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Inspiration for this article comes from Brett Borders, an online reputation management researcher in Colorado.
Spend any length of time in the social media scene and you’ll almost certainly encounter a person with a severe character flaw called Narcissistic Personality Disorder (NPD). The psychiatrists’ DSM manual describes it as “a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.” Narcissists (NPD people) are excessively preoccupied with personal adequacy, power and prestige. Everyone has some need for attention, but NPD people are pathologically obsessed with it.

NPD is Commonplace in the Social Media Scene

People with NPD have a fragile, deeply wounded self-concept and they puff their ego up like blowfish in order to hide the flaw and overcompensate for it. Some use their cunning & charm to become materially successful and accomplished in the business world. A significant percentage of venture capitalists (VCs) have high-functioning NPD… and some of the online “rockstars” and glitterati do too. If you go to a big city tweetup or social media conference, you’re almost guaranteed to meet a clique of NPD people and their minions engaged in an ego-stroking circle jerk.

Certain professions supply a continual buffet of ego food: politics, acting, modeling, television, pro sports and social media. Social media participation has no barriers to entry and take minimal skills – just drive and copious free time. It’s the perfect habitat for NPD people to put themselves on a digital pedestal and receive lots of one-way attention (”narcissistic supply”). The exhibitionist aspect provides endless opportunities for narcissists to reinforce their vanity and activate their grandiosity.

Identifying Narcissistic Personality Disorder

Some common characteristics of NPD types who inhabit the Web 2.0 / social media scene:

• Narcissists can be irresistibly charming. They appear to be so deeply in love with themselves that others get taken along for the ride with them. They develop polished communication and manipulation skills that can easily dazzle you like the Wizard of Oz. Narcissists “go big” leave an “epic” first impression on many people.
• Narcissists are all about themselves. A relationship with a narcissist is typically a “one-way street.” When the conversation is focused on the narcissist, they become alive and animated. When it’s someone else’s turn to talk or take the stage, they tend become distant and withdrawn.
• Narcissists lack empathy for others. Narcissists are impostors who are so wrapped up in the drama of their own internal world, they almost completely lack the ability to empathize with others. The best they can offer is “psuedo-empathy” of the type that a telemarketer offers during a closing pitch. They may act nice when they want something from you, but once they’ve gotten what they came for – they’ll drop you faster than a call on the AT&T cellular network.
• Narcissists are preoccupied with power, status, recognition, money, followers, fame. They will stop at nothing to get more fans, more followers, more time in the limelight, more accolades. They are relentless, inexhaustible social climbers who sometimes excel at sales, business development and executive roles. Many high-level narcissists use money and its privileges as the perfect bait to draw the chosen into their inner circle of loyal supporters and admirers. (The ugly side of this cozy equation is the sacrifice of self, the abuse and the humiliations many exchange for their privileged status.)
• Narcissists are defensive & hypersensitive to criticism. NPD people protect their brittle self-esteem by launching biting, harsh attacks on those who dare to criticize and question them. They are also very controlling about how others view and think of them – by positively rewarding the praise and tyrannically punishing dissent. When it’s impossible for them to attack the critic directly, they’ll do anything in their power to block or sabotage their future success.
• Narcissists indulge themselves extravagantly. They’ll do anything to get first class travel, new gadgets, sexual conquests, spa treatments, exclusive after party invites, fancy swag bags, exclusive club memberships, extravagant homes and cars. All these things provide external proof of their adequacy and help (momentarily) fill the enormous emptiness inside them. When they get them, they’re quick to brag about it and post lots of details and TwitPics.
• NPD people can be exhibitionists. In order to keep the life-sustaining supply of attention focused on them, they will metaphorically “drop their pants” and reveal TMI that most professionals never would. They will open talk about their drug use, sexual life or fantasizes, their income, their enemies or their business exploits. They especially love speaking gigs, interviews, video blogging, karaoke, etc., – becuase moments in the limelight are life-sustaining soul food for their inadequate self concept.
• NPD people keep score. They watch rivals with microscopic vigilance, and will come up with cunning ways to sabotage, outdo or humiliate them. Multimillionaire VCs with NPD are envious of the billionaire ones. On Twitter, you’ll notice that narcissists almost always maintain a very high ratio of followers to friends — reflecting their lack empathy and primal need for their numbers to reflect “one- way” attention. They never “give back” and pay attention to someone else unless they absolutely have to.
• Narcissists demand total loyalty from their followers. No matter how badly an NPD person behaves, their fans and subordinate “yes men” will cheer them on and publicly declare how “awesome” they are, etc. People (unconsciously) sense they have a dangerously fragile self-concept… and are intuitively afraid of getting on their “bad list” – so they tend to leave lots of ego stroking (”You rock!”) comments. One you get on the bad list, there is no way off without heavy ass-kissing and contrition. (Unless you get access to something they desperately want.)

The Narcissist’s Bleak Inner World

The narcissist selectively chooses an “inner circle” of others who will resonate with her vision of self. The successful NPD person creates an intricate matrix of positive feedback in the form of fans, friends, followers and partners who fulfill their endless needs. When the sources of these ego rewards (comments, accolades, retweets, speaking gigs) become unavailable or fail, the narcissist experience intense feelings of emptiness.

In her excellent book on high-level narcissism, Dr. Linda Martinez-Lewi says:

“The narcissist’s experience of emotional emptiness is beyond longing or sadness. It is a severe and intractable wounding, a pain so savage and deep that it seems intolerable. The psychological landscape of the narcissist is bleak. He has no inner resources to sustain him. He cannot turn to himself or others for real affection or solace. Although he enjoys the transient loyalty of dedicated followers, no one really cares about him.”

Social media addiction is the ultimate dual-action stimulant + painkiller for the narcissistic personality.

Dealing with NPD Individuals

Being in a family, business, or romantic relationship with a narcissist is living hell. Working for one can be an ‘emotional holocaust.’ There are some excellent books on the deeper aspects of defending yourself against the narcissist’s insidious nastiness – The Wizard of Oz & Other Narcissists: Coping With the One-Way Relationship in Work, Life and Family is highly-recommended.

In a more shallow social media type of relationship, you must remember that narcissists they demand loyalty and perfect ego stroking. If you choose to get involved in their world, prepared to perpetually walk on eggshells and keep your true feelings masked – no matter how disgusting or annoying the person’s behaviors are. Never criticize them unless you are willing to go on their permanent “shit list.”

If you don’t need or want anything from the Social Media Narcissist, it’s best to be cordial and distant from them. Keep firm boundaries. Stay far away, don’t be drawn into their charismatic web of illusion, and if they attack you — you don’t have to attack back. Recognition and awareness of the painful-yet-common disorder in the social media scene can save you intense pain and grief.

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Democrats in both the House and Senate must win the support of seniors to get health care reform passed. One of the bribes is the promise to close the infamous “Doughnut Hole” that can cost seniors $4,550 out-of-pocket in 2010. That’s in addition to the out-of-pocket deductible and co-pays before you even get to the doughnut hole.

But, don’t hold your breath. The hole won’t be fixed immediately. Instead, it will be phased out … gradually. The House bill plans to eliminate the doughnut hole by 2019; the Senate bill waits until 2022. That’s 12 years from now!

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– 2010 Deductibles / Co-Pays –

Note: Your Part B premium will be based on your modified adjusted gross income. Most people will pay the amount shown in the chart above. But, if you filed an individual tax return for 2008 and your modified adjusted gross income was more than $85,000, your Part B premium for 2010 is shown in the table below. If you filed a joint tax return for 2008 and your modified adjusted gross income was more than $170,000, your Part B premium for 2010 is similarly shown in the table below. The Social Security Administration will compute your premium for you. However, we recommend that you double-check their computation against your 2008 tax return.

2010 Part B Monthly Premium

If your 2008 income was …
Individual Tax Return	Joint Tax Return	You Pay
$85,000 or less	$170,000 or less	$110.50*
$85,001 – $107,000	$170,001 – $214,000	$154.70*
$107,001 – $160,000	$214,001 – $320,000	$221.00*
$160,001 – $214,000	$320,001 – $428,000	$287.30*
Above $214,000	Above $428,000	$353.60*

*If you don’t have to pay a late-enrollment penalty.

Medicare is the federal health insurance program that covers nearly everyone age 65 and older. Some younger people who are disabled or who have End-Stage Renal Disease (permanent kidney failure) are also eligible for coverage.

People covered by Medicare are called beneficiaries. Medicare pays for much of their health care, but not all of it. That is, Medicare covers most acute medical conditions – conditions from which a patient usually recovers. But, Medicare does not cover most care given at home, in assisted living facilities or in nursing homes, for people with chronic disabilities and lengthy illnesses. And for many people, there are large gaps in Medicare’s prescription drug plans.

Medicare benefits are provided in 4 parts – A, B, C and D. Part A helps pay for inpatient hospital care, some skilled nursing facilities, hospice care, and some home health care. Part A is premium-free for most people. Most beneficiaries do pay a monthly premium to be covered under Medicare Part B – the part that helps pay for doctors, outpatient hospital care, and some other care that Part A doesn’t cover, such as physical and occupational therapy.

Part C allows various HMOs, PPOs and similar health care organizations to offer health insurance plans to Medicare beneficiaries. Part C includes the much-talked-about Medicare Advantage plans. At a minimum, they must provide the same benefits that the Original Medicare Plan provides under Parts A and B. Part C organizations are also permitted to offer additional benefits such as dental and vision care. But, to control costs, Part C plans are allowed to limit a patient’s choice of doctors, hospitals, etc., to just those who are members of their networks. This can be a major disadvantage if a patient’s favorite doctor or hospital is not a member of their networks.

Medicare’s Part D provides prescription drug benefits through various private insurance companies. For more information, including how to enroll, click on Medicare Prescription Drugs benefit. Like Part B, most people have to pay extra premiums each month to be covered for prescription drugs under Part D. Premiums for Part D vary from state-to-state, and from company-to-company. For more information, visit Medicare’s website.

Most seniors are covered under the Original Medicare Plan. That plan requires them to pay for some of their health care in addition to their monthly Part B and Part D premiums. Those additional amounts are called deductibles and coinsurance. All premiums, deductibles and coinsurance amounts change every year on January 1st. To see the current Part B premiums, deductibles and coinsurance amounts, click on 2010 Medicare benefits.

Seniors can purchase other insurance policies to cover part or all of Medicare’s deductibles and coinsurance amounts, or to cover many types of care that it doesn’t cover. These include:

Supplemental Medicare insurance (Medigap) from a private insurance company. To avoid confusion, 12 standardized plans have been defined by federal law. Not all states allow all 12, and not all companies offer all 12. For more information, click on Supplemental Medicare Insurance for Seniors.
Employer or union coverage
Long-Term Care insurance
Other kinds of insurance

Seniors don’t need to buy Supplemental Medicare insurance if they are covered under Medicaid, or if they are enrolled in a Part C Medicare Advantage plan such as a …
Managed Care Plan (a Medicare HMO)
Private Fee-for-Service Plan
Medical Savings Account
Religious Fraternal Benefit Plan

Medicare has more than 40 booklets to help people understand the program. To review the list,
click on -

– Medicare FAQs, Tips and Nasty Surprises –

Medicare often runs smoothly without a hitch. At other times, it can be very annoying – even downright frustrating. For some people, it is full of potholes that cost them thousands of dollars out of their own pockets. Bottom line – what you don’t know can hurt you. For some helpful tips, visit our page Medicare FAQs, Tips and Nasty Surprises.

Medicare Plan D – Prescription Drug Plans