Brian Hamilton's Narcissistic Personality

Diagnosis: Thirty-two year old Brian Hamilton has been court ordered to receive psychotherapy. His history suggests that he has Narcissistic Personality Disorder. Brian displays feelings of superiority and specialness (Criterion 1). He believes that he is so special and unique that he can only be understood by other special high-status people (Criterion 3). When Brian first sought out therapy, he insisted that he needed an expert and even questioned the experience of a well-qualified highly regarded clinician. He has a strong need to be admired and ends relationships if he doesn’t feel this (Criterion 4). Brian has unreasonable expectations of especially favorable treatment or automatic compliance with his expectations (Criterion 5). This sense of entitlement is clear in almost every aspect of
He demanded a fee reduction or time extension after missing half of an appointment due to heavy traffic. His lack of empathy (Criterion 7) for the other patients in this situation was apparent as well. He thought he deserved to be seen no matter what. He also insulted a police officer after being pulled over for speeding, and then sped off again. Extreme entitlement was evidenced by his refusal to pay for a haircut and threats to sue for damages after he received a haircut that was not up to his standards. Brian can be interpersonally exploitative (Criterion 6). He dated a teaching assistant to learn the exam questions ahead of time, and then dumped her once she could no longer benefit him. Co-workers explained that he would “stab you in the back” to get ahead. When surrounded by other successful people, Brian felt competitive and envious (Criterion 8). Finally, he has been described as cocky, self-assured, and arrogant (Criterion 9). Like many others with Narcissistic Personality Disorder, Brian is highly sensitive to criticism, often feeling devastated and humiliated by the