Narcissism: Considered Diagnosis or Easy Insult?

The term narcissism has been around for a long time. Thinkers as diverse and influential as Havelock Ellis, Sigmund Freud, Otto Rank, Carl Jung, and Karen Horney have used it, each in different ways, but always highlighting the pathology of excessive self-love.

In the last several years, though—catalyzed, perhaps, by the behavior of some elected officials—narcissism has become a kind of personality disorder du jour, much discussed by psychotherapists and life coaches, and flung around by laypeople as an all-purpose insult, a highfalutin substitute for names referencing body parts or a birth out of wedlock. Adding malignant intensifies the term. And overuse tends to devalue it.

According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), a diagnosis of narcissistic personality disorder (NPD) requires that at least five of nine identifying traits be present, along with impairments in intra- and inter-personal functioning. Anyone seriously interested in narcissism should read the full DSM section on the disorder. It’s important to understand that having four or fewer of the listed traits is insufficient for a diagnosis of NPD.

I’m far from the first to point out that virtually everyone sometimes exhibits narcissistic traits. Children go through a necessary stage of narcissism. Few adults have not, at one time or another, been called “selfish” or told, "The world doesn’t revolve around you.”

Exhibiting some narcissistic traits to some degree can be a sign of mental health. How effective will a job applicant be who, walking into the Big Interview, rather than thinking, “They’re gonna love you,” thinks, “There must be a lot of better candidates.” Yet the current obsession with calling out narcissism and defending against it can pathologize useful traits and cause unnecessary acrimony and conflict.

Justified confidence may be mistaken for grandiosity and/or arrogance. (Muhammad Ali said he was “the greatest” and proved it.) High ambition may be mistaken for fantasies of unlimited success. (Countless young musicians dream of becoming world-famous rock stars. Four became The Beatles; five more, The Rolling Stones.) Appropriate self-esteem may be mistaken for a sense of entitlement. (Many citizens of Montgomery, Alabama, saw Rosa Parks as embodying this.)

Was Einstein wrong if he saw himself as special and unique, able to be understood only by others almost as special and unique? People with exceptional abilities may easily be mislabeled as narcissists. Some narcissistic traits may actually be prerequisites for persevering in theoretical physics, the arts, professional sports, entrepreneurship, or any field in which the possibility of failure and rejection is extremely high. I heard a talented poet called a narcissist for stating that she intended to be “better than Shakespeare.” She didn’t say that she was better, only that she was trying to be. As Robert Browning states in his poem “Andrea del Sarto,” “. . . a man’s reach should exceed his grasp, / Or what’s a heaven for?”

I’m struck by the number of YouTubers currently advancing complex, often convoluted theories that expound on the causes and results of narcissism and offer ways to cope with narcissists. These ideas may be interesting and inventive. They may advance careers — no one attracts followers by shouting, “Movie!” in a crowded movie theater — but these theories rarely have much empirical data to back them up.

Are the theories correct? Are the explanations accurate? Do the suggested strategies help people with NPD (who rarely enter therapy) or those who have to deal with such people? The jury is still out and likely will be for some time.

The tendency to see narcissism hiding behind every shrub does raise awareness of “narcissistic abuse.” On the other hand, it can make normal, everyday conflicts worse, causing people to see plots, perfidy, and peril where none exist. In the movie Gaslight, a man tries to make his wife believe that she is psychotic so that he can have her institutionalized. This gaslighting—a term often used in conjunction with narcissism—threatens serious harm to the wife. Trying to convince someone to doubt his/her own senses constitutes a major psychological assault. On the other hand, a man convinced that his wife is a narcissist may accuse her of gaslighting simply because her memory of an incident differs from his.

Any number of behaviors can be labeled narcissistic, especially if “covert narcissism” is added to the mix. Too often, the label depends entirely on the labeler’s opinion and emotional state. Outside the realm of legitimate psychotherapy, to call someone a narcissist is not only more insulting than non-clinical insults; it may well evoke more hostility. The labeler seizes the role of expert and looks down with contempt on the pathological wretch below.

None of the above is meant to minimize the seriousness of genuine NPD or the harm it can cause. The true narcissist’s grandiosity, attention-seeking, envy, denigrating of others, impaired empathy, etc., can be unendurable and may give rise to soul-crushing and physically dangerous situations. Like all personality disorders, NPD is notoriously difficult—some say almost impossible—to treat. People who interact with a full-fledged narcissist will likely suffer more than the narcissist. Even relatively mild NPD can ruin a partner’s life.

Narcissism Essential Reads

Do Narcissists Have Empathy?

16 Signs the Narcissist Is Going on the Attack

The greatest danger from NPD comes when it overlaps with psychopathy, as shown by a consistent disregard for the feelings of others and not just impaired empathy but its absolute lack. The adjective “malignant” is, in this case, deserved. The husband in the movie Gaslight is a psychopath, willing to do whatever it takes to steal the jewels he covets, with no regard for those he hurts along the way. When narcissism crosses into that territory, all warnings are appropriate. We disregard them at our peril.