How Do I Know If Someone Has Narcissistic Personality Disorder?
The term narcissist is frequently misapplied and misinterpreted in casual conversation. By clinical definition, a narcissist is a person who has been diagnosed with narcissistic personality disorder, a mental health disorder characterized by symptoms of narcissism.
Narcissistic personality disorder is a clinical condition diagnosed by a mental health provider, while the term narcissist has become frequently used as a catch-all to describe individuals who exhibit extreme confidence and self-centered behavior or dismiss the needs of others. However, true pathological narcissism tends to involve a range of certain personality traits, such as low self-esteem, manipulative behavior, and lack of empathy, which often emerge in early adulthood and may require interventions like talk therapy or family therapy.
This article will explore common symptoms of narcissistic personality disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders. We’ll also offer resources for individuals who wish to find mental health support.
The broad, often inconsistent definition of narcissism in popular culture can make it challenging to accurately identify narcissistic behaviors and warning signs. While narcissistic personality disorder (NPD) can only be accurately diagnosed by a mental health professional, understanding narcissistic traits as they appear in day-to-day life may help the average person better understand how those traits impact them.
Narcissistic personality disorder
In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), narcissistic personality disorder (NPD) belongs to Cluster B personality disorders, which tend to be characterized by dramatic, impulsive, self-destructive, or emotional behaviors.
To be diagnosed with NPD, a person must display five out of the following nine:
A grandiose sense of self-importance and self worth
Heightened perception of physical appearance
Belief they deserve privileges above others
Preoccupation with fantasies of success, power, beauty, or brilliance
A belief that they are unique and can only be understood by similarly unique individuals or institutions
Excessive need for admiration
Carries a sense of entitlement or unreasonable expectations of favorable treatment
Exploits others and takes advantage of others to their own ends
Lacks empathy and concern for the needs of others
Is often envious or thinks others are envious of them
Displays arrogant, self-aggrandizing behaviors
Researchers believe there is an overarching theme within NPD’s diagnostic criteria: self-esteem. Narcissism is frequently framed as characterized by a person’s inability to develop a positive self-image in a healthy way. Without a strong sense of self-esteem, a person may feel forced to rely on pathological narcissistic traits to feel positively about themselves.
It can be difficult to make sure NPD is the right diagnosis instead of other personality disorders. A person with narcissistic tendencies may or may not meet the diagnostic criteria for NPD, but their actions may affect others in the same way as those of someone with the diagnosis. Individuals should seek treatment from a clinical psychologist to receive a formal diagnosis and the right treatment to treat NPD and other mental health conditions.
Types of narcissism
Narcissism is often divided into two distinct subtypes: grandiose and vulnerable. A person with grandiose narcissistic tendencies tends to be outgoing, charming, and generally free from self-doubt and anxiety. A person in this category tends to have a very high opinion of themselves, considers themselves above their peers, and expects special treatment.
A person with vulnerable narcissistic tendencies may be self-absorbed, need constant reassurance, and be anxious about how they are perceived. They are rarely outgoing and may shy away from attention. While those with vulnerable narcissistic traits believe themselves superior to others, their fear of even the slightest criticism may lead them to keep that belief to themselves.
A person with narcissistic tendencies in either subtype can be deceitful and manipulative or disregard the needs of others to achieve their goals.
Where does narcissism come from?
The term narcissism stems from a mythological figure named Narcissus, who fell in love with his own reflection in the water and died staring at himself. The cause of narcissism is not fully understood, but some prominent theories point to childhood factors. Narcissism tends to be viewed as a core defect in developing a healthy self-image. This could stem from parents who praise their child with either too much adoration or too much criticism, or from unempathetic parents. Unempathetic parenting, which may be addressed through parenting classes, is commonly associated with the development of narcissistic tendencies, as unempathetic parents tend to provide few opportunities for a child to gain approval or understand other people’s perspectives.
On the other hand, empathetic parents tend to provide opportunities for a child to receive attention healthily and cater to their own needs. Compassionate parents may also model behaviors that encourage high self-esteem, such as resiliency when making mistakes, and help children develop a strong sense of self. They may teach children to face their own emotions head-on and not resort to the shame narcissists may experience.
Recognizing narcissistic tendencies and narcissistic traits
Therapists often point to core features of narcissism to help people identify narcissistic tendencies in others.
Chronic entitlement
Those with narcissistic tendencies tend to believe they are superior to others, even when presented with evidence to the contrary, which can create a powerful sense of entitlement. This entitlement encourages the belief that the person should receive more money, credit, or respect for doing the same work as others. They may also demand special treatment or extra resources.
Lack of empathy
A person with narcissistic tendencies may be likely to disregard the feelings and needs of others. Generally, those with narcissistic tendencies tend to be worse at recognizing the emotions of others and responding appropriately. They may struggle to understand why someone is upset by their actions or why a person reacts negatively to having their boundaries violated.
Grandiosity
Grandiosity refers to a belief that a person is inherently superior to others. Grandiosity may be most visible in the egomaniacal behaviors often associated with grandiose narcissism, but grandiosity tends to be present in both subtypes. Those with grandiose narcissistic tendencies tend to put their inflated sense of themselves and expect others to align with their beliefs. Those with vulnerable narcissistic tendencies often still believe they are superior but may hide their grandiosity to avoid criticism.
Chronic validation-seeking
A person with narcissistic tendencies typically demands attention and validation from others. They may struggle to feel safe and require constant positive social feedback to maintain their self-image and sense of self-importance. A person with narcissistic tendencies may be likely to avoid or respond negatively to criticism and anything that does not validate their feelings of superiority.
When do narcissistic tendencies become narcissism?
Most people display some form of narcissistic behavior at some point in their lives. Nearly everyone has moments of arrogance, overconfidence, or insensitivity to others. The behaviors can become concerning when they are frequent or severe enough to impact the life of the person displaying them or the lives of those around them.
What do I do if I think I'm a narcissist
If you've identified traits in yourself that appear to coincide with narcissistic tendencies, it may be helpful to continue exploring these tendencies. Individuals who meet the criteria for narcissistic personality disorder may not be able to recognize their own narcissistic tendencies without a great deal of effort.
You might consider seeking the help of a therapist to organize your thoughts and set realistic goals. It’s important for people with narcissistic personality disorder (people with NPD) to maintain self-esteem at a healthy level and develop healthy boundaries to manage their condition.
You might consider taking some time to write out the narcissistic tendencies that concern you. Do you worry you lack empathy? Are you constantly seeking attention or validation? Do you feel like you never get what you deserve? Taking some time to understand the source of your concerns may be beneficial when working with a professional.
What do I do if I think someone else is a narcissist? Recognizing symptoms of narcissism
If you think that someone else may have narcissistic personality disorder, it may help to assess the impact of their narcissistic tendencies, but with caution, given that only a professional can make a diagnosis. Regardless, you might look for certain signs in a person’s relationships. For example, a person in a committed relationship with a narcissist may experience significant emotional turmoil in their relationship.
If you’re in a relationship with someone who may have narcissistic personality disorder (NPD) or shows signs they will develop NPD or related conditions, it may help to consider ways to boost your self-esteem to combat some of the emotionally draining effects of being around someone with NPD. You may also find it beneficial to set clear boundaries, as those with narcissistic tendencies often fail to recognize them.
If a person's narcissistic tendencies are limited in severity, you may be able to form a positive working or social relationship with them. The key may be to recognize how you feel around the person. If a person regularly drains your energy or makes you feel inferior, it may help to limit contact with that person as much as possible.
How can therapy help?
If you're worried that someone in your life may have narcissistic tendencies, you may benefit from speaking with a licensed counselor. If you don’t feel comfortable with in-office therapy at this time, you might consider online therapy, which research has shown to be just as effective as in-person therapy.
If someone displaying narcissistic tendencies is affecting your well-being, online therapy may help you set boundaries, build your self-confidence, or develop resiliency using empirically supported techniques. With online therapy, you can choose how you’d like to communicate with a therapist, whether by audio, video, or live chat. You can also message your therapist at any time through in-app messaging, and they’ll respond as soon as they can.
Takeaway
Narcissism is a complex and nuanced topic that is often poorly defined in day-to-day conversations. Narcissistic personality disorder is a clinical psychopathology characterized by grandiosity, a need for validation, a lack of empathy, and sensitivity to criticism. While very few people meet the criteria for NPD, some people may display some form of narcissistic behavior or have narcissistic tendencies that can affect those around them.
In some cases, the assistance of a licensed online therapist could be beneficial during this process. It’s essential for mental health professionals to assess the individual's history, including any risk factors or inherited characteristics for mental health conditions, to understand signs someone is developing NPD. With BetterHelp, you can be matched with a therapist who has experience helping people recover from a traumatic event. Take the first step toward healing and reach out to BetterHelp today.
Frequently asked questions
What are the top 5 signs of a narcissist?
At their most extreme, narcissistic tendencies may qualify a person for a diagnosis of narcissistic personality disorder (NPD). However, a person can still display narcissistic behaviors without meeting the criteria for diagnosing a personality disorder, which is sometimes called sub-clinical narcissism.
Whether sub-clinical or not, narcissistic behavior tends to follow themes of grandiosity, a lack of empathy, entitlement, and validation seeking. A person with narcissistic tendencies may be adept at hiding their more problematic thoughts and behaviors, and it is not always clear when certain behaviors amount to narcissism. Everyone can be selfish or uncaring at times, but narcissists tend to establish a pattern of repetitive behavior that affects their social relationships.
Below are some of the signs that you may be interacting with someone who has narcissistic tendencies:
They frequently react to criticism with anger or hostility, even if it is constructive, and are likely to perceive a lack of validation as an insult.
They tend to have an inflated sense of self-worth and usually believe they are better than others. Even those with vulnerable narcissism tend to believe they are superior but may express it less frequently.
They tend to disregard the feelings and needs of others. They may struggle to understand the impact of their actions and often find it difficult or impossible to apologize sincerely.
They believe they deserve privileges more than those around them. This sense of entitlement isn’t typically due to extra effort on their part; they often just feel they deserve more than those around them for the same effort.
They may diminish the achievements of others and generally approach others with contempt.
How do you know if a person is narcissistic?
It is not possible to know for certain if someone meets the criteria for a diagnosis of narcissistic personality disorder unless you are a qualified mental health professional. However, it may be possible to recognize narcissistic tendencies in their behavior. If they lack empathy, seek constant validation, and seem entitled compared to those around them, they may be demonstrating narcissistic behavior.
People with NPD may disguise their narcissistic traits in the early days of a social relationship. It may also be more complicated to determine if someone is a narcissist depending on what type of narcissism they may be presenting. Also, other factors may cause temporary changes in behavior that make a person seem more selfish or less caring than they typically are.
If you’re trying to figure out if a person is a narcissist, you might consider focusing on the impact their actions have on you rather than certain personality traits. Narcissists can have a significant adverse effect on those they frequently associate with. If a person is consistently enjoyable to be around, demonstrates empathy, and appears to put effort into the well-being of others, they may not be a narcissist, even if they are occasionally vain or selfish.
What are the most obvious signs of a narcissist?
One of the most apparent signs of narcissism tends to be a lack of empathy. Although empathy can be complex and may be interpreted differently from person to person, narcissists rarely try to demonstrate generally agreed-upon empathetic behaviors. If you notice that a person regularly dismisses the feelings of others, lacks patience for those in distress, or regularly insults or diminishes others, it is possible that narcissism is the cause. However, other personality disorders, like borderline personality disorder, can sometimes cause similar behavior.
Some people with narcissistic tendencies can disguise them. If you are concerned that someone in your life may be a narcissist, you might pay close attention to how they make you feel and how they treat those around you. If a person makes you feel worse about yourself or demeans you, it may help to distance yourself from them for some time, regardless of whether narcissism is the cause of their behavior.
How do you know a narcissist is toxic?
Whether or not a person is “toxic” is not uniformly defined. Determining what constitutes toxicity can involve a personal judgment, and each person’s definition may vary. However, most personal definitions of toxicity are likely to include behavior that reduces a person’s overall well-being and lowers their self-esteem. A person who makes you feel worse about yourself can be toxic to be around, even if their behaviors fall short of narcissism.
A person can be toxic without being narcissistic. Focusing on the toxicity, rather than the narcissism, may be more useful for determining if you need to defend yourself from potential harm. If a person regularly demeans you, focuses entirely on themselves, or rarely shows you empathy, you might consider distancing yourself from that person, even if you’re not sure they are a narcissist. If you spend time away from the person, it may also make it easier to see the impact of their behavior.
How can you test a narcissist?
Only a qualified mental health professional can diagnose clinical narcissism, also known as narcissistic personality disorder. A licensed professional may be able to differentiate between narcissistic tendencies and similar behaviors that have a cause other than narcissism. A mental health professional may conduct a clinical interview designed to elicit symptoms of narcissistic personality disorder. They may also use standardized personality measures, such as the Narcissistic Personality Inventory, to differentiate other mental health conditions.
Some online tools claim to evaluate narcissism in the same manner as professional inventories and assessments. However, professional assessments are reviewed by a qualified mental health practitioner who can interpret their results in the context of the person they are evaluating. Without that context, the utility of such measures may be significantly reduced. Freely available assessments may also lack the rigorous testing of professional measures and may not produce results consistent with standardized assessments.
How should you treat a narcissist?
Narcissistic personality disorder can be treated through psychotherapy. No FDA-approved medications treat narcissistic personality disorder specifically, but medications are sometimes used to treat co-occurring mental health conditions, such as depression or anxiety.
Schema therapy and other advanced forms of cognitive-behavioral therapy have shown some benefit in recent research regarding the treatment of narcissistic personality disorder. Schema therapy tends to focus on self-schemas, which are frameworks of information and beliefs that individuals use to define themselves and the world around them. Schema therapy tends to focus on emotional activation techniques and early maladaptive schemas.
Therapy may also help a person with narcissistic tendencies relate better to others. During therapy, they may also explore the causes of their competitiveness with others and learn to accept their real abilities so that they can accept criticism from others.
Can narcissism be cured?
Narcissism can be treated through various forms of psychotherapy. For those who meet the criteria for a diagnosis of narcissistic personality disorder, their prognosis may depend on the presence of co-occurring disorders and the severity of their symptoms.
Evidence suggests that aggression may be a good predictor of illness severity. The more aggressive a person appears, the more severe their narcissistic personality disorder is likely to be. Those with lower severity may be more able to learn healthy ways to manage their narcissistic tendencies.
What causes narcissism?
The cause of narcissistic tendencies and narcissist personality disorder is poorly understood. Researchers believe that genetics, environment, and neurobiology may play a role. In terms of environment, experiences that occurred in childhood, such as rejection by a parent, may lead to narcissism. However, others think that excessive praise may be responsible for introducing narcissistic tendencies.
What are the 4 stages of narcissism?
Narcissism likely develops gradually and may be related to events that occur in childhood. In adulthood, people with narcissistic personality traits may be likely to demonstrate a four-stage pattern of behavior in romantic relationships. Narcissism is often related to short-term relationship success but long-term relationship instability, which may be explained by the four stages of a narcissistic relationship:
The idealization stage. In this stage, a person with narcissistic tendencies may love bomb the object of their affection. They might shower the person with compliments, gifts, or other gestures of affection. It may feel as though they have fallen in love from day one.
The devaluation stage. After idealizing their partner, a person with narcissistic tendencies may slowly begin to devalue them. They may become passive-aggressive, introduce subtle criticism, call their partner names, and consistently compare them to others. Gaslighting,* a form of abuse, can also be common at this stage.
The repetition stage. A person with narcissistic behavior typically continues devaluing their partner until their partner withdraws. When withdrawal occurs, the person with narcissistic tendencies will likely become upset with their partner, and their partner may indicate their displeasure with how they are being treated. At that point, the cycle may begin again, returning to the idealization stage. The person with narcissistic tendencies may resume their love bombing and intense displays of affection.
The discard stage. At this point, a person with narcissistic behavior may become tired of their partner or realize they can no longer benefit from them. They typically reject them quickly and completely.
Recognizing whether you are the victim of love bombing may help you separate genuine affection from behaviors designed to keep you in an unhealthy relationship. If you believe you are in a relationship with a narcissist, there are resources that can help you.
*If you have experienced abuse, whether physical or verbal, you can contact the National Domestic Violence Hotline at 1-800-799-7233 or text "START" to 88788 for 24/7 support.
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