Throughout my career as a psychiatrist, I’ve worked with a personality type that I call Narcissus. One such person was Richard, a successful executive chef whom I was asked to see after he threw a knife at a sous chef in the kitchen. During a seemingly uneventful food preparation demonstration, he asked his assistant for a particular knife, but was presented with a different one. In a dramatic episode of screaming and yelling, he threw the knife back toward the horrified chef and stormed out of the kitchen, swearing about how incompetent she was.

Thankfully, most of us do not have to deal with knife-throwing at work. But a lot of us encounter narcissistic types in the office—people who try to inflate their sense of self-worth by exaggerating their accomplishments, overestimating their abilities, and blaming others for shortcomings. This tendency is rooted in an underlying, deeply entrenched sense of insecurity. (In everyday conversation, we tend to think of a narcissistic person as having too high an opinion of himself, when in fact the Narcissus just appears self-absorbed in order to protect himself from low self-esteem.) It is never fun to work with someone who behaves this way. But if you have a narcissistic co-worker, there are strategies you can employ to soften their ego-driven blows.

Remember that the only commentary that the Narcissus will be able to actually hear will contain some degree of praise in it.

On a day-to-day basis, appealing to this person’s egocentricity can be very effective. The occasional recognition of the person’s achievement, strengths, or values may go a long way in avoiding anger or demeaning comments; in some instances, you may simply want to remark upon a person’s good efforts. Fanning the embers of narcissism is particularly effective in avoiding unwanted conflict. Particularly if the Narcissus is your boss, you have to let them think that you perceive them as important. No matter how difficult it may be to do this, the Narcissus boss can make the workplace a living hell for anyone who they think is not on board with their success. Give them compliments, and try to do so without mocking them.

Remember that the only commentary that the Narcissus will be able to actually hear will contain some degree of praise in it. So when asking for a favor or for some type of change that could be perceived as an insult, definitely attempt the route of first praising him in some way. Even a simple statement like a reminder about a deadline might need some positive reinforcement embedded in it: “I can’t wait to see your draft of the proposal on Friday.” Remember that the Narcissus has special techniques for avoiding hearing criticism and can interpret even a simple suggestion or reminder as an insult if it doesn’t contain anything positive.

Another strategy is paying attention to the Narcissus. If enough attention is not paid, he will perceive criticism. Even simple moves, like stopping by to say, “Have a good weekend” on the way out the door, can have positive effects on your workplace relationship. By the same token, it is important to respond to the Narcissus when asked, if it is possible. When this person asks you to swing by his office, it is far better to do so immediately—and postpone listening to your last voice-mail message—than to even say, “Let me finish up what I’m doing and I’ll be over when I can.” The Narcissus might hear this benign statement as, “I’m doing something important right now and in fact it’s more important than you are because I think you are worthless,” and this will nourish his rage. By the time you get to his office five minutes later, he’s boiling inside and about to assign you two extra tasks in retaliation for the perceived criticism. The same goes for replying to his text messages, e-mails, and other forms of communication. Quick responses let the Narcissus imagine that you respect him and think he is important.

An effective strategy is to sandwich a critique between compliments and to offer alternative manners of acting in specific situations.

Resist the impulse to spontaneously react to your annoyance with a Narcissus. Risky, poorly timed confrontations may cause the individual to avoid your suggestions or go to extreme lengths to criticize your own person before you have a chance to challenge him again. The Narcissus avoids hearing anything that may injure his self-esteem. An effective strategy is to sandwich a critique between compliments and to offer alternative manners of acting in specific situations. For example, “I really like the presentation that you gave this morning and think I learned a lot from your extensive experience. I wanted to note, though, that next time everyone might learn even more if you can keep from calling some of our coworkers’ questions ‘stupid’ because I think it hurts people’s feelings and distracts them from all of the great information you had in the presentation. I know I wouldn’t want to miss out on any of that.” This approach is probably more likely to be effective coming from a boss, or possibly a colleague, and only if done sensitively.

Obviously, all of this can feel incredibly frustrating. No one wants to accommodate Narcissus—not only is it difficult, but it feels extremely unfair to have to do so. You might find yourself asking why you should leap at someone’s beck and call, and that question certainly makes sense. At the same time, however, you want to recognize that you are doing this because it is what works best. The other options are to be berated, bullied, or otherwise taken down by their ego. As difficult as it feels to cater to Narcissus, remember that you do it because the other options are even worse.

There are also a few things you can do to attempt to modify the Narcissus’s behavior. Although the Narcissus is known for a relative inability to understand others’ emotions, recent research has indicated that this trait may be more flexible than previously understood.

Though the Narcissus may not consider another’s perspective on his own, he may be prompted to do so. In pointing out a behavior that offended someone, it may not be enough to simply say, “It was rude of you to insult Alex at the staff meeting.” If said this way, the Narcissus may simply hear you insulting them. “You are rude!” However, compliment sandwiches can be helpful in getting the Narcissus to hear what is coming next. Then, stating something along the lines of, “Imagine how Alex felt when you called her stupid. Imagine if someone called you stupid.” Although it may not come naturally, evidence shows that being instructed to consider something from another’s perspective can actually influence the Narcissus’s ability to do so.

Another technique is to reflect the person’s underlying emotions back to them. Because we understand that beneath the arrogant exterior is someone who feels scared, insecure, and small, statements that let the Narcissus understand that he isn’t expected to be perfect, or that undertaking large projects can be difficult, can be incredibly useful. The secret is to not single him out or make him feel undervalued in the process. For example, we might say something like, “We are all stressed about the upcoming deadline right now. I know I am a bit on edge about how I will do” can translate into “Hey, it’s okay if you’re scared right now because we all are. You don’t have to puff up.” Such a statement might take the person’s defenses down a notch. They can let out a sigh and relax from self-protection mode a bit. On the other hand, it could be nearly disastrous to say something like, “You look really stressed right now. Are you worried you aren’t going to do a good job or something?” which would translate into “insult insult insult, insult?”

As for management, it is important for leadership to set limits with narcissistic types and to stick to their consequences. For the Narcissus, the extreme behaviors that require forced intervention will usually be dramatic displays of anger or rule breaking, both of which can be potentially unsafe in the workplace. The Narcissus must know that loss of money, power, or status is at risk if he messes up again. It is important to be direct. For example, the Narcissus must clearly hear from a boss, legal, or HR that if he does not attend therapy or if he becomes enraged at work again, he will be subject to a demotion, will be moved to a less desirable office space, will lose income, or will lose the respect of someone admired. If such methods fail, the Narcissus is likely impossible, and should be removed from the office.

This excerpt is adapted from The Schmuck in My Office: How to Deal Effectively with Difficult People. Copyright © 2017 by Jody Foster, M.D. and Michelle Joy, M.D. and reprinted by permission of St. Martin’s Press.