What Is The Link Between Narcissistic Personality Disorder And Self-Importance?

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated October 21, 2024by BetterHelp Editorial Team

Narcissistic personality disorder (NPD) is a condition that usually affects people’s views of themselves and others, frequently leading to challenges at work and in relationships. 

Narcissistic personality disorder and self-importance often go together, meaning that those with NPD usually see themselves as having more value and importance than others. However, many people with this disorder experience low self-esteem despite their inflated sense of self-importance. Therapy may help individuals with narcissistic personality disorder gain a healthier sense of self-esteem and develop more empathy for others.

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What is narcissistic personality disorder (NPD)? 

Narcissistic personality disorder, or NPD, is a condition generally affecting the ways people view themselves, behave, and interact with others. In the United States, NPD affects an estimated 7.7% of men and 4.8% of women

The exact causes of narcissistic personality disorder are still being studied. That said, having a family history of NPD may make someone more likely to develop it. Certain early life experiences may also play a role, such as the following:

  • Rejection by parents or caregivers
  • Excessive judgment or praise during childhood
  • Childhood trauma or abuse

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guidebook published by the American Psychiatric Association. The DSM lays out criteria for different mental illnesses, including NPD. In the most recent edition of the DSM, the DSM-V, narcissistic personality disorder is listed as a “cluster B” personality disorder. Cluster B personality disorders tend to involve intense or unpredictable emotions and behaviors. Antisocial, histrionic, and borderline personality disorders also fall into this category. 

It can be common for people with narcissistic personality disorder to: 

  • Believe they are entitled to other people’s time, money, or attention
  • Be obsessed with beauty, success, and power
  • Prioritize themselves over other people
  • Need constant praise and admiration 
  • Exploit others for personal gain
  • Lack empathy for other people
  • Be extremely jealous of other people’s success

These symptoms and behaviors can lead to personal and professional challenges. These can range from problems collaborating at work to unrealistic expectations in relationships, frequent conflicts, and difficult interactions with others. 

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The DSM-V doesn’t break NPD into specific categories. However, some researchers have proposed that NPD may come in two forms:

  • Grandiose: People with the grandiose type of NPD may have a noticeable lack of empathy. They may be more likely to exploit other people. They may also seem bold, aggressive, and arrogant. 
  • Vulnerable: People with the vulnerable type of NPD may be extremely sensitive to rejection or criticism. They may also be more likely to become defensive or blame others for their challenges. 

According to the Harvard Medical School, people with NPD often have other mental health disorders, such as depression, anxiety, bipolar disorder, or substance use disorder. 

Self-importance and self-esteem in people with NPD

Another common symptom of narcissistic personality disorder is a sense of self-importance. Self-importance can be easy to mistake for self-esteem, but they are two different personality traits. 

The Cambridge Dictionary defines self-importance as “the belief that you are more important or have a higher value than other people.”

On the other hand, self-esteem can be thought of as your general belief in yourself, your worth, and your abilities. In general, self-esteem also includes the belief that you deserve to live and be happy

People with NPD may seem confident or self-assured on the outside. As a result, they might seem to have high self-esteem. In reality, people with NPD often struggle with insecurity, self-doubt, and challenges with their sense of identity

According to a paper from 2017, people with NPD tend to experience more frequent feelings of shame, helplessness, and self-directed anger. The authors of the paper also point out that NPD may be linked to a higher risk of suicide. 

In another study from 2021, researchers measured different personality traits of nearly 300 young adults. They found that for people with the “vulnerable” type of NPD, the disorder appears to be a response to insecurities, rather than a form of extreme self-love

Improving your self-esteem and relationships when you have NPD

Living with narcissistic personality disorder can be isolating. Often, people with NPD don’t believe they have a mental health condition. Even if they do, they may not seek treatment or know where to turn for help. 

That said, if you’re living with NPD, you may be able to improve your mental health and relationships with proper support. According to a research review from 2022, it is possible for people with NPD to improve their symptoms over time. The study authors point out that treating the disorder tends to involve setting clear goals and giving careful attention to relationships and self-esteem.

According to the National Alliance on Mental Illness, therapy is often the first-line treatment for NPD. Working with a therapist may help patients develop a healthier sense of self and learn to practice empathy. Therapy may also improve symptoms of other mental health concerns, like depression and anxiety. That’s why, if NPD is negatively affecting your relationships or well-being, you might want to talk to a mental health provider. 

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Finding a therapist who specializes in helping people with NPD can be the first step toward improving your symptoms, but this may not always be easy. If you’re living with NPD, opening up to a therapist can also be challenging. Finding the right therapist for you may be easier with online therapy. With BetterHelp, an online therapy platform, you can be matched with a therapist based on your specific needs. You can also change therapists at any time, for any reason, at no extra cost. 

While more research may be needed regarding the efficacy of online therapy specifically for NPD, existing studies show that online therapy can improve symptoms of mental illnesses that often co-occur with the disorder. In a 2017 analysis, researchers looked at data from over 300 studies of internet-based therapy. They concluded that online therapy could be an effective treatment for anxiety, depression, substance use disorders, and bipolar disorder, among others.

Takeaway

Narcissistic personality disorder, or NPD, often involves an obsession with success, beauty, or power. People with NPD may need excessive praise, exploit others, and feel jealous of others’ success. They may also show a lack of empathy toward others. 

Another common symptom of NPD can be a sense of self-importance, meaning that people with the disorder may believe they are more important or special than others. Self-importance is different from self-esteem, or the belief in your worth, abilities, and value. People with NPD often struggle with low self-esteem, experiencing feelings of insecurity and shame. Online or in-person therapy may help those with the disorder develop a healthier sense of self and improve their mental health.

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