The Trouble With Calling Each Other Narcissists

"They are a narcissist." What is known as a complex personality disorder in the clinical world has become a household term. It's not hard to find information on narcissism these days, mostly bent toward people who've experienced maltreatment at the hands of someone with these traits. A common misunderstanding is that people will never get help for narcissism, so it's okay for those around them to "diagnose" and characterize them instead: People with NPD don't want help and can't be helped anyway, so the best we can all do is identify, disempower, and avoid them. It's almost as if people with narcissistic personalities were not fully human.

A little less than a year ago, I attended a training on mentalization-based treatment, a therapy often used to assist individuals with personality disorders in relating to themselves and others. We talked about narcissistic personality disorder in a humanistic way, as a cause of suffering to someone and something that can be treated. These are humans who do find their way to therapy sometimes, and who can improve. It felt refreshing.

While I have met people harmed by those with reported narcissistic personality traits, I have also met at least a few people who may meet the criteria for a narcissistic personality disorder who I do not believe hurt anyone more than anyone else. Instead, their battle is a more internal one. Narcissistic personality disorder does not always mean abuse.

In many cases, untreated narcissistic personality can mean experiences of detachment, pain, and isolation. Often in narcissistic personality disorder, it is difficult for a person to find meaningful relationships or genuine self-acceptance. In addition, there is a strong correlation between narcissistic personality disorder and childhood trauma as well as post-traumatic stress disorder (Pietrzak et al., 2011). People with a narcissistic personality are often those who have significant attachment difficulties that have developed since childhood.

Narcissistic Personality Disorder

Narcissism itself comes from the Greek myth of Narcissus, the story of a man who fell in love with his reflection to the exclusion of all else. The psychoanalyst Dr. Heinz Kohut took time to understand narcissistic traits, finding ultimately that a level of self-love is healthy and necessary, yet that pathological narcissism, what we now call narcissistic personality disorder, represents a false self where the need for admiration takes a darker turn.

Narcissistic personality disorder is a complex condition associated with a particular pattern of relating to self and others. In the DSM V, the condition is described with aspects of grandiosity, exploitation of others, need for admiration, and entitlement. When understood through the alternate dimensional model of personality disorders, this can be understood more complexly through functioning in areas of intimacy, empathy, self-direction, and identity. While the DSM tends to focus on the grandiose type of narcissistic personality disorder, other manifestations have been outlined, such as a more vulnerable presentation.

Diagnosis of narcissistic personality disorder is difficult. Few people who have NPD reach out to mental health professionals specifically seeking support for narcissistic personality traits (and many self-diagnosed are found not to have NPD but another cause of struggle). Still, they may seek support due to unhappiness in a variety of other areas, especially if a serious ego injury has occurred. Diagnosing narcissistic personality involves an assessment process that will ideally involve formal psychological testing. The evaluator must be objective. It can't be diagnosed by a family member or friend, even if said is a mental health professional. In addition, mental health professionals cannot diagnose a client's friend or family member due to both the ethical problem of a dual relationship and the reality that a diagnosis of NPD requires more than a description.

Understandably, someone who has been hurt by another would wish for an explanation for their behavior. For some, learning about how someone with certain personality disorder diagnoses may act could provide a level of relief. Yet, there is also a strong capacity for problems as well when we choose to label each other with narcissistic traits.

A Limiting Title

When we view someone through the lens of a diagnosis, especially a diagnosis that they have not been medically given, we can be limited in our views. Hearing messages about narcissistic personality when we conflict with someone can be re-enforcing giving us a sense of us being in the right and the other in the wrong. When conflict has been longstanding, it can be very validating. So much so, that we can look for any signs to confirm our suspicions. It makes it difficult for us to relate with the person, and to gather what they may be feeling/thinking outside what we have learned to associate with narcissism.

Narcissism Essential Reads

A New Peek Behind the Mirror of Narcissism

4 Dubious Pop Psychology "Understandings"

We can cease to think about each other complexly. The limiting title of "narcissist" can be a way to devalue someone to a point where it can be even more difficult to relate and communicate with them. In its strongest form, this can take the form of dehumanization. People with narcissistic personality disorder are people first.

Adding Stigma to a Treatable Disorder

Nonclinical use of the term "narcissist" also adds to the mountains of stigma that the personality disorder carries. The reality is that psychotherapy does exist for narcissistic personality disorder, including mentalization-based therapy (Drozek and Unruh, 2020), cognitive behavioral therapy (Freeman and Sox, 2013), and others. We all benefit when people who have a narcissistic personality disorder can reach out for help—most of all, the person with the condition, but also those around them. Demonizing the condition serves to fan the flames of denial and discourages one from seeking support.

Alternatives to Labeling

Of course, this is not to excuse patterns of treating each other poorly. We can call these actions out more effectively by calling them what they are. When abuse is present, we need to acknowledge that and call it what it is---abuse. Categorizing manipulative strategies such as gaslighting can be empowering, and education about these tactics can be helpful.

We can accomplish much more by labeling the behavior rather than the person. For example, if someone is demeaning others, pointing that behavior out explicitly does a lot more than just calling them a narcissist, regardless of whether they truly have narcissistic personality traits.

When we are concerned for each other's mental health, we do right to encourage each other to seek help when necessary. Let's stop calling each other narcissists and treat narcissistic personality disorder as the health condition it is.

Facebook/LinkedIn image: Srdjan Randjelovic/Shutterstock