Like other personality disorders, narcissistic personality disorder (NPD) is associated with specific narcissistic traits. You may perceive someone with narcissism as arrogant, rude and self-absorbed. They often behave in ways that have a negative impact on others. But there’s more to this disorder than meets the eye, and a narcissistic person doesn’t choose their disorder. If you’re wondering what narcissism is, read on to learn more.

What Is a Personality Disorder?

Personality disorders are a type of mental health condition that affects how people think, feel and behave. A person with a personality disorder has a world view that deviates from the norm, often with rigid thought patterns and behavior. It is hard for a person with a personality disorder to see how those patterns affect their life and the lives of those around them. There are 3 different categories of personality disorders with 10 disorders altogether. Narcissistic personality disorder is a Cluster B personality disorder. These disorders are defined by dramatic, erratic and emotional behavior. Other kinds of Cluster B disorders include antisocial, histrionic and borderline personality disorders.

Understanding Narcissistic Personality Disorder

What Is Narcissism?

The word “narcissism” comes from a Greek myth in which a handsome young man named Narcissus falls in love with his own reflection. Narcissists are people who have an inflated opinion of themselves. For instance, many narcissists hold an exaggerated belief in their skills or achievements. Some are obsessed with their appearance. Some try to gain power or influence. Narcissists typically regard themselves as elite or exceptional compared to everyone else. Regardless of their actual social standing, they perceive themselves as very important – and expect others to view them as such. They thrive on the praise and admiration of others. However, their grandiosity can easily be shattered by criticism from others. When this occurs, it usually elicits rage, rejection or a torrent of condescending remarks. These words are skillfully rendered to put the offending person back in their place. All of these behaviors have made society less compassionate toward the narcissist than toward others with mental illnesses.

Understanding Narcissism and NPD

Many people have mild elements of narcissism in their personality. It’s only human to feel proud when you do something important, or to feel good about yourself when you look good. And sometimes, those feelings of pride might make us a little more self-involved than usual. Having those feelings from time to time doesn’t make you a narcissist, however. For true narcissists, the narcissist traits dominate their personality and their life. The disorder affects every aspect of life, including their career, friendships and intimate relationships. Like all personality disorders, NPD is a complex condition. People with NPD have an exaggerated sense of their own importance. They lack empathy for and interest in other people, but also have a strong need to be admired by others. So, although they might not be interested in others, they seek people out to get the adulation they believe they deserve. At the core of NPD is a fragile, inflexible and unrealistic sense of self. To maintain their fragile self-image, people with NPD need to believe that they are exceptional. This is the root cause of many of the patterns of behavior that they develop. For instance, this is why people with NPD react strongly to even the most superficial criticism. It’s also why their behavior is so single-mindedly oriented towards gaining praise and recognition. Without it, their identity is highly vulnerable.

What Causes Narcissistic Personality Disorder?

There is no single known cause of NPD. Genetics likely plays a role, but it’s also believed that early life experiences are a contributing factor. For instance, children who experience abuse, neglect or trauma might be at risk. Having a narcissistic or overly critical parent may likewise be a risk factor. Whatever the cause, these children become adults with a fragile sense of self and a strong need for external approval. Many narcissists also have extremely low self-esteem. These traits cause them to exaggerate their skills or achievements. And, they constantly seek attention and approval from others. This is a key factor in understanding the narcissists in your life. Their behavior is arrogant and self-absorbed but stems from deep-seated feelings of inferiority.

Symptoms of Narcissistic Personality Disorder

The defining symptoms of personality disorders are patterns of thought, belief and behavior. In people with NPD, these patterns are self-aggrandizing. These include:

Self-involvement to the point of obsession

An exaggerated sense of importance

May lie about or exaggerate talents and accomplishments

Lack of empathy for and interest in other people

A need for constant attention and praise

Strong overreaction to criticism

May manipulate or take advantage of others to further their own goals

Avoid taking personal responsibility for their behavior or problems

The Stigma of Personality Disorders

In recent decades, important advances have been made in our understanding of mental illness. Despite this, some mental illnesses—including personality disorders—are still stigmatized. This is partly because they have historically been difficult to treat. Another reason is that people with personality disorders behave in ways that often negatively impact others. This is particularly true for narcissistic personality disorder. For most people, understanding narcissists and the way they think is very difficult. People with this personality disorder often act in ways that make it hard to be around or even to like them. It’s important to understand, however, that people with NPD don’t choose to have a disorder. Moreover, since their disorder has a profound impact on their worldview, people with NPD don’t recognize when their behavior is hurtful or harmful. These days, treatment for personality disorders is more effective than it used to be. With therapy and hard work, people with NPD can learn to recognize why their behavior is harmful. They can even learn to challenge and change their patterns of behavior.

Can NPD Be Cured?

Personality disorders aren’t curable. With good treatment and hard work, the symptoms of the disease can be managed and minimized. However, there’s always the possibility of a relapse into old ways of thinking and behaving. Therapy is the mainstay of treatment for NPD. In therapy, people with NPD learn how to:

Understand the emotional roots of their behavior and why they have developed narcissistic behavior patterns.

Better relate to other people.

Let go of the need to achieve impossible goals, and instead recognize real skills and accomplishments.

Understand what drives their self-esteem.

Give themselves internal validation instead of seeking it from others.

Sometimes group, couples or family therapy can be helpful too. These are useful because they help people with NPD understand how their behavior hurts others. Unfortunately, there is a major barrier to treatment. People with NPD don’t usually see anything wrong with their behavior. This means they don’t understand—and may not care—that their behavior is harmful. They’re likely to be resistant to treatment and never believe they need it. Since they don’t have the motivation to change, therapy may not be successful. There are no medications for the treatment of NPD. However, people with co-occurring problems such as depression or anxiety can benefit from medications to treat symptoms of those disorders.

Living with NPD

NPD is a hard disorder to treat, but that doesn’t mean there is no hope. Like all therapy, it does take a lot of hard work. The important part is that the person is willing to change. Then they can progress week by week to make improvements they desire. If you are living with a person with narcissism, the most effective way to help them may be to help yourself first. That may mean going to counseling on your own or learning to set better boundaries. If you are living with a narcissistic abuser, the most critical boundary will be to get out of an unsafe situation. However, not all narcissists are abusers, and many are trying to be good people. With help, you may be able to find peace living with your narcissistic loved one while taking care of yourself.