Most of us know more than one person who we’d describe as conceited, self-absorbed and — if they’re really insufferable — narcissistic. The term “narcissist” is often used colloquially when we’re speaking about people with the aforementioned qualities, but narcissistic personality disorder is different. It is a real psychological condition that’s not often discussed.
You may be ready to start diagnosing your coworkers, acquaintances or family members as narcissists — but not so fast! NPD is a rare condition that affects between 0.5 and 1 percent of the general population according to the Diagnostic and Statistical Manual of Mental Disorders.
There’s a significant difference between a clinical narcissist and a person who loudly sings their own praises and posts a few too many selfies for our liking.
“It’s important to note the difference between someone with narcissistic features and someone with narcissistic personality disorder,” Dr. Marissa Long, licensed clinical health psychologist and founder of Thrive Wise, tells SheKnows. “We can’t simply imply that the person who frequently checks themselves out in a mirror or fishes for compliments is a [clinical] narcissist, but they might be.”
Long points out that children exhibit features that could be described as clinically narcissistic. Everything’s about them and they become angry when things don’t go their way and exhibit “look at me, look what I can do!” behavior that parents learn to manage. These traits are totally normal in kids, and they grow out of them. Long explains that the disorder comes in when adults exhibit these behaviors.
“We can’t simply imply that the person who frequently checks themselves out in a mirror or fishes for compliments is a [clinical] narcissist, but they might be.”
“[These tendencies] will likely cause significant distress within interpersonal relationships and ultimately impaired functioning across many areas of life,” she says. “Narcissists suffer from a grossly inflated sense of importance, which is used to protect a highly fragile sense of self.”
Long explains that the hallmark behaviors of someone with NPD include “grandiosity, frequent lying, high levels of defensiveness, exaggeration of their own attributes and achievements and displays of arrogance and self-importance.” Rather than being related to one situation or area of a person’s life, these behaviors persist over time.
Sharon Diaz, a psychotherapist and marriage and family therapist, tells SheKnows that people with NPD are frequently charismatic — but pay attention, because “the conversation will always be more about them than you unless you can serve a purpose for them.”
Diaz says other qualities exhibited by people with NPD include entitlement, lack of empathy, mental or emotional put-downs, refusal to take accountability for their actions and “a distorted sense of reality because they twist situations to suit them.”
Another way to identify someone with NPD is to ask them what they think their worst faults or weaknesses are. “If they have none or if previous relationships didn’t work because it was the other person’s fault, then they are probably narcissistic,” Diaz says.
Long explains that reviewing repeated encounters with a person and how they made you feel is a tried-and-true way to spot someone with NPD. “Stay on the lookout for ongoing patterns of these three common signs: gaslighting, lack of empathy or sensitivity to others and exploitative behaviors,” she advises. “Because narcissists are often quite charming, these clearly difficult and negative behaviors can go unnoticed for some time, making the experiences that much more unnerving.”
Unlike other mental health conditions, NPD is very rarely treatable — mainly because people who have the condition don’t think they need any form of professional help or treatment. “Some behavioral growth can be made in the course of therapy, [but] unfortunately, narcissists do not typically seek treatment unless their interpersonal relationships are under so much distress that the loved ones are insisting on it,” Long notes.
Diaz adds, “There is no inner desire for them to change because they can’t acknowledge any faults or improper behavior. She also notes that there’s no type of medication to treat NPD.
Due to the behaviors exhibited by individuals with NPD, platonic and romantic relationships will inevitably involve emotional gaslighting, exploitation and a callous disregard for your feelings. For the sake of your own mental health, extricate yourself from a relationship with a clinical narcissist — they won’t change, and you deserve to be treated with dignity and respect.
A version of this story was published May 2018.
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