Most of us have someone in our lives who comes to mind when we are asked if we know a narcissist. Perhaps, the person we think of can’t stop praising themselves, treats others as inferior, or seems unaffected by anyone else’s feelings and opinions. Or maybe, the person we think of is someone who always seems to turn the conversation toward themselves, who constantly needs reassurance, or who feels devastated by not being acknowledged.

According to the 5, the “most important characteristics of (NPD) are grandiosity, seeking excessive admiration, and a lack of .” However, there are actually two main types of narcissism that help break it down a little further.

Grandiose narcissists often have an inflated sense of self. They can come off as arrogant, entitled, and . Vulnerable narcissists frequently seem insecure, focusing on themselves, but seeking reassurance from others. To me, as a clinician and researcher, one of the most fascinating aspects of understanding these two types of narcissism is looking at how the manifestation of a person’s narcissism may be shaped by their earliest relationships. Recent research has explored connections between these two types of narcissists and the early style a person experienced.

I’ve noticed that individuals I’ve worked with who struggle with vulnerable narcissism have tended to experience more attachment patterns, in which they become anxious about and preoccupied with partners and unsure of whether they are loved. Grandiose narcissists, on the other hand, have tended to experience a more avoidant attachment pattern early in their lives which has led them to feel they have to take care of themselves, that they don’t need anyone else, and they should be pseudo-independent.

In both cases, these attachment patterns tend to be recreated in adult relationships. In recent years, research has offered some support of a connection between a type of narcissism and attachment style.

Results from one study indicated that “attachment avoidance and attachment anxiety exert distinct influence on narcissism's self-enhancement (i.e., admiration) directly, while both attachment anxiety and avoidance foster self-protection (i.e., rivalry) directly.” More specifically in regard to grandiose and vulnerable narcissism, some research has found that “whereas avoidant attachment is associated with overt narcissism or grandiosity, which includes both self-praise and denial of weaknesses, attachment anxiety is associated with covert narcissism, characterized by self-focused , hypersensitivity to other people's evaluations, and an exaggerated sense of entitlement.” Other studies similarly concluded that “vulnerable narcissism appears to be related to an anxious or fearful attachment … whereas grandiose narcissism seems related to either a secure or dismissive attachment style.”

Of course, this is by no means suggesting that everyone who experiences an insecure attachment style is destined to become a narcissist, but rather that the attachment style a person experienced may be of real significance and offer valuable insight for both understanding and treatment. To explore this connection further, it’s helpful to break down the characteristics of each form of narcissism as they may relate to patterns of attachment.

A vulnerable narcissist often has a tendency to feel desperate toward another person in order to feel secure. They may seek to be built up and reassured by others to help them feel okay about themselves. In relationships, they may worry “does he really love me?” or “is she giving me enough attention?” Even though the person may not feel very confident in themselves, they often seem to make things “all about them.” Vulnerable narcissists tend to feel super-focused on what they’re getting (or not getting) from others. They swing from feeling superior to inferior based on the ways other people see them or the ways they think other people see them. They may have the attitude that “I’m nothing if I’m not amazing.”

This style of relating is similar to what we see in someone with an anxious/preoccupied attachment style. Treatment that helps a vulnerable narcissist develop their ability to regulate their emotions and develop more inner security could contribute to reducing their narcissism, as well as to helping heal their attachment style.

Where one study reported that “vulnerable narcissism was linked to low and interdependent self-construal,” the researchers also found that grandiose narcissism was linked to “high self-esteem and independent self-construal.” Grandiose narcissists are less likely to worry about what others think of them, as they think highly of themselves. They may lack empathy or awareness of how another person is feeling.

Some patterns in grandiose narcissists align with an avoidant attachment style of relating, in which the person learned to rely on themselves and adapted to feel as if they don’t need anything from others and developed the tendency to disregard or not care about others’ needs. They are often cold toward other people and seem to lack compassion.

For those with avoidant attachment, it’s important for them to get more in touch with their own needs, which eventually allows them to have more feeling for the needs of others. One approach is to help them develop more insight into why they adopted this style of relating through exploring their attachment history. A technique that assists them in accessing this history is the development of an autobiographical narrative.

Exploring how patterns of attachment relate to the expression of narcissism may be another avenue by which we can shed light on the subject of how a narcissistic forms, as well as how we can treat it. Findings from a 2014 study led researchers to conclude that “assessing adult attachment may be important in understanding pathological narcissism [both vulnerable and grandiose].” It is quite possible that by gaining insight into a person’s attachment history, we can better understand and treat their narcissism.

For the narcissistic individual, it may also be helpful for him or her to recognize the influence of their own attachment history, so they can better understand themselves and develop more self-compassion, and thereby start to challenge their maladaptive, dysfunctional ways of relating to others. This could be done in the context of and/or through the process of creating a coherent narrative. This examination of attachment history and patterns offers individuals who struggle with either form of narcissism a tool to help counter narcissistic tendencies that alienate others and create distance in their relationships.

Read more from Dr. Lisa Firestone at PsychAlive.org.