Narcissism

I rarely see clients with Narcissistic Personality Disorder (NPD). However, I do often see those who are in relationship with those with NPD. The loved ones of someone with NPD often bear the weight of emotional and psychological distress.

The Cleveland Clinic is unsure how many Americans have Narcissistic Personality Disorder (NPD), but research indicates it may affect 0.5% to 5%. It’s more common in men, who make up 50% to 75% of cases.

If you were in a relationship with a narcissist, they likely manipulated you, emotionally abused you, and showed no empathy. This involvement could be with a partner, friend, colleague, or even parent. You may struggle with feelings of low self-worth, self-doubt, and confusion about your own reality.

Narcissism is a popular topic and is an often misunderstood subject. There are various types of narcissism. Not everyone with narcissistic traits acts the same way. Individuals with NPD can present in diverse ways. Some people seem impressive and try hard to make a good impression. Another person may have low expectations due to a sense of entitlement.

There are many different opinions concerning the types of narcissism, but we are going to consider 5 main types:

• • overt
  • covert
  • antagonistic
  • communal
  • malignant

Narcissistic Traits -vs- Narcissistic Personality Disorder

Before you start diagnosing yourself, let’s get real. Sometimes we all act “a little” narcissistic, like when we’re hangry. You may be having a bad day or may even have some personality traits that would qualify as a narcissistic symptom.

However, aving narcissistic traits doesn’t necessarily mean someone has NPD. NPD is a personality disorder in the DSM-5, under cluster B. To be diagnosed, a person’s narcissistic traits must severely affect their functioning and relationships.

Traits associated with NPD are pervasive, inflexible, and often resistant to change. People with NPD often don’t realize their behaviors and attitudes are problematic.

4 Core Elements of Narcissism

There are four key elements to Narcissism.

• • 1. Grandiosity: Individuals with narcissism often exhibit a sense of superiority and entitlement. They believe they deserve special treatment, admiration, and praise from others. Their grandiosity may come off as arrogance or condescension. They may constantly seek to impress others through displays of wealth, status, intelligence, or beauty.
    2. Extreme self-focus: is another hallmark of narcissism. Narcissistic individuals tend to prioritize their own needs and desires above others. They may constantly talk about themselves and struggle to empathize with others. Their relationships tend to be shallow and superficial. In some cases, they may even exploit others to achieve their own personal gain.
    3. Inflated sense of self-importance:  is prevalent in narcissistic individuals. They expect special treatment and often exaggerate their accomplishments, considering themselves to be uniquely gifted and deserving. Their self-esteem and sense of identity rely on the validation and recognition they receive from others.
    4. Strong need for praise and recognition. They rely on others to maintain a positive view of themselves and seek validation to bolster their self-esteem. They may feel envious of others’ positive traits or accomplishments, further highlighting their need for affirmation.

5 Types of Narcissism

1. Overt Narcissism

Research suggests that people with overt narcissism tend to be extroverted, open-minded, and have high self-esteem. They also experience fewer negative emotions. This does not do justice for the trail of frustration left for those in their lives.

Overt narcissism is the most recognizable and classic form of narcissism. People with overt narcissism are outgoing, arrogant, entitled, and have an exaggerated self-image. They constantly seek praise, admiration, and attention. They can be exploitative, competitive, and lacking in empathy.

Overt narcissists may overestimate their abilities and intelligence. They are highly concerned with how others perceive them and are focused on status, wealth, flattery, and power. They may achieve high levels of success but are extremely sensitive to criticism, even minor ones.

Overt Narcissism Example: High School Football Coach

Coach Johnson, a high school football coach, constantly seeks admiration and attention. He interrupts team huddles to share stories of his past glory as an athlete and emphasizing his coaching abilities. He criticizes players’ mistakes, rarely providing constructive feedback. Off the field, he seeks recognition from the media, dismissing contributions from others. This overt narcissism creates a toxic environment, overshadowing teamwork and player development.

2. Covert Narcissism

Covert narcissism, also known as closet narcissism or vulnerable narcissism, is in contrast to the more commonly recognized overt narcissism. While overt narcissism is characterized by loud and overbearing behavior, covert narcissism manifests in more subtle ways.

Individuals with covert narcissism may display traits such as expressions of low self-esteem, higher likelihood of experiencing anxiety, depression, and shame, introversion, insecurity or low confidence, defensiveness, avoidance, and a tendency to play the victim. Despite being self-focused, those with covert narcissism often struggle with a deep fear or sense of inadequacy, which conflicts with their self-centered tendencies.

Research suggests that covert narcissism is strongly linked to high neuroticism and disagreeableness. Individuals with covert narcissism tend to have difficulty accepting criticism, and they may internalize or take criticism more harshly than intended.

People with covert narcissism show less obvious negative behaviors compared to those with overt narcissism. Instead of openly bragging or demanding respect, they may engage in blaming, shaming, manipulation, or emotional neglect to fulfill their needs and keep the focus on themselves. They may also perceive themselves as victims.

Covert Narcissism Example: Mother-Daughter Relationship

Sarah grew up with a mother who exhibited covert narcissistic traits. Her mother used guilt and emotional manipulation to control their relationship, often playing the victim and undermining Sarah’s achievements. Sarah felt unheard and constantly questioned herself, struggling to establish boundaries and prioritize her own well-being.

3. Antagonistic Narcissism

Antagonistic narcissism is a type of overt narcissism. It is marked by competitiveness, arrogance, and rivalry. Individuals with antagonistic narcissism are overly concerned with appearing superior to others and strive to come out on top. They may exhibit traits such as arrogance, a tendency to take advantage of others, a strong desire to compete with others, and a proneness to arguing.

Studies show that people with antagonistic narcissism are less likely to forgive others than those with different types of narcissism. They may also have lower levels of trust in others.

Individuals with antagonistic narcissism may engage in exploitative behaviors, put others down, or start arguments to assert dominance.

It’s important to note that all individuals with narcissistic traits can be concerned with their appearance to others,. Antagonistic narcissists place particular emphasis on achieving superiority.

Antagonistic Narcissism Example: Workplace Scenario

Sarah, a senior executive, exhibits antagonistic narcissism in the workplace. She dismisses her colleagues’ ideas, engages in power struggles, and undermines their credibility to assert her dominance and be seen as superior. This creates a hostile work environment, eroding trust and collaboration.

4. Communal Narcissism

Communal narcissism is a type of overt narcissism that is characterized by valuing fairness and presenting oneself as altruistic. Research shows that people with communal narcissism may not always act in line with their beliefs. While they may easily become morally outraged and describe themselves as empathetic and generous, their actions may not align with their professed values.

The key distinction of communal narcissism is the involvement of social power and self-importance. People with communal narcissism may seem moral and caring, but their actions may not match. Their actions are often driven by the desire for praise and admiration, rather than a genuine desire to help others.

Although individuals with communal narcissism may not appear ego-driven, they often position themselves as leaders or the face of social causes or communities. They perceive themselves as more empathetic, caring, and selfless than others. They may exhibit moral outrage in response to perceived injustices.

Communal Narcissism Example: Political Leader

Imagine a political leader who presents themselves as deeply caring and advocates for social justice causes. However, their actions primarily serve their own self-interest and reputation. They engage in performative acts, aligning with popular movements for personal gain. They lack true empathy and fail to establish meaningful connections with individuals and communities. This self-centered approach undermines the authenticity and effectiveness of social initiatives.

5. Malignant Narcissism

Malignant narcissism is considered the most severe form of narcissism and is closely connected to overt narcissism. Individuals with malignant narcissism exhibit common narcissistic traits, such as a strong need for praise and a desire to be elevated above others. However, they also display additional characteristics that distinguish them from other types of narcissism.

One notable trait of malignant narcissism is vindictiveness. People with this type of narcissism may strongly want revenge and try hard to harm others they see as threats or who have upset them. They may seek opportunities to seek retribution and take pleasure in inflicting pain on others.

Sadism is another characteristic of malignant narcissism. These individuals derive pleasure from the suffering of others. They may enjoy exerting power and control over others, and their actions may be driven by a need to dominate and manipulate those around them.

Aggression is common in individuals with malignant narcissism. They may exhibit hostile and confrontational behavior in their interactions with others. This aggression can manifest in verbal, emotional, or even physical forms. They may use intimidation tactics to assert their dominance and maintain control over their relationships.

Paranoia is another trait associated with malignant narcissism. Individuals with this form of narcissism often have an exaggerated sense of threat and worry about potential dangers or conspiracies targeting them. They may be highly suspicious of others’ motives and intentions, leading to a constant state of heightened vigilance and mistrust.

It is worth noting that individuals with malignant narcissism may also share traits with antisocial personality disorder (ASPD). This can manifest as a higher likelihood of engaging in illegal activities, experiencing legal trouble, or struggling with substance use disorders.

Malignant Narcissism Example: College Professor

Dr. Johnson, a college professor, exhibits malignant narcissism. He consistently belittles and undermines his students, using derogatory language and personal attacks to assert his dominance in the classroom. He takes pleasure in publicly humiliating students who challenge his authority or question his expertise. Driven by a need for power and control, he manipulates students’ grades and academic opportunities to punish those who do not conform to his expectations. His aggressive and sadistic tendencies create a toxic learning environment, causing emotional distress and hindering students’ growth and development.

How is Narcissistic Personality Disorder Diagnosed?

To be diagnosed with Narcissistic Personality Disorder (NPD), a person must exhibit narcissistic traits in unhealthy (pathological) ways that significantly interfere with their daily functioning and their ability to relate to others. NPD is diagnosed by mental health professionals through clinical interviews. They ask questions about the person’s life, identity, past, and relationships. In addition, formal tests and input from loved ones can be used to diagnose.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria, a person must meet the following criteria to be diagnosed with NPD:

• They must have chronic, long-term impairments in social and personal functioning as a result of their narcissistic traits.

• They must display pathological personality traits that significantly affect their relationships and well-being.

It’s important to note that the person’s behaviors cannot be attributed to their developmental stage (e.g., adolescence) or other challenges they may be facing with their mental or physical health (e.g., substance abuse).

DSM Requirements for Diagnosis

5 out of 9 of the following criteria must be present for a diagnosis of NPD.

1. 1. Grandiose sense of self-importance.
   2. Fantasies of unlimited success, power, brilliance, beauty, or ideal love
   3. Belief in being “special” and unique
   4. Requires excessive admiration;
   5. Sense of entitlement,
   6. Interpersonally exploitive
   7. Lacks empathy
   8. Envious of others or believes that others are envious of him/her;
   9. Arrogant, haughty behaviors or attitudes

Treatment for NPD

Treating Narcissistic Personality Disorder (NPD) can be difficult because those with the disorder often don’t see their behavior as a problem and may not want to change. However, if a person with NPD is open to it, participating in psychotherapy can be beneficial.

Talk therapy, specifically psychotherapy, can help individuals with NPD improve their relationships, develop self-esteem, set more realistic goals and expectations, and work through past traumas. Some areas that psychotherapy can address include:

• • Developing a sense of self that is not solely reliant on external validation.

  • Setting realistic goals and learning to accept limitations.

  • Dealing with and healing from past traumas that may have contributed to the development of NPD.

  • Improving relationships with partners, friends, colleagues, and relatives by developing healthier patterns of interaction.

  • Developing a greater sense of empathy for others, which can help individuals with NPD understand and consider the needs and perspectives of others.

Treating NPD needs a licensed mental health expert to do a thorough evaluation and diagnosis. The therapist can tailor the treatment approach to the specific needs and challenges of the individual with NPD.

Resistance to Treatment

Individuals with Narcissistic Personality Disorder (NPD) often have difficulty recognizing their own behavior as problematic or seeking treatment for their condition. There are several reasons why individuals with NPD may be less likely to seek mental health treatment:

• Lack of Insight: People with NPD typically have limited self-awareness and struggle to recognize the impact their behavior has on themselves and others. They may believe that their thoughts, feelings, and behaviors are justified and fail to see the need for change or intervention.
• Defensiveness: Individuals with NPD often have fragile egos and a strong need for control and validation. They may be highly defensive when confronted with criticism or suggestions for improvement, perceiving it as a personal attack. This defensiveness can hinder their willingness to engage in therapy or accept help.
• Externalizing Blame: People with NPD tend to externalize blame and attribute their difficulties to external factors rather than recognizing their own contributions to their problems. They may be more likely to blame others, circumstances, or external events for their challenges, rather than taking responsibility for their actions.
• Lack of Motivation for Change: Individuals with NPD may have limited motivation to change because they believe that their behavior and attitudes are superior to others. They may view seeking help as a sign of weakness or vulnerability, which goes against their self-perceived image of grandiosity and superiority.
• Difficulty Establishing a Therapeutic Relationship: Establishing a productive therapeutic relationship can be challenging with individuals who have NPD. Trust and rapport are essential in therapy, but individuals with NPD may struggle with trust, engage in manipulative behaviors, or attempt to control the therapeutic process. These challenges can impede progress in therapy and discourage individuals with NPD from continuing treatment.

Special Note: Gaslighting and Narcissism

Gaslighting is a manipulative tactic that involves making someone doubt their own reality, memory, or perception. While anyone can engage in gaslighting behavior, it is often associated with individuals who have narcissistic traits or Narcissistic Personality Disorder (NPD).

Gaslighting is a way for narcissists to gain power and control over others by undermining their confidence and making them question their own thoughts, feelings, and experiences. It is a form of psychological abuse that can have serious emotional and mental health consequences for the victim.

Here are some common examples of gaslighting behavior exhibited by narcissists:

• Denial and Minimization: Narcissists may deny or minimize their hurtful actions or words, making the victim doubt their own perception of the situation. They may say things like, “I never said that,” or “You’re overreacting.”
• Blaming and Shifting Responsibility: Narcissists often deflect blame onto others and refuse to take responsibility for their own actions. They may twist the narrative and make the victim believe that they are the ones at fault.
• Invalidation and Dismissal: Narcissists may dismiss the victim’s feelings and emotions, making them feel as though their experiences are not valid or important. They may belittle their concerns and undermine their self-esteem.
• Creating Doubt and Confusion: Narcissists may manipulate information and present conflicting narratives to create confusion in the victim’s mind. They may distort the truth, change their story, or use gaslighting techniques to make the victim question their memory or perception of events.
• Isolation and Control: Narcissists often isolate their victims from friends, family, and support systems, making it easier to maintain control over them. By cutting off external sources of validation and reality checks, they can further manipulate and gaslight their victims.

Gaslighting can have severe consequences on the victim’s mental and emotional well-being. It can lead to feelings of confusion, self-doubt, anxiety, depression, and a loss of self-worth. Victims of gaslighting may find it challenging to trust their own judgment and may become dependent on the narcissist for validation and approval.

It is important to recognize and address gaslighting behavior in relationships involving narcissistic individuals. Victims should prioritize their safety and well-being by seeking support from trusted friends, family, or mental health professionals. Therapy can provide a safe space for victims to process their experiences, regain self-confidence, and develop strategies to cope with gaslighting tactics.

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