Narcissism in life and psychological practice

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What is Narcissism?

Narcissism is generally seen as a negative character trait.

That is probably for good reason. After all, it implies that the person is self-absorbed to the point of being relatively disconnected from others, severely compromising their relationships. However, as with all personality characteristics, there are a number of positive aspects of narcissism. For example, it can support self-belief, drive for achievement and resilience in the face of adversity. If we were largely devoid of such attributes we could be passive, directionless and simply bending to the influences around us. We might need a touch of narcissism to develop our capacity for individual creativity, leadership, or being able to assert ourselves when this is called for. Along with other personality characteristics, there are both advantages and disadvantages to narcissism. It is mainly a matter of the degree to which we have such characteristics and their fit for our current circumstances and roles.

However, when we refer to someone as narcissistic, it generally implies that a person shows a clear imbalance in weighing up their own interests in relation to those of others, being focused on their own needs and desires to the point of unduly disregarding other people’s rightful interests and concerns. When this pattern is more extreme, we might refer to pathological or “malignant” narcissism.

This article covers the following themes:

  • How pathological narcissism might manifest in everyday life

  • The defining characteristics of narcissism

  • An understanding from depth psychology about narcissism

  • Contemporary examples of narcissism

  • How those with narcissistic traits might present in psychological practice

  • Therapeutic strategies for addressing narcissism

  • Dealing with narcissism in others


How Narcissism Presents in Everyday Life

People with very strong narcissistic traits generally appear self-centred and self-absorbed.

They have a focus across a wide range of situations on how things might benefit themselves rather than others. They can ride roughshod over others’ interests, showing relative disregard for their welfare. They will demonstrate a strong sense of entitlement, and often see themselves as being above the rules. They will tend to treat other people as objects, exploiting or manipulating them to their own ends.

People with strong narcissistic traits are also preoccupied with their reflected glory, meaning they are unduly concerned with how they might look to others and how things seem on the surface. They may be charming – indeed they often are – and might come across very favourably in social settings. However, they react excessively to perceived slights and are generally not open to critical feedback.

If their needs for achievement and recognition are met they may continue to come across in a charming and congenial way.

However, if not, they will tend to become angry and antisocial. This can become most obvious when a narcissistic person leaves a situation that has not worked out well for them. It might be said, albeit somewhat crudely, that they will tend to “leave a turd” behind them. In my experience, the more narcissistic the person the larger the “turd”. That points to a major benefit of being able to recognise narcissism early in those you might have dealings with – it helps to anticipate and hopefully avoid some of the more extreme negative outcomes of associating with narcissists in important relationships.

Narcissistic individuals might not experience much subjective distress from such patterns of behaviour themselves, but those around them will tend to suffer. The main time this impacts on the narcissistic person themselves is when they lose important relationships or work roles, when they are called to account for antisocial behaviour or when they face significant or repeated failure that punctures their illusion of superiority or greatness.

Pathological Narcissism

Describing someone’s behaviour as narcissistic could amount to little more than name-calling unless we define disruptive patterns of such behaviour in more objective ways.

A helpful reference point is the diagnostic criteria for Narcissistic Personality Disorder in the Diagnostic and Statistical Manual of Mental Disorders (5th Edition), a manual widely used by health professionals.

The term “personality disorder” only applies if there is a pattern of problematic behaviour that “deviates markedly” from cultural expectations, is persistent and inflexible, and leads to either significant distress to the individual or impairment in their social, occupational or other core areas of functioning.

Core features of Narcissistic Personality Disorder include:

A pervasive pattern of grandiosity, need for admiration and lack of empathy.

The term only properly applies if someone displays at least five of the following characteristics.

Defining features include:

  • a grandiose sense of self-importance
  • being preoccupied with fantasies of unlimited success, power or other favourable attributes
  • believing you are special
  • requiring excessive admiration
  • having a sense of entitlement
  • being interpersonally exploitative
  • lacking empathy
  • often being envious of others or believing that others are envious of you
  • being arrogant and haughty

Clearly, there is quite a degree of subjectivity in appraising these things.

Technically, the term should only be applied if someone has been directly assessed by an appropriately qualified mental health professional. In more extreme examples it can readily seem that the term is well justified, when we might justifiably refer to someone as displaying pathological narcissism.

Pathological Narcissism and Depth Psychology

In my view, some of the most enlightening descriptions of narcissism come from the psychoanalyst Karen Horney, in her 1950 book, Neurosis and Human Growth.

The following passages draw heavily on Horney’s own terminology, which may bring one or more well-known contemporary figures to mind.

Horney highlighted that narcissism stemmed from the person confusing their real self with their ideal self.

She described narcissism as being driven by a need for self-aggrandizement, associated with a person’s unquestioned belief in their greatness and uniqueness. However, this self-glorification is more truly a means to overcompensate for underlying insecurity or self-doubt that is too painful to admit to consciousness. As a result, they may go to extreme lengths to avoid evidence of failure. However, their unchecked belief in themselves may help them to be resilient, and to appear uncommonly buoyant and youthful.

The narcissistic person often has an uncommon skill or other attributes that have led to early or noteworthy success.

They might aim to actualize their ideal self through ambitious pursuits that draw on their intelligence and willpower. They tend to speak incessantly of their exploits and wonderful qualities. They need ongoing confirmation of themselves through other people’s admiration and devotion. They have a knack for turning their own flaws into virtues. Their work plans can often be too expansive as a result of overrating their abilities and failing to recognize their limitations.

Horney described how narcissists could often be charming and even generous, but this was motivated more by the need to receive admiration than a genuine interest in others.

They might be relatively unconcerned about breaking promises, being unfaithful, or carrying debts. They feel their needs, tasks or roles are so important that they are entitled to every privilege. They expect others to love them unconditionally no matter how much they might have acted without regard for others’ rights.

Narcissists may be proud of their ability to fool other people, but fear being fooled themselves as this would be most humiliating.

They speak in glowing terms of their family and friends as well as their own work and plans. However, they expect unswerving loyalty. If others express wishes or opinions independent of their own, or are critical of them, they can feel humiliated and resentful and angry.

These characteristics can often be combined with an “arrogant vindictiveness.”

The person’s needs for vindictive triumph leads them to be extremely competitive and to show contemptuous disregard for others who they might be convinced are “crooked”. They are prone to violent rages and intimidating others. They tend to be openly arrogant, rude or offensive, seeing themselves as superior to others. They feel entitled to have their needs met whilst disregarding those of others. If their needs are not met, they may respond with punitive vindictiveness, irritability and sulking.

It might be said that Karen Horney’s description of narcissism has very well served the test of time.

Recognizing such patterns early in our political aspirants or other actual or potential leaders, and choosing not to appoint them or keeping close checks on their potential transgressions, might help avoid a lasting trail of harm. Interest in doing so has no doubt been strengthened by the “Me-too” movement. This suggests that in contemporary culture many people are less inclined to allow excuses for exploitative and boundary-crossing behaviour, regardless of an individual’s role or status.

How Narcissism Presents in Psychological Practice

In my experience, there are two main ways that people with prominent narcissistic patterns of behaviour present to a psychology practice.

The first occurs when they are directed or influenced to attend by somebody else who is aggrieved or concerned about their behaviour.

For example, a partner might have given them an ultimatum that they must pursue treatment for an addiction or anger-related problem or they’d leave them, the courts may have referred the person for assessment and treatment of sexually exploitative behaviour, or an employer might have initiated an intervention for a staff member to receive counselling for a conflictual relationship with co-workers.

In such circumstances, it is important that the person soon comes to see some benefit for themselves in attending or little beneficial change is likely to occur.

A second pattern for presenting is that the person with narcissistic traits feels distressed or depressed after a loss or crisis or perceived major failure which has punctuated their idealized self-image.

In such circumstances, the individual is likely to be exquisitely attentive to their pain. They might see themselves as being a victim of unduly harsh circumstances and may continue to idealize how things would have been if the crisis or loss or defeat had not occurred.

In these circumstances, if the person can ultimately tolerate their emotional pain, their distress that has prompted their pursuit of psychological therapy might allow them a helpful window into a more honest self-appraisal. This can help them gain further insight and potential breakthroughs in understanding. Rather than externalizing the blame for their circumstances on others or on unfortunate events, the person might be open to looking at what they might do differently to have more positive and reciprocal relationships with others, deepening their connection with others as well as improving their relationship with themselves. This is typically marked by greater compassion for themselves and others.

The Nature of Psychological Therapy for Narcissism

A key goal of psychological therapy is to help the person let go of their excessive sense of uniqueness and specialness relative to others.

More specifically, therapy involves challenging their grandiosity, hypersensitivity to evaluation and lack of empathy. The person is encouraged to seek deeper and more meaningful connections with others. This includes appreciating other people’s positive attributes, rights and concerns. Therapy is primarily about helping the person shift the balance in the emphasis they place on their own needs relative to others, allowing themselves to be ordinary and increasing their capacity for compassion, humility, forgiveness and kindness.

Experiencing therapy is typically a challenging process and is especially so for those with narcissistic tendencies. People can be tempted to leave therapy early. Effective therapy tends to call for a judicious balance of affirmation and challenging. Without affirmation, the narcissistic client is not likely to tolerate the discomfort of acknowledging their less than admirable behaviours and attributes. However, without challenge, the person is not likely to engage in any meaningful change.

Therapy for narcissistic tendencies is likely to progress more gradually than usual to help manage with such challenges, and people are more likely to be seen over an extended period with sessions of reducing frequency.

Relevant modalities for therapy can include cognitive-behavioural therapy, to help challenge unhelpful thinking and behaviour patterns. Sometimes two-chair work, encouraging the person to help separate out aspects of thoughts and feelings, can help identify underlying emotions and conflicts that might then be addressed more directly. Sometimes it may be helpful to meet with a significant other for more realistic feedback and more direct scope to address relational issues. However, the prevailing method is likely to be individual psychotherapy reflecting on current stresses in the person’s life with an emphasis on interpersonal conflict and connection.

Components of Psychological Therapy for Narcissism

Psychological therapy for pathological narcissism will partly aim to help the person accept their vulnerability as an important human quality, and to acknowledge some feelings of insecurity for which the narcissistic behaviours may be overcompensating.

Psychoeducation may include objectively describing characteristics of narcissistic behaviour and circumstances that might contribute to their development. Such circumstances may include being exposed to emotional abuse, neglect or trauma in childhood that can interfere with healthy attachments and promote a sense of insecurity or unworthiness. Alternatively, narcissistic tendencies might have been reinforced by the person being particularly admired or favoured or not being exposed to appropriate limit setting. This might have enhanced their sense of entitlement and compromised their capacity to tolerate frustration and to curb inappropriate impulses. Modelling by parents or other significant figures might have encouraged little empathy for others or consideration for following rules.

The therapist will typically encourage expressions of vulnerability, set some limits in therapy and will aim to identify and challenge the person’s comments or actions that overemphasize or reinforce concerns about social status.

Specific goals of therapy may include to:

  • Curb exploitative and abusive behaviour

This includes highlighting the negative consequences of a sense of entitlement, challenging the person’s view of being special, encouraging empathy, and encouraging the observance of relevant rules

  • Improve mood regulation, including substance abuse

This includes strategies to bolster frustration tolerance in impulse control

  • Curb exaggerated response to failure

This can include encouraging the person to acknowledge and take responsibility for circumstances that have not turned out well, whilst showing a degree of self-compassion in acknowledging mistakes or failures

  • Challenge all nothing or black-and-white thinking, including about failure
  • Address exaggerated concerns about disapproval
  • Encourage a capacity to be open to critical feedback

When the person is more open to feedback they are in a better position to curb behaviours or actions that have created more difficulty and distress for others and that have compromised their relationships

  • Accept that everyone is unique and to increase their ability to see others’ positive attributes
  • Recognize and keep in mind that mistreating others will lead to losses, including lost relationships and opportunities for cooperation and collaboration.

Positive Psychology Strategies to Address Narcissism

The field of positive psychology encourages the use of a range of interventions that can help counter narcissism.

Positive psychology encourages bringing out your best in the service of others and supporting and encouraging others to do the same. A core maxim in the positive psychology field is that “Other People Matter”.

Relevant positive psychology strategies include the following…

Completing the Survey of Character Strengths allows for a more objective appraisal of one’s positive character attributes.

Appreciating one’s top strengths in a more objective way can help counter the person’s underlying, albeit often unconscious, insecurities. This survey also helps to more objectively identify relative personality weaknesses, perhaps including lesser strengths in humility, forgiveness, kindness or capacity to love. The person can then be encouraged to bolster such strengths with a more convincing rationale that this might help them have more positive and rewarding relationships in future. Positive psychology descriptions and explanations about specific strengths often acknowledge the interests of others, such as defining leadership in terms of encouraging collaboration and bringing others along with you as opposed to autocratic direction.

Appreciating one’s individual character strengths is also a reminder that other people have their own unique and positive combination of personality attributes as well. Positive psychology promotes the theme of seeking to have a meaningful life being by drawing on one’s top character strengths in the service of other people. This serves as a reminder that one’s personal gifts are best used in connection with others. The character strengths approach also encourages people to recognize and help draw out the character strengths in others, including partners, children, friends and coworkers.

Appreciating activities that provide a sense of “flow” can encourage engagement in activities for the intrinsic sense of satisfaction that they provide, as opposed to extrinsic rewards, recognition or social status.  Acting on our top character strengths in novel ways is an especially practical way of increasing flow.

The character strengths test can be found here.

Other positive psychology interventions including promoting self-compassion, helping counter one’s expectations of literally meeting an ideal.

Whilst helping address underlying insecurities or harsh expectations of oneself, positive psychology also promotes compassion for others, encouraging empathy and countering excessive expectations of other people. Of equal importance is promoting kindness, whether through random acts or in other ways.

Other positive psychology principles for workplaces and relationships include aiming for a ratio of offering approximately five positive statements or gestures for every one negative statement or gesture.

This helps provide an objective benchmark in gauging the supportiveness of our communications.

Reflecting in work group meetings on “What Went Well” can actively promote a positive attitude in team settings, encouraging corporation and teamwork that may help counter excessive negativity and helplessness.

Dealing with Narcissistic Behaviours in Others

This is largely a separate topic that might be addressed at a later date.

A key issue is that if a person repeatedly treats you in an abusive or exploitative manner it is important to set some limits on them. At very least, it is important to help yourself be a smaller target. This might include arranging things so you have less need to interact with someone who demonstrates patterns of pathological narcissism.

It is often difficult to directly raise issues or concerns with someone who is narcissistic owing to their difficulty accepting critical feedback. That means it’s important to pick the timing and to be careful with one’s language when raising concerns. As described by David Cherry, clinical psychologist, when having a difficult conversation it helps to have a positive purpose. Such a purpose might include a desire to give the person the opportunity to recognize that their behaviour is having a negative impact on you and is affecting your response to them in a particular way. This might give them more opportunity to make amends, or at least to gauge whether they are prepared to factor in your expressed concerns. It helps to think of what might be a motivation for that person in curbing their behaviour.

If problematic behaviour continues, there are three main coping alternatives.

They include attempting to change a situation, to accept the situation, or to leave. When a relationship or work situation is repeatedly abusive in a serious way, it would not likely be wise to accept it.

Attempts to influence the person to change their behaviour would often involve some form of giving feedback and aiming to set limits on their behaviour. This may include being withholding toward the person. When people have strong narcissistic patterns, it is more likely that relationships and partnerships will ultimately end, as other people are less likely to put up with such behaviours indefinitely. One’s charm, intellect, status or other positive attributes are only going to like to go so far in maintaining a long-term relationship. Marital or relationship therapy may help make more rapid progress.

When dealing with narcissistic behaviours in a partner or co-worker, it is not uncommon for a person to feel insecure, distressed and to doubt themselves.

When raised by a narcissistic parent, or even worse – two narcissistic parents – people are more likely to be susceptible to depression, self-doubt and harsh self-criticism. In more extreme situations, the person is more susceptible to suicidal feelings, even as an adult, following interactions with abusive, narcissistic parents. They might be indirectly acting on a sense they gained from their parents that the world would be a better place if they were not around. In more extreme situations, people are better off limiting any and all contact with narcissistic parents or family members. Sometimes narcissistic behaviours, particularly including various forms of emotional abuse, are modelled and reinforced across generations. In such cases, the best many individuals might do is to containing contact with their family of origin and aim to “turn things around in a generation”, meaning to raise their own children and family in a supportive and loving way. Self-compassion might be called for in acknowledging and dealing with one’s own negative behaviours and reactions that have been influenced by the cross-generational abuse.

When people are narcissistic, they tend to externalize blame for situations that turn out poorly, leading others to carry more responsibility and to feel more distressed and insecure.

Discussing concerns with a trusted friend or therapist about exposure to narcissistic or abusive behaviours can help become more objective about such behaviour, its negative impact and who is primarily responsible for it. This can bolster people’s capacity to set limits with those who exhibit more severe forms of narcissism, perhaps including minimizing contact with them.

Final Considerations

As with all personality characteristics, any particular attribute we might have will have both advantages and disadvantages.

Sometimes we hear of the expression “the age of entitlement”, to suggest that our wider culture is becoming more narcissistic. Perhaps a flip side of this is that in current times people are more likely to respond to the Swiss psychiatrist, Carl Jung’s, urging that we might all best aim to “individuate”, or aim for self-actualization, to help realise our potential as well as to deal with the increasingly diverse problems of a more complex world. Some degree of narcissism may help us to have the inner drive and direction to pursue such goals, without caving into mere conformity.

However, when people recognize that their own tendencies to narcissism may have got out of balance to the cost of their more important relationships or connections, they might gain the greatest return for effort for their mental, emotional and social wellbeing in addressing narcissistic patterns more directly. All personality patterns are amenable to change by conscious choice to deliberately practice different behaviours over time.

In the case of addressing narcissistic tendencies, making many little changes can add up to major change over time. A good place to start includes to engage in acts of kindness, forgiveness and compassion, appreciating that this is in the interests of both oneself and others.


For other mental health articles and resources on e.g., anxiety, depression and trauma reactions, see our Chris Mackey and Associates’ Resources page. You can also listen to Chris’s podcast, Psych Spiels and Silver Linings, including the November 2020 episode on narcissism below.

Chris Mackey is a clinical psychologist and Fellow of The Australian Psychological Society with 40 years’ psychotherapy experience. He received the 2019 Australian Allied Health Impact Award. He is the author of The Positive Psychology of Synchronicity: Enhance Your Mental Health with the Power of Coincidence (See book website).