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Are there really that many undiagnosed narcissists today?

Narcissistic Personality Disorder or NPD is a one of several types of personality disorders. It is a mental condition in which people have an inflated sense of self, of their own importance; they have a deep need for excessive attention and admiration and they lack empathy for others.

This makes people with NPD generally unhappy and disappointed when they do not receive the admiration or the attention they believe they deserve.

The exact cause of NPD is not known.

The disorder may result from a combination of factors that include:

• Childhood trauma (such as physical, sexual and verbal abuse).

• Early relationships with parents, friends and relatives.

• Genetics (family history).

• Hypersensitivity to textures, noise or light in childhood.

• Personality and temperament.

• Neurobiology

Do you believe you know someone with NPD?

People with the disorder can:

• Have an exaggerated sense of importance, or sense of self, or sense of entitlement

• Have expectations of entitlement requiring excessive admiration

• Believe they are superior, and must be treated as such in every aspect of their lives

• Need excessive admiration

• Have an unwillingness or an inability to recognize or empathize with the needs of others

• Become impatient when angry

• Have significant interpersonal problems

• React with rage or contempt, belittling others to appear superior

• Have difficulty regulating emotions or behavior

• Secretly feel insecure, shame, vulnerable

These are not a comprehensive list or criteria for diagnosis, but it might be helpful to identify certain attributes that may incline people to get diagnosed.

A mental health professional can determine if you have NPD, and there are tests available to help determine if this is the case.

Given the increased notoriety of this disorder, many people assume that they know someone who is a narcissist.

Without proper, voluntary diagnosis, it is not possible to determine. But if NPD is present, what can be done?

Treatment for Narcissistic Personality Disorder is primarily treated with counseling. In some cases it can be treated with medication alongside psychotherapy.

Can people with NPD get better?

The short answer? Yes.

The real answer? Only with a very willing disposition.

Therapy can help, but willingness is very important

• Psychotherapy is centered around understanding emotions and learning to manage relationships.

• Psychotherapy helps with accepting responsibility for ways in which NPD contributes to issues.

• Psychotherapy helps with the issues that are more often relational.

• Psychotherapy can also help increase the ability to understand and regulate feelings and emotions.

Someone with NPD might not think treatment is necessary at all, and the very nature of the disorder can give one the impression that therapy isn’t worth the time of day.

If you find that you want to give psychotherapy a try, it’s important to keep an open mind, stick to the treatment plan, and stay focused on the goal.

Issues around NPD are personal and unique to each person. We find that therapy and diagnosis and treatment for any sort of mental health ailment still carries stigma.

It might be beneficial to prepare for treatment by listing off any concerns and questions for your therapist.

• You may ask if NPD is the proper diagnosis

• You may ask if it is possible you have other mental health conditions

• You may ask what is the goal of treatment, as this is tailored to the

person’s unique needs

Your mental health provider will also want to better understand your symptoms, your relationships and how NPD is affecting your life.

Narcissistic Personality Disorder is not one that individuals personally identify with. More often, the people around them identify characteristics that align with NPD traits.

If you know or love someone who has officially been diagnosed, there is help for you as well.

It can be challenging to be in a relationship with someone who lacks empathy, and struggles to understand the feelings of others. Learning to empathize with narcissists without judgment is an important step to gaining trust and it makes seeking treatment easier. It is possible to learn to increase empathy and reduce narcissistic tendencies with treatment.

Understanding your role in the narcissistic relationship is important, as you contribute to the relationship with your own behavior.

Lastly, it is vital to keep in mind that abuse is a real possibility for those in a relationship with narcissists. It is very important to differentiate between acceptance of NPD and tolerance of abusive behavior.

It is helpful to accept your loved one suffering from a mental illness, and they are indeed in need of compassion. However, it is not acceptable to endure abusive behavior or mistreatment that can come in the form of physical, sexual, or financial abuse. For these kinds of abuse, and cases of severe emotional and mental abuse, you may need to move on from the relationship for safety .(I say severe emotional and mental abuse, because many may feel the lack of sympathy from a person with NPD as abusive, but this is exactly what needs to be worked on in therapy.)

If it is safe and reasonable to stay in the relationship, establish a support system and include therapy as part of the circle of people who assist you. It can be emotionally exhausting to work or live with a person who has NPD and it is important to maintain one’s own self of health and wellbeing.

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