Narcissistic Personality Disorder: How to recognise a narcissist; diagnosis and treatment
Have you ever heard someone been described as a narcissist, leaving you wondering what it meant? Here’s how to recognise if a person may have Narcissistic Personality Disorder (NPD).
Summary:
What Is Narcissistic Personality Disorder?
Narcissistic Personality Disorder (NPD), commonly known as narcissism, is a type of personality disorder. It is more often present in men, though women can also experience this condition. Narcissistic traits include an inflated sense of self, an excessive need for admiration and attention, a lack of empathy, hypersensitivity to criticism, and inauthentic relationships.
It’s important to note that people can exhibit narcissistic traits without having NPD. However, for individuals with NPD, these traits and beliefs affect all aspects of their life, including work, family, friendships, and relationships.
NPD is often masked by negative self-esteem in an exaggerated "fake it ’til you make it" manner, which has serious consequences not only for the individual but also for those around them.
NPD is recognised as a mental health issue and treated accordingly in clinical psychology. Diagnosing and treating those with NPD can be difficult, as they often do not believe anything is wrong with their behaviour.
How Can Someone Identify NPD?
Narcissistic Personality Disorder exists on a spectrum and can be disruptive and harmful when it leans toward manipulative and emotionally abusive behaviours, rather than mere self-confidence.
Here are a few initial signs and key symptoms to consider when identifying a narcissistic personality:
Charm and Manipulation
People with narcissistic personality disorder are often extremely charming. They act in ways that further their own personal agenda, usually to fulfil their need for admiration and validation. Their deep-rooted insecurities make them excessive admiration-seekers, and their intense charm helps them lure in potential partners.
Others may think a person with narcissistic personality disorder has a lot of confidence and is very charismatic, but this charm is often short-lived once the other person is drawn in. It is only then that less-positive qualities emerge, such as irritability and moodiness, alongside their true behavioural patterns.
People with NPD can change their personality very quickly without warning, often followed by emotional manipulation. Once they become bored, they may lose interest in their partner’s life and stop focusing on them entirely.
Love Bombing
In a relationship, a narcissist often praises and compliments their partner excessively within the first few weeks of knowing each other. This is known as love-bombing, and it comes with the expectation of reciprocity.
It can sometimes be difficult to distinguish between love-bombing and genuine admiration. However, if a person seems to be fishing for compliments, even subtly, they are likely seeking positive attention reinforced on themselves. If they offer grand praise despite barely knowing someone, this admiration may not come from a genuine place.
Narcissists have motives rooted in self-absorption and prioritise meeting their own needs above their partner's.
Inability to Recognise Needs in Others
A lack of empathy is a common narcissistic trait. Even when empathy is displayed, it may not be as genuine as it would be from someone without this personality disorder.
Narcissists often fail to understand how their actions or inactions impact those around them, including their partner. The other person’s needs, such as setting and maintaining boundaries, may not be recognised or respected.
Narcissists tend to act impulsively and make decisions that best suit their own interests, often disregarding the consequences for others. Their "me-first" attitude excludes consideration for others’ needs, leading to unbalanced relationships where they take priority.
Trauma Dumping
A narcissist may unload their childhood trauma or psychological issues onto others early in a relationship, a practice known as trauma dumping.
Narcissists use trauma dumping to create a bond and gain sympathy from others. This trust and sympathy are then manipulated to create an exaggerated sense of worth. They seek constant reassurance and praise, though the satisfaction they gain is usually temporary.
While open and honest communication is important in any relationship, it’s the appropriateness of timing that matters. Narcissists tend to share intimate details very early on before trust is established, a sign that they are desperate for attention. If conversations seem one-sided, where others have no opportunity to share, it may be indicative of narcissism.
Future Faking
When a relationship begins, it is normal to discuss personal values and goals, such as marriage or having children. However, narcissists often engage in future faking. Future faking is when a narcissist makes grand plans for a future together, even when the relationship is still in its early stages, in order to gain affection and approval.
Narcissists want their ideas praised, and the future they describe is often hypothetical. Their interests may not be grounded in reality, leading to emotional distress for their partners, who may perceive their grand plans as manipulative or deceitful.
What Causes Narcissistic Personality Disorder?
The exact cause of Narcissistic Personality Disorder (NPD) has not been confirmed, but decades of research suggest several contributing factors — biological, psychological, and environmental.
Psychologists and neurobiological researchers propose that some of the primary causes of NPD include poor self-esteem, feelings of unworthiness, and a strong need for favourable treatment. These feelings may have genetic origins or stem from childhood experiences where interpersonal development was compromised.
Vulnerable children can be deeply affected by the parenting styles they are exposed to. For example:
When children are not valued within their family unit, their own emotions may be devalued in favour of others, a dynamic known as enmeshment. As adults, narcissists may use manipulative behaviours to regain control over their feelings of inadequacy and pursue personal gain in their relationships, even if these people didn’t cause the initial self-esteem issues.
Narcissism is often seen as a coping mechanism for deep-seated feelings of inadequacy, developed when childhood needs were unmet. Over time, patterns of behaviour emerge to combat these self-esteem issues.
Diagnostic Criteria for NPD
The core features that characterise Narcissistic Personality Disorder (NPD) are complex and deeply rooted in an individual’s sense of self. These traits can profoundly impact a person's life and relationships. It’s important to approach these characteristics with understanding and empathy, recognising that they are often protective mechanisms formed in response to underlying vulnerabilities.
Grandiosity
Grandiosity is a defining characteristic of NPD. It involves an inflated sense of self-importance, where individuals may feel they deserve special treatment or recognition. This belief in their own superiority can lead to fantasies about achieving power, beauty, love, or success beyond what is realistic. As a result, they may find it difficult to relate to others as equals, viewing people either as beneath them or as competitors.
Excessive Need for Admiration
Individuals with NPD often have a strong desire for admiration and validation from others. When they are not the centre of attention, they may experience distress and sometimes react with frustration or emotional defensiveness. This excessive need for admiration often stems from a deep sense of insecurity or low self-worth. Their reliance on external validation can create challenges in maintaining balanced, reciprocal conversations, as they may inadvertently dominate interactions in an effort to seek affirmation.
Superficial and Exploitative Relationships
Relationships for individuals with NPD can be challenging, as they may focus more on what others can offer them rather than on mutual connection and support. They may view relationships through a transactional lens, asking themselves how the other person can enhance their own life or self-image. While this mindset can lead to relationships that appear shallow, it is important to remember that these behaviours often arise from a need to protect their fragile sense of self. When a relationship no longer serves their needs, they may distance themselves or disengage.
Lack of Empathy
A significant trait of NPD is difficulty with empathy. This does not mean that individuals with NPD are incapable of caring for others, but they may struggle to fully understand or appreciate the feelings and needs of those around them. Their focus tends to be on their own experiences, which can make it challenging to prioritise the emotional well-being of others. This lack of empathy can strain relationships, as the emotional needs of their loved ones may go unrecognised or unaddressed.
Identity Disturbance
Though people with NPD may appear confident, this external display of self-assurance often masks a more fragile and unstable sense of identity. They may construct a grandiose self-image to protect against feelings of inadequacy or vulnerability. When this projected image is threatened—through criticism or perceived failure—they may react with hostility or defensiveness. Their difficulty in reflecting on their own behaviour can make personal growth and self-improvement particularly challenging.
Difficulty with Attachment and Dependency
For individuals with NPD, relationships often serve to reinforce their sense of self-worth. If they feel that a relationship no longer validates their self-image, or if they perceive a challenge to their importance, they may withdraw emotionally. They can develop a dependency on those who provide positive feedback and may struggle with setting and respecting healthy boundaries. When faced with feedback or requests for mutual care, they can become defensive or emotionally reactive.
Chronic Emptiness and Boredom
When individuals with NPD are not receiving the attention or praise they feel they deserve, they may experience deep feelings of emptiness and boredom. These feelings can lead to restlessness, and in some cases, to unhealthy coping mechanisms such as infidelity, substance abuse, or risk-taking behaviours. The sense of dissatisfaction can be persistent, driving them to seek constant stimulation or validation from external sources.
Vulnerability to Life Transitions
Life transitions, such as entering adulthood, changing careers, or experiencing loss, can be particularly difficult for individuals with NPD. The reality of these transitions may conflict with their idealised self-image, leading to increased stress, anxiety, or feelings of inadequacy. These moments of vulnerability can highlight the internal struggles that NPD individuals face when their external circumstances no longer align with their grandiose self-view.
Envy
Individuals with NPD may feel that others envy them due to their perceived success or superiority. At the same time, they may harbour feelings of envy towards those they believe have achieved more or possess qualities they desire. This complex interplay of envy can lead to exaggerated claims about their own accomplishments or abilities, as a way of maintaining their self-image and sense of importance.
Arrogance and Haughty Behaviours
The outward confidence displayed by individuals with NPD may sometimes manifest as arrogance or haughty behaviour. They may appear overbearing, prideful, or boastful, believing they deserve special privileges or exemptions from rules that apply to others. When they do not receive the treatment they believe they deserve, they can become frustrated or upset. It is important to recognise that this behaviour often masks deep-seated insecurities and a need for reassurance.
NPD Risk Factors
Individuals with NPD face a range of risk factors. These include suicide or suicidal behaviour, substance abuse, difficulties in maintaining healthy relationships, and workplace conflicts due to a need for admiration and validation. They may also encounter financial or legal problems linked to impulsive decision-making, as well as depression, anxiety, and physical health issues resulting from chronic stress and emotional instability. Additionally, they can experience social isolation, emotional burnout, and may display aggressive or violent behaviours when their self-image is threatened. Co-occurring mental health disorders, such as mood or anxiety disorders, often complicate the diagnosis and treatment of NPD, making early intervention crucial for managing these risks.
Therefore, it is encouraged that individuals with NPD seek treatment from a mental health professional.
Treatment for Narcissism
Those suffering from narcissistic mental health issues may make no effort to improve themselves because they believe they are perfect and nothing is wrong.
It can be challenging for a narcissist to accept responsibility for their behaviour, and discussing it may be perceived as criticism. However, it is crucial for them to reflect on their sense of self and recognise that fragile self-esteem is no excuse for mistreating others.
Depending on the level of insight and motivation to change, common evidence-based therapies can assist in treating narcissism.
Common Therapies Include:
These therapies aim to help individuals with NPD gain better insight into their behaviours and how they affect others.
For instance, psychologists help clients to:
In some cases, medication-based treatments may be recommended by a GP or psychiatrist, including:
If you or someone you know may be experiencing Narcissistic Personality Disorder, our experienced psychologists can provide professional, evidence-based treatment tailored to individual needs. Contact us today to start the journey toward a healthier mindset and stronger relationships.