How do I know if someone in my life is a narcissist? Here's what it is – and what it isn't

You may think the toxic person in your life is a narcissist. But what exactly does that mean?

People throw around the term loosely to describe those who are self-absorbed, entitled and manipulative – from overbearing parents to destructive exes. But narcissism is a complex phenomenon that is often misunderstood and oversimplified.

Psychologists say a pathological narcissist is someone who is diagnosed with narcissistic personality disorder, a condition that only affects an estimated 1% of the population. Narcissists can be controlling and intolerant while refusing to acknowledge wrongdoings. Instead, they'll use manipulative strategies to escape blame, such as gaslighting or devaluing.

Ego, Narcissistic Self Love Behavior Concept. Male Character in Crown Imagine himself as Center of Universe with Planets Roll around him. Psychological Disorder Symptom. Cartoon Vector Illustration
Ego, Narcissistic Self Love Behavior Concept. Male Character in Crown Imagine himself as Center of Universe with Planets Roll around him. Psychological Disorder Symptom. Cartoon Vector Illustration

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"We all go through periods where we might be temporarily self-preoccupied … That's normal and that happens," says Craig Malkin, a lecturer at Harvard Medical School and author of "Rethinking Narcissism: The Secret to Recognizing and Coping with Narcissists."

"The difference is if somebody is extremely narcissistic, they're so driven to be exceptional or special that they lose sight of other people's needs and feelings. They become (out of touch with) what's going on to the point that it wreaks havoc on their career or in their relationships."

Because of its rare prevalence, misconceptions persist about what narcissism is and isn't.

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Narcissism vs narcissistic personality disorder: What's the difference?

Not all people with narcissistic personality traits are diagnosed with narcissistic personality disordersome may merely be self-absorbed but can still show empathy.

Ramani Durvasula, a clinical psychologist and author of "Should I Stay or Should I Go? Surviving a Relationship with a Narcissist", says narcissism more generally is a personality style characterized by arrogance and entitlement. "It cuts across most situations, and it's stable and consistent," she says.

In contrast, narcissistic personality disorder is an official, medical diagnosis that requires psychological evaluation to determine if the behavior is not only pervasive, but also "causes subjective distress, meaning a person is uncomfortable with it or it causes some social impairment in their lives." For instance, someone with narcissistic traits may act self important but still demonstrate consideration for others' opinions and feelings; diagnosed or pathological narcissists often ignore the needs of people close to them and manipulate or vilify them regardless of harm.

"It becomes a problem when you have that inner world defined by a lack of empathy or need for admiration," explains Kim Sage, a licensed clinical psychologist specializing in narcissism and trauma. "That creates stress and impairment… and they will often struggle in their relationships as well."

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What are the common traits of a narcissist?

Unlike selfishness, narcissism includes a distinct set of traits that go beyond self-obsession. Common signs include:

  • Lack of empathy

  • Entitlement

  • Grandiose sense of self-importance

  • Preoccupation with fantasies of unlimited success, power, beauty or love

  • Excessive need for validation

  • Arrogance

  • Interpersonally exploitative behavior

  • Manipulative

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What 'causes' narcissism?

Are narcissists born or made? Experts say both biological and sociological factors come into play.

Numerous studies have shown that narcissistic traits like grandiosity and entitlement are heritable – to a degree. But childhood experiences like neglectful parenting can also contribute to the development of narcissistic traits: A landmark study conducted over the course of 20 years found that secure, authoritative parenting played a pivotal role in preventing the development of maladaptive narcissism in children with narcissistic precursors including melodramatic or bullying behaviors.

Durvasula clarifies that most victims of childhood trauma do not become narcissistic. Rather, it's a combination of these risks that lead to "variability in the developmental path of narcissism."

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Who are the different types of narcissists?

Some experts like Sage believe narcissism exists on a spectrum: On one end, it can stem from ignorance. On the more extreme end, it can become a pathological inclination to inflict pain on loved ones.

"It's really important not to say (narcissists) are always cruel," Sage warns. Contrary to popular belief, she says narcissism can often stem from an inability to process underlying feelings of guilt, shame or insecurity.

"Some can be intentionally hurtful and manipulative, but it's very complex. You have to remember these people with these disorders tend to lack insight, so it's a combination of a lack of empathy and their need for entitlement that often end up hurting people."

According to Malkin, there are three subtypes of narcissists:

  • Overt narcissism: Most commonly known as "the narcissist we all know and loathe," overt or grandiose narcissists describe someone who is inclined to feel "special, exceptional or unique." "You know, loud, chest thumping braggarts who enjoy looking at themselves in the mirror and they just really stand out and like to be out there," Malkin adds.

  • Covert narcissism: Unlike overt narcissists, covert or introverted narcissists are not preoccupied with looks, fame or money: They can appear to be quiet or reserved, while possessing an inflated view of how unattractive, unfortunate or misunderstood they are. 

  • Communal narcissism: These are people who believe they are exceptional because they're more altruistic than others. They may strive to be famous for their deeds, though it has little to do with a desire to help others. Rather, it's an attempt to attract validation.

Can narcissism be treated?

There is no treatment that will rid a person of narcissistic personality disorder. Appropriate therapy, however, can help diagnosed narcissists learn tools to reduce harmful behaviors while increasing their compassion and self-awareness.

  • Eye movement desensitization and reprocessing: Trauma-informed therapies like EMDR can be helpful for those whose narcissism stems from childhood trauma, like neglectful or emotionally abusive parenting.

  • Dialectical behavior therapy: This skills-based program can teach narcissists healthier ways to manage and express their emotions when things aren't going their way, according to Durvasula.

  • Schema therapy: This approach combines elements of cognitive behavioral therapy as well as psychoanalysis to uncover and understand early maladaptive patterns called "schemas." It can be especially helpful for those whose emotional needs weren't met as a child.

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Ultimately, treatment for extreme narcissism is to help individuals "learn to not deny feelings of sadness, fear or even healthy anger," Malkin says. "In healthy relationships, we have to be able to express these emotions and still care about the other person, still feel connected to them."

Regardless of which therapy is best for each person, successful treatment and change require "a willingness to play the long game."

"Narcissism is a personality style. It's difficult for anyone to change a whole personality," Durvasula says. "You're going to need longer-term therapy with a professional who actually understands it. Understanding this personality style is only half the battle."

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This article originally appeared on USA TODAY: What is a narcissist? Narcissistic personality disorder explained.