Narcissistic personality disorder is a mental health condition marked by a pattern of grandiosity, a need for admiration, and a lack of empathy in a person. For someone to be diagnosed with this condition, they must meet certain criteria outlined in the DSM-5 diagnostic manual, notes Dr. Loreto Aldunate Vidal, clinical psychology specialist at ABC Medical Center.
- An unfounded, often exaggerated, sense of their own importance in the world.
- A preoccupation with fantasies of unlimited success, love, or power. They also tend to believe they’re special and unique and should associate only with people who share those same qualities.
- A sense of entitlement, along with a constant need for admiration.
- Exploiting others and lacking empathy to achieve their goals.
- A persistent sense of envy, along with a belief that others envy them.
Depending on their specific traits, people with narcissistic tendencies can fall into different categories, such as low-empathy narcissists, whose behavior revolves around ego, or malignant narcissists, who may show traits more closely resembling sociopathy.
When discussing treatment for narcissistic personality disorder, the first thing to understand is that someone with this condition is unlikely to seek therapy voluntarily, notes Dr. Aldunate, largely due to how vulnerable or weak this makes them feel in front of others.
That said, there are three key moments when a narcissistic person often does end up in therapy:
- After facing the threat of being abandoned by someone else.
- After experiencing clinical psychiatric or psychological symptoms, such as depression, poor anger management, anxiety, sleep disturbances, or substance use, among other issues.
- The “narcissistic wound,” a term used to describe a long-standing, often medication-resistant sense of chronic depression, which typically stems from not having achieved the goals they set for themselves in life, whether professional success or recognition from others.
Regardless of what brings a narcissistic person into therapy, treatment generally follows one of two therapeutic approaches.
The first is cognitive behavioral therapy combined with dialectical behavior therapy, which focuses on managing symptoms directly, such as emotional regulation, depression, or anxiety.
The second is a psychodynamic approach, which aims to address childhood trauma and other underlying factors linked to the development of narcissistic personality disorder.
To conclude, Dr. Aldunate notes that it’s important to understand that not every narcissistic person is a sociopath, many simply show reduced empathy when their ego is challenged. That said, seeking help is important regardless of which form the condition takes.
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