What Are the Nine Traits of a Narcissist?

Reviewed on 8/10/2020

What Is Narcissism?

Narcissistic people often have trouble forming deep relationships because of their lack of empathy and the superficial way in which they assign value to people.
Narcissistic people often have trouble forming deep relationships because of their lack of empathy and the superficial way in which they assign value to people.

Narcissistic personality disorder (NPD), or narcissism, is a personality disorder characterized by a sense of grandiosity, the need for attention and admiration, superficial interpersonal relationships, and a lack of empathy. It often accompanies other psychiatric disorders and can be difficult to treat.

Nine Signs and Symptoms of Narcissism

Symptoms – called core features – of narcissistic personality disorder (narcissism) include:

  1. Grandiosity
    • Exaggerated sense of self-importance
    • Feeling superior to others and that one deserves special treatment
    • Feelings are often accompanied by fantasies of unlimited success, brilliance, power, beauty, or love
  2. Excessive need for admiration
    • Must be the center of attention
    • Often monopolize conversations
    • Patients feel slighted, mistreated, depleted, and enraged when ignored
  3. Superficial and exploitative relationships
    • Relationships are based on surface attributes and not the unique qualities of others
    • People are only valued only to the extent they are viewed as beneficial 
  4. Lack of empathy
    • Severely limited or totally lacking ability to care about the emotional needs or experiences of others, even loved ones
  5. Identity disturbance
    • Sense of self is highly superficial, extremely rigid, and often fragile
    • Self-stability depends on maintaining the view that one is exceptional
    • Grandiose sense of self is easily threatened
    • Patients retreat from or deny realities that challenge grandiosity 
  6. Difficulty with attachment and dependency
    • Relies on feedback from the environment
    • Relationships only exist to shore up positive self-image
    • Interactions are superficial
    • Intimacy is avoided 
  7. Chronic feelings of emptiness and boredom
    • When attention and praise are not available, patients feel empty, bored, depressed, or restless
  8. Vulnerability to life transitions
    • Difficulty maintaining reality-based personal and professional goals over time
    • Compromises required by school, jobs, and relationships may feel unbearable
    • Young adults may have a “failure to launch” 
  9. Narcissistic personality disorder is also a significant risk factor for suicide and suicidal attempts.

How Is Narcissism Diagnosed?

Narcissistic personality disorder (narcissism) is diagnosed using The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. A person must meet five of nine of the following traits for a diagnosis of narcissistic personality disorder.

  1. A grandiose sense of self-importance 
  2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. Belief that he or she is “special” and unique and can only be understood by or should associate with, other special or high-status people or institutions
  4. Requires excessive admiration
  5. Has a sense of entitlement
  6. Is interpersonally exploitative – takes advantage of others
  7. Lacks empathy
  8. Envies others or believes others are envious of him or her
  9. Shows arrogant, haughty behaviors and attitudes

What Is the Treatment for Narcissism?

Treatment for narcissistic personality disorder (narcissism) can be difficult but therapy can often help. Types of therapy include: 

  • Supportive psychotherapy that uses both psychodynamic and cognitive behavioral techniques, often combined with psychopharmacologic management
  • Structured psychotherapies
    • Mentalization-based therapy
      • Patients are taught to self-reflect
    • Transference-focused psychotherapy
      • Identifies patient’s treatment goals and established a treatment contract between therapist and patient
    • Schema-focused psychotherapy 
      • Uses cognitive-behavioral therapy, attachment theory, and psychodynamic therapy to treat negative perceptions of self, others, and of one’s place in the world that are established in early life
    • Dialectical behavioral therapy
      • A form of cognitive behavioral therapy (CBT) that combines individual therapy with group treatment, has core principles of acceptance and change

Medications may also be used to treat narcissistic personality disorder, particularly in patients who have severe symptoms and may be a risk to self or others, and patients who have other, treatable psychiatric conditions. 

Medications that may be used to treat narcissistic personality disorder include:

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Reviewed on 8/10/2020
References
Medscape Medical Reference

https://www.uptodate.com/contents/narcissistic-personality-disorder-epidemiology-pathogenesis-clinical-manifestations-course-assessment-and-diagnosis

https://www.uptodate.com/contents/treatment-of-narcissistic-personality-disorder

https://www.healthdirect.gov.au/causes-of-npd