Neurosis vs. Character Disorder: Self-Image Issues

Neurotics often have damaged self-images that stem from low self-esteem. Disordered characters see themselves as superior which leads to a sense of entitlement. What’s more, disordered characters aren’t compensating for anything, they really do think they’re all that!

Neurotic individuals and disordered characters differ on many dimensions, such as what they need most from counseling, how they respond to adverse consequence, etc. (See, for example: “Neurosis vs. Character Disorder: Contrasting Needs in Therapy”, “Neurosis vs. Character Disorder: Responses to Adverse Consequences”.) But there is perhaps no aspect of their personsonality in which they differ more than the dimension of self-image. Neurotics often have significantly damaged or tenuous self-images. This typically arises out of a deficient sense of self-worth or self-esteem. Underneath it all, neurotics feel defective in some way and unsure that they are truly lovable. Sometimes their impaired self-esteem leads to a profound sense of inadequacy and weaknesses of character. Sometimes it prompts them to try far too hard to please others in order to feel of value. When these tendencies are not excessive, they can be critical inducements to being socially responsible. In other words, when a person thinks they must earn the approval of others, they can be motivated to develop certain qualities of character, make significant social contributions, and otherwise attempt to “earn” the approval of others to validate themselves and demonstrate their worth.

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Disordered characters have problems with self-image too, but their problems most often arise from an inflated sense of self-worth. As some researchers have commented, they tend to be “legends in their own mind.” They see themselves as superior to others, which in turn leads to a sense of entitlement to use and exploit others as they see fit. The most severely disordered character, the psychopath (alt: sociopath), has such a pathologically inflated self-image that he tends to see all other creatures (by virtue of their inferior status) as rightful prey.

Traditional thinking has always been that ego inflation always represents a “compensation” for underlying deficiencies in self-esteem. Such thinking also led many to presume that “underneath it all,” bullies are really cowards. Fortunately, some fairly sound science in the last 20 years has helped debunk this myth. The “compensation” metaphor still has some validity when you’re dealing with neurosis. But it’s a risky and potentially damaging point of view to hold when you’re dealing with character disturbance. Disordered characters really do think they’re all that! Sometimes, it can appear like they’re struggling with compensation issues, but that’s because we often confuse the concepts of self-esteem and self-respect. I’ll be posting on self-image issue again and will expand upon the distinction that should be made between self-esteem and self-respect and how achieving a healthy balance of the two is critical to character formation.

Of all the issues raised in my first book, In Sheep’s Clothing, readers unanimously report this distinction to be one of the more illuminating and helpful concepts in understanding and dealing with persons with disturbed characters.

All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by on and was last reviewed or updated by Dr Greg Mulhauser, Managing Editor on .

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