Narcissistic Personality Disorder: What Is It & How Is It Treated?
Dr. Sheri Jacobson
January 1, 1970
What is Narcissistic Personality Disorder?
Narcissistic Personality Disorder (NPD) is a personality disorder in which the individual is engrossed in their own personal power, prestige and vanity. The disorder was named after a mythological Greek character called Narcissus who became infatuated and in love with his own reflection in a lake. As such, someone suffering with NPD will often fantasise of their own fame, intelligence, skills, success and beauty. They may believe that they are truly unique and should only associate with other unique or high status individuals. Arrogance, selfishness and a lack of empathy characterise this disorder and the person requires constant admiration and attention to prevent uncontrollable rage. Although presenting with an elevated sense of worth, someone with NPD does not handle criticism well and is often found to be critical of others in an attempt to validate their own self-worth. It is this sadistic tendency that is characteristic of narcissism as opposed to other psychological conditions affecting self-worth.
Symptoms of Narcissistic Personality Disorder
- Reacting to criticism with anger, shame, or humiliation
- Taking advantage of others to reach own goals
- Exaggerating own importance, achievements, and talents
- Imagining unrealistic fantasies of success, beauty, power, intelligence, or romance
- Requiring constant attention and positive reinforcement from others
- Becoming jealous easily
- Lacking empathy and disregarding the feelings of others
- Being obsessed with self
- Pursuing mainly selfish goals
- Trouble keeping healthy relationships
- Becoming easily hurt and rejected
- Wanting “the best” of everything
- Appearing unemotional
What Causes Narcissistic Personality Disorder?
A variety of factors are thought to lead to the development of NPD, although no specific cause has been highlighted. Most research points to a combination of biological, social and psychological causes. These include:
- Genetics: Inherited characteristics from parents including oversensitive temperament.
- Trauma: Childhood trauma is a common experience of many people with a diagnosis of personality disorder and in particular early and severe abuse. A 1994 study by Gabbard and Twemlow highlighted histories of incest associated with NPD in some adult men.
- Family Context: The environment that people grow up in has a large impact on their personalities as adults. There are some suggestions that NPD may be more likely in children who experience extreme pampering and over-attentive parenting. However, similarly it may also develop through abuse or trauma inflicted by parents as noted above.
Are there any treatments for Narcissistic Personality Disorder?
There is no known ‘cure’ for NPD but as with all personality disorders, psychotherapy can substantially aid the day-to-day struggles of the disorder and help them relate to others around them in a more positive and rewarding way. Psychotherapy can help to offer greater insight into interpersonal problems and can target surrounding issues such as substance misuse, depression or anxiety which may be exacerbating the problem. Medication may also be used to treat any distressing symptoms that may also occur with this condition.
What is important to remember is that there is help out there for any one struggling with NPD. It can sometimes feel like no-one understands the day-to-day struggles that someone who has NPD suffers. But help is available. See here for more information on personality disorder counselling.
If after reading this blog you feel you may have NPD or want to work on narcissistic traits, you may want to talk to someone who is medically qualified such as your GP or a psychiatrist and establish whether psychotherapy is indicated.
I need to see someone to obtain help. I am married to a man with Narcissistic personality disorder. Our marriage is pretty much in ruins. He won’t get help because he believes he is PERFECT I need to learn how to cope as he is making me very ill. It is very important I have counselling from someone who understands and ha treated this disorder before. I have seen a psychiatrist at my husbands insistence only to be told I had no psychological problems but it may be better to try to get my husband to seek counselling or couples counselling.
If you are in the UK, you’d want a counsellor or psychotherapist and not a psychiatrist. A psychiatrist deals with clinical disorders and conditions that might require medication. A psychotherapist or counsellor, however, is trained in listening and supporting you understand your situation and yourself, as well as helping you identify and harness the personal power you have to make life choices that are better for you. Any counsellor or psychotherapist will be of great help, as almost all therapists work to build your self-esteem and identify childhood trauma, both of which are leading causes for ending up in relationships with narcissists. If you are in London, and want to consider a therapist at Harley Therapy, choose ‘self-esteem’ under our ‘issues’ page and you’ll see all the therapists we have who can help.
I need help. My wife I’m sure has NPD, I want our relationship to work but I fear it won’t because of this. I would not dare put this too her for obvious reasons. Any suggestions?
It’s very brave of you to do the research and reach out. You are right, most people with NPD do not respond well to being offered the label. Although it might not be NDP, it could be several other things – borderline personality disorder, extremely low self-esteem – and it is best to leave diagnosing to professionals. But yes, that is all quite out of your control as it would need to be her decision to seek help.But what you can do here is take care of your side of things. If she does truly have NPD, that can’t be an easy relationship. It might be an idea to seek support yourself. You can get a clearer picture of how this relationship is and isn’t working for you, and learn new tactics for handling your interactions in your marriage. And if there was any chance she’d go to therapy, it might be if she sees those around her benefitting from it. An idea to consider? We wish you all the best.
Hello,
I recently ended a relationship with a man with a combination of Makiavellian (a lying con-artist with no morals) and Narcissist (expert love bomber).
My concern is not for me, but for his next ‘victim’……..she is a vulnerable widow of five years, he is morphing himself to be everything she has lost.
She is accomplished and wealthy, he is financially strapped.
I could be wrong, but after experiencing his lies, secrecy and mutltiple sexual partners, including this lady while seeing me, I ended it once I realized what was going on, but he is still contacting me, while planning to move in and marry this unsuspecting lady.
I am starting to feel I should warn her……I am not expecting her to believe me, but at least give her a chance to step back and assess her situation and the type person she is planning on being with.
What do you think……mind my own business and let them get on with it??
Your advice would be much appreciated.
Hi Jane, it sounds like your energy and thoughts are still very much on him, and the details of his life. Unhealthy relationships can lead to obsessing and overanalysing afterwards. But you can’t change another person. We’d always recommend to do the best you can to put your energy back on you, and do everything you can how to make steps to take care of yourself, make better decisions, and raise your self-esteem so you don’t get involved in another unhealthy relationship in the future.If he is contacting you, you have the power to not respond and to block communication channels and take care of yourself.As for getting involved further, remember, self-care is key. Is that really a way to take care of yourself? We are certain you will make the better decision here if you keep that in mind.
Hi, I understand this article is about four years old but I’ve been trying to read up on NPD because I think this guy I have an off and on “friendship” with might have it. He fits a lot of the check list but I also read that there’s a thing called Low NPD and I think he fits that best. The first “round” of our friendship lasted a couple months. He was testing me and my best friend to see which was better relationship material. He treated us very similarly when I finally broke down and compared experiences with her. When I confronted him, he seemed to not understand at all what he did wrong which I thought was just because he’s male. He was always trying to make himself seem better than me like he was competing with me even though he was kind of a loser. My best friend and I found ourselves googling narcissism and thought it fit but I wrote it off and started hanging out with him again. He was very clingy but I realized I’d never turned down seeing him because the first time I tried to turn down meeting, he threw a tantrum so I caved and went to him. He was extremely jealous but was always trying to make me jealous of other women though so I left him that day. He texted, messaged, and called us until we blocked him on every media. One day he tried my email and I admitted my feelings for him and then things got quiet for months. My friendship with my best friend crumbled and I ended up hanging out with him again for about a month after four months from our first “round” as “friends”. When we got back together, his clingy personality completely flipped. He was a weird combination of sweet one minute and cruel the next, except he never seemed to realize he was mean. One day, he flat out told me he has a hard time empathizing with me or feeling sorry for me. He told me he hated me but wanted to hang out still. He’d talk to me on the phone for hours but tell me he needed space and honestly made me cry on the phone a couple times with his back and forth-ness. He’d accuse me of calling him a liar when I’d never called him one. The last day we were together, he kept telling me how fat I am and basically that he’d change everything about me if he could including my personality which annoyed him. He also asked me about when you see someone attractive, does your heart skip a beat. He’s a grown man and it genuinely seemed like he didn’t know. When I told him I still loved him but I was done trying to be friends because it was making a mess of me, he said he hoped we could be friends again someday even though hours earlier he hated my fat self and my personality. Weirder yet, I had a dream once that we were in a crowded room and every time I tried to get away from him, he’d end up right behind me somehow and I was really afraid he’d try to kill me. When I told him about it like I was joking, he had a tantrum. Even if doesn’t have NPD, I’m certain there’s something psychologically wrong here. Is there any other reading I could try to learn more? I really hope there’s someone still out there to respond and offer their advice.
Hello, thanks for sharing your story. Yes, he certainly sounds to have his issues to deal with. But here’s the crucial question – how does diagnosing him help you? Is this the right question to be asking? You cannot change him in any way. The only person who you can truly help and change and seek support for is yourself. What within you was attracted to someone who from the get go was so obviously struggling with issues? What within you sabotaged a friendship for a man who was clearly unstable? What do you think love is? Do you think you deserve love just as you are, or that you have to earn it or win it somehow? In summary, we can’t diagnose someone based on a one-sided story, or without meeting them, narcissistic personality disorder requires a very careful diagnosis. We’d encourage you to read our other article, “Is he or she really a narcissist?”
I think I have at least one mentall illness, or disorder, and I’m afraid of it. Like, REALLY afraid.
Since years, people tend to leave me, reject me, insult me, mock me, and I never knew the reason why. People always kept on criticize me, or my supposed “intelligence” (I’m good at school since I’m a child). People always avoided me, and whenever someone was nice to me, it always seemed odd to me. Since then, I think I tried everything to keep the person by my side. I didn’t care about them being a manipulative or nice person I just wanted them to stay by my side, to stay with me, at all costs. I otfen talked with those people, and… I can’t help but talk about myself.
It’s not like I like myself. If I had to be sincere, I hate myself to the point I wanna puke. My appearance, my voice, my writing, my clothes, everything that refers to me in any way possible, I hate it. And yet, I can’t help but talk about myself, what I did good and bad, my skills and unskills, my likes and unlikes, everything. It’s not egoism, well I hope it’s not. The truth is, if I talk about myself so much AND NOT ABOUT OTHERS to people, it’s because I don’t have and won’t EVER have the pretention to talk instead of someone, or to pretend to talk about someone. Since I don’t consider myself able to talk about someone better than the person him/her/itself, I prefer not to talk about’em than to say something even a little bit, slightly wrong or not exact.
I don’t want to look like an egoist who’s talking about herself all the time, it’s just that I can only pretend to know myself and only myself, I can’t do something as daring as pretending to know someone better than themselves, then talk about them like I knew’em. I know that’s irritating people, and that they come to hating me, and leaving me behind, or even worse: REPLACING ME. Whenever a friend leaves the place where I am with him/her, I feel like a panic crisis, and I can even start to cry under the fear of them not coming back. Even if it’s only 20 seconds, it can happen, and I can’t explain ’cause I’m afraid of them being weirded out, or that they’d laugh at me, or just find me weird.
I care more about what other think about me than what I think about myself. Because I perfectly know that what I think about myself is at some point wrong, I need the approval or the review of someone, of some people to know if what I’m doing is good or not, if I look okay or not. I also need someone nice, who’s not gonna scream, yell at me, or criticize me and beat me down, to remember me what to do and why. I don’t care if they are someone emotionally and psychologically manipulating me, as long as they’re nice. And I know that it’s wrong, but I can’t help it. I NEED someone, and I’m ready to do ANYTHING to keep them by my side, even if that’s immoral or dangerous.
I don’t want attention of everyone, I just want to talk with someone, to stay with just one person. And now… I don’t feel anything anymore, except for this supposed person
I mean …it’s been almost one year since I feel almost nothing. Like, a very few things. Like somtimes I’m happy and sad and angry and in love and whatever you want, well I have emotions normally like everyone, then suddenly I feel a… weird thing in my heart that STOPS EVERYTHING.
It does like an ultra unpleasant filter that … blocks all the strong emotions like…I can feel joy, but not happiness. I can be sad, but not cry. I can be angry, but not become mad or burst. I can be in love, but not fully.And the thing is that … it hurts. Really, REALLY bad. Physically, it hurts, I feel that there is something that compresses my heart, my chest, my emotions, and it pulls my chest and everything, it makes REALLY hurt, worse than a REAL burn (and I’ve already experienced a burning).
And sometimes I’m joyful or angry or whatever, then suddenly I feel … nothing anymore. Sometimes I fell completely empty, I don’t even feel any DAMN thing anymore. Sometimes I manage to recover after a few hours, but most of the time it lasts, and regularly I feel like spikes. Like a really unpleasant sensation, like a feeling of being stung, it burns and pull then push, then the horrible feeling of that sting flows everywhere …
I can’t even manage to differentiate my emotions … Right now I don’t even know if I’m happy or sad or angry … And the only thing I can distinguish is pain. That’s the only thing I clearly feel when I’m in this state, pain. Physical, and moral, and even MENTAL. But I can’t even cry or be angry, or express/externalize it. I’m just in pain, it only hurts. And I feel nothing but this pain, when I’m like that.
And you see dopamine, the hormone of pleasure and satisfaction (often provoked by the person itself), which activates in the brain a sort-of-like reward system. Like you get a 19/20 or a promotion, you get proud and happy. Guess what ? I don’t even have that feeling anymore. It’s not blocked or what, just I don’t have it anymore. Like had 616/700 at my exam, and I didn’t feel proud. And that’s not a confidence excess or something, I was joyful, but not proud of myself or the note itself.
For years I work in order to have good grades. But these good notes I don’t really have them to be proud, I have them so no one can mock me on that point. I don’t have them by will, but by FEAR. And not a small fear or some anxiety, it would be too indulgent. I mean the kind of fear that puts a knife under your throat and makes you cry for HOURS. I FEAR to be mocked and If I don’t get good marks. Even when I have a 20/20, I don’t feel any pride or joy anymore.
And yet… Yet I felt some a couple years ago. It has nothing to do with the fact of being used to have a lot of good marks or anything. When I was 11 I only had good one and I felt dopamine, I was proud of myself and I was working so I could feel this pride and dopamine. And now … Nothing anymore. I no longer feel any pride or dopamine, no matter what I achieve and how good it could be.
And I want to be treated/healed to feel some again … because this lack frustrates me so much that I become SICK of it. I always try to do better and better to be congratulated and know that what I did is good, because my brain doesn’t transmit the information no more … I’m not seeking for attention, just an indication that I must be proud of this or that, because my brain doesn’t tell me, I need some one to tell me… and that’s why I pretend I know that what I do, say, did, and will do is good. Not to be mocked. That’s why I’m asking for help.
But my parents keep telling me that I’m lying, cause when I was a small child (like 5years old), I had mythomaniac problems (but it’s healed since years tho), and they think it’s still here. They look at me and treat me as if I was a monster, an anomaly, an error, something that’s like a taboo.
Then, they make fun of me cause I may be “just a poor dumb young bitch that cant find anything better to do than creating and staying in her own little shitty world” (what my mother said), not a girl who’s asking for serious help cause she definetly knows that something is wrong with her, with her head and mental health, and who’s wishing to get better so people dont hate her anymore.
Plus, they totally hate me for trying to explain that I ask for help, that I didnt want nor deserved to have all of that, that I’m trying my hardest to deal with it, and that I need just some understanding at least, and some comforting at most…
I need someone to talk, to tell me to do something to get of this living hell, please.
Thank you for sharing, Phoebe. What we see here is a whole lot of self-judgement, criticism, depression, and anxiety. Yes, anxiety. Did you know that some people talk about themselves a lot because they are anxious? And the more they feel social anxiety, the more they talk? In any case, it sounds like you don’t have anyone you can trust, and that is really sad to hear. Because what we read is a person who desperately wants to be heard and appreciated just as she is, flawed and all, and we all have flaws. They are what make us interesting. The trouble is, when we are depressed and anxious, it’s normal to push people away. So the more we want to be accepted and loved, the more we push away, until we feel totally alone. On a good note, you are very self-aware, intelligent, and you want to move forward. And all these issues you are talking about, they are all treatable. None of them have to be a life sentence. We have every reason to believe you can come through all of this to a better place. Of course what you need is support, someone to talk to you can learn to trust. It doesn’t seem like your parents will help you with that. Is there a school counsellor you could trust enough to chat to? If not, look into mental health charities in your area and see if they have support groups or low-cost counselling for young people. In the UK we have Childline and Mind charities, but you might not be in the UK. In the US we do know that Good Samaritans runs a free text service, they might have some advice. Don’t give up. Reach out where you can. And keep in mind what you want for yourself, over what anyone around you think, and do what you can to move towards that. Many people find once they go off to college and university and get away from their family they find they can relax and be themselves more. We wish you courage!
I am engaged to my partner who has a NPD, it’s been 2 years and all those years I suffered a lot from him. I love him so much that made me so stupid and idiot of kept letting him nonstop hurting me physically, verbally, and emotionally for 2 years. He always accused me of cheating and fucking someone else which God knows I never did since we’ve been each other. He always make stories towards me which never even happened. He always hurt me physically once I don’t accept his accusations and beat me sooo bad and almost kill me. I always caught him chatting and dating a lot of women and brought them into his apartment and once caught he always just said that the woman is just his friend. I even read all his conversations of many different women but still denied everything. Once he will call abd I cannot answer immediately, he will immediately accuse me of fucking someone else. He always belittle, criticize, humiliate,disrespect, embarrass me anytime anywhere he want even in public. I hate myself so much because I always let him do all of this things towards me. I felt so tired all of the things he have done towards me but still I always placed my heart over my head. I don’t pray anything only for him to change but his not. Now I don’t know what to do. 😭😭😭
Dear MJ, notice how this entire thing is ‘he did this, he did that, I am praying for him to change’. Here’s the cold hard truth – the only power you have to change anyone or anything here… is to change yourself. You cannot change him. Do whatever it takes to shift your obsessive thinking around him onto yourself, and seek support. You are in an abusive relationship, and from what it sounds like dependent or even addicted on the pain. Don’t feel bad about this, many of us get stuck like this. If we had a painful upbringing then we mistake pain as ‘home’ and think it is what we deserve. It isn’t. Not even remotely. So do whatever you can to get help. Call a hotline for women in abusive relationships or a charity, if you can find a counsellor. We wish you courage!
Hi
Do you provide any online counseling or something for ppl suffering with this problem?
Hi Sarah, if you are asking for yourself, you can search for a suitable online therapist on our booking site https://harleytherapy.com/. We would just point out that if it’s not for you but you feel someone else is a narcissist and plan to tell them to seek therapy, please do read our article on how to tell someone they need therapy first here http://bit.ly/lovedonetherapy. Otherwise telling someone to seek support can backfire.
Hi. I am pretty certain I have step daughter with NPD & really struggle with things. I can’t just cut her off as she is a single parent & we help with childcare. She lives way above her means. Never goes without her own pampering sessions etc but then tells us she can’t afford to feed her child & expects her father to step in & supplement her lifestyle. She gets aggressive verbally when she doesn’t get her own way & badmouths us to whoever will listen. She lies, she ‘borrows’ money from her friends & when she doesn’t pay it back justifies it by saying they can afford it. She constantly demands our attention. She has no empathy for others & will bring any subject back to herself.
It is totally draining I don’t want to let her child down as it isn’t their fault but don’t know where to go with this.
Hi Margaret, we can’t say if someone does or doesn’t have NPD over a comment , we’d have to know the person and their perspective as well. We would say it’s much rarer than the internet would have you believe. What is of interest to us here is not her but you. What boundaries have you set here? How have you discussed this with your partner? How healthy is the communication between you and your partner? What issues is this triggering for you, personally? There seems to be a lot of anger. At the end of the day we can’t control or change another person, we only have power over ourselves and our own boundaries. Best, HT
Hi, I think I have suffered years of abuse with a narcissistic mother who had a physically abusive parent herself. Since my fathers death she has been living with us and I am going through my child hood again with constant control and abuse and being made to feel like its me. I can’t abandon her or financially her move out but I am struggling to cope with it now. I phoned NHS for help today and that’s when they suggested she was Narcotic. So I read up and I am now so worried I have picked up these traits – luckily I am trying to spot it and do the reverse but I have children early teenagers who are witnessing this with my mother and I am worried I am doing the same. I have read their is no cure and it is passed down and I am really worried I will loose them or they will feel about me the way I do with my mother. I try to not put them down or take any credit for their actions or abilities. How do I get help with a restricted budget – healing me and turning the cycle so I don’t become her – it must be possible?
thanks for info
How do I bring up the fact I think, I might have NPD to my psychiatrist? Would he judge me? I was recently diagnosed with EUPD last year but I’ve become aware of some behaviours I’ve been portraying and I’m absolutely terrified I’m actually an NPD, I unintentionally show these tendencies and when I become of aware of them I try to stop them but half the time the damage has been done and then I’ve hurt people without realising I’ve hurt them. I am single parent to a teenage daughter and I’m scared I’ve affected her mentally and emotionally forever.
I don’t want to hurt people but I keep doing it. I feel suicidal a lot but I try not to self harm as to protect my daughters emotional and mental well-being we try to talk out emotions. I do have what would be considered a favourite person and I don’t know what I would do if I lost that person but I have treated them badly too and they believe I may be a covert and not realise. Is this possible?
The thought of actually hurting people sickens me and the thought of possibly having NPD and how I am hurting people without realising is destroying me