Narcissism: What it is, What it isn’t, and What to Do about it

Previous blogs have allowed us to define and understand a bit more about the popular term “Gaslighting” that you have probably seen floating around online. As was explained in the previous articles, gaslighting is considered an unhealthy approach to conflict and is often related to narcissism. Unfortunately, though, gaslighting is common in toxic or abusive relationships. This may be in an intimate partner relationship, between friends, or even with domestic violence between family members. Those who gaslight or are narcissistic act the way that they do because of how they view themselves and the world. Let’s take a look at what this means.

In a nutshell, narcissism is feeling that one is better than others. Because of this belief about one’s self, it can cause a mistreatment of others because others are viewed as “less than” or, frankly, not worth the respect. Narcissism can look like entitlement at its most innocent or cruelty at its worst. However, there are different considerations when we think about narcissism.

Tendencies or a Disorder?

The term “narcissism” is taken from the formal diagnosis of “Narcissistic Personality Disorder”. Narcissistic Personality Disorder is a formal diagnosis that can only be applied by a licensed therapist, psychiatrist, or other healthcare professional. This formal diagnosis can only be applied to an individual after an assessment is completed and if certain criteria are met. While we will review these diagnostic criteria here so that you know what they are, if the person does not meet the following criteria, they are not “officially” a narcissist because they do not have Narcissistic Personality Disorder. One could say the person has “narcissistic tendencies” if they do not meet the clinical criteria but still have similar behaviors. However, having Narcissistic Personality Disorder versus having “narcissistic tendencies”, while it never feels good for those on the receiving end, are two very different things.

The American Psychiatry Association, the author of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), which is the source for all official mental health diagnostic criteria, defines the general category of personality disorders as “an enduring pattern” that “is pervasive and inflexible, had an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.”

Keep in mind that there are many different kinds of personality disorders, as is outlined in the DSM-5-TR. Narcissistic Personality Disorder is an example of only one of the possible personality disorders. However, the necessary feature of creating “distress or impairment” is the key feature for all mental health experiences. A disorder is only a disorder if it causes distress or impairment. If it does not cause distress or impairment, it is merely a symptom or characteristic.

This clinical line is complicated in the case of narcissism because rarely are narcissists going to even ask for help that would allow them to obtain a formal diagnosis from a therapist. This is the case because they believe they are better than those who could offer them help and do not want to show or may not even believe they have any weakness. If they seek therapy, it is usually as a manipulation or to “prove” to themselves or to someone else that they are “right”. This can even happen in conjoint couples therapy if the therapist seeing the couple is not savvy enough to screen for domestic violence (which is widely considered to be a contraindication for couples therapy for various safety reasons, whether emotional or physical) or to not fall prey to the often-crafty narcissistic person’s game playing. 

If the narcissist does enter therapy and gets a formal diagnosis of Narcissistic Personality Disorder, however, the individual would need to have at least five of the following symptoms: 

• A grandiose sense of self-importance (e.g. exaggerates achievements and talents).
• A preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
• A belief that they are “special” and can only be understood by other special or high-status people or organizations.
• Requires excessive admiration.
• A sense of entitlement (i.e. unreasonable expectations of especially favorable treatment).
• Patterns of being interpersonally exploitative to take advantage of others to achieve their own ends.
• A lack of empathy, which presents as an unwillingness to recognize or identify with the feelings and needs of others.
• Envy of others or believing that others are envious of them.
• Arrogant, haughty behaviors or attitudes.

Source: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision. 2022 APA Publishing.

If the person does not have at least five of the above characteristics, they do not have Narcissistic Personality Disorder and, therefore, are not formally “a narcissist” even if they still have frustrating narcissistic characteristics. 

Types of Narcissism

Whether having a formal diagnosis of Narcissistic Personality Disorder or hurtful narcissistic tendencies, such behaviors can manifest in different ways. Overt narcissism is usually easy to spot. It is obvious demonstrations of people believing they are better than or exploiting others. This could be bragging loudly or being actively critical of others for being “stupid”. For a narcissist, relationships are viewed as transactional. Rewards and/or punishments are frequent displays of behavior for narcissists. Put simply, you will know when you have upset someone who shows overt narcissism by not doing what they want because they will tell you and/or make it blatant to others.

Covert narcissism is also a thing. These are these insidious manipulative behaviors that the average observer may not necessarily notice unless they know the narcissistic person well. Even if it is less obvious, covert narcissism is still, at its core, the response of the narcissist when they do not get their way. Conversations you initiate with them when in need for support may subtly turn into talking all about them. When going out for dinner, they may discount all of your suggestions as unappetizing and you may find that you are always going where they want to go. They may even make off-handed sarcastic comments about how you are always making poor life decisions but disguise them as jokes and tell you that you are “too sensitive” if you show hurt.

Something important to note here, as was discussed in the previous blog about gaslighting, is that narcissism is not always inherently malicious. Remember: people who have a personality disorder see the world in a certain way. Hopefully the narcissist or the person with narcissistic tendencies in your life wants to look at what they could improve in relationships and will do just that. If they do no’t, though, narcissism may look like that person who always views things as “my way or the highway”.

It is worth noting that the internet is also filled with other descriptions of “types” of narcissism, like “emotionally-needy narcissism” or “communal narcissism”. But, you should know that, as of the most-current diagnostic criteria from The American Psychiatry Association, there are no formal subtypes of narcissism. There are simply the core patterns reflective in the five key features mentioned above.

Are you a Narcissist?

All this talk of narcissism may have you concerned about if you are a narcissist, especially if you come from a family where being self-absorbed is the norm. However, here is the good news: if you are wondering if you are a narcissist, chances are that you are not one. This is because narcissists would not be able to entertain the idea that they are lacking. Because of this, there is rarely a tendency for narcissists to focus on personal improvement. So, if you are introspective and genuine enough to want to improve yourself and not hurt others in relationships, you are very likely safe from this affliction.

Something that can look similar to narcissism, however, is Borderline Personality Disorder. While this is a whole different personality disorder with a whole different set of required clinical criteria for a formal diagnosis which would need its own separate blog, The National Education Alliance for Borderline Personality Disorder summarizes it well. Compared to Narcissistic Personality Disorder’s focus on self-importance and a lack of empathy, Borderline Personality Disorder is characterized by self-damaging behaviors, a fear of abandonment, mood swings, constantly-changing relationships, and often threats of or actual self-harm behavior. Because this is also a very serious diagnosis that can be life-changing, for more information about additional topics related to mental health and relationships, you can sign up for our newsletter here.

When You are Dealing with One

If you are still on the fence about whether you are dealing with a narcissist, the key theme you will have during and/or following interactions with them is confusion and/or hurt. Often you will not know how you ended up being blamed for something when the conversation simply started out as a calm dialogue. Maybe your needs are not even considered or valued.

Taking narcissism to an extreme via domestic violence, research from Batterer’s Intervention Programs show that, although narcissism presents as arrogance, it is often ironically rooted in the trauma and insecurities of those who abuse. The challenge is, because of the narcissism, such people are unlikely to reveal, discuss or even have awareness about such insecurities . It is for this reason and for the tendency of the narcissist to see themselves as above any rules or law that Batterer’s Intervention Programs focus on peer confrontation. 

At the end of the day, you will know you are in a relationship with someone who, at the very least, has narcissistic tendencies because something will feel off. You will feel like you always wind up walking away hurt. The most important thing for you to do here is take care of yourself. You cannot save or solve their personality disorder. It is their set of symptoms to address. So, take care of yourself, distance yourself, and get support for your safety if you need it.