Narcissist Personality Disorder: Identification and Treatment

Have you ever been told you’re a narcissist and wondered what it meant? Here is how to recognise if you have Narcissistic Personality Disorder (NPD).

On this page:

  1. What is narcissistic personality disorder?
  2. How to identify
  3. Causes
  4. Diagnostic criteria
  5. Risk factors
  6. Treatment

PS – read this guide if you suspect your partner is a narcissist.

What Is Narcissistic Personality Disorder?

Narcissistic Personality Disorder (NPD), most commonly known as narcissism, is a type of personality disorder. Narcissism is commonly present in men; however, women can experience this mental health condition too. Narcissistic traits include an inflated sense of self, an excessive need for admiration and attention, a lack of empathy, hypersensitivity to criticism, and inauthentic interpersonal relationships.

It must be acknowledged that people can display some narcissistic personality traits without having a Narcissistic Personality Disorder. Individuals with a narcissistic personality have these characteristics and beliefs impacting every aspect of their life, including work, family, friendships, and relationships.

Narcissistic Personality Disorder is often masked by negative self esteem in an exaggerated ‘fake it ’til you make it’ way that has serious consequences, not only for the narcissist themselves but also for the people in their life.

Narcissistic Personality Disorder is recognised as a mental health problem and treated as such at a clinical health psychology practice. There can be diagnostic and clinical challenges to provide medical advice to a personality with narcissistic personality disorder, as oftentimes they do not believe there is anything wrong with their own behaviour.

How Can I Identify As A Narcissist?

Narcissistic personality disorder exists on a spectrum, and can be disruptive and harmful when it is more towards manipulative and emotionally abusive behaviours, rather than mere self-confidence.

Here are a few initial signs and key symptoms to consider if you suspect you have a narcissistic personality:

  • Charm and Manipulation
  • Love Bombing
  • Inability to Recognise Needs
  • Trauma Dumping
  • Future Faking

Charm And Manipulation

Narcissists are extremely charming people. They act in accordance with furthering their own personal agenda, usually to fulfil their need for admiration and value. Their deep-rooted insecurities mean they are excessive admiration-seekers, and intense charm helps them lure in a potential partner.

Others may think a person with narcissistic personality disorder has a lot of confidence and are very charismatic, but their charm can be short-lived once the individual is drawn to the narcissist. It is only then the less-positive qualities are shown, alongside the narcissists true behaviour patterns which are often irritable and moody.

Those with narcissistic personality disorder can change their personality very quickly without warning, and this is often followed by emotional manipulation.

When a narcissist gets bored, they will become disinterested in their partner’s life and no longer focus on them at all.

Love Bombing

In a relationship, the narcissist will often praise and compliment their partner excessively within the first few weeks of knowing each other. This is known as love-bombing, with the expectations of reciprocity.

Sometimes, it can be difficult to distinguish between love-bombing and genuine expressions of admiration. If a narcissist seems to be fishing for compliments, even in subtle ways, they probably are wanting positive attention reinforced on them. If someone with narcissistic personality disorder has grand claims of praise despite not knowing someone well enough yet, they probably are not coming from a genuine place.

A narcissist has motives rooted in self-absorption, centered around wanting to meet their own needs above the needs of their partner.

Inability To Recognise Needs In Others

Lack of empathy is a narcissistic trait. If empathy is displayed, it might not be as genuine as it would be coming from someone without a personality disorder.

Oftentimes a narcissist will have no idea of how their actions or inactions are impacting those around them, including a partner. The other party’s needs in the relationship will not be recognised, for example, setting boundaries and maintaining these boundaries.

Narcissists tend to act impulsively and do what best suits them despite the consequences for other people, as they have a me-first attitude that excludes the needs of others. By favouring themselves and acting impulsively, their partnerships can be diminished as there is no balance between the two parties.

Trauma Dumping

A narcissist may unload their childhood trauma or psychological issues onto others in the very early days when getting to know one another. This is known as trauma dumping.

Narcissists trauma dump to form a connection with others in order to gain their trust and sympathy. This trust and sympathy are then manipulated so a narcissist can further create an exaggerated sense of worth from others. Narcissists want others to reassure them of the praise they seek to hear, and help heal old wounds, even though the satisfaction is temporary for them.

While open and honest communication is important in a relationship, and sharing intimate details of your life does lead to further connection, it is the appropriateness of the timing that is crucial. Narcissists will want others to bond and engage with them almost immediately if possible, as they are desperate for attention.

Opening up so early on before trust is built can be a telling sign of narcissism, especially when the conversation is one-sided with no opportunity for others to share.

Future Faking

When a relationship begins it is normal to discuss values and goals for your personal relationships, for example, in family and love relationships, whether you want to get married and have children.

However, narcissists will often engage in future faking. Future faking is when a narcissist will make grand plans about a future together when you barely know each other, in order to gain your affection and approval. They want their ideas praised and to receive favourable treatment from you.

People with NPD are capable of deep feelings, although these feelings are often tied to their own self image because it is difficult for them to be placed in other people’s shoes.

Their interests are often not grounded in reality, and the future they seek with you is most probably hypothetical. This can cause emotional distress for partners of narcissists, as their future faking can be seen as lying, manipulative, and disrespectful.

What Causes Narcissistic Personality Disorder?

The cause of Narcissistic Personality Disorder has not been confirmed, although decades’ worth of research suggests possible causes.

Psychologists and neurobiological researchers propose some of the main causes of Narcissistic Personality Disorder (NPD) are a poor self-esteem, feelings of unworthiness, and the need for favourable treatment. These feelings can be based on genetics or stem from childhood upbringing where interpersonal development was compromised.

Vulnerable children can be deeply impacted by the parenting styles they are raised with, for example:

  • If a parent is overprotective, a child could view themselves as never meeting the standards and expectations set upon them because they are continuously being punished for not being good enough.
  • If a parent is neglectful or absent, a child could view themselves as a burden and feel as though they were not worthy of love, affection, and praise.
  • Learning manipulative behaviour from parents or caregivers.
  • Experiencing inconsistent and unpredictable caregiving, including withholding affection.
  • Being excessively praised, admired, and overindulged by family and peers, with no feedback or healthy criticism given.
  • Receiving excessive compliments based on physical appearance or abilities, demonstrating value and worth through external factors rather than internal being.

When children are not valued within a family unit, their own emotions are often devalued in favour of another’s. This is known as enmeshment, and narcissists use manipulative tendencies to take back control over their feelings of inadequacy and maintain personal gain over people in their life – even if these people were not the ones who caused the initial self-esteem issues.

Therefore, it can be posited that narcissism is a coping mechanism for deep-rooted feelings of inadequacy, wherein childhood needs were not met, and patterns of behaviour emerged to combat their low self-esteem issues.

Self confidence can be diminished, and while emotional regulation around a sense of self is important, narcissists can overdo their need for a strong sense of special treatment and constant admiration to compensate for the lack during their upbringing, reinforcing ideas within themselves of low self esteem and low self worth and leading to further mental health issues.

Diagnostic Criteria

The following core features of narcissistic personality disorders are:


The most telling trait for a narcissist is grandiosity. Grandiosity relates to an exaggerated sense of self importance, leading individuals to believe they deserve special treatment because they are superior.

Narcissists often have fantasies of obtaining power, beauty, love, and unlimited success. While some narcissists believe others can be both above and below them, they find it difficult to be equaled with another.

Excessive Need For Admiration

Narcissists have an excessive need for admiration, they must be the centre of attention, and when they are not – they lash out and become emotionally manipulative.

Conversations are often focused on them, as people with mental disorders often don’t have the usual range of self-awareness others do. Their monopolisation of conversations can leave others feeling drained, depleted, and ignored.

Their need for admiration comes from a place of deeply rooted low self-worth. Narcissists crave approval from others because they cannot facilitate internal validation for themselves.

Superficial And Exploitative Relationships

The relationships narcissists have with others are often superficial and exploitative, because they are less concerned about the other person and more concerned about themselves.

Narcissists view others in a transactional light – What benefit can they bring to my life? What can they do for me?

This mindset is selfish and lends itself to relationships that lack authenticity. They lack depth and are surface level interactions, and when a person is no longer viewed as valuable, the narcissist will stop engaging with them.

Narcissists are exploitative and take advantage of others, especially those with more empathetic qualities.

Lack Of Empathy

Narcissists lack empathy, as they are so concerned with themselves that they find it difficult to take the needs of others into consideration.

Their number one priority are themselves.

The emotional needs of others, even people close to them, are not a priority and are rarely thought of with this mental illness.

Identity Disturbance

Narcissists will seem to have a high sense of self, but this exterior is not what is mirrored inside. They are fragile, projecting an inauthentic and superficial sense of self to the world.

The image of themselves they project to the world is based on their grandiose sense of self, and when this is threatened, they become hostile.

Narcissists refuse to accept they are anything less than what they project they are. They lack self awareness and are not capable of self-reflection, and due to this, they have an intense hypersensitivity to criticism.

Narcissists are quick to point out the flaws in others, including their partners, but refuse to believe they need to better themselves.

Difficulty With Attachment and Dependency

Relationships for narcissists are all about reaffirming their fragile sense of self. If a narcissist is engaged in a relationship where they no longer feel special or valued, or if their self image is challenged, they will often withdraw from the relationship.

When they receive positive feedback from others they begin establishing dependency towards those who satisfy their needs for attention.

Many narcissists have difficulty maintaining boundaries, as they often over-communicate and make unreasonable demands. Yet when the other party expresses concerns, or wants attention reciprocated, the narcissist can be defensive and emotionally abusive.

Narcissists avoid intimacy, and therefore cannot truly engage in healthy, loving, and stable relationships with others.

Chronic Emptiness and Boredom

When narcissists are not receiving the praise, recognition, and attention they believe they deserve, they feel intense feelings of emptiness and boredom.

They can become restless and depressed, leading to possible infidelity and substance abuse.

Vulnerability To Life Transitions

Narcissists are often vulnerable to life transitions, as they find it difficult to exist within reality and boundaries set by others around them.

This can be especially difficult during early adulthood.


Narcissists operate with the belief that others are envious of them because of their grandiose sense of self-importance.

They usually exaggerate their achievements and talents, hoping others have an inflated perception of their self.

Arrogance And Haughty Behaviours or Attitudes

People with narcissistic personality disorder will often display their false sense of confidence in an arrogant way. They engage in haughty behaviours, such as being obnoxious, overbearing, prideful, and boastful exhibitionism.

Narcissists believe they are deserving of certain privileges in life and are exempt from rules that do not serve them. If they do not receive special treatment, they often get upset and angry.

NPD Risk Factors

Risk factors for narcissists include suicide and suicidal attempts, like other mental disorders, therefore it is encouraged for those suffering to seek treatment from a mental health professional.

Treatment For Narcissism

Those suffering from narcissistic mental health issues can often make no efforts to improve themselves because they believe they are perfect and nothing is wrong with them.

It can be difficult for your partner to accept responsibility for their narcissistic tendencies, and it is possible that by raising this there could be perceived criticism on them.

It is important for them to do their own reflection on their sense of self, including a sense of self importance, because having fragile self esteem is no excuse for treating people they supposedly care about poorly.

Depending on a person’s level of insight and motivation to change, here are some common evidence-based therapies that can assist.

  • Psycho-education
  • Cognitive-behavioural therapy includes:
    • Behavioural interventions
    • Behaviour modification
    • Cognitive interventions
    • Cognitive therapy
  • Mindfulness and relaxation techniques
  • Skills training
  • Interpersonal therapy
  • Couples and family counselling (if this is impacting your close relationships).

These narcissistic personality disorder therapies are aimed at assisting an individual suffering from NPD to gain better insight and understanding of their behaviours and how they impact others.

For example, psychologists often seek to help clients to:

  • understand what defines healthy and sustainable relationships
  • understand how to better control impulses and develop skills to effectively solve problems in life
  • improve effective communication with others, and;
  • build self-esteem and confidence.

In some cases, it may be helpful to see a GP or a psychiatrist for medication-based treatments. Pharmacotherapy may include any of the following:

  • Antidepressants: These medications treat depression. Healthcare providers commonly prescribe selective serotonin reuptake inhibitors (SSRIs). This class of drugs has fewer side effects than other antidepressants. SSRI medications include fluoxetine, sertraline and paroxetine.
  • Mood stabilizers: To reduce mood swings, your provider may prescribe a mood-stabilizing drug such as lithium.
  • Antipsychotic drugs: This type of medication can help with key symptoms of depression and anxiety. Aripiprazole and risperidone are two kinds of antipsychotic drugs.

Need Help Finding The Right Psychologist For You?

New Vision Psychology can help with 5 convenient locations across Sydney