Is image really everything? It's time to see a psychiatrist

A supersized pickup truck hurtles through town. Its driver's demands are simple: an immediate and non-negotiable right of way, a disproportionate share of the road and the right to burn more fossil fuel than a small Third World village. Despite its massive bulk, the only heavy load this vehicle ever carries is the driver's own overinflated sense of self-importance. This is New York, this is London, this is Abu Dhabi. Welcome to generation "I"; welcome to the age of narcissism.

Narcissistic personality disorder (NPD) takes its name from the myth of the cruel and beautiful Narcissus, a young man forever self-smitten unable to tear himself away from his dashing reflection. Clinically NPD is characterised by an excessive sense of entitlement, self-importance and superiority. Normal events in everyday life suddenly appear rather different from this view. Walk into a coffee shop in any city and there an army of self-promoting cyber-citizens beaver away at their virtual images, providing status updates for their admiring public, informing loyal followers of their latest antics, as if anyone really cares.

High on caffeine and fuelled by a deep-seated sense of entitlement, a youth pushes to the front of the queue. He is wedded to the delusion that being served first is his immutable birthright. The young man's T-shirt bears one of those slogans that is supposed to arrest our attention and at the same time impress upon us his staggering individuality, rebelliousness and wit: "FCUK", "I love me, who do you love" or "Same Same, but Different".

While it may seem like harmless style choices, there is a negative side to the pattern of behaviour. Narcissists can often be exploitative, envious and intrusive. They generally have problems seeing or caring how other people might feel. In short, they lack empathy. NPD in its full-blown clinical manifestation is fairly rare, but in recent years researchers in western nations have noticed a dramatic increase in narcissistic personality features in the general population.

In their recent book The Narcissism Epidemic, the psychologists Jean Twenge and Keith Campbell report data from 37,000 college students suggesting an increase in narcissistic personality traits on par with the rise of obesity, with the trend particularly pronounced among females. It is easy to see how contemporary society fosters narcissism. Many have accepted the advertising mantra that "image is everything". Everyone from politicians to college girls now seek out the services of "appearance-augmentation specialists", be they spin doctors or cosmetic surgeons.

In her book Why is it always about you?, the psychotherapist Sandy Hotchkiss reports that, between 1992 and 1998, there was an 89 per cent increase in breast augmentation surgery among US females under the age of 19. Many of these teenage girls compromised their college finances to undergo these enhancements, and the most often cited reason for augmentation was "to feel better about themselves". In many cases they were encouraged by well-meaning mothers who also "knew" that image is everything: to look good, is to feel good; and to feel good, is to be good.

Another area of obsessive attention seeking is the cult of empty celebrity that has arisen in recent years. Reality TV shows make people famous based only on an individual's ability to shamelessly self-promote. All publicity is good publicity, we are often reminded. One of the worst culprits in the narcissism epidemic is the self-esteem movement. From tearful self-disclosures about low self-esteem on Oprah to feel-good boosters sponsored by schools, everyone is supposed to be a special, unique, talented, beautiful individual, even if they are not.

The basic idea behind the self-esteem movement is that bad behaviour is the product of feeling bad about one's self. Therefore, inculcating positive feelings of self worth will result in good people. Ms Hotchkiss suggests the "feel good, be good" idea has gone wrong, and we now have many young adults who feel entitled to be celebrated regardless of how well they perform. There is little doubt that narcissistic tendencies are a cross-cultural phenomenon. But if we are to reverse this vapid trend in the UAE, then there is a lot of hard work to be done, especially within our educational institutions.

Justin Thomas is a psychologist in the department of health sciences at Zayed University in Abu Dhabi