Understanding narcissism & narcissistic personality disorder

What Is narcissism?

The origins of the term narcissism come from the Greek myth of Narcissus, a great hunter known for his beauty and disdain for those who loved him. In the story, he is lured to a pool, where he falls in love with his own reflection, unaware it is an image, he is unable to leave the beauty of his own reflection, and eventually changes into a flower bearing his name, the Narcissus.

We all have the capacity to display some level of boasting or bravado, and may at points feel an inflated sense of our own prestige. Narcissism however, should not be confused with self-worth, self-esteem or responsibly caring for oneself. Narcissism is a state of egotistical preoccupation with the self, personal preferences, aspirations, success and how you are perceived by others. It is a state in which an individual has an overwhelming need for admiration, usually accompanied by a lack of empathy for others. It is often said that narcissists ‘love themselves too much’, however a large part of what defines narcissism is an inability to love or form meaningful relationships, so the above statement is largely inaccurate.

Narcissistic characteristics

Common characteristics include -

  • obvious self-focus in interpersonal exchanges

  • problems sustaining or satisfying meaningful relationships

  • lack of psychological awareness

  • difficulties displaying empathy

  • difficulty distinguishing the self from others

  • hypersensitivity to insults or imagined insults

  • vulnerability to shame

  • flattery towards those who admire them and detesting those who don’t

  • using others without considering the cost

  • inflated sense of importance

  • subtly bragging or exaggerating achievements

  • claiming to be an expert at many things

  • inability to view the world from other perspectives

  • denial or removal of gratitude.

It’s important to note that although these characteristics can be displayed by an individual, it does not necessarily mean they are narcissistic. Narcissism and narcissistic traits are displayed in different ways, depending on the individual. It’s important that any assumption of narcissistic characteristics are investigated before assumed as fact, as there can be numerous reasons for these behaviours.

Causes of narcissism

The exact causes of narcissism are unclear, but it’s unlikely that one single factor is the cause. More likely is that it’s a result of different factors such as biological, genetic, psychological and social. It is also thought that narcissism could be linked to factors such as individual personality or an oversensitive temperament. Usually however, it is thought that early childhood experiences are the most significant factors.

Such as -

  • insensitive parenting

  • lack of attention of praise

  • neglect or emotional abuse

  • trauma

  • extremely high expectations

  • unpredictable or negligent parents

  • excessive criticism.

Types of narcissism

For the most part it is agreed, that narcissism operates on a continuum, meaning there are different ends to the spectrum, and that narcissistic behaviours and traits can be widespread, and fall anywhere between extreme or subtle. At the lower end of the spectrum, that most of us at some point experience, are slight narcissistic traits such as an over inflated sense of ourselves or achievements, however this is often brief.

Narcissistic personality disorder

At the extreme end of the spectrum is a person who has a constant sense of their own weakness and resentment at being a victim in the face of mistreatment of others. This wounds their sense of self meaning there is a constant fight to be validated, appreciated and valued for their achievements.

A person with narcissistic personality disorder will find it impossible to tolerate the discomfort brought about through the need for validation. So much so, that they simply will not recognise it as a difficulty. These individuals need to maintain grandiose validation, respect and self-worth at all costs. This is essential because the alternative consists of an all destroying abyss where they are worth absolutely nothing.

Those around an individual with narcissistic personality disorder will be serving to reflect their self-worth back at them. When this occurs, the narcissistic individual is keen to respond with flattery to their admirer. However when the flattery stops, or fails to make the narcissist feel good about themselves, which is almost inevitable in any relationship or interaction, they will trigger destructive behaviours within the narcissist, including criticism and rage, and will inevitably be discarded.

Narcissistic personality disorder is often split into three types –


Characterised by grandiosity that is used as a defensive function to ward off painful feelings. These individuals wish to feel important and privileged, and when defences are operating effectively, they do. When defences fail, there is a powerful undercurrent of negative feelings often accompanied by rage.


  • alternating feelings of grandiosity and inadequacy

  • feelings of unhappiness

  • critical of others

  • anxiety

  • envious and competitive

  • extreme reactions to criticisms.

High functioning/exhibitionistic

Difficult to recognise due to the fact they are often responsible, hold down a job, have a successful history of relationships and can be highly creative and intelligent.


  • competitive

  • attention seeking

  • can be sexually seductive or provocative

  • highly articulate

  • energetic

  • goal orientated.


These individuals exploit others with little regard for their welfare, have an exaggerated sense of their own importance, feel entitled and possess little empathy. Often putting their own needs first, they tend to be controlling of others.


  • seething anger and rage

  • interpersonal manipulations

  • pursuit of interpersonal power and control

  • lack of remorse

  • exaggerated self-importance

  • feelings of privilege or entitlement

  • little insight into their own behaviours.

How therapy can help

A range of talking therapies can be used to address narcissism, and assist an individual in working on how they relate to others. Through encouraging and giving positive feedback for greater levels of honesty, kindness and shows of emotional vulnerability, rather than goals or progress, a narcissist can begin to see others less as objects or possessions for their own satisfaction, and more as people.

Although progress will be made in ups and downs, and it’s likely the process will not be a quick one, with support of a therapist as well as family and friends, change is possible.

Counselling Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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London E5 & SW1W

Written by Joshua Miles

London E5 & SW1W

Joshua's an experienced integrative psychotherapist who's worked with people with a wide range of mental health difficulties. He provides people with a space to be reflective about their own lives & assists them in exploring their feelings & experiences at depth as well as working on strategies to cope & manage. He's based in Shoreditch East London

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