Understanding the Narcissist – a Closer Look at Narcissistic Personality Disorder

If you’re like most people, you’ve encountered at least a few narcissistic individuals in your lifetime. You know the type – the person who is typically described as vain and self-absorbed. They often regard themselves as the center of the universe – and you (along with everyone else) are expected to cater to them, even if that means neglecting your own needs and desires.

Although many people can be selfish and conceited from time to time, some individuals take it to a whole other level. When these traits define the person – and they negatively impact everyone who is part of their life for as long as they are a part of it – they usually signal a mental health condition known as Narcissistic Personality Disorder. Like all personality disorders, naricissism can have far-reaching consequences for both the one suffering from it and the people who care about them.

What are Personality Disorders?

Before taking a closer look at narcissistic personality disorder, let’s consider what the term “personality disorder” actually means. Although they are complex disorders, a personality disorder is essentially characterized by a person’s consistent use of maladaptive coping techniques throughout their adult life. This is especially evident in social situations.

Individuals with personality disorders have significant difficulties in their personal lives as well as their professional lives. It’s not uncommon for them to harbor feelings of distress that cause them to act out in various situations. Although these individuals do experience many consequences of their disorder, those who are impacted the most are those closest to them.

There are several different types of personality disorders, each with its own unique set of traits or symptoms. As with all disorders, the degree of severity can vary quite a lot.

Narcissistic Personality Disorder

Individuals with narcissistic personality disorder have a very distorted sense of self. They are generally “grandiose”, which means they have an inflated or exaggerated opinion of their positive traits and / or abilities. Even though some are very attractive, highly intelligent, or exceptionally talented, narcissists typically regard themselves as elite or exceptional compared to everyone else. Regardless of their actual social standing, they perceive themselves as very important – and expect others to view them as such.

Narcissists thrive on the praise and admiration of others. Their air of superiority is exaggerated often quite obvious, although some narcissists are very skilled at pretending to be humble when necessary. However, their grandiosity can easily be shattered by criticism from others. When this occurs, it usually elicits rage, rejection, or a torrent of condescending remarks skillfully rendered to put the offending person in his or her place.

Narcissists, as a general rule, are very selfish. They have very little, if any, empathy for others. They may pretend to, however. Successful narcissists can initially come across as very understanding, very giving, and very selfless. In time, however, this façade will crack because they can’t sustain it. Their true colors always show eventually. Sadly, this can be quite a shock to anyone who was initially fooled by their act.

In the eyes of a narcissist, the world literally revolves them. They regard other people as objects, whose sole purpose is to either “mirror them” (and by doing so, enhancing their inflated view of themselves) or to cater to their needs. This is why being in a relationship of any kind with a narcissist is very difficult, and over time can be very painful. As most have found, trying to have a genuine relationship with a narcissist is a constant no-win situation. No matter what they do, or how hard they try, it’s never enough and it’s never right.


As with all personality disorders, the symptoms of narcissistic personality disorder occur repetitively and to a significant degree. While many people exhibit some or all of these symptoms at various moments in time, it doesn’t necessarily mean that they have narcissistic personality disorder. With narcissism, the symptoms don’t just appear once in a while – they are a consistent part of their makeup. They always impact their relationships. When these symptoms are present consistently, a diagnosis can be made by a qualified professional. Keep in mind, though, that narcissisms very rarely seek treatment so many are never officially diagnosed.

  • Exaggerated sense regarding their accomplishments and talents
  • Unreasonable expectations of favoritism
  • Striving for constant admiration and attention
  • Obsessive self-involvement
  • Inability to feel empathy; lack of a sincere interest in others
  • Use of others to get what they want in life
  • Belittlement of others to boost their fragile self-esteem
  • Slightest criticism is met with rage and/or shame
  • Inability to maintain healthy relationships
  • Fantasies revolving around personal success and attractiveness

Problems Often Associated with Narcissistic Personality Disorder

Ironically, most narcissists are not really bothered by their symptoms. They have an amazing ability to rationalize their problems or blame them on someone or something else – they very rarely take any personal responsibility for their problems. However, their personality disorder often does create significant problems in their life. These may include:

  • Alcohol or drug abuse
  • Frequent relationship conflicts with significant others, friends, family members, coworkers, and employees or employers
  • Depression
  • Anxiety
  • Suicidal tendencies
  • Co-occurring mental disorders

Narcissists are particularly vulnerable to depression if their world implodes. As long as they can stay buoyed by their inflated sense of superiority and success in life, symptoms of depression are kept at bay. But if things spiral out of control and they hit rock bottom, the depression they feel is very real. It may lead to self-medicating with alcohol or drugs, and can also lead to suicidal thoughts and actions. On the rare occasion when a narcissist does seek therapy on their own, depression is often the motivating factor.


Science has yet to reveal a specific cause of narcissistic personality disorder. However, family dynamics and parenting during early childhood are believed to play a significant role by many experts. For example, children who have experienced extreme parenting with regard to affection or excessive pampering and praise are more likely to develop the disorder. Severe neglect and abuse may also play a role in some cases.

There may also be a genetic predisposition or hereditary factor. Some believe that individuals who are overly sensitive to feedback, both positive and negative, have a greater risk of developing this particular personality disorder. Still other theories suggest that cultural influences such as narcissistic TV role models or war-infested environments preclude developing the disorder. Most likely, it is a combination of factors that lead to the development of narcissism.


To date, there are not blood tests or other lab tests to determine if someone has narcissistic personality disorder (or any personality disorder, for that matter). A diagnosis is typically made by psychologist, psychiatrist, or other mental health professional based upon a diagnostic interview of the patient. Since patients with personality disorders – particularly narcissism – tend to give a very distorted picture of themselves and others, information provided by a family member, spouse, or close friend will often make the diagnosis clearer. Psychological testing may also reveal patterns that suggest the presence of a personality disorder.

A physical exam and other tests can be helpful in terms of ruling out any medical issues or substances that may be contributing to or causing symptoms.


While medication can help treat symptoms of depression or anxiety that may also be present, there is no medication that is effective for the treatment of narcissistic personality disorder. Psychotherapy may have some effectiveness, but even that is limited and often requires years of treatment to make any real progress. Those who will benefit the most from therapy will generally be on the mild end of the narcissistic continuum.

Family therapy, couples therapy, and group therapy can be beneficial in terms of helping the narcissistic individual gain some degree of awareness of their impact on others. Couples or family therapy can be beneficial to those who live with a narcissist in terms of helping the spouse or other family members develop a greater understanding of the disorder. Because the prognosis is poor, most – if not all – health insurance plans do not cover the treatment of narcissistic personality disorder. This can make it financially unfeasible for many people to have ongoing therapy.

Dealing with a Narcissist

Living with someone exhibiting the behavior patterns such as selfishness and lack of empathy can be trying at best. Convincing them to get treatment will also be difficult because admitting they have any flaws goes against their inner belief that they are superior. However, the best way to begin to cope with a narcissist partner or family member – especially if the person is unwilling to get treatment – is to seek therapy for yourself.

A skilled therapist can help you understand the narcissist’s world and guide you with regards to how to best interact with the person. You will need to accept, however, that narcissists rarely make any significant changes – even if they do go to therapy. At some point you may have to make a tough decision. Many people come to the conclusion that it is simply not in their best interest to stay in a relationship with a narcissist.

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