No one wants to be called a narcissist. In our day-to-day lexicon, the term’s become a go-to insult for abusive exes, demanding bosses, selfie-obsessed influencers, and celebrities who casually decide to run for public office. Often, narcissists are boiled down to self-centered jerks you’re best off avoiding at all costs.
In the world of psychology, though, narcissism is far more complex than that. “As a personality trait, narcissism exists on a spectrum from healthy functioning to severely disordered,” explains Mark Ettensohn, Psy.D., a clinical psychologist and author of Unmasking Narcissism. Some level of narcissism is normal and even healthy and adaptive, he says. It’s only when your narcissistic tendencies become a life-disrupting constant that you veer into the territory of a bona-fide mental health condition known as narcissistic personality disorder (NPD).
According to the DSM-5, people living with NPD have an overblown self-image, an inexhaustible need for admiration, and a lack of empathy. They believe they’re part of an elite group and therefore deserve the best of everything, from special treatment at the DMV to the perfect love to match their idealized version of themselves. About 6% of Americans may fit the criteria for a diagnosis of NPD at some point in their lives, and risk factors include being young, male, and single.
Are all narcissists the same?
There are two main subtypes of narcissists to be aware of, explains W. Keith Campbell, Ph.D., a social psychologist and author of The New Science of Narcissism. Grandiose narcissists are most closely aligned with the stereotypical narcissist: They’re often charmers with off-the-charts high self-esteem driven by a relentless need for more attention and a higher status. Vulnerable narcissists, on the other hand, suffer from dangerously low self-esteem and can be more quiet, reserved, and resentful, like the undiscovered “genius” who refuses to get a job that’s “below” him.
If you suspect that someone in your life is highly narcissistic (or may even be living with NPD), maintaining your relationship can be a huge burden, especially if you’re romantically involved, per a 2019 study published in the Journal of Personality Disorders. In order to prop themselves up, narcissists may put you down, sabotage you, or even publicly humiliate you, says Bill Eddy, L.C.S.W., a therapist, lawyer, and author of Splitting: Protecting Yourself While Divorcing Someone with Borderline or Narcissistic Personality Disorder. In the worst-case scenario, some people with NPD could also become aggressive or violent when they sense their shaky ego has been threatened.
Besides letting it out on you, narcissists can also hurt themselves. Often, a diagnosis comes along with health issues including addiction, depression, and anxiety. All in all, people with NPD are more likely to end up with a criminal conviction and spend time in prison.
If you’re living with a narcissist, the advice caring friends give tends to be along the lines of, “Run fast and don’t look back.” For the sake of self-preservation, that makes sense. However, it’s not always easy or even possible to cut off all contact with a narcissist when they’re your parent, partner, or friend.
In this case, a few questions are likely top of mind: Can narcissists change? And if so, what does it take? As someone who cares about them (or at least has to live with them), is there anything you can do to support their recovery while protecting yourself?
Can narcissists actually change?
Unfortunately, there’s no simple “yes” or “no” answer to this question, and it may depend on where exactly this person falls on the spectrum of narcissism. “Anyone can change, but as is true with any personality disorder, the path to healing is long and difficult,” says Ettensohn.
While there’s no one-size-fits-all treatment for narcissistic personality disorder, therapy with an experienced mental health professional can help a narcissist reflect on their feelings, come to understand their history, and develop new skills to cope with their condition. As far as the empathy deficit goes, research suggests that it is possible for some narcissists to build up their capacity for empathy when they practice taking on someone else’s perspective, says Campbell.
Ultimately, the greatest barrier to a narcissist’s success tends to be their own narcissism. Narcissists have to be motivated to change, and many aren’t simply because they can’t see that they have a problem or they just don’t care. Sometimes, it isn’t until they experience a major personal crisis such as a failure at work, the loss of an important relationship, or another deeply humbling experience that they feel compelled to seek help.
Even if a narcissist makes it into therapy, though, it can be a herculean task to keep them committed to the hard work that real and lasting change requires, as many would rather quit than kill their ego.
What should you do if you think someone in your life may have narcissistic personality disorder?
If you’re looking for a sign that change is possible, ask yourself if this person has ever taken responsibility for their own behavior or tried to behave differently, says Eddy. An acknowledgement such as, “I’m sorry I hurt you, that wasn’t my intent,” may indicate that there is a path forward.
Then, use these tips to navigate life with a narcissist:
1. Check in with yourself.
It’s extremely difficult to change yourself let alone your partner or family members, so remember that it’s not your job to “fix” a narcissist in your life. While narcissism and abuse are not always intertwined, if this person is abusive towards you (or you’ve noticed some red flags in your relationship), your first priority should be your own safety, says Ettensohn. Talking to a domestic violence advocate or therapist can help you figure out what next steps are right for you (to reach the National Domestic Violence Hotline, call 1-800-799-7233 or text LOVEIS to 22522).
2. Don’t call them a “narcissist.”
Only a therapist or psychiatrist can make an official diagnosis of NPD and just as you shouldn’t diagnose yourself with a mental disorder, it’s best to avoid flinging labels that could be stigmatizing or hurtful at a loved one.
“I wouldn’t recommend suggesting to the person that they are narcissistic or have narcissistic personality disorder because those terms are so loaded,” says Ettensohn. And if they do indeed fit the criteria for NPD, it’s important to approach the issue carefully because they’re likely very sensitive to feeling criticized, he says.
3. Focus on symptoms.
Having NPD can be deeply distressing, especially if the person is in an endless battle with low self-esteem. As such, it may help to point out that they seem to have trouble feeling consistently good about themselves and that therapy might help them feel better, says Ettensohn. To balance out these observations, reassure them that they’re loved and valued just the way they are, he suggests.
4. Set boundaries.
If this person has shown you that they’re not interested in changing, it’s important to identify what you want from this relationship and what you’re willing to put up with. While setting boundaries can be a difficult task if you’ve gotten used to putting up with hurtful behavior, it’s a great way to protect yourself from the worst of someone’s narcissistic tendencies, says Eddy.
For example, if you have a family member who frequently jabs at you with petty insults, calmly and clearly communicate that you will not allow this to go on: “If you’re going to speak to me like that, I’m going to have to end this conversation and talk when you’re ready to be respectful. It isn’t good for either of us for you to talk to me that way.”
5. Walk away.
“If a narcissistic loved one refuses to get help, then you should consider whether staying in the relationship is the best option moving forward,” says Ettensohn. While it’s painful to break up, consider divorce, or distance yourself from a family member, especially if you’ve shared a lot of great memories, it is possible to move on—for your benefit and theirs.
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