Narcissistic Personality Disorder

The term “Narcissistic Personality” is popping up a lot in the news currently, so I thought it would be a good subject for a blog. Any time a mental health diagnosis begins to surface a lot in popular culture, distortions and misunderstandings occur about what it really means. This has happened a lot with the diagnoses Bi-Polar Disorder and ADHD.

I’ll warn you up front that this is a longer than usual blog, but the subject matter is complex and I want to make sure I cover it well so you have a good understanding of it.Let’s start by defining what’s meant by “personality disorder.”

Definition of Personality Disorder

Here’s a definition from the American Psychiatric Association:

A personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.

In plain English, this means that someone develops a pattern of personality traits (ways of thinking, feeling and behaving), that are not in line with what our culture sees as normative or okay.

These patterns are considered to be pathological or abnormal, and show up in a person’s self image, character (distorted or lacking), relationships, social interactions, and work behavior.

In general, personality disorders are not diagnosed until late adolescence, usually 18 years of age. That’s because during adolescence we are still developing and solidifying our identities, character, and personality traits. You can sometimes see precursors of an enduring personality disorder among some teens, especially those that are already sociopathic, however, the diagnosis comes later when it appears that the personality traits are fixed across time and show up in the main areas of a person’s functioning.

Personality Disorders are not mutually exclusive which means someone may have characteristics of more than one personality disorder. This is true of what’s called Malignant Narcissism which I’ll discuss a little further on.

Personality Traits of a Narcissistic Personality Disorder (NPD)

Here are the main characteristics or personality traits that are seen in people who are diagnosed with Narcissistic Personality Disorder:

Lack of Empathy

This is perhaps the hallmark trait of this personality disorder.

NPDs cannot and do not recognize others’ feelings, needs, desires or experiences. When interacting with anyone, the prime objective is always to cater to oneself, sometimes at the expense of the other person.

All conversations or interactions will focus on or veer back to the NPD. They are not interested in how someone else is doing, what they think, or how they feel, unless what the other person has to offer is flattering or useful in meeting the NPD’s goals.
If you ask for something, voice a need, or express a true feeling, you will be seen as weak, and will be made to feel small or dismissed.

NPDs are famous for one-upping.


NPDs are highly grandiose, and have a very exaggerated sense of themselves and their worth.

They use big words, big numbers, extreme adjectives, and expansive gestures, all of which always point back to how great they are.

The words “the best” appear often in relation to themselves, their accomplishments, or who they know.

Constant Need for Admiration

Narcissists need excessive and constant admiration and adoration. They will require it from those around them and verbalize it themselves.

They see themselves as having excessive talent, intelligence, looks, popularity, and power.

Conversely, they are extremely envious of those who are admired by others, and may openly attack or try and sabotage them.

Entitlement and Special Treatment

NPDs feel entitled to have things others don’t.

They have different rules or are above the rules.

They expect to be treated with high regard at all times, and to receive favorable treatment. They are often quite cocky and brag about their ability to get away with more than other people do, or to have more, or hold a special place at the top of the hierarchy. They can be manipulative, arrogant and quite self-centered.

Blame Others for Mistakes or Failures

When a Narcissist makes a mistake, he blames it on someone else. He doesn’t take responsibility for his failures, and in general won’t admit to them. He will find a scapegoat, or completely rearrange the facts of a situation to release himself from responsibility.

Preoccupation with Unlimited Power, Success, Status, Beauty and Ideal Love

NPDs seek power and outward success, and align themselves with others in highly powerful positions. They can also be very envious of those who threaten their view of themselves as being better than everyone else.

They may seek ideal love, but in actuality are not really capable of love.

They become infatuated temporarily until the other person has served his or her purpose which is to make the NPD feel special.

Exploitative, Manipulative, and Vengeful

Any hint of criticism will bring on revenge of some sort, or a cold dismissal.

Distort Reality

NPDs are actually highly emotional, even if they appear in some cases to be very cool and dismissive. Their main goal is always to preserve and enhance their grandiose self image. As a result, they do not make use of what’s called executive function.

That means they can’t take in information and analysis facts in order to make reality based decisions. They distort factual information, and often scoff at it.

They do not learn from experience, and so they make repetitive mistakes. They are unable to observe themselves critically. They use words to provoke emotions in others rather than as a means to actually communicate. Conversations with them can be cut short without explanation, or feel very twisted and muddy.


In general, there are more men with NPD than women. Between 50 and 75 percent of NPDs are men.

NPDs and Relationships

It is very difficult to be in a relationship with a Narcissistic Personality. These folks don’t have real and abiding attachments to others.

They see others as either an extension of themselves, or as a means for some sort of self gratification, or as a vehicle to achieve something they want.

If you’ve ever been involved with someone who has this type of disorder, you’ll note that they rewrite history as they go. They distort whole conversations held previously, and any attempt on your part to remind them of something that was said or done will be met with anger, a counterattack, and usually a flat out denial.

If they do something for you, it isn’t out of real love or concern, but rather because it will get them something or add to their need to be admired.

NPDs can sometimes pose as pillars of the community by participating in charitable events, however, their participation is a vehicle to point out how wonderful they are rather than a feeling for the charity itself or for the recipients of the charity.

They view their spouses and children as extensions and commentaries on themselves. “I have the most beautiful wife, and the most accomplished kids.” As soon as the spouse or child does something disappointing that will not reflect well on the Narcissist, he will turn away icily and emotionally abandon them.

Worse, many NPDs are envious and jealous of their children. They insist that the child achieves and reflects well on them, but at the same time is jealous that the child may surpass them.

If they become too threatened by a child’s success, they will subtly or not so subtly sabotage it. They often compete with their kids, and involve them in contests where they will win, leaving the child feeling small and inept.

When you meet a Narcissist, you may have one of two experiences:

  • The first is that for some reason, the Narcissist sees you as having some special beauty, power, status, or importance in which case he will place you on a pedestal and shower you with accolades.
  • The second is that you will immediately feel insecure, less than, dismissed, or put down. Narcissists gravitate towards powerful figures, and will ingratiate themselves to win over those people in order to feel powerful themselves. If they experience you as less powerful than themselves, they will dismiss you, often with haughtiness, condescension or disdain.

A note about the pedestal: it never lasts. You will eventually fall off, or in most cases be thrown off. Narcissists do not have real and lasting attachments. Involvement with them long-term can be emotionally damaging. They’re abusive.

Work and Public Image

NPDs can succeed in a work setting. You will find them leading companies, in positions of political power, professors in university settings, attorneys, entertainers, and even as innovators. In whatever setting you find them, they will always have problems in relating to other people, and will be described often as arrogant, abusive, unbending, and authoritarian. They see themselves as above the grade, and if you work along side of them, you will always be in a subordinate position. Everyone is dispensable. They can turn on you in a heartbeat if you either oppose or criticize them.

In many cases, NPDs sabotage their work relationships and are not successful. They are ultimately self destructive because they cannot make use of previous history or foresee the consequences of their actions, and they don’t realize that others will eventually see through them.

They are also very often impulsive, overly reactive, and attacking when they feel insecure.

They have no real ideology or values to speak of other than the promotion of their grandiose self.

In positions of power, they can be quite dangerous.

Malignant Narcissism

Malignant Narcissism is a more extreme form of narcissism because it mixes in characteristics of other personality disorders, especially Antisocial Personality Disorder. Malignant narcissism is considered to be untreatable. Wikipedia defines it as follows:

Malignant narcissism is a psychological syndrome comprising an extreme mix of narcissism, antisocial disorder, aggression and sadism.

Someone who fits this category has all of the characteristics of a Narcissistic Personality Disorder as I’ve outlined above, but in addition has traits that include extreme manipulation and usury, lack of remorse, involvement in illegal and/or sociopathic behaviors, and a tendency to seek sadistic pleasure in harming anyone in his or her way.

Outwardly charming, these people have absolutely no conscience and no attachments to others.

NPDs are different in the sense that they do need to be admired, and generally don’t get involved in criminal activities or have record of such activities. They bend rules, however, usually stay under the legal radar. Those with Malignant Narcissism ride that bridge between Narcissism and Psychopathy, and can become involved in illegal, aggressive, and sadistic activities with no real remorse.

The main difference is that a Narcissist’s goal is to feed his grandiose sense of himself and garner admiration, whereas the goal of an Antisocial Personality is his own power and gratification without any real concern for how anyone sees him.

The combo is a person who is concerned first and foremost with focusing on the grandiose self, but also involves himself in illegal and often criminal ties, as well as promoting sadistic actions that will bring harm to others, especially those he considers to be needy and weak.

Can they be treated?

Someone who has what I call narcissistic trends rather than a full blown personality disorder can be successfully treated. In these circumstances, the person can learn to be more empathetic and to maintain a real attachment to another person. Someone with a full-blown Narcissistic Personality Disorder whose patterns are well entrenched usually is not treatable. NPDs may change as they age, and become less difficult to deal with, and even soften a bit, but their personality structure remains intact. Those with Malignant Narcissism cannot be treated.

NPDs don’t initiate treatment because they don’t see themselves as having problems. If they do enter into treatment, it is usually because someone else initiates the treatment such as a spouse or a child. In both cases, the NPD will use treatment to point out what’s wrong with everyone else, and they will not continue if there is any hint that they need to make changes.

The interesting thing about NPDs is that they are highly dependent, although they would never admit or recognize this.

Because they need a continuous feed of admiration, they must be linked to others. They also often cannot run their lives all that well because they don’t foresee the consequences of their actions, can’t think objectively, have low frustration tolerance, can’t regulate emotions, and as they age can feel empty and depressed.

They become attached to those that will take care of them even as they abuse them.

Successful psychiatric treatment requires recognition of the problem at hand, as well as a commitment to staying in treatment over time until progress is made.

Sometimes someone who has aged, or who has suffered a severe loss, may enter treatment and if they stay long enough and have a therapist that understands the psychopathology well enough, treatment can have a positive effect. It requires an ongoing attachment to the therapist and a rebuilding of the basic trust normally acquired in the first years of life.

What are the Causes?

There is a lot of controversy about this, and in general researchers disagree. The two causes most often noted are related to parenting and early environment.

  • One is that a child is raised with excessive pampering, permissiveness, doting, and admiration while also being rescued from having to live with the consequences of their actions, having no limits on behavior, being enabled, and consistently given the message that they are better than others without having to work for anything.
  • On the other side is the child raised with significant emotional neglect, or who is harshly abused and criticized.

All of these factors can certainly play a role, but as is always the case, two children can be raised in the same circumstances and turn out differently. There may be some bio-genetic predispositions in some cases, such as a particular temperament, or a parent that is also a Narcissistic Personality.

In my experience, I would cite early emotional neglect as one of the most significant factors in the making of an NPD.

The development of a healthy sense of self arises through the positive, consistent, and affectionate interactions between the infant and his or her mother (or primary parent).

This nurturing, empathetic, and abiding love given consistently over the early years of a child’s life is responsible for foundational developments in personality, self image, self worth, development of the brain, cognition, and nervous system.

Infants who experience emotional remoteness and neglect consistently do not form normal, healthy attachments, and later as adults create a pseudo-self that insulates and replaces the maladaptive and fragmented self. This can happen also with children that are consistently physically and emotionally abused by a harsh, critical, and punishing parent.

Normal Narcissism

We all have some degree of narcissism. Healthy narcissism helps us maintain a positive regard for ourselves, yet we are able to hold ourselves accountable and can incorporate humility into our outlook and dealings with others while yet performing well and achieving our goals.

Narcissism also appears to a greater degree during certain developmental periods. In particular, the budding teen can be quite narcissistic, however, this is normal and almost a necessary development to assist the teen in exploring and building his identity. As the teen moves toward early adulthood, narcissism decreases and is incorporated into a healthy self-image that is characterized by both positive self regard and the ability to empathize with others.

For all of us, it’s always a good idea to take a personal inventory and examine the balance between positive self regard and regard for others. Moving too far on either side of the scale is problematic. The aim is to:

  • Feel good about oneself, yet be able to honestly assess areas that need improvement.
  • Show compassion and empathy for others, but maintain proper boundaries that inhibit being taken advantage of, or coerced into actions that reach outside of your values.
  • Act in ways that are prosocial, which means behaving in ways that are for the good of all.
  • Feeling remorse when causing harm to someone, and taking action to make reparations.
  • Taking responsibility for yourself and your behavior.
  • Learning from experience, and making corrections when indicated.

Ultimately, we are all connected to each other, and everything we think, do, or feel has an impact on the whole. Keeping that in mind will help steer you away from unhealthy personality traits, and create a more fulfilling and gratifying life.

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