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What is narcissism and what is narcissistic personality disorder?

Narcissists tend to:

  • Have an exaggerated sense of self-importance;
  • Have a sense of entitlement and require constant, excessive admiration;
  • Expect to be recognised as superior even without achievements that warrant it;
  • Exaggerate achievements and talents;
  • Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate;
  • Believe they are superior and can only associate with equally special people;
  • Monopolise conversations and belittle or look down on people they perceive as inferior;
  • Expect special favours and unquestioning compliance with their expectations;
  • Take advantage of others to get what they want;
  • Have an inability or unwillingness to recognise the needs and feelings of others;
  • Be envious of others and believe others envy them;
  • Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious;
  • Insist on having the best of everything.

They may also:

  • Have trouble handling anything they perceive as criticism;
  • Become impatient or angry when they don’t receive special treatment;
  • Easily feel slighted;
  • React with rage or contempt and try to belittle the other person to make themselves appear superior;
  • Have difficulty regulating emotions and behaviour;
  • Experience major problems dealing with stress and adapting to change;
  • Feel depressed and moody because they fall short of perfection;
  • Have secret feelings of insecurity, shame, vulnerability and humiliation.

Narcissistic Personality Disorder

Narcissistic personality disorder is one of several types of personality disorder.  Personality disorders are labels for patterns of behaviour which are persistent and severe enough to do harm to the individual or to others.  Other personality disorder types include ‘emotionally unstable’, ‘avoidant’, ‘histrionic’ and ‘antisocial’.  Although these behaviours can occur in a milder form in the general population, to be called personality disorders they need to be extreme.  For example, many people are a bit narcissistic but narcissistic personality disorder is an extreme form of narcissism to the extent that it causes harm.

How bad does it have to be?

The threshold for considering a narcissistic person to have a narcissistic personality disorder is a matter of opinion.  Troubled relationships are not in themselves a sign of a personality disorder but if either you or the person involved are needing help to cope with the behaviour, it may be helpful to think of it as a disorder.  If the pattern of behaviour extends to the point of causing the person to commit an offence, it has clearly passed the threshold for a disorder.

People with narcissistic personality disorder are unlikely to think that anything could be wrong with them, so they are unlikely to seek help. If they do seek help, it’s more likely to be for relationship breakdown, or symptoms of depression, drug or alcohol use, or another mental health problem.


It’s not known what causes narcissistic personality disorder but it is often understandable in light of the individual’s past.  For example, the individual may have grown up being treated as if they were a very special child and had special entitlements.  Alternatively, they may have grown up in great hardship but clearly learned at some stage that if they focus fully on their self-interest they often succeed in getting what they want. As with personality development and with other mental disorders, the cause of narcissistic personality disorder is complex.

Risk factors

Narcissistic personality disorder is diagnosed more often in men than women but this may only be due to diagnostic bias and social attitudes towards attention seeking in men and women.  The patterns of behaviour are often easily recognised from late childhood onwards.  However, although children may show traits of narcissism, this may simply be typical of their age and a stage in development and doesn’t mean they’ll go on to develop narcissistic personality disorder.  Nevertheless, how parents respond to it may be very important in teaching children a proper respect for other people’s needs.


Because the cause of narcissistic personality disorder is poorly understood, there’s no known way to prevent the condition other than sensible, balanced parenting.


Of the individual:

As with all personality disorders, treatment of narcissistic personality disorder is very difficult and the behaviour tends to persist throughout life.  It is particularly hopeless to try to treat an individual who does not want treatment.  If, however, a person with a narcissistic personality disorder seeks help, there are treatments which claim to be effective, although with little evidence.  Principally these are various forms of psychotherapy, or talking therapies.  Obviously, however, giving a narcissist appointments to talk about themselves is likely to reinforce rather than reduce their self preoccupation.

Of those affected:

The more important therapy is for those affected by the narcissist’s behaviour, such as family and partners.  Here, education about the behaviour and its persistence are likely to be the most important help that can be given.  Help to cope with the stress of separating, which is likely to involve much anger and recrimination, may be essential.  For those who wish or have to remain in a relationship, supportive psychotherapy may be helpful as will learning ways of staying more emotionally distant and finding techniques for managing the relationship.

Here are some commonly used coping techniques suggested by psychologists:

  • Know what you’re dealing with. Get to understand how narcissists operate by reading about it;
  • Leave;
  • If you’re going to stay involved, maintain realistic expectations. Narcissists are predictable and won’t change. They will upset you or let you down in predictable ways so you can prepare for it and not be surprised or disappointed;
  • Keep your interactions superficial, don’t get emotionally involved and don’t join in by rising to the challenge;
  • Set boundaries. Manage your time and interactions with the narcissist to reduce your stress and limit the harm.

To gain more understanding about narcissism and narcissistic personality disorder, there are plenty of YouTube videos by psychologists talking about what it is, how to recognise it and what to do to manage your relationship.

Here’s 3 key things to know about narcissism:

Narcissism is not a legal term

Lots of people complain online about the impact of narcissists and people with narcissistic personality disorder and the harm they’ve suffered at their hands. There are Facebook groups, blogs and YouTube videos dedicated to the topic, discussing the signs and symptoms, the perils of getting involved with someone who presents in this way and how to manage your interactions with them. It’s interesting to hear about these problems and to think about it in terms of diagnosis and whether someone meets the criteria for diagnosis, but if you are involved in legal proceedings, such as a divorce or child care dispute, narcissism and narcissistic personality disorder are not sufficiently precise or meaningful terms to use.  They are terms which include a wide range of behaviours, some of which the person in question may have and some that they will not have.  For the purposes of a legal case you need to concentrate on describing the person’s actual behaviour, the things they do, and it’s impact.

There is a wide range of severity

As in all legal cases, it’s the behaviour that counts and it’s the record of the things that happen that is the evidence of a problem.  For example, an extreme narcissist may engage in fraud and deception, bullying, gaslighting, domestic abuse including verbal and psychological abuse, coercive control or non-compliance with court orders. At the milder end of the scale, they may just be an attention-seeking nuisance or even charming company and never commit any offences at all.  From a legal point of view, being a narcissist is not relevant.  The key question is whether they have done anything which is a criminal offence or relevant to a civil court case.

Recognise and understand it

It’s easy to get into a relationship with a narcissist because they will often work hard, at first at least, to be charming and to get you to like and admire them.  But being in a relationship with a narcissist can have a huge impact on your psychological health and wellbeing. The narcissist could be your partner, another family member, an in-law, a colleague, your boss, a friend or even a customer or client.  You may be being criticised or blamed unfairly or you may find that somehow you can’t satisfy the person’s demands in spite of your best efforts.  You may feel undervalued or infuriated by the way everything always seems to be about the other person and never about you.  That’s when it’s helpful to be able to recognise and label the behaviour for what it is.

Understanding the patterns of narcissistic behaviour will help you to understand what is happening and to decide how to deal with it. In many situations the fundamental issue is whether to leave or stay.  In less flexible situations, such as at work, you will benefit from understanding how to best manage your interactions with the narcissist to cause you the least stress and harm.