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What is narcissism? Signs, causes, and treatment options

What is narcissism? Signs, causes, and treatment options

The word “narcissism” comes from a Greek myth where an attractive man named Narcissus looked at his reflection in a pool of water—and fell in love with it.

You may know somebody like Narcissus. They might think about the world of themself and all of the great things they accomplish in life. You can’t miss hearing about it because this person will let you know how wonderful they are in nearly every conversation you have with them. 

While it’s normal to brag or be selfish every now and then, people with narcissistic personality disorder (NPD) have an inflated sense of their importance, an extreme need for admiration, and a lack of compassion for others.

What Is Narcissistic Personality Disorder?

As stated above, narcissistic personality disorder is characterized by having an excessive need for admiration and praise and, often, a belief that they are entitled to it. In addition, individuals with NPD don’t value other people’s feelings and ignore their needs. The personality disorder is lifelong and consistently presents symptoms throughout one’s life. 

What lies beneath this ultra-confidence is a person who has a fragile self-esteem and is sensitive to even the smallest criticism or perception of abandonment. People with the disorder may have problems at work, school, and in relationships. Other people often don’t like being around them due to their self-centeredness and lack of empathy toward the problems of others.

Because they are convinced they are special or unique, narcissists believe they should be associating with high-status people, though they can tend to spend limited time with them in case those people start to take attention away from them. 

Due to their sense of entitlement, they also become disappointed and frustrated when they don’t get special favors or the admiration they think they should get. They can even start to feel envious of other admired people because they want to be the ones admired and exalted—the person that other people are jealous of.

What’s an Example of Narcissistic Behavior?

You may have a coworker who does just about everything better than the rest of the staff. Maybe your relative always thinks she knows more than anybody, and she has to give her two cents in every conversation. Maybe you have a friend who makes all conversations—no matter what the topic is—about himself. Any of these interactions could point to someone exhibiting narcissistic traits. However, the only way to know for sure whether someone has NPD is if they get a diagnosis from a mental health professional.

How Can You Tell If Someone Is Narcissistic? Recognizing the Signs of Narcissistic Personality Disorder

When a person has NPD, they may find that other people are often upset with them. It is difficult for them to keep relationships, and they often put themselves first. These are only a few traits of a narcissist. The following are more signs of a person with the disorder.

  • Narcissists are likable and make wonderful first impressions. They’re personable and are usually fabulous in job interviews. However, that’s at first glance. Over a period of time, people may find that the positive person they thought they knew is actually very negative.
  • Many times, narcissists are in leadership roles. It isn’t usually because they are good leaders, but more often because they seek out positions of power and superiority.
  • A conversation can be about anything—your plans for a luxurious vacation or a piece of jewelry you just received—but somehow the conversation suddenly becomes all about the narcissist.
  • Narcissists like to name-drop in order to make themselves seem more important.
  • Narcissists like to tell stories about themselves, and it’s not uncommon to hear the same one again and again. The story is usually about something wonderful they did. However, if the story is about something negative, it is never caused by the narcissist.
  • People with NPD like to buy nice things—clothes, jewelry and fancy cars—because it is their way of showing how important they are or the position of prestige they are in.
  • Narcissists take great care in how they present themselves and set a high value on looking physically attractive, such as making sure their hair is always neatly styled and nails are perfectly polished.
  • They love to have lots of friends on social media, and narcissists make sure to have only their most attractive pictures posted.
  • People who are narcissistic are very sensitive to criticism, and often react drastically to any perceived insult or slight.
  • They often blame everyone else for their mistakes and have dozens of excuses.
  • Many narcissists destroy working relationships and go from one job to another. They also often commit infidelity in their relationships and move on to new ones.
  • When things don’t go their way or they don’t get the recognition they think they deserve, the narcissist may get angry. They believe people are against them and misunderstand them.
  • The narcissist exaggerates their talents and achievements.
  • When it comes to taking other people’s feelings seriously, the narcissist has a hard time due to their trouble with feeling empathy.

Important to note is that NPD is only diagnosed in adults. Since children are continuously developing and learning about interpersonal relationships and emotionality, they can sometimes exhibit some of the traits of narcissism. However, it is distinctly possible that they will grow out of it, hence the adulthood restriction.

Understanding the Causes of Narcissism

A rare disorder found in only about 6% of people, NPD affects more males than females and often begins in early adulthood. The cause of NPD isn’t known, but researchers think that extreme parenting behaviors—neglect or excessively indulging a child—may be at least partly the cause. The following are some of the possible causes of NPD:

  • Little affection or praise toward the child from their parents.
  • Emotional abuse or extreme neglect as a child.
  • Parents ridiculing or scorning the fears the child expressed.
  • Parents were unreliable in their care of the child.
  • A hypersensitive temperament at birth.
  • Parents, family and friends overly praised the child.
  • Seeing and learning manipulative behavior from parents.
  • Constant praise for exceptional looks or talents.
  • Extreme approval for good behavior, and extreme criticism for bad behavior in childhood.
  • Genetics may also play a role in the development of NPD.

Though the root cause of narcissism is unknown, narcissism in children is thought to be cultivated by parents. When parents overvalue their child, believing that their child is more special or deserving of things than other people, it can make the child feel entitled while also giving them low self-esteem. 

That low self-esteem coupled with entitlement can make someone very insecure, prone to acting out with aggression when those insecurities are touched on. 

On the other hand, emotional and physical abuse experienced in childhood can also play a part. By making a child feel worthless and incompetent and imposing strict rules and punishments, parents can also cause children to develop very low self-esteem. This can then cause those children to become very sensitive to criticism and desperately seek external approval through presenting a very inflated ego.

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How to Cope with Narcissistic Personality Disorder in Relationships

Narcissists can be difficult to deal with in relationships, as their lack of empathy and self-centeredness can cause them to use people close to them in order to meet their own needs and reach their goals rather than putting anything into the other person. 

One way to deal with being in a relationship with a narcissist is to draw firm boundaries and challenge your place in the relationship. If you are worried that your partner might have NPD, it would also be good to see a couples counselor or seek individual counseling. They will be able to lead to a concrete diagnosis and give you clarity on how best to move forward.

However, whether someone you love has NPD or not, if they exhibit symptoms that are not good for you and your relationship with them, it may be best to assess whether being in a relationship is the best thing for you.

Treatment Options for Narcissistic Personality Disorder

Therapy for Narcissistic Personality Disorder

Talk therapy, such as CBT or DBT, is an effective treatment for NPD, though there is no specific treatment approach that is used consistently to help with NPD. With the help of a therapist, the individual with NPD can learn to relate better with other people in order to enjoy closer and more meaningful relationships. 

The therapist will work with the individual to identify the cause of their emotions and why they feel the necessity to compete with and distrust others. In addition, a therapist will work with the person to be able to find out their true competencies and talents in order to better receive criticism or deal with failure. They will learn to understand the issues that cause distress to their self-esteem and strategize ways to deal with them.

Medication for Narcissistic Personality Disorder

There are no specific medications commonly recommended or used specifically for NPD. However, NPD has many co-occurring conditions like anxiety and depression, so oftentimes people with NPD will be prescribed medication for their comorbid condition which will then in turn help with their symptoms of narcissism. 

Through the use of psychotherapy and any medications deemed necessary by a mental health professional, NPD can be treated. By learning new ways to conceptualize life and oneself, people with NPD can discover new perspectives, understand how their self-esteem is tied to their behavior, and find effective ways to be in healthy, reciprocal relationships with others.

  • Medical writer
  • Editorial writer
  • Clinical reviewer
  • 1 sources
  • Update history
Kate Hanselman, PMHNP in New Haven, CT
Kate Hanselman, PMHNP-BCBoard-Certified Psychiatric Mental Health Nurse Practitioner
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Kate Hanselman is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC). She specializes in family conflict, transgender issues, grief, sexual orientation issues, trauma, PTSD, anxiety, behavioral issues, and women’s issues.

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Alexandra “Alex” Cromer is a Licensed Professional Counselor (LPC) who has 4 years of experience partnering with adults, families, adolescents, and couples seeking help with depression, anxiety, eating disorders, and trauma-related disorders.

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Hannah DeWittMental Health Writer

Hannah is a Junior Copywriter at Thriveworks. She received her bachelor’s degree in English: Creative Writing with a minor in Spanish from Seattle Pacific University. Previously, Hannah has worked in copywriting positions in the car insurance and trucking sectors doing blog-style and journalistic writing and editing.

We only use authoritative, trusted, and current sources in our articles. Read our editorial policy to learn more about our efforts to deliver factual, trustworthy information.

    1. Stinson, F. S., Dawson, D. V., Goldstein, R. B., Chou, S. P., Huang, B., Smith, S. L., Ruan, W. J., Pulay, A. J., Saha, T. D., Pickering, R. P., & Grant, B. F. (2008). Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Narcissistic Personality Disorder. The Journal of Clinical Psychiatry, 69(7), 1033–1045.

We update our content on a regular basis to ensure it reflects the most up-to-date, relevant, and valuable information. When we make a significant change, we summarize the updates and list the date on which they occurred. Read our editorial policy to learn more.

  • Originally published on May 27, 2019

    Author: Lenora KM

  • Updated on May 16, 2023

    Authors: Hannah DeWitt & Kate Hanselman, PMHNP-BC

    Reviewer: Alexandra Cromer, LPC

    Changes: Updated by a Thriveworks psychiatric nurse practitioner in partnership with our editorial team, including supplementing information about what NPD is, what might cause it, and possible treatments; added an example of narcissism; included more information regarding how to cope with in a relationship with a narcissist; article was clinically reviewed to double confirm accuracy and enhance value.

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