Is narcissistic personality disorder real


Meet the Real Narcissists (They're Not What You Think)

By Rebecca Webber published September 5, 2016 - last reviewed on December 15, 2017

Last winter, a friend told me she was considering a divorce. "I really think my husband is a narcissist!" she said. More recently, over brunch, an acquaintance explained his family dynamics: "My aunt is such a narcissist, we're not sure why my uncle is with her."

The term narcissist has been widely deployed to describe not only a passel of difficult relatives and regretted exes, but also both nominees for president and the entire generation known as Millennials. Is narcissism really so widespread or on the rise in the general population?

A growing consensus among psychologists says no, it isn't. True pathological narcissism has always been rare and remains so: It affects an estimated 1 percent of the population, and that prevalence hasn't changed demonstrably since clinicians started measuring it. Most (but not all) putative narcissists today are innocent victims of an overused label. They are normal individuals with healthy egos who may also happen to indulge in the occasional selfie and talk about their accomplishments. They may even be a bit vain. But while we're diagnosing friends, relatives, and our kids' classmates, true pathological narcissists may be evading detection because most of us don't understand the many forms the condition may take.

Photo by Dean Alexander

What Narcissism Is (And Isn't)

Narcissism is a trait each of us exhibits to a greater or lesser degree. As it has become trait non grata, though, it's become necessary to add the qualifier "healthy" to specify the socially acceptable type of narcissism. "It is the capacity to see ourselves and others through rose-colored glasses," says psychologist Craig Malkin, a lecturer at Harvard Medical School and the author of Rethinking Narcissism. That can be beneficial, because it's helpful for all of us to feel a bit special. It fuels the confidence that allows us to take risks, like seeking a promotion or asking out an attractive stranger. But feeling too special can cause problems.

The Narcissistic Personality Inventory (NPI) is the most commonly used measure of the trait. Developed by Robert Raskin and Calvin S. Hall in 1979, it asks an individual to choose between pairs of statements that assess levels of modesty, assertiveness, inclination to lead, and willingness to manipulate others. Scores range from 0 to 40, with the average tending to fall in the low to mid-teens, depending on the group being tested. Those whose score is a standard deviation above that of their peers could reasonably be called narcissists. But a score anywhere along a wide range of the scale might still indicate a fundamentally healthy personality.

A diagnosis of pathological narcissism—which is a mental health disorder—involves different criteria. "Narcissistic Personality Disorder is an extreme manifestation of the trait," says developmental psychologist Eddie Brummelman, a fellow at Stanford University. The disorder can be diagnosed only by a mental health professional and is suspected when a person's narcissistic traits impair his or her daily functioning. The dysfunction might be related to identity or self-direction or cause friction in relationships due to problems with empathy and intimacy. It might also arise from pathological antagonism characterized by grandiosity and attention-seeking.

"Narcissism is a continuum, and the disorder sits at the very end," Brummelman says. The NPI can detect a person's level of narcissism, but additional real-life effects are necessary for a diagnosis of NPD.

"A personality disorder is a pervasive disturbance in a person's ability to manage his or her emotions, hold onto a stable sense of self and identity, and maintain healthy relationships in work, friendship, and love," Malkin says. "It's a matter of rigidity."

Someone who scores high on the NPI may indeed encounter occasional awkward or stressful social interactions, but for someone with NPD, Malkin says, "all the psychological defenses are working against healthy functioning" all the time.

The Many Faces of Narcissism

Popular culture has long relied on narcissistic traits to sketch problematic characters in sharp relief, from Dorian Gray to Don Draper. Gaston from Disney's Beauty and the Beast presents a silly but fairly apt model of grandiosity, probably the most recognizable feature of people high in narcissism and those with NPD. That brawny braggart sings, "As a specimen, yes, I'm intimidating!...As you see, I've got biceps to spare!...I'm especially good at expectorating!...And every last inch of me's covered in hair." Other narcissists may indeed perceive themselves as being in the top .1 percent in terms of talent, appearance, success, or all of the above.

But it's a mistake to assume that all narcissists will be such obvious preeners. "Not all narcissists care about looks or fame or money," Malkin says. "If you focus too much on the stereotype, you'll miss red flags that have nothing to do with vanity or greed."

For example, he suggests, some narcissists can be of the "communal" variety and actually devote their lives to helping others. They might even agree with such statements as "I'm the most helpful person I know," or "I will be known for the good deeds I have done. " "Everyone has met grandiosely altruistic martyrs, self-sacrificing to the point where you can't stand to be in the room with them," Malkin says.

And there are highly introverted, or "vulnerable," narcissists. These individuals feel they are more temperamentally sensitive than others. They react poorly to even gentle criticism and need constant reassurance. The way they feel special might actually be negative: They may see themselves as the ugliest person at the party or feel like a misunderstood genius in a world that refuses to recognize their gifts.

What all subtypes of narcissist have in common, Malkin says, is "self-enhancement." Their thoughts, behaviors, and statements set them apart from others, and this feeling of distinction soothes them, because they're otherwise struggling with an unstable sense of self.

"Narcissists feel superior to others," Brummelman says, "but they are not necessarily satisfied with themselves as a person."

Photo by Dean Alexander

A Link to Depression

That struggle is at the core of a new conception of narcissism, one focused as much on depression as on grandiosity. "What people hypothesize is that narcissists are prone to higher highs and lower lows," says Seth Rosenthal, a research specialist at Yale's Program on Climate Change Communication, who did his doctoral research on narcissism. "They have this constant need to have their greatness verified by the world around them. When reality catches up with them, they may react by becoming depressed."

When a clear setback, such as a job loss or divorce or even a plan being scuttled, dents the carefully burnished self-image of a narcissistic individual, "this is a real attack on who he is," says Steven Huprich, the president-elect of the International Society for the Study of Personality Disorders and a professor at the University of Detroit Mercy. "Somebody he thought was going to trust him now very much dislikes him and is unwilling to put up with him anymore. Not surprisingly, he finds himself a little more down and depressed."

Of course, even people with healthy mental states struggle to deal with such dramatic turnarounds, Huprich says, "but for narcissists and narcissistic personalities, loss is really very difficult, because it suggests vulnerability and weakness. It suggests that you actually aren't immune to life's challenges and ups and downs."

The narcissist might also exhibit defensiveness and anger at such moments. "When they don't get the admiration they crave, they feel ashamed and lash out aggressively," Brummelman says. Others are unlikely to have the same sort of aggressive outbursts.

When a disappointment cuts through narcissists' thick layer of grandiosity and self-promotion and breaches their core, their resulting melancholy or boiling rage might motivate them to seek outside help. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), in fact, advises clinicians that individuals with NPD may present with a depressed mood. They rarely, however, come in seeking treatment for their narcissism. "I've never heard anyone say, 'I think I'm a narcissistic personality,'" Huprich says.

That doesn't mean narcissists are oblivious to their trait. A 2011 study in the Journal of Personality and Social Psychology—titled, with a wink, "You Probably Think This Paper's About You"—reported that narcissists did have insight into their personality: They described themselves as arrogant and knew that others saw them less positively than they saw themselves. But they generally didn't see this as a problem, and the debate continues over whether their grandiosity reflects an ironclad belief in their superiority or masks an underlying absence of self-confidence.

Over years of research, Huprich and colleagues have developed a concept that may be related to narcissism. They call it "malignant self-regard." It's a potential explanation for a constellation of not-quite clinically diagnosable personality disorders with overlapping features, including depressive, self-defeating, and masochistic personality styles.

Applied more widely to narcissistic subtypes, the theory suggests that deep-seated insecurity about the self and an exceedingly fragile sense of self-esteem can lead to maladaptive thoughts and behavior. Extraverted narcissists exhibit grandiose attention-seeking. Vulnerable narcissists, meanwhile, simply succumb to their damaged self-image. "They're not able to keep a coherent sense of who they are, so when they are attacked, instead of fighting back, which is the first reaction of the grandiose narcissist, they have an immediate reaction of sadness and depletion and depression," Huprich says.

People may develop malignant self-regard as children in the context of their relationships, Huprich proposes. These individuals may have had inconsistent experiences with their parents, related in particular to how success and achievement were recognized. Parents might have refused to acknowledge achievements or discouraged bragging about them, taking away the rose-colored glasses of healthy narcissism that could have eased the way as a child encountered new challenges in life.

Photo by Dean Alexander

Are They Made or Born?

Childhood experiences may play a major role, but most experts agree that both high levels of trait narcissism and NPD arise from the combined influences of nature and nurture that likely begin in the genes. "There are personality traits we come into the world with," says Kali Trzesniewski, a social-development psychologist at the University of California, Davis. One's environment can either weaken or strengthen those traits, "though there are always people who don't seem to react to their environment; they're just kind of resilient to it. "

One twin study found that narcissism was a highly heritable trait. It can also manifest early in life: Another study found that dramatic, aggressive, attention-seeking preschoolers were more likely to end up as narcissistic adults. But parenting styles, the influence of other relationships, and one's social and cultural environments can encourage (or deter) its development.

Culture matters as well: Lifetime rates of NPD are about four times higher in notoriously competitive New York when compared with Iowa. But across the globe, cultures with a more collectivist tradition tend to put the group before the individual: "You're taught from a very early age that you have to pay attention to other people and put their needs before your own," says David Ludden, a professor of psychology at Georgia Gwinnett College in Lawrenceville, Georgia. "Of course, there are narcissists in Japan and China as well, but they don't show up quite the same way as here, where we say, 'Hey, it's OK for you to promote yourself. '"

High narcissism is not the same as high self-esteem. "They are typically only weakly related," says Brummelman, who has studied how parenting approaches can foster each. He and his colleagues found that when mothers and fathers are warm and affectionate, spending time with their kids and showing interest in their activities, "the children gradually internalize the belief that they are worthy individuals—the very core of self-esteem—and this doesn't spill over into narcissism," he says. By contrast, parental overvaluation—placing children on a pedestal—does promote narcissistic traits. To avoid raising narcissists, it's better for parents to say to children, "You did a good job," rather than, "You deserved to win" or "Why weren't you as good as she was?"

An early pronounced focus on success can lead to an insecure attachment between parent and child, as a son or daughter learns that a mother's or father's love and attention are available only if high expectations are met. Children who feel they can never measure up can move into adulthood with a fragile ego and latch onto narcissistic thoughts and behaviors to shore it up.

Parents who raise narcissists, Ludden says, "present to their kids a world where everything is a competition: There are winners and losers and you've got to be a winner." A healthier approach would be to teach children that "they don't have to be the best, just the best that they can be."

Mislabeled Millennials

Photo by Dean Alexander

No matter how hard parents try to steer children away from all-or-nothing competition, many eventually have to vie for college admission, internships, and jobs. Shrinking opportunities may be what's contributing to a perception of raging narcissism among young adults.

"When you set up highly competitive environments, you're really encouraging people who are more ruthless," Ludden says. "That's where the narcissists are going to flourish, because they are willing to do more to get ahead than the average person would. We've set up a society that encourages the narcissist as opposed to one where that kind of behavior is discouraged."

And so young people polish their résumés, update their LinkedIn profiles, brand themselves online, and of course, flood social media with carefully posed, cropped, and filtered selfies. "We have a lot more opportunities to express our narcissistic tendencies than we once did," Ludden says. Many young people who might have come across as quite modest in another time or milieu may just be trying to keep up and may deserve more of a pass for it.

"Our norms have changed," Trzesniewski says. "If you took somebody from the '60s and put them in today's society, would they look any different? I would argue that they would be the same." A better question, she suggests, is "Why is there such a huge trend to be negative about the next generation?" This tendency goes back to the time of Socrates, she argues: "Older generations get fearful when younger ones are doing things they don't fully understand. "

The question of whether narcissism—the trait or the disorder—is on the rise is a subject of fierce debate in the research community. For example, while NPI scores have risen across generations, they have not done so as much as might be expected if a major cultural shift had taken place. Experts also disagree on whether it's fair to make cross-generational comparisons: Would the Greatest Generation have become as notable for its reticence if soldiers had been able to tweet from the European or Pacific theater?

What is clear is that people are always more narcissistic when they're younger. "Everyone is more narcissistic at 18, 19, or 20 than they are at 40," Trzesniewski says.

It's a logical developmental trend: Young adulthood is a time when people are largely free of responsibilities, either to their family of origin or the family they will eventually establish. "It's a self-absorbed stage of life, when you're trying to figure out who you are personally and professionally," says Emily Bianchi, an assistant professor of organization and management at Emory University. Her research shows that generations exposed to hardships, such as recessions, tend to end up less narcissistic than those that face fewer large-scale challenges. "Recessions seem to leave a humbling imprint on people who were young adults at the time," she says.

That may mean that Millennials—still struggling to establish themselves in a slowly recovering economy—might actually end up far less narcissistic than pre-2008 data would suggest.

On the World Stage

History offers many examples of figures presumed to have had narcissistic personality disorder. "A Napoleon complex is essentially being narcissistic," Rosenthal says. "And if you look at video of Mussolini, he has a dominant, chest-thumping body language, a very physical manifestation of what we might think of as narcissism."

Apparent self-assurance can propel a narcissist into power. "If you're a great talker and people gravitate toward you, then your ego might drive you to seek that out," Rosenthal says.

At first, people high in narcissism, and those with NPD, can be quite charming, easily attracting friends, lovers, and voters. Over time, though, their self-focus can become insufferable. People high on the narcissistic scale tend to annoy friends and loved ones, at least occasionally, while those with NPD may ultimately send them fleeing, serially costing themselves jobs, friends, and spouses. "People figure out that this isn't so great," Rosenthal says.

However, many people with healthy levels of narcissism are wrongly labeled as narcissists when interpersonal tensions rise. "Whenever couples are in high conflict, they become more self-centered," Malkin says. "Rage makes narcissists of us all." And when we feel hurt or angry, we tend to focus on our own psychic needs and fail to show empathy towards others—both classic narcissistic behaviors. After a parent-teenager conflict or a feud between spouses, the term narcissist might be thrown out, even when it never seemed applicable before.

Another reason partners may label each other as narcissistic stems from how we pair off in the first place, a narcissist being more likely to attract what Malkin calls an "echoist," someone who suffers from a lack of normal self-enhancement. "They fear being a burden, so they can easily end up partnering with their opposite and getting stuck in the relationship."

One clue that a potential partner might be a narcissist: He or she claims to be "great at everything—except relationships," Malkin says. Narcissists might announce that they don't need anybody. They'll admit to preferring a trophy spouse to true love. And they're unable to do the fundamental repair work every relationship demands.

Photo by Dean Alexander

Sparks of Empathy?

The impaired-empathy aspect of Narcissistic Personality Disorder can confuse those who haven't been trained to diagnose it. A complete lack of empathy would identify a psychopathic personality, but people high in narcissism, or with NPD, exhibit flashes of compassion. "The higher functioning narcissists have the capacity and ability to empathize," Huprich says, but ultimately their own needs come first. "The empathy is often shallow and short-lived. They'll acknowledge that someone else is suffering, but that will quickly dissipate so they can get back to their own self-promotion."

Within a relationship, narcissists might be able to show empathy until something upsetting occurs and they reflexively move to soothe themselves by putting a partner down. "Even a partner is worth sacrificing if it makes them feel superior," Malkin says

If a fragile self is the true underpinning of narcissism, one way to strengthen it is with self-compassion. A survey of more than 3,000 people showed that self-compassion led to more stable feelings of self-worth, as opposed to self-esteem, which has a stronger association with narcissistic traits. An emerging body of research suggests that "you can unblock the blocked empathy of people who are narcissistic by constantly focusing them on relationships, community, and connection to others," Malkin says. "It makes sense: Unhealthy narcissism is a way of coping with attachment insecurity. By increasing that security, narcissism drops."

That may be the most promising takeaway from the recent research on narcissism. Malkin says: "We used to think it couldn't be changed."

A Brief Cultural History of Narcissism

DSM-5 Girlfriends sketch from Inside Amy Schumer

In "DSM-5 Girlfriends," a sketch from the latest season of Inside Amy Schumer, a group of women gather to talk about recent relationships gone bad, each diagnosing her ex with increasingly pathological disorders, and then attacking the one woman who suggests they might be off base. Slinging personality disorders in casual conversation has never been more in vogue. It wasn't always this way.

Narcissism was once a term used mostly in academic research and clinical diagnosis. Then, in 1979, researchers developed the Narcissistic Personality Index, cultural historian Christopher Lasch published The Culture of Narcissism, and the term went mainstream. "In grad school, we talked about our narcissism freely," psychologist Craig Malkin says. In 2006, with Jean Twenge's book, Generation Me, the idea that narcissism was on the rise nationwide, and might be rampant among the Millennial generation in particular, entered the public consciousness.

Now some researchers are debunking claims of mass narcissism, expressing concern that a label meant to refer to a serious clinical disorder is being wielded after every breakup, family dispute, or selfie encounter. "We might throw around the term too much when someone is just a little bit of a show-off or ends up in charge," psychological researcher Seth Rosenthal says. Such individuals may have personality traits that seem similar to narcissism, but "to really qualify as a narcissist, they have to have certain other motivations and behaviors."

Most concerning for some experts is the thought of a cultural rejection of healthy expressions of confidence or self-esteem. "Self-esteem is healthy," psychologist David Ludden says. "Narcissism is something different."

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Narcissistic Personality Disorder (NPD): Causes, Symptoms, Treatment

Personality Disorders

What is Narcissistic Personality Disorder? What causes it? Who gets it and why? How do you deal with it? Find clear answers to these and other questions you may have about narcissism from top docs here. Get solutions and reassurance now.

Krista Soriano

Medical ReviewerJean Kim, MD

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What Exactly Is Narcissistic Personality Disorder?

A healthy (even sometimes inflated) sense of self can be a good thing. In fact, some researchers believe those who have somewhat grandiose views of themselves are mentally tougher, less stressed, and less at risk for depression. However, narcissism exists on a spectrum: On one side, it’s craving the occasional compliment. On its darkest side, it can creep into pathological territory.

Narcissistic Personality Disorder (NPD) is one of 10 personality disorders recognized in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The hallmark signs of NPD read like laundry list of what NOT to look for in a significant other: An inflated sense of self-importance, a lack of empathy for others, and a deep need for constant attention or admiration.

While someone with NPD’s self-esteem can be off the charts, ironically, it can also be super fragile, dependent on external validation, or self-deception. They’ll believe grandiose fantasies about themselves (i.e. they’re smarter, more attractive, and successful than everyone they know), easily put other people down, and generally hijack any conversation/situation to make themselves feel better or superior. Feeling “less than perfect” is very uncomfortable for a narcissist, and they’ll protect themselves from it at all costs.

A personality disorder like NPD is about disturbed relationships, says Modesto, California-based psychologist Robert Moody, PhD. “People with personality disorders, as a class, have a lifetime of struggles with intimate, interpersonal relationships with their family, friends, and co-workers—and that’s especially true for those with narcissistic personality disorder.”

The disorder affects anywhere from 0.5 to 5% ¹of the general US population with a greater prevalence in men than women.² The percentage is low because, in order to be diagnosed, someone with NPD has to admit they have issues—which they often don’t. “The real problem with a narcissistic personality disorder is that the individual lacks good insight into what’s going on,” says Dr. Moody. “They think that the problem is all about everyone else, not them.”

And it can manifest differently in men versus women. According to research, compared to males, a narcissistic female personality is more likely to include deep insecurity, martyrdom, jealousy, and competitiveness with other women, often seeing them as a “threat” (think the overbearing mother-in-law).³ Men on the other hand are more likely than women to exploit others and feel entitled to certain privileges. They’re also more apt to exhibit qualities of assertiveness or power hunger.

However, this is not to say these traits are exclusive to either sex. When it comes to vanity and self-absorption, both sexes rate equally.

Narcissism Subtypes

When you think of a narcissist, certain people you know may come to mind: case in point, the guy at the gym in the too-tight tank who’s more concerned with how his muscles look in the mirror than actually working out; the co-worker who fills her Insta feed with her face—at every angle. But narcissism isn’t just about looking pretty: There are, in fact, a few different types of narcissists.

Narcissism Subtypes

#1. The Covert Narcissist (or vulnerable narcissist). Basically the exact opposite of the stereotypical type, instead of craving the spotlight and constant admiration, covert narcissists tend to be shy, self-effacing, hypersensitive to how others perceive them, and chronically envious. They often think their pain or suffering is worse than everyone else’s—and may even believe they’re the ugliest person in the room.

#2. The Cerebral Narcissist. They derive their self-importance from their intellect, believing they’re smarter than everyone else.

#3. The Somatic Narcissist. Somatic narcissists get their self-worth from their bodies. They tend to obsess over physical appearance, including weight, and criticize others based on their appearance.

#4. The Spiritual Narcissist. They use religion or spirituality to intimidate or justify harmful behaviors to others that can creep in when an individual takes a "holier than thou" stance, overemphasizing their level of spirituality or closeness to God. Harmful behaviors can happen when, as an example, a church leader claims they had a vision from God about someone else, or that they're in a "higher" position to use Biblical passages to control, hurt, or shame someone.

Other types mentioned in NPD research include grandiose, or "overt"—that stereotypical over-the-top, attention-seeking type—and high-functioning, meaning those who may use traits such as competitiveness and exploitation to succeed in a profession or endeavor.

However, it should be noted that there is a broad spectrum of presentable traits with NPD, each with varying levels of severity, so subtypes should be used as guides rather than hard-and-fast rules.

What Are The Symptoms Of Narcissistic Personality Disorder?

Narcissism is a label that gets thrown around a lot, especially when someone seems conceited or acts out of self-interest, says psychologist Kristina Hallett, PhD, ABPP, associate professor of graduate psychology and the director of clinical training at Bay Path University in Connecticut. “But a narcissistic action every now and then isn’t the same as having a personality disorder.” With the latter, a narcissist’s self-absorbed and self-centered way of thinking and behaving surfaces in every area of their life, from work and friendships to family and love relationships.

The nine most common traits for NPD include:

  • Having an inflated sense of self-importance and entitlement. Deep down, you feel like you’re the best, most successful, competent, [insert praise here] in any situation.

  • Needing constant admiration. Your self-esteem is like a balloon without a knot, requiring a steady stream of attention, approval, and recognition to keep it inflated. No matter how much someone tells you that they love or look up to you, it feels like it's never enough.

  • Expecting special treatment. Whether it’s favors or apologies, whatever you want, you believe you deserve to have it—because you’re superior to everyone around you, and they know it and should comply.

  • Exaggerating achievements and talents. You have no problem embellishing the facts—or even outright lying—about your life, resume, and experiences.

  • Reacting negatively to criticism. Even though you crave control and take full credit when things are going well, you’re quick to blame others whenever a situation doesn’t go as planned. It’s extremely hard to accept criticism or admit to mistakes because, naturally, it’s always someone else’s fault, not yours.

  • Being preoccupied with fantasies about power, success, and beauty. You tend to create and believe exaggerated, unrealistic narratives around your success, relationships, even how good you look to help you feel special and in control. Anything that threatens the fantasy is rationalized away or simply ignored. You also want people to feel envious of you, and you feel pretty envious of people who have what you want.

  • Taking advantage of others. You often don’t think twice about using or exploiting other people to achieve your own ends—whether maliciously or obliviously. You care about your relationships and the people in your life on a superficial level—if they elevate your social status, or make you look or feel good, for instance—and you don’t really think about how your behavior might affect them.

  • Having an inability or unwillingness to recognize the needs and feelings of others. You’re super sensitive to how people treat you and react to your needs and feelings, but on the flip side, you can’t put yourself in other people’s shoes and empathize with their experiences. You might belittle others or even bully people to feel better about yourself. You never really “go deep” in any of your relationships, either—and, frankly, it doesn’t bother you all that much.

  • Behaving in an arrogant manner. With an inflated ego and sense of superiority and entitlement, you probably insist on having the best everything—the best car, office, designer clothes—monopolize conversations, look down on people you perceive as “inferior,” and only associate with those you think are equally special, successful, and talented.

How Is Narcissistic Personality Disorder Diagnosed?

NPD is not the kind of condition that can be diagnosed with a blood test, MRI, or exact scale, and according to the DSM-5, a person needs to exhibit only 55% of the above traits, symptoms, and behaviors to be considered narcissistic. But nailing down NPD can be a little more complicated. Since narcissists tend to think there's nothing wrong with them, they rarely enter treatment.

This in part may explain why we might feel we know and encounter many narcissists, but only an estimated 5% of people actually have NPD. (This is also why you can’t ask your therapist to diagnose your narcissistic husband with the disorder if he doesn’t think he has a problem.)

Narcissism hinges on personality traits alone—most of which are objectively negative (it’s pretty easy to label someone with these tendencies as, well, a jerk). But psychologists want to be extremely careful about pathologizing someone’s personality.

A clinical NPD diagnosis is given to someone who’s experiencing social and occupational impairment and subjective distress—which is a fancy way of saying that their narcissistic behavior is not only messing with their work and personal lives, but they’re actually aware that it’s destructive, and it’s making them uncomfortable.

In other words, if a self-entitled, grandiose, empathy-lacking person doesn’t see a problem with the way they live their life, they’re simply just a narcissist—full stop. A clinician usually won’t diagnose a narcissist with NPD until they’re struggling with their behavior and seek help to change it.

“These individuals most frequently come to therapy to either a) get support for their perspective; or b) because a family member is insisting and it’s easier to comply,” says Dr. Hallett. Sometimes, it takes facing a serious ultimatum, failure, or loss for someone with this personality type to get help, and it’s not uncommon for them to seek treatment for another mental health problem altogether, like depression.

What Causes Narcissistic Personality Disorder?

There’s no single cause of NPD. But, researchers agree that both genetic and environmental causes are at play. Individuals with narcissistic personality disorder have been found to have less volume of gray matter in the left anterior insula, the part of the brain related to empathy, emotional regulation, compassion, and cognitive functioning.

It can be hard to resist the confidence, assertiveness, and excitement that surrounds a person with narcissistic personality disorder. But those same traits that drew you to that person in the first place may eventually become a turnoff when you start to notice the impact of their unemotional response to relationships, the cruelty of their lack of empathy for others, and the grandiose belief they are greatly important and should be treated as such.

“By definition, personality disorders are developed over time and through childhood experiences, genetics, and environment,” says Dr. Hallett, noting that as an adult, narcissistic traits on their own are not likely to develop into a personality disorder. Often, NPD will begin in the teenage years or early adulthood.

Personality disorders are typically diagnosed at 18 years or older, according to Dr. Hallett. The thing to keep in mind with kids is that some narcissistic traits are simply just typical of their age (teenagers by definition are self-absorbed), and it doesn't mean they'll go on to develop a full-blown disorder.

Scientists believe that the full onset of NPD may occur when interpersonal development is compromised, for example:

  • Being born with an oversensitive temperament

  • Learning manipulative behavior from parents or peers

  • Being excessively praised for good behaviors and excessively criticized for bad behaviors

  • Suffering from severe childhood abuse or neglect

  • Inconsistent or unpredictable parental caregiving

  • Growing up with unrealistic expectations from parents

  • Being excessively pampered or overindulged by parents, peers, or family members

  • Being excessively admired with no realistic feedback to ground you with reality

  • Receiving excessive praise from parents or others focused on your looks or abilities

[Click to Learn More: 9 Signs You are Married to a Narcissist and What to Do About It]

What Are the Treatments for Narcissistic Personality Disorder?

For those who do seek help, “psychotherapy, also called talk therapy, can help by working to increase empathy and compassion,” says Dr. Hallett. Meeting with a therapist, you’ll learn how to better relate to others, which can encourage more functional and improved interpersonal relationships, as well as gain a better understanding of your own emotions and why you feel the way you do. Along the way, your therapist might work with you on:

  • Accepting and maintaining relationships with co-workers and family

  • Tolerating criticisms and failures

  • Understanding and regulating your feelings

  • Minimizing your desire to attain unrealistic goals and ideal conditions

But don’t expect a personality adjustment overnight: Treatment for NPD can be a long, slow-going, uphill battle—and just as with other personality disorders, patients may need to be more motivated than a typical therapy client to make progress and resolve their issues.

While in treatment, those with this personality type tend to be mistrusting and reluctant, exhibit negative reactions, and often drop out early. Since the work deals primarily with personality traits, which are pretty steady over time, it could take many years of psychotherapy before a breakthrough happens (as they say, you can’t teach an old dog new tricks).

The good news is, studies in intervention with those living with NPD have shown that some narcissists are in fact capable of learning and feeling empathy, which is the ultimate antidote.⁴

And while there are no psychotropic medications to treat the disorder specifically, keep in mind that the likelihood of a co-occurring psychiatric disorder along with NPD is a possibility. If you are living with this condition and also dealing with depression, anxiety, addiction problems or substance use disorder, bipolar disorder, eating disorder, or any other illness, you may be prescribed medications that are helpful in treating these conditions.

FAQs About Narcissistic Personality Disorder

Q: Do narcissists have high or low self-esteem?

Narcissists have high self-esteem. The thing is, they lack a secure sense of self-esteem, having what researchers call “fragile high self-esteem.” This form of high self-esteem is extremely dependent on external validation and self-deception or having fantasies of success, power, and beauty.

Q: Can a narcissist fall in love?

Yes, but their personality will make it very difficult for a truly intimate relationship to come into full bloom, says Dr. Moody. Unfortunately, the other person in the relationship may even not notice the red flags until several months down the line, when they realize that their relationship should have naturally reached a deeper level.

Q: How do I deal with a narcissist in my life?

Setting strong boundaries is an important way to protect yourself in any type of relationship with a narcissist. For coupled partners, participating in therapy to learn healthy ways to communicate, cope, and manage emotional distress can help. The good news is that the relationship can get better if both people are willing to stick through treatment.

Q: What are the different types of narcissists?

There are 4 types of narcissists. The covert narcissist tends to be shy, self-effacing, hypersensitive to how others perceive them, and chronically envious. They often think their pain or suffering is worse than everyone else’s—and may even believe they’re the ugliest person in the room. The cerebral narcissist derives self-importance from their intellect, believing they’re smarter than everyone else. The somatic narcissist tends to obsess over physical appearance, including weight, and criticize others based on their appearance. The spiritual narcissist uses religion or spirituality to intimidate or justify harmful behaviors to others. They might look down on anyone who is “unevolved,” “unawakened,” or “asleep” and claiming that they can't possibly understand you because they're not at your level of consciousness or spiritual/religious maturity.

Helpful Resources for Narcissistic Personality Disorder

There is no known way to prevent the condition, but if you suspect that you might be dealing with NPD, are in a relationship with a narcissist, or if a loved one is struggling with it, it’s important to get help as soon as possible.

  • Find a psychiatrist or psychologist who specializes in helping people with narcissism.

  • If you or a family member is dealing with narcissistic or psychological abuse, call the National Domestic Violence Hotline at 1-800-799-7233.

  • Read these tips on ending or leaving a relationship with a narcissist.

  • If you are physically threatened or abused, seek immediate help by calling 911.

  • Find more hotlines and organizations for support in our mental health resources directory.

Narcissistic Personality Disorder By The Numbers

  • 0.5-5% – the estimated percentage of people with NPD in the US population-based on community samples.

  • 50-75% – the percentage of people with NPD who are men.

  • 40% – the percentage of people with NPD who also have an anxiety disorder.

[Read This Next: What is Empathy and Why We Need It]

  1. Stinson FS et al. Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2008 Jul;69(7):1033-45. Available at www.ncbi.nlm.nih.gov/pubmed/18557663. Accessed September 14, 2020.
  2. Stinson FS, Dawson DA, Goldstein RB, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2008;69(7):1033-1045. doi:10.4088/jcp.v69n0701 Accessed September 14, 2020
  3. Grijalva E, Newman D A, Tay L, Donnellan M B, et al. (2015). Gender differences in narcissism: A meta-analytic review. Psychological Bulletin, 141(2), 261–310. Available at: https://doi.org/10.1037/a0038231 Accessed September 14, 2020/
  4. University of Surrey. Psychology research breakthrough suggests narcissists are capable of empathy. July 21, 2016. Available at: https://www.surrey.ac.uk/features/psychology-research-breakthrough-suggests-narcissists-are-capable-empathy Accessed September 14, 2020.

Sources

  • Pincus AL, Lukowitsky MR. Pathological narcissism and narcissistic personality disorder. Annu Rev Clin Psychol. 2010;6:421-446. doi:10.1146/annurev.clinpsy.121208.131215. Accessed September 14, 2020.
  • Papageorgiou K, Gianniou FM, Wilson P et al. The bright side of dark: Exploring the positive effect of narcissism on perceived stress through mental toughness. Personality and Individual Differences. Vol 139. March 1, 2019. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0191886918305877?via%3Dihub Accessed September 14, 2019.
  • Caligor E, Levy KN, Yeomans FE. Narcissistic personality disorder: diagnostic and clinical challenges. Am J Psychiatry. 2015 May;172(5):415-22. doi: 10.1176/appi.ajp.2014.14060723. Available at: https://ajp. psychiatryonline.org/doi/10.1176/appi.ajp.2014.14060723 Accessed October 13, 2021

Notes: This article was originally published October 13, 2021 and most recently updated April 25, 2022.

Krista Soriano

Krista is a content creative who is dedicated to human-centered, purpose-driven work. She's spent 10 years editing and producing content at one of the world's largest media publishers as well as award-winning startups. She's focused on topics ranging from lifestyle, sustainability, science, health, and wellness space.

Narcissists: who they are, signs of narcissism, rules of conduct

The article was checked and commented by clinical psychologist and scientific researcher Christina Andreyuk.

  1. Who is
  2. How to recognize
  3. Men and women
  4. Types
  5. Treatment
  6. How to communicate
  7. How to leave

Who is a narcissist?

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Narcissism is a feature of the psyche in which a person perceives himself as a unique individual, considers himself better than others, which is not always true. In fact, these traits are present in the character of many people. In a healthy personality, they result in ambition and a desire to please. But under a certain scenario, laid down in childhood, such behavior can turn into a pathology, which is often accompanied by other diagnoses, such as bipolar disorder and depression.

Contrary to popular belief, people with narcissistic personality disorder do not like themselves very much. Rather, they admire their grandiose projection, which allows them to close gaps in their own self-esteem. Such protection allows narcissists to avoid deep feelings and self-doubt. A person with this disorder does not tolerate minimal criticism, he perceives remarks as a personal insult and is able to throw a tantrum if someone refuses to admire him. You can check how narcissistic traits are characteristic of you or your partner using the NPI questionnaire [1]. The more positive answers a person gives to statements from the list compiled by American psychologists and researchers Robert Raskin and Howard Terry, the more narcissistic features appear in him. Meeting people with a true personality disorder is not easy. According to various sources, their number in society varies from 1 to 6%.

How to recognize a narcissist?

According to the American psychiatrists' handbook "Diagnostical and Statistical Manual of Mental Disorders" [2], there are nine signs of narcissistic personality disorder. If at least five of these are present, a doctor may suspect a disorder. Usually such a person:

  1. Has an inflated sense of self-importance. He often exaggerates his achievements and talents. Expects people to admire his actions, even if they were minor. If the narcissist organized the cleaning of the yard, then at least the district newspaper should write about it.
  2. Preoccupied with fantasies of unlimited success, power, beauty, or ideal love. To each new partner, the narcissist can say that he is the love of his life or wait for him to fulfill his fantasies. The beginning of such a relationship is a magical, but short period. In work, the narcissist, according to him, is a genius. If he has not been able to achieve great results, he is simply sure that success lies ahead of him, even if it is time for him to retire.
  3. Believes that he is not like others and has few equals. Therefore, the environment must match. The narcissist chooses “special” people as friends and partners, for example, with high social status or model appearance. Thus, he seems to reflect himself through them, because his problems are unique and can only be understood by special people. Narcissists like to be associated with big brands, whether it be in their work projects or clothing choices.
  4. Requires constant attention, recognition and admiration, even if you just took out the trash or cooked dinner.
  5. Absolutely sure that everyone owes him. Expectations for other people are usually very high. Close people are obliged to fulfill the requests of the narcissist at the first call.
  6. Uses other people to achieve his own goals. For him, it goes without saying. The narcissist is not used to sincerely thanking for services and does it only within the framework of the accepted ethical norm.
  7. It is difficult for him to experience empathy. Such people are not able to draw a parallel between their feelings and the feelings of others. Therefore, the narcissist does not even think about when he hurts someone. Very often, this behavior is mistaken for abuse by partners of narcissists. In fact, he may be concerned with how to hide the shame of his failure and not lose his greatness.
  8. Often jealous of others and believes that others envy him. In the latter case, it is by this circumstance that the narcissist explains the criticism of others in his address.
  9. Arrogant towards other people. Such a person absolutely sincerely believes that he is better than others, and other people's shortcomings are an excellent reason to assert himself.

To decide to end a relationship with a narcissist, write down the reasons for breaking up and keep the list with you

© Unsplash

Men and women are narcissists disorder in one form or another, men are more likely to be affected by this disorder than women. The data were collected over a period of 30 years, and the percentage ratio between the sexes did not change much during this time [3].

In doing so, the researchers noted two important points. First, male narcissists were more likely than females to exploit others and believe they were entitled to certain privileges. Secondly, men were more likely to seek power. Scientists explain this by the fact that until recently, leadership qualities did not meet the criteria for femininity. According to one of the authors of the study, Emily Griyalva, girls are more often criticized for aggressiveness and authoritarianism. Thus, society unconsciously suppressed manifestations of narcissistic behavior [4].

As regards vanity and striving for a bright self-presentation, in this respect there was no significant difference between men and women.

Types of narcissists and how they are formed

There are different approaches to the formation of narcissism, including studies that allow for genetic influence, but this is not a decisive factor in the formation of personality.

In 1914, Sigmund Freud stated that children somehow go through a stage of primary narcissism. He believed that this was an intermediate stage of growing up, but later he singled out other forms of narcissism, to a greater extent associated with mental disorders.

Neuro-Freudian Karen Horney argued that the development of such character traits may be due to the fact that parents in various ways pushed the child to create psychological protection. For example, they could delegate the embodiment of their ambitions or rejected the real manifestations of the child, instilling a sense of inferiority.

The contribution of parental figures to the formation of narcissistic disorder is also noted by psychotherapist and researcher Otto Kernberg. He compares narcissism with a false prop that a person erects in order to receive from others the admiration and confidence that he did not receive from his parents in childhood and cannot give himself in adulthood [5].

In the book of psychologist Elinor Greenberg "Borderline, Narcissistic, and Schizoid Adaptations: the pursuit of Love Admiration and Safety" [6], the author divides narcissists into three types:

  1. Open, or grandiose. Embodied stereotype. A bright character illustrating this feature of development and behavior. His whole being screams, "Look at me." This childish behavior indicates that a person is stuck at an age when adults pay a lot of attention to the child, praise him excessively, suggest that he is special, forgetting to teach him empathy.
  2. Hidden or depressive. Such people can grow up in families where one of the relatives, including mother or father, was a narcissist. At the same time, there was a high level of competition for love and attention. On the one hand, children copied the behavior model of narcissistic parents, on the other hand, such a child formed protective mechanisms, since an adult narcissist would certainly assert himself at his expense. Growing up, such people may not openly say that they are special. They would rather choose a person, a book, an object and exalt their virtues. Thus, the narcissist puts them on a par with himself. In personal relationships, such people do not like direct conflicts. Their weapon is passive aggression. A favorite technique is to promise and not deliver, and then blame the other person for everything. They tend to be insecure, and ambivalent behavior often leads them to depression.
  3. Perverse or toxic. Such people go even further. They love not only admiration, but also submission. Narcissists of this type love to wreak havoc around themselves, the same that reigned in their childhood in relationships with their parents. These narcissists often give their partners an emotional rollercoaster of humiliation and praise. They take pleasure in destroying other people's careers, destroying people morally and spiritually.

Mixed representatives of these types also exist.

Treatment for Narcissism

Most often, narcissists do not even suspect that something is wrong with them, because they do not tend to blame themselves for something. So if such people were seen by a specialist, then the reason for this could be related problems: depression, bipolar disorder, or excessive alcohol consumption. There is no cure for narcissism yet. Psychotherapy has a positive effect on such patients. Properly structured classes can help a person establish relationships with loved ones, learn to withstand criticism, stop despising themselves and others, set realistic goals and achieve them, and not dream of sky-high heights [7].

Although there is no cure for narcissism yet, psychotherapy has a positive effect

© Thiago Matos / Pexels

How to communicate with a narcissist?

Building an even relationship with a narcissist is not always easy. Some prefer to just cut them off. But what if this is not possible? Let's say that person is a family member or ex-husband/wife with whom you have children in common.

  • The first thing psychologists advise is to try to detach yourself emotionally. Ignore toxic statements and manipulations. It is useless to expect sudden changes in behavior from such people. According to research, narcissists do not tend to learn from their own mistakes simply because they are sure they did not make them [8].
  • Your personal boundaries are your guard against the actions of a narcissist. “This won’t happen to me anymore”, “I won’t fall for these manipulations” - phrases that will help to avoid an unpleasant conversation or intrusive requests of a narcissist. You can't wait for a response.
  • The shortest possible answers, conditionally “yes” and “no”, are your main allies in a dialogue with such a person if he began to resort to manipulation. By minimizing communication, you give him much less reason to hook on to some phrase and launch an attack.
  • Stick to the topic of conversation and don't get sidetracked. Perhaps your counterpart will try to knock you out of the saddle with accusations or get personal. In this case, the phrase “We are going off topic” will help bring the discussion back on track.
  • Compliments. If you really need to get something out of a narcissist, don't be stingy with praise. Most likely, he will even enjoy fulfilling your request. Yes, this is manipulation, but who said that only a narcissist can use this technique?

How to get away from a narcissist

The end of a relationship is never easy. With a narcissist, breaking up can be doubly difficult. For him, the fact that he was abandoned is an intolerable insult. That is why he will try by hook or by crook to bring the partner back. During this period, he will become sensitive and gentle, will swear eternal love and will do this until his victim loses his vigilance. Often, therefore, relationships with a narcissist develop into a cycle of breaks and reunions. Nevertheless, if you decide to put an end to your communication, psychologists recommend the following:

  • Write down the reasons why you want to leave. It's best to keep this list around in case the narcissist decides to drag you back into the relationship by talking about eternal love.
  • Give up illusions. It is difficult for such people to change, especially without the help of a specialist. Do you have time to wait until he finally learns to show empathy and respect?
  • Break all contacts. Ask a friend to pick up your belongings from the narcissist. Block this person in all phones and messengers. If you have children in common, at first ask someone close to you to be with you at general meetings.
  • Release your feelings. Breaking up, even with a toxic person, is always hard. Give yourself time to get over this situation. Just don't expect the narcissist to suffer in return. Most likely, during this period, he will try to restore his shattered ego and will choose not the most pleasant ways for this: either he will tell everyone what a bad person you are, or seek solace in the arms of someone else.

There are nine signs of narcissism, but five signs can already be suspected of it

© Martino Pietropoli / Unsplash

Kristina Andreyuk, clinical psychologist, researcher. Research interests: mentalization, manipulative behavior, personality disorders

In addition to family relationships, external factors can also enhance narcissistic traits. Media and social networks broadcast often unattainable ideals, and self-improvement services are imposed by advertising. All this can affect the psyche.

In "normal narcissism" people try to please others, to achieve success in work, which helps them to adapt in society. However, in the case of pathology, a person's ideas about themselves are distorted. In this case, the emphasis is on the grandiosity of his figure. He experiences difficulties in forming adequate ideas about other people, abuses manipulations, grossly violates the boundaries of the interlocutor and ignores his comfort. Narcissistic features can manifest themselves in pathological perfectionism, hypochondria, constant attempts to correct their "flaws", including, for example, transforming one's appearance as the most noticeable attribute of self-presentation for others.

On the surface, narcissists give the impression of being rather pleasant people. According to research, many socially active narcissists have charisma, know how to hold an audience, are not afraid to express themselves, appear self-confident, and have high claims regarding academic and professional achievements. These qualities often show up in job interviews and help narcissists get into leadership positions. However, such bosses may use too subjective criteria when evaluating employees, focusing not on their professional achievements, but on the degree of admiration, devotion, and the absence of doubts about the correctness of the leader's decisions.

Close relationships are difficult for narcissists. In partners and friends, they are primarily looking for confirmation of their exclusivity, superiority (which reinforces vulnerable self-esteem). Often, such people confuse the attachment that accompanies healthy partnerships and collaborations with the addiction that can shackle and inspire fear. The demands of constant adoration and recognition of their grandiosity, which the narcissist often implements in the form of excessive control over the thoughts and feelings of a partner, in most cases, sooner or later are not fully satisfied, which leads to conflicts and increased manipulative behavior.

If you have found any manifestations of narcissistic traits in yourself and want to change them, then it will be useful for you to develop the skills of self-reflection, mentalization (understanding mental states), work on the development of emotional intelligence, empathy (for example, discuss with friends the films you have watched, read books in terms of understanding the inner world of the characters, their motivation, etc. ). It is very important to learn to analyze what is happening from different positions, without sliding into extreme points, such as, for example, idealization and depreciation - look for alternative explanations. Try to look at situations or actions from different angles, noting the possible positive aspects of seemingly negative events, including during conversations with loved ones.

If your loved one has narcissistic traits, you need to learn how to track the emotional states of both you and your interlocutor. It is necessary to soberly analyze situations of interpersonal communication. For example, learning to recognize imposed guilt requires being able to maintain your boundaries and autonomy of choice. Psychotherapeutic help will be useful in both cases.

Tags: psychology

“To be happy, I need to become the king of the world”: what it is like to live with narcissism

Narcissism is a mental trait shrouded in many myths. Narcissists are feared and sometimes envied, portrayed as those who easily manipulate other people's feelings for personal gain. On any psychological resource you can find a lot of advice on how to save yourself from a charismatic, but heartless and extremely dangerous narcissist (he usually appears in the guise of a successful man).

In fact, the real narcissist's world is not at all rosy. An inflated ego protects a very vulnerable person who is tormented by anger, shame, disappointment in life and a tendency to depression. Afisha Daily talked to people whose diagnosis sounds like "narcissistic personality disorder" and a psychotherapist to find out what narcissism is from the point of view of science and what it's like to live with this feature.

Artem

Radio engineer, Australia

How to detect narcissism

I had no idea what exactly my problem was until it was pointed out to me directly. Once I had depression, during which I started looking at groups about mental problems on the net. In the community dedicated to bipolar disorder and narcissism, I found many life things. On the advice of the group admin, I went to psychologists and psychotherapists, who pointed to a pronounced narcissistic radical. At first, experts believed that it appeared due to an exacerbation of bipolar disorder, but in the end I was diagnosed with narcissistic personality disorder.

The disorder greatly affects both my condition and mood. And I'm not just talking about a "bad" or "good" mood, but about severe depressions that can lead to suicidal attempts, binges and self-destruction. And there are moments of "grandness" when you feel like the king of the world. There is rarely anything in between. By the way, even in depressive states, megalomania does not disappear.

I feel exhausted from narcissism because I constantly have to do something, but nothing brings me pleasure if it does not work for status or recognition. I can't do something just because I like it.

It seems that in order to be happy, I need to become the king of the whole world. But even if I became one, I would still be dissatisfied. There is only short-term narcissistic euphoria, and there is no happiness and pleasure from life.

How narcissists really live

The image of the narcissist in popular culture as a narcissist who exploits mere mortals is close to reality, but very superficial. Everyone is capable of taking advantage of others and everyone is narcissistic in some way. Perhaps there are tough manipulators among narcissists, I can't speak for everyone, but in general we are strongly demonized.

Narcissism also has some advantages. For example, I need to always look good in front of others, and this pays off. I know how to raise other people's sense of self-importance, because I myself need it. I also can’t have sex with just anyone, I can only do it with special and very close people to me, because others are not worthy of my attention. But there are more cons. For me, the main difficulties are envy of more successful people, depreciation of my own achievements, a feeling of emptiness inside and constant rivalry.

Behind the narcissist's charisma lies a fear of appearing ordinary, behind ostentatious narcissism is a very low self-esteem, behind arrogance is a fear of insignificance, behind exploitation is a desire to be accepted.

I have no desire to constantly use people, and I do not. I also have no need to hurt anyone. But I need to be special in the eyes of others, worthy people, I need their recognition. If you don’t get this, you quickly slide into a feeling of your own insignificance and paranoia. This is called the lack of narcissistic nutrition, which shakes the mood.

I can't open up to people because it's embarrassing. This shame is unbearable, but sometimes I don’t even realize it, because the fear of shame is even stronger.
Envy in narcissism is very painful. It really hurts from her. You can just see how someone is having fun hanging out, and that's it, you immediately feel bad.
Or depreciation. Everything that I have achieved in life will be devalued by me in a short time - a new house, an expensive car quickly become nothing, as if it never happened. And because of this, it’s empty inside, you gradually fall into depression.

In relationships, unfortunately, the same. I idealize people because I need special people. But idealization sooner or later passes, and I lose interest in an ordinary person. That's the end of the relationship.

Rivalry among narcissists is also not very healthy. You don’t notice how you start to compete even with the guy in the queue for a psychotherapist.

I don't have examples to inspire because they are perceived as rivals. If my girlfriend becomes successful, I compete with her.

There is a feeling of emptiness inside me - this is due to the lack of a real personality. That is, it exists, but it is hidden very deeply, because it was badly wounded in childhood. If someone hurts the real you, there is fear. As a result, you hide even deeper. And then you yourself don’t understand where you are real: what features are really yours, what feelings you experience, how you really relate to people. You don't know anything about yourself. But at the same time, you feel that everything around is hostile.

I would like to have a healthy narcissism like other people. So that my achievements make sense, so that it is easier in relationships, so that I don’t exhaust myself with constant attempts to achieve something that never bring satisfaction.

How to cope with narcissism

Doctors told me that narcissists need to be “warmed up”, that is, to be an understanding, loving partner for them who does not criticize or compare with anyone. Also, the partner can repeat the narcissistic injury, but with a positive outcome, that is, show that it can be different. But for this, it is necessary first to ensure that the narcissist trusts his partner or therapist with his real self, and before that he himself realizes what he is real.
Non-specialists often unknowingly take on this task, do everything wrong and, as a result, harden us even more. Therefore, I recommend professional psychotherapy.

I once managed to be ordinary for a short time thanks to a healthy relationship. The girl accepted my antics to the end and saw me as special, even when I revealed my vulnerabilities. She was unconditionally with me in everything and considered me perfect. Then we gradually began to move on to the fact that I can be worse than others in some ways, but she still loves me. This took about four years. And then I got aggravated again. But I believe that in the future I will be able to cope with frustration and not act like an asshole through love and acceptance.

Elena Shmeleva, 20 years old

Public admin panel Face Your Disorder

How to understand that you are a narcissist

I first thought about the reasons for my condition after a friend said that I looked like a person with a narcissistic disorder. I decided for fun to take a couple of tests on the Internet for NPD (narcissistic personality disorder. - ed. ) and was shocked when I got the maximum score. I decided to study the issue, and then for the first time in my life everything fell into place. Everything was like in classic articles: “I read the stories of patients, studied the symptoms and saw myself in each of them.” Later, a psychiatrist confirmed that I had three diagnoses: narcissism, bipolar disorder, and an eating disorder.

I would like to note right away that NRL is primarily a problem for the patient himself, and not as is commonly believed. Not all narcissists are monsters and abusers, although we are able to piss off others with ostentatious self-confidence and a desire to be in the spotlight.

Living with NPD is hard because this disorder makes happiness unattainable.

Some will object that it is a priori impossible to be happy all the time. But it is impossible for a narcissist to be satisfied with anything even for one week. The joy will last at best for a couple of days, and then we will again plunge into the swamp of self-criticism. Even if you have achieved everything, it will sadden you, because now the dream is over and there is nothing to strive for. A narcissist has two paths in life: either you become a workaholic and break into a cake in order to achieve heights (and it doesn’t matter in what exactly), or the desire to even try will die in you.

What the public thinks of narcissists

When people talk about narcissists, they always mean the grandiose version of the disorder. But there are no less depressive narcissists, and they are far from this brilliant image.

The grandiose narcissist was able to adapt to parental pressure with the "win always" mindset. Imagine Tony Stark from Marvel comics - in my opinion, the most flamboyant grandiose daffodil.

A depressed narcissist in the same circumstances will fold his hands and will not even try to express himself. I think the reason is that in childhood he was so crushed by demands that he lost hope of becoming better than his peers in some way. However, if you dig deeper, they are brothers in spirit, since both live with an emptiness inside that cannot be filled. There are also mixed types of narcissism (just my case): a person who outwardly is prosperous and self-confident, but in fact he is constantly devoured by self-criticism and fear of competition.

Our most hated myth : "All narcissists are evil abusers." There are many resources on which women demonize violent men. They are sure that if the ex-husband is the last asshole, he beat, scolded, limited everything, then he is definitely a “toxic narcissistic psychopath”. But to be an asshole, you don't have to have any disorder and even, imagine, you don't have to be a psychopath. Narcissism shouldn't be a stigma that turns the average person into a villain, it's a personality disorder that hurts ourselves in the first place.

Myth 2 : “Children who are spoiled too much become narcissists.” Also fundamentally wrong. There is little in common between high self-esteem and narcissism.

Most often, narcissists are unloved children who have been criticized and shamed for not being perfect.

Third myth : "Narcissists are heartless and unable to listen, help, sympathize." In addition to emotional empathy, which we have weakened, there is intellectual. Even if we do not experience what you feel, we are able to imagine what it is like, listen carefully and give advice. Such support has an advantage: the ability to analyze the situation and find a way out with a cold mind.

About living with narcissism

It's hard to talk about the benefits of having a personality disorder, but in some ways it really helped me. In the darkest periods of my life, it more than once saved me from suicide, because I could not afford to "leave unknown, unsuccessful and useless to anyone."

But the number of difficulties it causes is enormous. It's hard to be in a relationship, because we have huge problems with trust and shame. Narcissism is living in an eternal confrontation between the "real me" and the narcissistic façade.

Narcissists may have different stories of becoming a villain, but we all agree on one thing: we hate our real, weak selves. Because they were scolded by their classmates, their parents did not like them, they were too emotional and open to this world. We were all hurt at some point, after which our life was divided into “before” and “after”. And then for several years we built up armor, created the appearance of cheerful, unflappable, super-confident people who have no weaknesses and negative feelings like pain and sadness. But when we first come across the realization that we have been living a lie for so many years, it becomes scary and sickening.

Because returning to your real self - weak, stupid, useless - is worse than death for a narcissist.

I would like to get rid of narcissism. Now I am undergoing drug therapy and drinking almost the maximum dose of an antipsychotic, which has alleviated both the symptoms of bipolar disorder and narcissism. But, unfortunately, there is still not enough money for psychotherapy, and with the doctor we limit ourselves to discussing symptoms and medications. I could tell the doctor more, but the disorder prevents even a psychiatrist from admitting his weaknesses.

I often envy "mere mortals" who genuinely enjoy buying a new pair of shoes, moving away from their parents, and even just good weather. I would like to learn how to open up to others, to be happy just because I have a job and a loved one, and not constantly think that I should become a star and move mountains.

— What is narcissism?

Narcissism is a concept that came to psychiatry from psychoanalysis, Sigmund Freud proposed it back in 1914 year. Today, there are many concepts regarding how it develops, manifests itself and how a psychotherapist should work with it. At the basis of this phenomenon lies the idea of ​​one's own grandiosity and easily arising shame because of thoughts about one's imperfection.

- When is it a disorder, and when is it just a personality trait?

Narcissism can be expressed in different degrees: from individual narcissistic reactions of a healthy personality to disorders of a psychotic level. The first case is normal, almost all people show such reactions in certain situations. For example, they react painfully to criticism, humiliation.

A person without narcissistic traits is a person without ambition, he lies on the couch and does not strive for anything.

There are many typical narcissistic personalities in big business and politics, because these are people for whom public recognition and external attributes of success come first. They need to move up within a clear hierarchy, they won't do something just because it's interesting and creative.

A personality disorder is when these reactions are so pronounced that they interfere with normal social life: work and, most of all, relationships with loved ones. Such people are fixated on external success, the pursuit of excellence, the struggle for recognition. But their trouble is that they do not see, do not feel the emotions of other people, they often confuse where their own desires are, and where are the expectations of others.

In Russia, the diagnosis of narcissistic personality disorder is usually not made. I think the reason is the domestic distrust of psychoanalysis, which was not officially recognized until the 1990s. Narcissism often co-occurs with other disorders, such as depression or bipolar disorder, and the patient gets help for this first.

There are also quite rare psychotic cases of narcissism, when the feeling of one's own grandiosity reaches the scale of delusions of grandeur or paranoia - it seems to the person that he is being watched, he is constantly discussed behind his back, all events revolve around his personality.

— What is the cause of narcissism?

Narcissistic personality disorder often develops in childhood. One possible reason is the so-called narcissistic expansion of one of the parents (usually the mother). Such a mother sees in the child not a separate personality, but a continuation of herself, a person who will fulfill her unfulfilled dreams and realize her ambitions. Narcissists are raised by parents who "always know what's best", scolding the child not for specific misconduct, but for the fact that they are "not the way they should be." A small child tries with all his might to earn praise, but, trying to live up to expectations, loses his own identity.

— Is there a link between narcissism and abusive behavior?

Contrary to popular belief, narcissism is not related to violent tendencies. Narcissus is himself a sufferer, doomed to torment from his own imperfection. I wouldn't call him an abuser per se. Rather, due to his lack of empathy for those around him, he can be considered an "energy vampire." After all, this person is constantly busy not with a partner, but with himself. In relationships, he is concerned about how not to lose his grandiosity and protect himself from shame for his failure. The typical abuser is not a narcissist, not a psychopath, and not mentally ill at all. Usually this is quite a healthy boor.


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