Narcissistic Personality Disorder

Updated: July 23, 2022

Narcissistic personality disorder (NPD) is a condition whereby people crave admiration and attention and amplify their own importance.  Because of their lack of empathy, narcissists often experience troubled relationships.  Even though they appear confident, narcissistic people are hindered by a fragile ego and low self-esteem.  This makes them sensitive to criticism even when it’s constructive.

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What Is Narcissistic Personality Disorder?

NPD is a personality disorder according to the Diagnostic and Statistical Manual V.  The DSM is a manual which outlines the many disorders that have been coined by psychiatrists.  It’s important to realise however that not all narcissists have NPD.  This is because to a greater or lesser degree, we all have narcissistic traits and tendencies.  Because in fact, narcissism is necessary for survival.


The two types of narcissism are grandiose and vulnerable, but there is symptomatic overlap between them.  A person with either of these forms will experience problems in many life areas.  For example, relationships with money, school, or work life.  People with NPD can appear very charismatic and charming at first, and will want to be around people who stroke their ego so they can reinforce their grandiose self-image.


This is because narcissists have repressed insecurities which create low self-esteem.  This means they require validation from others in the form of interest, and appreciation.  The sense of entitlement facilitates feelings of disappointment and unhappiness, especially when they do not receive the attention and admiration they believe they deserve.  Furthermore, because narcissists are self-absorbed and do not consider others’ needs, they can come across as arrogant and lacking empathy.


Because of these unreasonable and unrealistic needs and expectations, other people will often struggle to be around the narcissist.  It can be challenging to be in a relationship with a narcissistic person because of how they often try to manipulate and control others and disregard boundaries.  These difficulties also mean that the narcissist feels unfulfilled in relationships because they are often superficial.

What Are The Symptoms?


Narcissists can behave in ways that are considered rude by others.  This is because the narcissist views themselves as superior and looks down on those they perceive as beneath them.  They therefore come across as conceited, pretentious, boastful, and arrogant.

Envy Or Jealousy

Due to the need to feel superior and exaggerate their self-importance and achievements, as well as their need for superficial material things, and success, the narcissist will covet these things.  They feel unpleasant feelings when they are faced with people that have what they want.  This is due to their insecurities and the inability to regulate their feelings.

Exaggeration & Need For Validation

The tendency to exaggerate (lie) about abilities and achievements.  Attempting to paint a glorified image, one that deserves admiration, praise, and awe.  This is due to a need for appreciation and validation, which boosts a fragile and insecure ego.

Fantasist Tendencies

Narcissists often fantasise and become preoccupied by things like appearance, beauty, brilliance, success, power, or the perfect partner.  They insist on having the best things, like the latest phone, handbag, trainers, watch, or car.  These provide a sense of importance.

Inability To Handle Criticism

Because of the fragility of their ego, due to their insecurity, vulnerability, and shame, narcissists can be feel very sensitive to things they perceive as criticism.  This means they feel slighted and humiliated very easily.  When this happens they may attempt to ‘save face’ by reacting with veiled contempt and rage, for example, trying to belittle the person they feel angry at.

Inability To Regulate Emotions

Narcissistic people often feel moody, depressed, and anxious, because they are unable to attain the perfection they believe they should.  They can experience stress in situations that many would not, and feel overcome by these feelings because they are unable to regulate their response in a healthy or optimal way.

Interpersonal Problems

Due to their nature, narcissists will often experience significant problems with their relationships.  They can be very difficult to be around, treating those around them with disdain, and even abuse.

Lacking Empathy

The narcissist is unable or unwilling to recognise others’ feelings and needs.  This allows them to continue treating others poorly, as they do not have to be accountable for their behaviour.

Manipulative Or Controlling Behaviour

Narcissists will initially want to gain your approval, they will do this by trying to impress and please you.  But at some point they will no longer be able to keep up the façade, and their own needs take priority.  They often exploit people once they have sucked them in, and attempt to maintain control so they can take advantage.

Sense Of Self-Importance & Entitlement

A common symptom of narcissism is a feeling of self-importance and superiority and the belief that they deserve special attention, recognition, and admiration.  In those with NPD, this can also manifest as a belief that they are above the rules that apply to others, and others should oblige them.  When they do not receive the special treatment they believe is due, they can react with  impatience or anger.

What Causes NPD?

As with other mental health conditions, including personality disorders, there is an interplay between nature and nurture, that is, genetic inheritance and environment and upbringing.

Childhood trauma, distress, and fear due to abuse or neglect can often contribute to the development of a personality disorder like NPD.  As mentioned, narcissists often experience a weak ego, due to insecurities that relate to their self-esteem, which is impacted by earlier experiences.

How Phinity Can Help

Because narcissists do not see themselves as narcissistic, they rarely seek help for the problem.  They may therefore require the encouragement of a loved one to help them seek support, that person might be you.  Sometimes, the NPD itself may not be the issue they have come to work on, it may be a peripheral problem.  For example, they may seek help for difficulty in relationships, but this does not mean the problem goes unaddressed.  At Phinity, we will work with individuals on the difficulties they perceive, which often leads to greater self understanding and awareness, and therefore new choices.

For something like NPD, talk therapy, also known as psychotherapy is usually prescribed.  This is because it can help individuals to understand why they feel and think as they do.  For example, why they are suspicious of others and cannot trust them, or why they feel contempt towards themselves and others.  Over time, people can learn to better relate to themselves and others and enjoy more intimate and rewarding relationships.

Individuals may also wish to work on other goals, like learning to tolerate difficult feelings, and reframe how they perceive others’ behaviour towards them.  This can build the ability to tolerate failure and criticism, and help to regulate feelings.

Working on low self-esteem is also a helpful goal for NPD, since much of the issue relates from a need to protect a fragile self image, which is hidden under an over-compensatory exaggerated self.  But this latter ‘paper self’ is unable to withstand the elements (of life).

Self-care and compassion are also important goals which may be useful for individuals to work on in therapy.  People can learn how to show themselves kindness, rather than criticism and self-loathing.  One aspect around this may be a tendency to compare oneself with others and feel deficient, which leads to the need for validation in the form of recognition and praise.

Therapy can also help individuals to set realistic and attainable goals, and be less self-critical about one’s capabilities.  This means individuals are able to feel satisfied by what they do, rather than dissatisfied with what they don’t and cannot.

We can offer short term therapy for acute situations, for example if there is a time of particular stress or crisis.  Or, provide long term therapy for more substantial and longer lasting aims.  You also have the option of involving your partner or family, if that would be helpful for you.

What Causes NPD?How Phinity Can Help


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