In my experience as a clinician, I’ve been struck by what seems to be a higher rate of narcissism among alcoholics. I don’t mean that as put down. I simply mean that there is a tendency to slip into grandiose self-perceptions along with an oversensitivity to realistic appraisals that are deflating to grandiosity. So alcoholics frequently find confrontation with the truth to be hurtful, infuriating or both.

Alcohol has a tendency to stoke feelings of grandiosity, so alcohol intoxication initially offers a place of solace to the narcissistic drinker. But the cumulative effects of trying to maintain a chemically stoked sense of grandiosity are deleterious to every aspect of living in the real world.

I want to emphasize that I’m just talking about what looks to me like a tendency. Not all narcissists end up as alcoholics and not all alcoholics are narcissists. But I’ve certainly seen the narcissistic personality organization more often in alcoholics than in non-alcoholics.

I do think AA can be of great value to alcoholics. For one, the steps themselves, the support of a sponsor and the fellowship encourages more realistic self-appraisal, less narcissistic focus in relationships and a highly supportive, safe environment for contending with the painful wounds encountered when the focus shifts away from self-grandiosity and toward realism.