Narcissistic Personality Disorder

What is Narcissistic Personality Disorder?

In today’s pop psychology world, the term “narcissist” is often thrown around loosely—used to describe selfish exes, arrogant coworkers, or social media influencers. But Narcissistic Personality Disorder (NPD) is a serious clinical diagnosis, not just a buzzword for someone who acts entitled or self-absorbed.

NPD is not:

• Simply being confident or ambitious

• Occasionally being self-centered or insensitive

• Posting selfies or enjoying praise

• Being emotionally unavailable or insecure

• Making a mistake in a relationship

True NPD involves a long-standing, inflexible pattern of manipulation, lack of empathy, entitlement, and an inflated self-image, causing harm to others and dysfunction across relationships and work.

So while many people may have narcissistic traits at times (especially under stress or trauma), that doesn’t mean they have NPD. Using the label casually can dilute the serious impact it has on real survivors—and overlook the complexity of what drives the disorder.

Narcissistic Personality Disorder is characterized by pervasive patterns of:

• Grandiosity (in fantasy or behavior)

• Need for admiration

• Lack of empathy

These patterns must begin in early adulthood and be present in a variety of contexts (e.g., work, relationships, social interactions) to qualify for diagnosis.

To be diagnosed with NPD, an individual must meet at least 5 of the following 9 criteria:

1. A grandiose sense of self-importance

   • Exaggerates achievements and talents

   • Expects to be recognized as superior without commensurate achievements

2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love

   • Often lost in thoughts about being admired or revered

3. Believes they are “special” and unique

   • Can only be understood by, or should associate with, other special or high-status people

4. Requires excessive admiration

   • Constantly seeks validation and approval from others

   • Easily wounded by perceived slights or lack of attention

5. Has a sense of entitlement

   • Unreasonable expectations of especially favorable treatment

   • Believes others should cater to their needs automatically

6. Is interpersonally exploitative

   • Takes advantage of others to achieve their own ends

   • Little concern for others’ needs or rights

7. Lacks empathy

   • Is unwilling or unable to recognize or identify with the feelings and needs of others

8. Is often envious of others or believes others are envious of them

   • Can become competitive, bitter, or dismissive when others succeed

9. Shows arrogant, haughty behaviors or attitudes

   • Comes off as condescending, dismissive, or patronizing

Underlying Psychological Traits Often Seen in NPD

• Fragile self-esteem beneath the grandiosity

• Hypersensitivity to criticism or perceived rejection

• Difficulty maintaining healthy relationships

• Mood swings linked to validation or perceived insult

• Black-and-white thinking (idealization vs. devaluation of others)

• Chronic feelings of emptiness, boredom, or meaninglessness

Important Clarifications

• Not all narcissistic traits = NPD

  People can have narcissistic features without having a personality disorder. Diagnosis depends on pervasiveness, inflexibility, and functional impairment across multiple areas of life.

• Comorbidity

  NPD can co-occur with other disorders, especially:

  • Borderline Personality Disorder

  • Antisocial Personality Disorder

  • Substance Use Disorders

  • Mood Disorders (e.g., depression after a narcissistic injury)

    
    

Impact of NPD on Relationships

People with NPD often:

• Have difficulty sustaining long-term intimacy

• Blame others for their failures

• Struggle with empathy, emotional reciprocity, or compromise

• Use manipulation or gaslighting to maintain power

• React with narcissistic rage when confronted or challenged

  
  

Criterion	Key Feature
Grandiosity	Inflated self-image, brags, exaggerates
Fantasies of power or beauty	Obsession with idealized success or admiration
Believes they are "special"	Only associates with the “elite”
Needs excessive admiration	Constant need for validation
Entitlement	Expects special treatment, rule exemptions
Exploits others	Uses people for personal gain
Lacks empathy	Cannot/will not understand others’ emotions
Envious or believes others are envious	Competitive, spiteful, or dismissive
Arrogant/haughty behavior	Condescending, self-righteous, patronizing