At the core of narcissism is a form of sociopathy. So a narcissistic child may have heightened emotions, depression, criminal tendencies and an unrealistic sense of self. And because a narcissistic child overcompensates for feelings of inadequacy, he is profoundly invested in maintaining a persona of perfection and self-aggrandizement.

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Though a narcissistic child may have received parental messages that he is special, he also may have been punished by neglectful and abusive parents.

A parent of a narcissistic child may overcompensate for his own childhood’s narcissistic injuries, seeing the child as a reflection of himself. His self-worth becomes wrapped up in or projected onto the child. Or he might overcompensate for the guilt he feels, for disliking the child, by overprotecting him. According to Freud, “parents who over-evaluate are under a compulsion to ascribe every perfection to the child.”

The narcissistic child, therefore, develops a personality that must maintain his feeling of being special, having special talents and being entitled to special treatment. His need for attention and entitlement can lead to exaggerated emotional responses when those needs are not met. He is easily bruised emotionally and sensitive to any form of criticism, blame or shame. He is not empathetic and can become a bully, or act out in dangerous and aggressive ways.

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A narcissistic child also may have problems with intimacy. His lack of empathy and his need to be the center of attention impedes his capacity to relate to others, to see another’s point of view or to feel compassion. Unable to sustain a healthy social relationship, he may experience feelings of depression and anxiety and think about self-destruction.

But there is hope, because empathy can be taught. It requires psychotherapy, group therapy and family therapy. Narcissistic children respond especially well to group therapy, which creates an environment in which they are exposed, in a therapeutic manner, to other children like themselves.

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Since the personality develops along with cognitive, social and language skills, it's important to intervene therapeutically early and consistently, so that a narcissistic child can live a happy, self-confident and productive life. Wait too long and he will refuse therapy. His world view tells him that he must be right and perfect. He will be unable to see the perspective of others.