What is narcissism?

Medically Reviewed By Dr. Jose Toledo

Narcisissm treatment

Narcissism is a household word today. It’s a character trait used to describe many people and their behavior – and narcissistic personality disorder (NPD) is a recognized mental health condition.

As narcissism is on a spectrum, that means that not every narcissist has NPD. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) between 0.5 and one percent of the population is diagnosed with NPD. Up to 75 percent of people with NPD are male.

It is a behavior that sees extreme selfishness and self-centeredness, an exaggerated sense of self-importance, excessive need to be admired, conceitedness, and a lack of or no empathy. Because a narcissist has little or no empathy they cannot see the world from anyone else’s point of view.

Consequently, they never understand the negative impact their behavior has on others around them. It makes it difficult for a narcissist to seek the treatment they desperately need, since asking for help does not fit their image.

For this reason, some experts believe in fact that up to five percent of the US population has NPD to some degree. As with all personality disorders, NPD can make daily living extremely difficult – especially with family, social, and work relationships.

Allure of image

An ancient Greek myth from where the word “narcissist” derives fully reveals this destructive fixation with oneself, a detrimental love of self-image.

Narcissus was a young man known for his beauty. But he rejected anyone who wanted any romance with him.

Then one day he saw his reflection in a pond. He fell deeply in love with it.

He simply could not move from the allure of his image. But eventually, he melted from the passion burning inside him and turned into a white and yellow flower that still bears his name today.

History of NPD

In 1898 psychologist Havelock Ellis used the term “narcissus-like”, referring to excessive masturbation when someone becomes their own sex object. A year later psychiatrist Paul Näcke used the word “narcissism” in a study of sexual perversions.

Then in 1911, psychoanalyst Otto Rank published the world’s first psychoanalytical paper specifically about narcissism. Three years later, renowned psychotherapist Sigmund Freud published a paper entitled: “On Narcissism: An Introduction.”

In 1980, NPD was officially recognized as a disorder in the DSM. While the DSM does not state any specific categories of the condition, it is generally accepted that there are two distinguishable types of NPD.

Narcissism types

These two types frequently have common characteristics – but are believed to derive from different childhood backgrounds. They can also indicate different ways a narcissist will behave in their relationships with others.


– Grandiose Narcissism

People with this type of narcissism have an image of being better than anyone else. They are grandiose and often deluded with their importance, act elite, ostentatious, lack any empathy, take advantage of others and are aggressive, arrogant, and dominant.

During childhood, they were most likely treated as if – and constantly told – they were superior and better than anyone else.


Vulnerable Narcissism

People with this type of narcissism are neurotic, carry feelings of shame, hypersensitive and their behavior is to protect them against the feelings of inadequacy they have deep down. So they fluctuate between feeling superior and inferior to others. 

Yet they suffer from anxiety and are resentful and defensive when other people do not treat them as if they are superior. Their conflict is that they are desperate for love and approval from everybody, so if it’s not given they will often withdraw and suffer from low self-esteem.

Someone with vulnerable narcissism – also known as covert narcissism – is more likely to develop alcohol or drug addiction or indulge in behavioral addiction. This is to mask or numb the negative feelings that frequently arise in them.

Their parents may have been unreliable – and they often struggle with toxic shame and a “failure of love”. They were often abused or neglected and suffered trauma during childhood.

Narcissism symptoms

Major signs of narcissism

Since many narcissists and people with NPD will never reach out for treatment, it is still being looked into by mental health experts. But there are some definite character traits that narcissistic people frequently display.

  • Using others.

Narcissists exploit others to gain something for themselves. They often find and surround themselves with people who will feed their enlarged egos. These relationships are shallow. In order to keep in control, a narcissist will keep people at a distance and go to almost any lengths to stay completely in charge at all times.

  • Ostentatious and pretentious.

They often have to own lots of flashy material things such as cars, homes, showy watches, jewelry and clothes that they think tell the world just how successful and wonderful they are. Their need for these things is frequently an overwhelming drive that if they were honest they would admit is out of control.

  • Oversensitive.

Even though they seem full of themselves, narcissists need constant attention and relentless admiration and praise to reinforce their fragile inner selves. This means that they are extremely sensitive and swift to anger if they are criticized or perceive something to be a criticism.

  • Sense of entitlement.

A narcissist insists on – and expects – special treatment because they have formed an image of themselves as being better and more important than anyone else. They will disregard rules – insisting that those are for people who are not as special as them, which in their mind is everyone else. They will demand that everybody always does exactly what they want and desire.

  • Manipulative.

A narcissist can be extremely charismatic and charming – at first. This is because they have become masters of manipulation in order to lure someone in and then get what they want from that relationship. So while a narcissist will attempt to impress and please in the beginning, it’s only so that as soon as they can they will put their own needs first and use the other person to that end.

  • Envy.

Many narcissists have an obsession with success and power. This is not only because they need to feed the overinflated image they have of themselves and to maneuver themselves into positions of control – but it’s also because they suffer from extreme envy and jealousy. Therefore, they are driven to make others envious and jealous of them instead.

  • Relentless need for praise and attention.

This is one of the major signs of a narcissist – a constant need for praise and admiration. They cannot get enough and will never be satisfied.

  • Lack of empathy.

A narcissist is unable to empathize with other people. They can only see the world through their eyes. So they have no humility or compassion – and cannot see anything wrong with their behavior or consequently take any responsibility for it. Frequently, a narcissist will never say the word “sorry”.

  • Arrogance.

Because they really believe they are superior to others, they will frequently be obnoxious, rude, and abusive when they get treatment or attention that they think is less than someone of their superiority deserves. Even if they are treated well or in a superior manner they will often act and speak rudely and be dismissive of others because they think the other people are inferior. A narcissist will have an overvalued (often deluded) sense of their own achievements and abilities.

Clearly, none of this makes for positive loving, and balanced relationships with anyone. If you recognize that you could be in a relationship with a narcissist, there are certain aspects that can be looked at and specific changes you can make.

It’s important to speak with someone with expertise in these matters as soon as possible. A narcissist will not see any problem in grinding someone down, including a partner, to get what they want.

Therapy can be especially challenging for people with NPD because they are often unwilling or unable to even acknowledge the disorder. But there are proven successful methods to treat it and help anyone with the condition.

Our experienced team has helped a great many people with all emotional disorders and types of mental health problems. Contact us today to talk about how we can help you or someone you know.

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