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What Narcissism Is and What It Isn't

Updated: Apr 3

Few topics in psychology are abuzz like discussions, well let’s face it, accusations, about narcissism. As mental health speak becomes a part of our regular, everyday conversations, it is unsurprising either joking, self-identifying or accusing others of various mental disorders is common discourse. It is wonderful that people are more and more likely to accept their own struggles and speak about them openly. Shame and suppression only make us feel worse, and as more people open up and realize they are not alone, these conversations can reduce stigma and create a generally more compassionate society. However, misinformation is lurking everywhere. One of my training experiences that was most densely populated with misunderstandings of mental health diagnoses was at an inpatient drug and alcohol rehab where clients spoke about feeling “bipolar.” Their basis for this diagnostic assignment was that their emotions were “up and down all day.” There is nothing silly or stupid about these individuals saying this – they were simply trying to find a word that characterized their experience and communicate it to others. However, emotions up and down during a day does not a bipolar diagnosis make. Where did this phenomenon arise? Mental health diagnoses making their way into mainstream media and their meaning becoming distorted.

 

This brings us to our main event! Narcissism!

 

Like the clients in the rehab I just described, narcissism is commonly used as an adjective to describe ugly behavior such as self-centeredness and self-importance. When others are accused of being “narcissistic,” it is usually because the accuser is feeling as if they are being abused in some way by someone who is only thinking of themselves and their needs. Few of us want to be around a person whose main agenda is solely their very own and so it only makes sense to call this person narcissistic because it seemingly describes the offense. In reality, the official, psychological DSM-V based diagnosis of narcissistic personality disorder is very rare, between .5% and 6%. The diagnosis is assigned more to men than women and may manifest differently in men than women due to differences in socialization.

 

True narcissistic personality disorder (NPD), rare as it may be, can cause tremendous suffering not only to others, but also the narcissistic individual. As uncomfortable or confusing as that may be to read, it is true that many of those with NPD are suffering underneath a very grandiose presentation. This is truer in the vulnerable presentation of narcissism, but narcissism may develop due to many factors including trauma. I have treated handfuls of individuals who describe incredibly neglectful or abusive childhoods where both parents treated them in ways that are unimaginable. The way that these individuals coped with their situations was to protect their fragile self-esteem by convincing themselves that they were always right, more talented or intelligent than others or bullying others so they could get what they wanted, the way they learned in their upbringing. Simply put, they puffed themselves up so they could face life and not collapse into the weakness they felt early on. While people often think those with narcissism are calculated and planful about their behavior, there are many cases where narcissism is an almost unconscious, automatic way of dealing with reality that was set forth at an early age and at a time when that behavior was adaptive to handing a difficult life. It is necessary to undo this damage in therapy or other self-help environments to minimize the pain caused to others and within the narcissistic individual's own psyche.

 

Narcissism is far more complex than all I have written (more blog posts to follow on the origin, treatment and various types of narcissism that are out there), but I want to mention that although the diagnosis is rare, personality disorders exist on a spectrum, which means that those out in the population thinking they are seeing more often than 5% may have some merit. However, I am here to caution that we can all exhibit moments of narcissism every single day and because of this, we must be careful to know what really is the diagnosis. We can all be selfish, we can all be braggarts, and we can all unintentionally take advantage. It is when these behaviors and other diagnostic criteria exist regularly, throughout many settings and have been present from a young age.

 

When we accuse others of narcissism, what we are really trying to communicate is that we are hurt, feel exploited and want more reciprocal interactions. When narcissism is actually present, we may truly be being abused by someone whose personality prevents them from behaving in prosocial ways.

 

As a psychologist who specializes in working with those who have NPD and those who have been affected by others with NPD, I am here to say that this diagnosis requires a complex and thorough conversation, which is why I will continue this series in my next post.



Personality disorder treatment Philadelphia telehealth

 

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