to challenge or heal that schema. Using guided imagery dialogues with key childhood figures, for example, can help identify and repair the false beliefs created back then. The persistent interpretive bias that comes from unconscious dysfunctional core beliefs needs modification. The aim is to make the person more adaptive and less self-defeating (presuming they are in therapy because they experience a defeat). This would mean increasing their capacity for empathy with others. It would mean also clearing out false cognitive distortions about the self that place the person in an inflated view. This could be done through examining evidence for the core beliefs (superiority or inferiority) and putting them to a reality test -- including for example drawing up a list of supports for the old belief and new belief side by side (Davidson, 2008, p. 93). It would involve breaking down their status consciousness and warding off threats to distorted self-image. Through systematic desensitization, the therapist could help tone down their sensitivity to criticism while developing a truly empathic self that does not rely on false self-centeredness and disregard for others.

Chad's prospects are not good. In the Company of Men ends with him in victory. His girlfriend does not realize his deception, and his former boss is unwilling to talk. He is confirmed in his grandiose self-view and has the professional rewards to prove it. Nothing in the film shows him developing toward awareness or falling into trouble. As a result, the events that would lead him toward therapeutic help are still in the future. He remains a callous and manipulative person with antisocial Narcissistic Personality Disorder.

Bibliography

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: author.

Beck, a.T., Freeman, a., Davis, D.D., and Associates. (2003). Cognitive therapy of personality disorders (2nd ed.). New York: Guilford Press.

Davidson, K. (2008). Cognitive therapy for personality disorders: A guide for clinicians (2nd ed.). New York: Routledge.

Ronningstam, E.F. (2005). Identifying and understanding the narcissistic personality. Oxford: Oxford University Press.

Silberstein, M.L. (2007). Disorders of the self: A personality-guided approach. Washington, DC: American Psychological Association.

Sperry, L. (1995). Handbook of diagnosis and treatment of the DSM-IV personality disorders. New York:…