How to Get Along With a Pathological Narcissist

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Being in a relationship with a pathological narcissist may seem like a complete impossibility. Their constant demands for attention, self-centeredness, and frequent put-downs mean that your interactions can only bring pain.

However, what if you have no choice but to be in the same circle of relationships with this person? Perhaps they are an in-law, aunt or uncle, or friend of a close neighbor. Even more stressful, the person may be your ex with whom you share custody of your children. You view each potential interaction with dread, knowing that you’ll end up feeling both infuriated and demoralized.

Contrast this set of circumstances with others in which the individual clearly shows pathologically narcissistic traits, but is not a relative, close or otherwise. You may have a coworker or fellow volunteer committee member who you only have to associate with over specific tasks.

This individual tries to edge you out when it comes to getting credit for the work you completed and seems obsessed with her self-image. Although it’s unpleasant to be stuck with this individual, your interactions never really end up being completely terrible. How is it possible that a relative can get at you in a way a non-relative cannot?

Core Relational Themes in Interactions With Narcissists

To answer this question, the University of Wollongong’s Nicholas Day and colleagues (2022) sought to understand the “dysfunctional modes of relatedness” that occur when people are in close relationships with a person high in pathological narcissism. Noting that these relationships can be marked by “significant pain and distress to others” (p. 2), the Australian researchers believed that by analyzing these patterns, they could also shed light on ways to develop productive avenues to treatment through psychotherapy.

Day and his collaborators undertook their investigation by using an approach informed by “Core Conflictual Relational Themes (CCRT).” This is a therapy-based method that makes it possible to examine the underlying dynamics of interactions. You may be someone who was always compared unfavorably to an older sibling; throughout life, you will replay that theme by seeking to be validated and when you’re not, becoming depressed or angered.

In the context of pathological narcissism, as the authors explain, the CCRT can identify “not only an individual’s characteristic way of interacting with others but also their fantasized or longed-for outcomes of interactions” (p. 2). The disturbance associated with their disorder therefore should prompt responses from other people that only serve to reinforce their dysfunctional patterns.

Measuring CCRTs in Pathological Narcissism

Rather than relying on people with this disorder to provide the data, the U. Wollongong researchers took the approach of asking people who knew them to describe what it’s like to interact with them. The 15 research participants (average age 53 years old) produced written narratives (no less than 70 words long) involving an interaction between themselves and a pathological narcissist to whom they were close. The narrative needed to be a specific incident (both current and past) and must include where it happened, what the other person said or did, what the participant said or did, how it ended, and when it occurred. Each participant completed this task twice, once for a relative whom they knew well and once for a non-relative.

Ensuring that participants would be describing others with pathologically narcissistic traits, the research team administered informant versions of a standard inventory, which participants used to rate the people they described in the narrative. To be eligible for the study’s analyses, the relatives and non-relatives had to receive a score high enough to put them in the pathologically narcissistic range.

In case you’re wondering how the research team could ensure that the people being described would make the cutoff, the answer is that the participants themselves were recruited through invitations issued on websites describing the purpose of the study as well as through a Narcissistic Family Support Group. Indeed, almost all family members were spouses/partners or former spouses/partners; two were mothers and two were siblings.

Looking now at the CCRT analysis, Day and his fellow investigators processed the narratives through a coding system in which they identified specific units that they classified as involving wishes (W), response of others (RO), and response of self (RS). The quality of the interactions, in turn, was rated as “harmonious” or “disharmonious.” The research team then counted the numbers of coded CCRTs and compared relative vs. non-relative interactions.

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In the first analysis, the Australian researchers identified the main categories of Ws in each type of relationship. The 4 Ws that emerged in their analysis were attending to (listening), supporting, loving (feeling well), and being self-determined. Surprisingly, the Ws emerged as similar across relative and non-relative interactions.

When it came to harmony/disharmony, though, clear patterns emerged. There was significantly more disharmony expressed in relationships with relatives. The largest categories of differences in disharmonious responses (RO) were labeled as “being unreliable,” “rejecting,” “subjugating,” and “annoying, attacking.”

In the responses of the self (participant; RS), the two differences in CCRTs were labeled as “rejecting” and “withdrawing.” Thus, when confronted with a relative showing those disharmonious ROs, participants pulled out, which most likely only continued to infuriate the pathologically narcissistic relative.

The non-relatives and relatives both elicited similar wishes, then, in their interactions with participants. However, participants maintained their equanimity with the non-relatives, even resolving a bad interaction in a satisfactory way. It was with the relatives that the interactions “involved escalating relationship conflicts, whereby both participants and relatives became increasingly conflictually entrenched and disconnected, and relationship wishes remained unfulfilled” (p. 8).

Returning to the example of the relative in your life who’s been a thorn in your side due to their narcissism, you can see how well this CCRT approach can be used to identify what goes wrong.

For non-relatives, the temperature is considerably cooler. Lacking the emotional connection, it may be easier to find ways to tiptoe through otherwise dangerous territory when a narcissist starts to react negatively to some perceived failure of yours to accede to their desires.

Turning Themes Into Corrective Actions

Therapists working with individuals high in pathological narcissism have to continuously monitor their own reactions to the insatiable needs and hostility of their clients. Relatives, including those whose relationship is romantic, have a different goal; namely, protecting themselves from attack by withdrawing from or rejecting the other person. Of course, this only exacerbates the problem.

Given that some of the themes identified in this study included interactions involving physical, verbal, or sexual abuse toward the participants and their families, that desire to withdraw becomes a survival mechanism. It’s at that point that therapeutic intervention is warranted to take the personal risk out of the equation and allow “repair” (p. 9) to begin.

From a practical standpoint, the U. Wollongong findings provide a useful way to unpack your relationships with individuals, narcissistic or not, to break down the interactions you have with others into the categories of wishes and responses, crossed with harmonious and disharmonious. CCRT analysis requires expert coding, but in an informal manner, you can apply it by comparing yourself and your interaction partners in these broad, enduring themes.

To sum up, it is surprisingly possible to have a good enough relationship with a pathological narcissist, as long as that partner isn’t someone you’re emotionally attached to. Identifying what works and what doesn’t based on the presence of an emotional attachment could help you, and those you care about, find some potential paths to fulfilling relationships.

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