Step 1: Establish and Maintain Firm Boundaries in Co-Parenting with a Narcissist

Establishing clear boundaries while co-parenting with a narcissist is crucial for emotional safety and stability.

A person with narcissistic traits often views boundaries as challenges to their control. Your ability to create and enforce clear boundaries becomes your most powerful protective tool.

Strong boundaries can protect you and your children when co-parenting with a narcissist.

Be Direct and Unemotional

When setting boundaries with a narcissistic co-parent, clarity and emotional neutrality are essential. State your boundary clearly and calmly: “I am not going to discuss this while you are yelling. I am hanging up now, and we can talk when you are calm.” Then, crucially, follow through immediately.

The follow-through matters more than the words. Narcissistic individuals test boundaries constantly, so consistency proves you mean what you say.

Don’t Explain or Justify

Avoid getting pulled into arguments or debates about your boundaries. Lengthy explanations provide manipulation opportunities. The boundary is non-negotiable, not because you’re being difficult, but because it protects your family’s emotional health.

When you justify boundaries, you’re implying they’re up for discussion. They’re not.

Remember Your “Why”

Adhering to boundaries with a narcissistic co-parent will be uncomfortable. You’ll likely face gaslighting, a manipulative tactic that the National Domestic Violence Hotline describes as making someone question their own reality, memory, or perceptions.

You may also encounter guilt trips, condescending behavior, or accusations of being “difficult” or “unreasonable.” Remind yourself regularly: you’re not doing this to punish them. You’re protecting your children and yourself from emotional manipulation and creating a healthier environment.

Step 2: Validate Your Children’s Reality

Co-parenting with a narcissist means being vigilant about your children’s emotional needs and offering them the validation they may not receive from their other parent.

Children of narcissistic parents often feel their feelings, thoughts, and very identity are invisible or “wrong.” Your role as the other parent is to be a consistent source of validation and unconditional love.

Children’s self-esteem is profoundly influenced by how their parents respond to them. When one parent is narcissistic, the other parent’s validation becomes even more critical.

Acknowledge Their Feelings

When your child expresses hurt or frustration about their interactions with the narcissistic parent, validate their emotions: “It makes sense that you feel upset about that” or “I see how hard you’re working, and I’m proud of you.”

Never dismiss their feelings, even when you’re trying to keep peace. Your validation teaches them to trust their emotional experiences, a crucial life skill that research from the Center on the Developing Child at Harvard University shows is fundamental to building resilience.

Separate Their Worth from Their Performance

Narcissistic parents often tie a child’s value to their performance or how the child makes the parent look. Counter this damaging message consistently.

Remind your children that their worth is inherent and not dependent on grades, athletic achievement, appearance, or living up to someone else’s unrealistic expectations. Celebrate who they are, not just what they do.

Correct Unhealthy Messages

If your children have been told they’re “too sensitive,” “not good enough,” or that their emotions are problems, gently counter these messages.

Without directly criticizing the other parent (which can backfire), you might say: “It’s important to learn how to manage emotions well, and yelling is an example of not managing them well. You are not broken or ‘less than’ because you have feelings. Feelings are information, and learning to understand them is a strength.”

Step 3: Prioritize Your Own Healing and Growth

Your healing journey is crucial in the context of co-parenting with a narcissist, where emotional turmoil can affect everyone involved.

You cannot pour from an empty cup. To be a strong, resilient anchor for your children while co-parenting with a narcissist, you must invest in your own well-being. This isn’t selfish, it’s essential.

Focus on What You Can Control

You cannot control another person’s behavior, manipulations, or emotional outbursts. But you can absolutely control your response. This shift in focus is incredibly empowering and reduces the emotional toll of the co-parenting relationship.

The concept of the “locus of control”, whether you believe events are controlled by your own actions or external forces, significantly impacts mental health. Research published in Frontiers in Psychology demonstrates that an internal locus of control is associated with better psychological outcomes.

Build Your Own Self-Esteem

The most powerful defense against narcissistic manipulation is a strong sense of self. Engage in activities you love, set and achieve personal goals, and celebrate your victories, no matter how small.

When your self-worth comes from within rather than external validation, narcissistic tactics lose their power over you. Mental Health America offers excellent resources on self-care practices that support mental wellness.

The Secret to Understanding the Narcissist

Understanding that narcissistic behavior often stems from incredible insecurity can help you emotionally detach from their manipulation. This doesn’t excuse the behavior, but it prevents you from internalizing their criticisms or taking their actions personally.

Your goal isn’t to force them to change, it’s to change your response and speak life into your children.

Step 4: Seek Professional Support for Co-Parenting with a Narcissist

Seeking professional support tailored to co-parenting with a narcissist can make a significant difference in how well you manage interactions.

You don’t have to walk this challenging path alone. Navigating co-parenting with a narcissistic individual while protecting your children’s emotional health requires tools and perspective that professional support can provide.

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a national helpline (1-800-662-4357) that offers free, confidential, 24/7 support and can connect you with local mental health resources.

A qualified therapist can help you:

• Develop effective communication strategies that minimize conflict
• Set and maintain healthy boundaries without guilt
• Process the emotional toll of the co-parenting relationship
• Recognize manipulation tactics and respond strategically
• Build resilience for yourself and your children
• Create a parenting plan that protects your children’s interests

Professional support also provides a safe space for your children to heal, process their experiences, and learn that their feelings are valid. The National Alliance on Mental Illness (NAMI) offers excellent resources on personality disorders and their impact on families.

Finding professionals who understand the intricacies of co-parenting with a narcissist will help you navigate this challenging relationship.

Legal and Practical Considerations

When co-parenting with a narcissist, documentation becomes essential. Keep detailed records of all communications, agreements, and concerning incidents. Many family law attorneys recommend using court-approved co-parenting apps like OurFamilyWizard or TalkingParents, which create timestamped, unalterable records of all communications.

If safety concerns arise, the Office on Women’s Health provides resources for creating safety plans and understanding your legal options. Remember that emotional abuse is just as serious as physical abuse, and protective measures may be necessary.

Building an Unshakeable Foundation

You and your children deserve peace, emotional safety, and healing. The greatest defense against the negative effects of narcissism isn’t winning arguments or changing the other person, it’s building an unshakeable sense of self-worth for yourself and your children.

When co-parenting with a narcissist, remember:

• Your boundaries protect your family’s emotional space
• Your children need validation more than they need you to keep the peace at all costs
• Your healing directly impacts your children’s resilience
• Professional support isn’t a luxury, it’s a strategic investment in your family’s future

Every step you take toward establishing boundaries, validating your children, and prioritizing healing creates ripples of positive change. You’re not just surviving this co-parenting situation, you’re modeling strength, self-respect, and emotional intelligence for your children.

That’s a legacy worth fighting for.

Narcissistic abuse is particularly insidious as it almost always damages every aspect of a person’s sense of self including their mental, emotional, spiritual, and physical well-being. Because of this, it’s important to begin to heal from this form of abuse from the inside out. With the right resources, it is possible to do more than just beat the pain, and instead, find a newfound sense of joy and self-empowerment in the aftermath.  

The Nature of Narcissism: Decoding the Disorder 

Narcissistic personality disorder (NPD) is a diagnosable Cluster B personality disorder marked with an inflated sense of self-importance, deep need for admiration, and a lack of empathy that often results in dysfunctional relationships. It can be found adjacent to antisocial personality disorder, histrionic personality disorder, and borderline personality disorder in the DSM. 

Deeply rooted insecurities are often the source of NPD, and the grandiose behaviors exhibited by narcissists are generally nothing more than defense mechanisms used to mask a very fragile ego. Cultural factors and social expectations can predispose an individual to this disorder, which also has a genetic component.   

It is important not to correlate every case of high confidence or egocentrism with an actual mental health condition. In today’s world, selfie culture is the norm, and it would minimize the damaging effects of NPD to assume that every person who snaps and shares photos of themselves has the disorder. In fact, it’s been estimated that a very small percentage of the population lives with this condition. This is where it’s important to consider the root causes of NPD and develop an understanding of an individual’s internal motivations.  

While personality disorders are generally considered incurable, symptoms of NPD can be well-managed with therapy, and often, with medication. The biggest hurdle, however, is getting those with NPD to accept and engage in treatment. Some have argued this is why it’s difficult to determine exactly how many people meet the criteria and, therefore, estimates remain low. 

Understanding Its Impact 

Acknowledging that NPD is marked by grandiosity, a need for constant admiration from others, and a lack of empathy, it’s perhaps not all that surprising that being in a relationship with someone with NPD would be difficult. If an individual can’t intimately connect with another person and share in their experience, it’d be challenging to advance any form of relationship with them. The issue is much deeper than just not making a genuine connection with others, however. The trouble stems from a narcissist’s underhanded intentions in the connections they do choose to make. 

Because those with NPD can’t intimately connect, they tend to only pursue relationships they see as beneficial to them, and there is almost always an end game to a narcissist’s willing participation. In other words, a narcissist views others as an extension of self – those they pursue have something they want. Of course, if that “thing” goes away, the narcissist does, too. They’re very quick to discard this person and simply move on. 

To get what they desire from relationships, narcissists nearly always lie and manipulate their victims. In fact, they’re known to use an especially detrimental form of manipulation called “gaslighting.” This is when they attempt to alter a person’s experience and make it their own.  

 Constant gaslighting makes victims begin to question their own perception of reality, which accomplishes two goals – it wears down a victim’s self-esteem and makes them more dependent on the narcissist. It also makes it tough for a person to pinpoint exactly what’s wrong even when they intuitively know something is “off” or they’re feeling hurt or betrayed by the narcissist.  

Because they can’t put a finger on why they feel this way, victims often blame themselves. They choose not to leave, and this allows for the cycle of abuse to continue. Over time, a sense of self is lost and, generally, a victim becomes isolated from meaningful people, places, and things in their “previous” lives.  

Can the Abuse Get Physical?  

The short answer is, yes, absolutely. Narcissists pride themselves on outward appearances, so they’ll often lead with mental and emotional tactics, which don’t leave visible marks. However, if a victim begins to recognize they’re being mistreated and speaks up, the abuse can quickly turn physical.  

 The term that’s commonly used for this is “narcissistic wrath.” Again, those with NPD have a fragile ego they’ll do anything to protect. When this is exposed, it infuriates them. Everything they’ve done to ensure others don’t see them for who they truly are is put in jeopardy and the individual responsible for this can begin to experience more overt abuse.  

In addition to pushing, shoving, hitting, choking, suffocating, and other common abusive reactions, narcissists also tend to intensify mental and emotional turmoil. They may move around the victim’s personal belongings in a very real attempt to drive them mad, or they may secretly contact a victim’s loved ones, friends, and even co-workers to spread lies about them. If a victim summons enough strength to leave their abuser, this is often met with “smear campaigning,” which involves defaming a person’s reputation as a last-ditch effort to instill control when the abuser can no longer exert control over the victim directly. 

What Happens if a Victim Returns? 

Victims of narcissistic abuse who’ve managed to break free frequently return to this relationship at some point. Not only has the abuser done a thorough job of stripping the victim of their own sense of self-worth, turning their lives entirely upside down, but chances are, the perpetrator hasn’t changed at all.  

Those with NPD actually gain “narcissistic supply” from “winning” their sadistic games, meaning they gain energy from exploiting others whereas living in constant contention will deplete an average person. An ultimate win in the narcissist’s mind would come from luring a victim back once their perceived opponent has managed to leave.  

Victims who’ve stayed with narcissists long enough to be left confused, isolated, and alone, and with limited options to move forward, are especially vulnerable to returning. And, unfortunately, once a victim returns, the narcissist generally performs an ultimate “discard.” Even if the individual with NPD seems to have changed, they’re still fundamentally incapable of feeling empathy, so their motives are almost always impure. Instead, they usually try to take what little good the victim has left in their lives and throw it all away, experiencing a sense of satisfaction when they can do so and exit abruptly, leaving the victim to pick up the pieces.  

 Ever heard the saying, “Insanity is doing the same thing over and over again expecting different results?” Unfortunately, expecting different results from reentering into a partnership with a narcissist almost always ends with the victim being left worse off than they were prior. And just like the cycle of addiction, every “relapse” will make it more difficult for the victim to heal as a result. 

Narcissistic Abuse & Declining Mental Health 

Given all that was said above, it becomes evident that it’s important to identify signs of narcissistic abuse early on so victims can leave before things get any worse. The longer an individual stays in a relationship with a narcissist, the more time the abuser has to chip away at their self-efficacy. Getting out as quickly as possible can save a victim from more lasting issues tied to trauma, including the development of posttraumatic stress disorder (PTSD).  

Before we come to any conclusions concerning how easy or difficult it is to identify early warning signs, we have to first take a look at another commonly referred to term when it comes to narcissistic abuse – “love-bombing.” This is the period, at the very beginning of the relationship, where the narcissist does everything in their power to lure in, and eventually trap, their victim with supposed love, attention, and adoration. Many victims find this to be endearing, and only come to realize that these efforts are especially over-the-top, overpowering, and even desperate, after they cease later on. 

Examples of love-bombing might include buying luxury items, including expensive gifts, vacations, or vehicles. It may involve paying off a partner’s debt or sending daily bouquets of flowers to desks at work. Or it may present in the form of excessive communication and compliments that make the partner believe they need to move the relationship along more quickly than they normally would.  

 The love-bombing phase almost always ends with abrupt and significant changes to a victim’s life which include the person relinquishing a fair amount of control (i.e., they’ve moved in with their partner, married them, combined all of their finances, etc.). At this point, the narcissist has succeeded in their quest to gain control and their true intentions become evident. They no longer have to put on a façade, and the mask begins to fall off. 

It is in this next phase that internal alarm bells will start to go off and a victim may feel significant buyer’s remorse. 

The Fight or Flight Response 

One of the most noteworthy internal alarm bells humans have is their natural “fight or flight” instinct. This inherent trait is meant to protect a person against an external threat. While the fight or flight response was especially vital for protecting our ancestors from natural predators, in modern-day life it has become less of a necessity. Despite this, the mind and body have a hard time distinguishing between being attacked by a tiger in the wild and amplified distress caused by work deadlines, piling bills – or being in an unhealthy relationship.  

When it comes to being in a relationship with a narcissist, the fight or flight response can both come in handy and end up being detrimental over time. Feeling this way can signal something’s off in the relationship, which helps with a victim’s decision to leave. But, at the same time, being “stuck” there for too long can cause difficult-to-reverse anxiety, paranoia, and hypervigilance. This is why it’s important for victims to maintain a sense of self-trust and to not second-guess what their body is telling them. 

Learning to trust this signal in the very beginning and initiating self-care can protect against lingering distress and bring one back into balance. In abusive relationships, self-care equates to leaving and rebuilding. 

Other Warning Signs 

Other indicators of narcissistic abuse include gradual disconnection from family and friends, not having control over finances, suspecting a partner is only sharing half-truths or feeling as if their stories don’t add up. One’s partner may also be unable to account for part or all of their day and they may get notably defensive when asked where they were. They may also be exceptionally unemotional unless and until they feel cornered.  

 Remember, those with NPD don’t experience emotions like others and their attempts to engage with people tend to come across as atypical or forced. It is also difficult for them to read the emotions of others. So, they commonly present as stoic or respond oddly to social-emotional cues unless provoked. When provoked, their anger can be over the top. 

 If these indicators aren’t obvious enough early enough, victims will begin to feel symptoms of progressing mental health issues including feeling lonely, anxious, lethargic, and depressed. Over time, deeper feelings of helplessness, unworthiness, and chronic discontentment will start to creep in, anxiety and depression will become more pronounced, and it may also be difficult to sleep or to function effectively in one’s day-to-day. This is when a victim is coming dangerously close to developing acute stress disorder and, eventually, PTSD. 

The Path to Recovery: Intentional Self-care 

Those who are lucky enough (albeit they may not feel “lucky” at first) to leave an abusive relationship generally have a lot of self-work to do in the aftermath. It is not uncommon to grieve the loss of their previous selves while grieving the loss of the relationship (even if it was a toxic one). There may also be significant tangible losses, including the loss of a job, home or other forms of property, or even financial stability. In most cases, victims feel as if they are starting over entirely. 

The good news is that it’s not only possible to rebuild what was lost in a physical sense, but it’s possible to thrive mentally and emotionally in the aftermath of abuse. This takes a conscious choice on the survivor’s part to make themselves a priority and engage in some much-needed self-care.  

Reintroducing activities that a person once enjoyed but may not have been able to do during the relationship can help reestablish pieces of self that were lost along the way. This will mean different things to different people, of course, and it may seem difficult at first to regain access to the person inside. Taking the time for in-depth self-reflection can bring forth ideas that aren’t readily available when trying to remember on the fly. A quiet, decluttered space, a favorite background song or scent, and a few uninterrupted moments can help summon lost memories and stir up ideas. 

A Solid Support System 

Support systems are often shattered when one is trapped in the clutches of a narcissist. Taking the time to rebuild meaningful relationships will help ensure a person is surrounded by the love and support they need as they emerge from this dark place. 

 It is important to note that it may be necessary to make amends with those who felt intentionally left behind during the storm, but many one-time victims have been amazed to find their loved ones are just waiting in the wings, having fully realized the gravity of the situation long before they did. 

Professional Help 

While regaining the love and support of a personal network is a vital step in the right direction, it may not be enough. A person may still be left with debilitating trauma symptoms that require professional treatment. Working with a therapist can help unlock lost portions of self and reconnect with these to heal sustainability. Some common interventions which address the most stubborn trauma symptoms include:  

1. Trauma-informed Cognitive Behavioral Therapy (TF-CBT). This approach seeks to identify, challenge, and eventually eliminate faulty thinking patterns and behaviors. It is perhaps the most common “frontline” approach to addressing trauma. Through TF-CBT, abuse survivors can also learn to establish healthy boundaries so they can avoid inviting in toxicity in the future, and they can build the resilience needed to find genuine happiness again. 

1. Eye Movement Desensitization and Reprocessing (EMDR). This technique is used to engage both hemispheres of the brain at once to bring blocked trauma memories to the surface, reprocessing and reintegrating them. In doing so, this can lessen their impact and alleviate lingering psychosomatic symptoms.  

1. Somatic Therapy. Somatic therapy focuses on the connection between the mind and body, encouraging individuals through various techniques to release physical tension, discomfort and/or pain caused by trauma. 

1. Psychodynamic Therapy. Considered a deeper dive, this approach explores events that have occurred over one’s lifetime. These events may have led to core beliefs about self that make one especially vulnerable to toxic relationships. Reparenting one’s inner child is a common psychodynamic technique. 

There are many other approaches that can be used in the trauma healing process, and all of these can be used at once. It’s important to work alongside a professional and not attempt clinical interventions without therapeutic support.  

The Bottom Line 

It’s possible to heal sustainably in the aftermath of narcissistic abuse. Doing so takes a determination to reconstruct a healthy sense of self from the inside out. Engaging in self-care and reinviting in lost supports can help jumpstart the healing process, while working with a licensed therapist can further this journey substantially.  

If you believe you are in a relationship with a narcissist, reach out for help, and make leaving a priority. There is no time like the present, and taking yourself out of the equation can help you regain much-needed peace and happiness. 

If you believe you have narcissistic personality disorder, therapy is a safe space for self-exploration. Schedule an appointment today to begin your journey towards a deeper self-understanding. 

*The terms in quotes used here to describe aspects of narcissistic abuse are not clinical terms associated with NPD. However, they are frequently used in various media and it’s important for those who suspect they are being abused to familiarize themselves with these terms. 

From: Michelle Ilyayev, LMHC 

Whether you’re frustrated by a coworker, friend, or family member, narcissism is often thrown around as an explanation.

But it can do more harm than good to an argument, friendship, or working relationship if you don’t know what narcissistic personality disorder is and why it might not be the correct label.

Additionally, consistent overuse of the term trivializes the genuine pain a narcissist is experiencing deep down and detracts it from its authentic meaning. 

Because of this, it’s essential to clearly define what a narcissist is and the potential dangers of overusing the term. 

A RELATED GOODTHERAPY ARTICLE: Codependency and Narcissism

According to the DSM IV, narcissism is characterized by: 

• A need to get attention and admiration from others 

• Lack of empathy for others 
• Often having troubled relationships 
• Grandiose sense of self 
• Preoccupation with fantasies of unlimited success and power 
• A sense of entitlement 

• A strong belief that others are envious of them 
• Display of arrogant and egotistic behaviors or beliefs 

You might think that you know some people who display some of these narcissistic traits, but that doesn’t always make them a narcissist. 

5 things you need to know before calling someone a narcissist: 

1. Narcissism is a spectrum; it’s not an all-or-none characteristic. Many narcissists are higher on the spectrum than most people. So much so, it tips them over into an illness. 
2. Diagnosing people can be an effective way of helping someone and guiding them towards recovery. When done with integrity and in an appropriate setting, it helps a clinician determine which type of treatment is best suited for a patient. It’s also beneficial in communicating with other medical professionals about the course of treatment. However, it can also place people into boxes. 
3. Labeling someone as a narcissist, while sometimes useful to explain their behavior, makes it harder to see the real danger. Many people want to be validated in their belief that their abusive partner is a narcissist and that hearing the label will provide a sense of security. But whether or not the abusive partner fits the criteria, it’s important to note that narcissism is not the problem; the abuse is. Narcissism shouldn’t excuse someone’s harmful behaviors and actions. 
4. Individuals with narcissistic personality disorder need to be diagnosed by mental health professionals. A narcissistic personality disorder shouldn’t be taken lightly. It can be extremely harmful to the people around them; just because someone is toxic and irresponsible does not make them a narcissist. Giving a diagnosis to someone without training to do so in a professional setting is both irresponsible and bound to cause harm. 
5. NPD is widely misunderstood, so educating yourself and others about what narcissism means is essential. In other words, while it may be tempting to jump to labeling your ex or abusive parent as a narcissist, it may be worth considering that they may have an actual personality disorder and could benefit from treatment. 

A RELATED GOODTHERAPY ARTICLE: How a Person with Narcissism Responds to a Perceived Offense

References 

https://www.psychologytoday.com/us/blog/romance-redux/201504/why-we-need-stop-throwing-the-narcissist-label-around 

https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662 

 

by Allie Dainow, Registered Psychotherapist (Qualifying), in Toronto, ON, Canada

“That Never Happened” — Experiencing Gaslighting

What Is Gaslighting?

Gaslighting is when someone distorts reality, which has the intentional or unintentional effect of causing another person to doubt their own perceptions. It has become such a commonly used term that there are even songs about it. In the Chicks’ (formerly known as the Dixie Chicks) song titled “Gaslighter,” Natalie Maines sings about someone cheating on her and trying to convince her she was imagining it:

You just had to start a fire, had to start a fire
Couldn’t take yourself on a road a little higher
Had to burn it up, had to tear it down
Tried to say I’m crazy
Babe, we know I’m not crazy, that’s you
Gaslighting

The term first originated from the 1944 movie Gaslight (based on a play written in 1938), in which a husband tries to prevent his wife from realizing that he’s a criminal by altering her reality and trying to make her believe she is imagining what’s happening. The title itself specifically comes from a scene where he makes the gaslights in the attic flicker and, when she asks him why they’re flickering, he tells her that she’s hallucinating it.

Gaslighting is a very common behavior that is used in many different situations and relationships to gain power and control. It also occurs at a group level, often with women and other marginalized groups, whose experiences are frequently dismissed, seen as “crazy” and “too emotional,” and judged by double standards (Sweet, 2019).

Understanding Why People Gaslight

Healthy ways of dealing with negative behavior involve acknowledging it, reflecting on why it happened, and trying to learn from it. Gaslighting occurs when the person is aware, either consciously or unconsciously, that their behavior is inappropriate in some way, but they are unable to acknowledge this because they cannot handle the guilt and shame associated with it. It is very commonly used as a narcissistic defense, because narcissists attempt to compensate for a core of shame by presenting themselves to others (and often convincing themselves) that they are perfect. They cannot admit to negative behavior (even if it’s actually quite minor) because it’s too threatening to this image. Narcissists also become immune to this sense of shame by developing a sense of shamelessness, which allows them to engage in unethical and cruel behavior that others wouldn’t.

Strategies Used in Gaslighting

There are several common tactics that gaslighters use to manipulate others. They can have a preferred strategy that they use the majority of the time or cycle through several of them, especially if the first ones they use are not having the desired effect. These tactics include:

• Denial — Claiming that something that happened didn’t happen or that something that didn’t happen did.
• Distraction — Changing topics to something unrelated.
• Deflection —  Blaming the situation on someone other than themselves. There are several different ways they try to deflect, including:
  • Projection — Denying they behaved negatively and accusing someone else of the behavior they engaged in.
  • False equivalencies — Excusing their inappropriate behavior by comparing it to a minor mistake that the other person made and acting as though those actions are of the same severity, e.g., “Yes, I did that, but what you did was just as bad (or worse).”
  • Black and white standards —Emphasizing mistakes the other person made to make them believe they’re at fault. This is effective because the other person will almost always make some mistakes, since no one handles situations perfectly. This is different from false equivalencies because when using false equivalencies, the gaslighter will acknowledge mistakes on their part, but claim that other person’s were worse. With black and white standards, they will deny any wrongdoing on their part.
  • Bringing up past mistakes — Causing the other person to doubt themselves by bringing up previous incidents that are irrelevant to the current one where they did or remembered something incorrectly, e.g. “You know you have a problem remembering things.”
  • Claims of misinterpretations — Saying that they didn’t do anything wrong and the problem is that the other person misinterpreted or misunderstood what they said or did.
• Omitting context — Presenting the other person or their behavior as bad by neglecting to mention the context in which it occurred, which would make it understandable or reasonable.
• Overnormalizing — Insisting that their behavior is fine because “everyone” does it when in actuality most people would not behave this way.
• Comparing to extremes — Downplaying the severity of their actions and framing them as acceptable or even good by bringing up examples of worse behavior that they didn’t do e.g. “What I did wasn’t that bad.”
• Invalidation — Minimizing and trivializing your feelings and the effect that an experience had on someone else, e.g., “You’re oversensitive,” “This isn’t a big deal,” “You shouldn’t feel that way.”
• Non-apologies — Giving apologies that deny any responsibility and put the blame back on someone else, e.g., “I’m sorry you felt that way,” “I’m sorry that you saw it that way.”
• Guilting/shaming — Making it seem as though the other person is doing something wrong or is a bad person for standing up against mistreatment, e.g., “You’re making me feel bad by bringing this up,” “You’re so negative.”

The Experience of Being Gaslit

Gaslighting can feel very disorienting, almost like having whiplash. It often causes us to leave a situation completely confused, wondering what just happened or thinking that something was wrong, but not being able to pinpoint what it was. It can lead to intense rumination where you go back and analyze every detail of a situation to ensure that you’re not imagining it. It’s exhausting to do this and it’s scary to feel like you can’t trust your own perceptions. Once you start to uncover what really happened, it can be extremely upsetting, disturbing, and infuriating. Gaslighting, especially when experienced repeatedly, can cause adverse psychological effects, including chronic self-doubt, shame, isolation, depression, anxiety, impaired relationships, trauma, and physical symptoms related to stress (Christensen & Evans-Murray, 2021, Pietrangelo, 2019).

Responding to Gaslighting

Trying to have a conversation with someone who’s gaslighting you is incredibly difficult and draining. Here are some strategies for how to communicate with them:

• Redirection — If they’re trying to distract you by changing the topic, keep redirecting the conversation back to the situation at hand.
• “I” statements — This is an assertiveness skill where you communicate how their behavior affected you and set a boundary (“I felt ______ when you did ______ so I would like it if you did/didn’t ______”). This is meant to be a non-blaming way of communicating that focuses on your experiences, which can reduce denial and defensiveness from the other person.
• The broken record technique — This is also an assertiveness skill where you can repeat what you’re saying if you think the other person is not hearing you (Larsen & Jordan, 2017). In this case, if the gaslighter is claiming you’re wrong about the facts, you can repeat and assert the facts.
• Collaboration — Try to find common ground by talking to the other person about the shared goal or values you have and how you can go about achieving them. This can shift the conversation’s tone to cooperation, rather than antagonism.
• Walking away — Talking to someone who’s gaslighting can be like talking to a brick wall. No matter what you say or how much evidence you provide, nothing gets through to them, and sometimes it’s just not worth it to keep trying. You can let the person know that you don’t think this conversation is productive and you’re not going to continue it.

Recovering from Gaslighting

It is important to give yourself time to identify that you were gaslit and process what happened. You can use mindfulness strategies to detach from your thoughts and reduce the urge to ruminate about it until you’re ready to reflect on it or if the distress from this is interfering with other aspects of your life. These might include meditation or thought diffusion techniques from Acceptance and Commitment Therapy, such as saying to yourself “I’m having the thought that…” before a distressing thought in order to distance yourself from it (Harris, 2006).

In order to process the feelings that arise from being gaslit, we need to identify and validate them. We often invalidate ourselves and say that we shouldn’t feel a certain way or that our reactions don’t make sense, but when we try to understand why we might have reacted that way, we realize it makes sense and stop criticizing ourselves. In the case of gaslighting, it is an extremely unpleasant experience, and it makes sense that you would experience negative emotions in reaction to it. It’s very helpful to practice self-compassion, which involves noticing these difficult thoughts and feelings and being kind to yourself about them. Many people describe self-compassion by saying it’s like speaking to yourself the way you would to a good friend.

Sometimes knowing that you were gaslit can stop you from criticizing yourself, but other times this just makes us feel bad and blame ourselves for being manipulated. Unfortunately, gaslighting is a very common behavior because it’s effective. The very nature of gaslighting makes it so difficult to identify what’s happening because it disorients you and makes you even wonder if you’re being paranoid for questioning the gaslighting behavior. Many of us also want to give others the benefit of the doubt and think that perhaps we did misremember or misinterpret their behavior because it can be so difficult to accept that not only did the initial hurtful behavior happen, but that the gaslighting did as well. It’s important to be self-compassionate about the pain you have experienced from both. Try to remember that the problem isn’t you, it’s the person who did the gaslighting.

References

Christensen, M., & Evans‐Murray, A. (2021, May). Gaslighting in nursing academia: A new or established covert form of bullying? In Nursing Forum.

Harris, R. (2006). Embracing your demons: An overview of acceptance and commitment therapy. Psychotherapy in Australia, 12(4).

Larsen, K. L., & Jordan, S. S. (2017). Assertiveness training. Encyclopedia of Personality and Individual Differences, 1-4.

Pietrangelo, A. (2019, March 29). What are the short and long-term effects of emotional abuse? Healthline. https://www.healthline.com/health/mental-health/effects-of-emotional-abuse

Sweet, P. L. (2019). The sociology of gaslighting. American Sociological Review, 84(5), 851-875.

For those in or getting out of a romantic relationship with a self-absorbed individual, the silent treatment can feel like a punishment worse than death.

Why Narcissistic People Use the Silent Treatment

The silent treatment is a form of emotional abuse typically employed by people with narcissistic tendencies. It is designed to (1) place the abuser in a position of control; (2) silence the target’s attempts at assertion; (3) avoid conflict resolution/personal responsibility/compromise; or (4) punish the target for a perceived ego slight. Often, the result of the silent treatment is exactly what the person with narcissism wishes to create: a reaction from the target and a sense of control.

The target, who may possess high emotional intelligence, empathy, conflict-resolution skills, and the ability to compromise, may work diligently to respond to the deafening silence. He or she may frequently reach out to the narcissistic person via email, phone, or text to resolve greatly inflated misunderstandings, and is typically met with continued disdain, contempt, and silence. Essentially, the narcissistic person’s message is one of extreme disapproval to the degree that the silence renders the target so insignificant that he or she is ignored and becomes more or less nonexistent in the eyes of the narcissistic person.

[fat_widget_right]

Emotional Maturity of a Typical Narcissistic Person

The emotional maturity of a typical narcissistic person is akin to a 5-year-old child who pouts and refuses to play with a friend in the sandbox because the friend wants to share the pail and shovel. The 5-year-old refuses to talk with the friend and angrily storms off to play on the jungle gym with someone else. The bewildered child with the pail and shovel may feel confused, rejected, and may not understand why they can’t share. He or she just wanted to build a sand castle together.

Because no further communication can ensue unless and until the narcissistic person decides to give the target another chance, a false sense of control is nurtured. Often, the narcissistic person will demand that the target apologizes for whatever inflated transgression the target may have committed (the target may have set a limit or asserted a boundary against emotional abuse, for example). Sometimes, a person with narcissistic qualities will decide to abandon and discard the relationship when his or her partner presents an ultimatum or attempts resolution requiring compromise. The person with narcissism may prefer to end the relationship and start over rather than be in a position of potential abandonment. The 5-year-old storms off and plays with a new, innocent target on the swing set. It is too much work to share the pail and shovel.

How to Deal With the Silent Treatment

So how does one deal with the silent treatment from a person with narcissism? For those leaving a toxic relationship with such an individual, many therapists suggest that the survivor understands that the person with narcissism has not developed the ability to express a high level of empathy, reciprocity, and compromise. The silent treatment is a form of emotional abuse that no one deserves nor should tolerate. If an individual experiences this absence of communication, it is a sure sign that he or she needs to move on and heal.

The healing process can feel like mourning the loss of a relationship that did not really exist and was one-way in favor of the ego-massaging person with narcissism. The minute the partner disagrees with the narcissistic person or asserts his or her healthy boundaries, the narcissistic person deploys an arsenal of abuse tactics. The silent treatment is a favorite weapon.

Do not accept emotional abuse. Know that you are worthy of a healthy relationship with someone who can communicate in a mature, emotionally healthy manner. Play with someone who has the ability to share the shovel and pail. You deserve no less.

People with narcissistic personalities may often have disturbances in both their self-regard and in their connections with others. Some believe that the narcissistic personality is created in early life as a result of maladaptive attachment.

One school of thought is that narcissism is a result of arrested development, in which the person remains fixated at an infantile or very young age and only manifests in terms of their wants and needs. For example, an infant does not think about what their mother wants or needs; they are only concerned for themselves. Similarly to infants, narcissists tend not to be concerned with the other person’s feelings, only their own.

It has been theorized that those who are “pathologically narcissistic” (a normal level of narcissism is essential for healthy self-esteem) are not fully “fixated” in a phase of early childhood development–the “me” phase, or narcissistic phase of development–but have instead developed pathologically. This affects their inner working models for self-love and object-love (the love of others).

People with narcissistic personalities often do not present seriously disturbed behavior and may function quite well socially and vocationally.

Narcissism in the Context of Object Relations

Objects are attachment figures. In object relations theory, the object is the person one attaches to in early development, usually the mother or primary caregiver. As a person progresses in age, new objects come along and become attachment objects as well.

Object relationships are the relationships people form with significant others. The first significant other is often the mother. As a person is developing, they are learning mental representations of the following:

• The object as perceived by the self
• The self in relation to the object
• The relationship between the self and the other

These concepts set the stage for all of one’s future relationships, both with the self and others.

The Development of Narcissistic Defense Mechanisms

Narcissists tend to have one or both parents who are chronically cold and covertly aggressive. While they may appear superficially well-organized, they may have an underlying degree of callousness, indifference, and nonverbalized aggression when parenting (Kernberg, 1992).

Part of development involves differentiation of the self from the other, where normal reality testing should occur. When early attachment objects are inconsistent, abusive, or neglectful, the developing individual needs a psychological mechanism which allows them to escape the conflict between the need for the external object and the dread of it (Kernberg, 1992). Coping or defense mechanisms may then ensue.

People who have developed narcissistic personalities often do so because they have not been able to internalize a “good” object; rather, they have internalized a frightening one, one which they are unable to draw comfort from. Because of this, instead of attaching to others in a healthy manner, they utilize defensive coping mechanisms for relating. One of these is idealization:

These individuals identify themselves with their own ideal self-images in order to deny normal dependency on external objects and on the internalized representations of the external objects. It is as if they were saying, ‘I do not need to fear that I will be rejected for not living up to the ideal of myself which alone makes it possible for me to be loved by the ideal person I imagine would love me. That ideal person and my ideal image of that person and my real self are all one, and better than the ideal person whom I wanted to love me, so that I do not need anybody else anymore.’ —Otto F. Kernberg, MD, FAPA

In other words, the normal tension between actual self (developing child with unmet needs) and the actual parent (emotionally unavailable parent) on the one hand, and ideal self and ideal object on the other, is eliminated by the creation of a fantasy self-concept and fantasy other-concept within. Concurrently, the images of the “unacceptable” true self are repressed and then projected onto others.

Note: This is why people in relationships with narcissists are often devalued and discarded–they are receiving the narcissist’s projection of their true beliefs about self as well as the disappointment and anger of not really being an ideal or fantasy partner/child/object.

How Narcissists Relate to Self and Others

People with narcissistic personalities may find it difficult to internally grasp the basic concepts of healthy connection. They may not have experienced it in order to internalize it appropriately. Healthy relating and attunement might not have been sufficiently “mirrored” onto the developing child. Thus, the child has an attachment deficit.

Narcissists may be especially deficient in feeling deep emotions, such as longing and sadness, and in relationships with others, they may experience feelings of indifference. The deep emotions narcissists feel are most often those that relate to personal ego-injuries. In these cases, narcissists will feel the emotions of rage, envy, and resentment.

The types of primitive coping or defense mechanisms for relating to others include splitting (all bad/all good), denial, projection, grandiosity, and idealization.

In addition to this, those with narcissistic personalities will adapt themselves to the moral demands of their environment as a “payment” or “price to pay” in order to gain narcissistic supply, such as praise and admiration. Don’t be fooled. Narcissists only do that which brings them a payoff for self. They are not conforming to society’s norms for any other purpose. In fact, because of this narcissistic point of view, they may also believe others think the same way; hence, they project this viewpoint onto others, which is why they tend not to trust other people.

Narcissists are known to lack caring about the feelings of other people. They may see others as mere objects, put in place to meet their own needs. However, this can cause a problem for narcissists, because in order for them to benefit from the praise and admiration of others, those others must, on some level, have value.

In essence, a narcissist may see others in a sort of shadowy form, an idealized representation of the narcissist’s internal, idealized self. This creates a duality and dilemma for the narcissist, but it explains a lot about the targets of narcissistic abuse. They may have been both idealized and devalued when in a relationship with a narcissist, both projections of the narcissist’s self-loathing and of their self-aggrandizement.

References:

1. Kernberg, O. (1992). Borderline conditions and pathological narcissism. Northvale, New Jersey: Jason Aronson, Inc.
2. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: The Guilford Press.

It’s not uncommon to hear “narcissism” and “narcissist” used to casually describe people who:

• Seem vain and self-centered
• Seem to care only about themselves
• Demand attention, admiration, and respect
• Exaggerate achievements
• Manipulate others for their own purposes

While these traits are all associated with narcissistic personality disorder (NPD), people with just a few of these traits may not necessarily meet criteria for diagnosis. What’s more, other significant characteristics of narcissism are less recognizable, so they aren’t always associated with the condition.

It’s generally a good idea to avoid labeling people with mental health diagnoses when you don’t have a full picture of their mental health. In other words, someone’s diagnosis is typically between them and their therapist or psychologist, unless they choose to share that diagnosis. But it is true that people with traits of narcissism generally show a mask of superiority and arrogance to the world. They may seem full of themselves, demand appreciation from others, and appear to have high self-esteem. But an inner core of insecurity often lies behind this mask.

Narcissism and Insecurity

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people with NPD almost always have a fragile sense of self-esteem. Because of this, they spend a lot of time thinking about how others perceive them and how well they’re doing in life. This insecurity contributes to the continuous demand for admiration associated with NPD.

Many people with narcissism struggle with pervasive feelings of insecurity underneath the outward superiority and entitlement they present to the world.

Many people with narcissism struggle with pervasive feelings of insecurity underneath the outward superiority and entitlement they present to the world. But this experience may be most commonly associated with covert, or vulnerable narcissism. Many people with this subtype of narcissism do show outward signs of sensitivity to criticism and insecurity. This insecurity, often tied to the concept of being less than perfect, can contribute to mental health concerns such as stress, anxiety, or depression.

This insecurity can manifest as difficulty accepting criticism, or anything seen as criticism, since critiques can trigger feelings of vulnerability. Someone with narcissism may, for example, take constructive advice from a supervisor as a personal attack and react angrily. They might offer a reply laced with contempt or derision or they make a passive-aggressive or mocking comment. This reaction, lashing out in response to a slight, can humiliate or reject the person offering the critique. People with NPD generally do this to help relieve the potential threat to their self-esteem.

NPD is a complex personality disorder that involves feelings of insecurity, but insecurity is not only linked to narcissism. It’s not uncommon to feel insecure or struggle with moments (or longer periods) of low self-esteem, even if you have no mental health diagnosis at all. One way to differentiate narcissistic insecurity involves looking at the person’s response to perceived criticism or other threats. Responding with aggression, rage, or passive-aggression could suggest narcissism, though this isn’t a definitive diagnostic tool.

Narcissism, Insecurity, and Relationships

Maintaining a relationship with someone who has NPD can be difficult, especially without support from a mental health professional. Many people living with narcissistic traits may have had a parent with NPD, experienced insecure attachment as a child, or have other attachment issues. It’s also not uncommon for people living with NPD to experience depression, anxiety, and suicidal thoughts, or abuse substances. These can all cause relationship difficulties, though dealing with the main traits of narcissism may pose the greatest challenge.

People with narcissism generally need a lot of admiration and approval, since receiving this admiration may help combat the underlying insecurity. But because NPD typically involves a lack of empathy, they usually don’t offer much in the way of reciprocation. This is one key reason why people living with NPD are usually labeled “toxic.” They need their romantic partners to praise them, listen to them talk about their feelings and topics of personal interest, and demand devotion and regard. They might talk about their envy for others or project those feelings by talking about how others envy them.

This can be draining for romantic partners and family members of people with narcissism, particularly as people with NPD may also express insecurity by accusing partners of being unfaithful, not caring about them enough, or not doing enough for them. They might use emotional abuse tactics, including gaslighting, to try and control partners so they’ll remain in the relationship and continue offering admiration and regard.

These attitudes and attacks can cause a lot of emotional pain. They can also lead to feelings of insecurity in anyone involved with a person with NPD:

• Frequent negativity and derision can have a significant impact on self-esteem.
• Gaslighting can cause doubts about what’s really true and make the person affected feel as if they’re in the wrong.

Are ‘Narcissists’ Insecure?

Existing research on narcissism suggests people with NPD do tend to feel insecure, whether they display this insecurity outwardly or not. Insecurity may provoke many of the problematic behaviors associated with narcissism. Both a 2015 article looking at the diagnostic challenges of narcissism and a 2017 review examining the connection between narcissism and behavior on social network sites like Facebook suggest insecurity is more often seen in people with vulnerable narcissism, who might present as humble or reserved and tend to put themselves down.

Katherine Fabrizio MA, a licensed professional counselor in Raleigh, North Carolina, helps people who were raised by narcissistic parents heal. She explains, “At their core, the person with narcissistic personality disorder is deeply insecure. They feel unworthy, ashamed, and empty. They hide this emptiness from themselves and others with a set of defenses that act as a storefront. The cover-up story they tell themselves and others constitutes those defenses, which are designed to artificially fill them up—all while hiding the fact that they feel truly empty.”

It’s important to recognize that although people with narcissism may struggle with unwanted emotions and experiences that cause distress, these feelings don’t excuse their behavior. Insecurity can be hard to face, but it’s possible to work through this, along with any other emotional or mental health challenges like anxiety, without emotional abuse or other problematic behaviors.

If you often feel insecure, working with a therapist can help you overcome this mindset and develop a greater sense of personal empowerment. If you struggle to recognize or understand the feelings of others, or if you tend to lie or manipulate others to get your needs met, you may want to reach out to a therapist who can help you learn new ways of relating to others so you learn how to meet your own needs and support the people in your life.

Anxiety and insecurity can result from setting too-high standards for yourself or wanting to achieve things that aren’t realistic. But in either case, a therapist can help you recognize your capabilities and potential for success so you can set more achievable goals for yourself.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association.
2. Caligor, E., Levy, K. N., & Yeomans, F. E. (2015, April 30). Narcissistic personality disorder: Diagnostic and clinical challenges. The American Journal of Psychiatry, 172(5). Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14060723?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
3. Dickinson, K. A., & Pincus, A. L. (2003). Interpersonal analysis of grandiose and vulnerable narcissism. Journal of Personality Disorders, 17(3), 188-207. Retrieved from https://pdfs.semanticscholar.org/8db5/d181e5ec85fd61de162d3c43e70611eaf4a4.pdf
4. Gnambs, T., & Appel, M. (2017, February 7). Narcissism and social networking behavior: A meta-analysis. Journal of Personality, 86(2), 200-212. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/jopy.12305
5. Jauk, E., Weigle, E., Lehmann, K., Benedek, M., & Neubauer, A. C. (2017). The relationship between grandiose and vulnerable (hypersensitive) narcissism. Frontiers in Psychology, 8, 1600. doi: 10.3389/fpsyg.2017.01600
6. Narcissistic personality disorder treatment. (n.d.). Retrieved from https://www.bridgestorecovery.com/narcissistic-personality-disorder/narcissistic-personality-disorder-treatment

Even people without an extensive knowledge of mental health concerns have likely heard of narcissistic personality disorder (NPD), or narcissism, as it’s commonly called. The term “narcissist” is often used casually to refer to people who don’t necessarily have a diagnosis of narcissism if they appear to have some narcissistic traits, such as grandiose delusions, low empathy, arrogance, and a need for admiration.

Portrayals of characters with narcissism in movies and television have also increased the condition’s notoriety. While depicting characters with mental health issues in the media can help increase awareness, it can also create problems. In the case of narcissism, much of what’s seen in popular culture rests heavily on stereotypes associated with grandiose and malignant narcissism. If people with narcissism aren’t portrayed as outright villains, they’re typically portrayed as toxic or harmful individuals.

If you’ve had a close relationship with someone who has NPD, you might agree that many of these stereotyped traits have truth to them. Still, it’s important to recognize that NPD can occur in varying degrees of severity, occurs on a spectrum, and can present in different ways. As a result, you may not always recognize someone has narcissism, especially if they live with a less-known subtype such as covert (vulnerable) narcissism.

Covert narcissism is also known as shy, vulnerable, or closet narcissism.

Covert vs. Overt Narcissism

Covert narcissism is also known as shy, vulnerable, or closet narcissism. People with this subtype tend not to outwardly demonstrate arrogance or entitlement. Instead, they might put themselves down and seem anxious about what others think of them, rather than exuding charm or confidence. Other people may describe them as quiet and sensitive, especially to criticism.

Similarities between subtypes may become more evident with closer exploration of symptoms and feelings. People with overt narcissism generally seek attention outwardly and put themselves forward as superior. They might show patterns of exploitative or manipulative behavior that relate to a personal sense of entitlement and need for recognition.

Covert narcissism often involves a more internalized experience. People with these traits still feel unappreciated, need admiration, have contempt for those they consider inferior, and believe they should get special treatment. But instead of displaying outward grandiosity, they may privately fantasize about having their special qualities recognized or getting revenge on people they believe have slighted or wronged them in some way.

Signs of Covert Narcissism

Not every person with some or all of the listed traits will have any type of NPD, but the following characteristics may help identify covert narcissism in people who meet criteria for NPD.

• A reserved or self-effacing attitude
• Humility or a tendency to put themselves down
• Smugness or quiet superiority
• Passive-aggressive behavior
• Envy of others and/or feeling that they deserve what other people have
• A lack of empathy for the feelings or situations of other people
• A tendency to step in and help others out of a desire for recognition

Narcissistic traits usually show up in all of a person’s relationships and interactions, but they might manifest in slightly different ways depending on the situation.

• In parents: Parents may seem to prioritize their child’s needs and feelings and make sacrifices to ensure their child’s success. But these behaviors generally result from the desire to be the “best” or perfect parent and achieve recognition and admiration from others. Not receiving this recognition may lead to anger or self-pity. Parents with covert narcissism may also use guilt to manipulate children who attempt to claim some independence.
• In the workplace: People with covert narcissism may feel superior to coworkers or supervisors, believe they’re the most intelligent or best at what they do, and harbor fantasies of being elevated above others. They may envy peers who do receive recognition, believing others don’t understand or appreciate them. This may contribute to interpersonal difficulties or subtle bullying.
• Among friends: Friends may offer admiration and respect, and it’s common for people living with narcissism to manipulate others in order to get sympathy, support, or attention. People with narcissism don’t always completely lack empathy for the difficulties of others, but the empathy they can offer tends to be limited to what they’ve experienced themselves. They tend to feel neglected or rejected when they’re not getting the attention they feel they deserve, so they may try to bring every conversation back to them—but this may be done in less obvious ways.

Covert Narcissism and Relationships

Recognizing covert narcissism in a loved one may be more difficult than recognizing grandiose or malignant narcissism. Some people living with narcissism may function well in society and maintain romantic relationships without causing their partner distress. But it’s very common for partners of people with NPD, especially untreated NPD, to experience gaslighting, neglect, and manipulation.

Some common experiences include:

• Lack of empathy from your partner
• Passive-aggressive attempts to get your sympathy
• Dismissiveness or contempt from your partner
• Feeling controlled or belittled

Covert narcissism involves a high level of sensitivity, so your partner might take things you say as criticism, rejection, or personal attack. They might act as if you bore them and show disinterest in your emotions and experiences. It’s important to reach out to a therapist if you feel manipulated, neglected, or otherwise distressed as a result of your partner’s actions. Couples counseling may help in some instances, but it won’t work unless your partner wants to change. Individual therapy, however, can help you get support.

Covert Narcissism and Mental Health

According to 2015 research looking at the diagnostic and clinical challenges associated with narcissism, people often seek treatment for co-occurring mental health conditions rather than narcissism itself.

People with covert narcissism may be more likely to have anxiety or depression than people with other subtypes. Non-suicidal self-harm is also not uncommon, and people with covert narcissism often experience feelings of emptiness or low self-esteem that can contribute to suicidal ideation.

Treating narcissism can be difficult, since many people living with the condition never seek or want help. The stigma associated with narcissism can make it even more difficult to get help. Receiving messages like “narcissists are evil” and “narcissists can’t change” may discourage even those who do want to seek help from trying.

Like other personality disorders, narcissism involves a long-standing pattern of emotions and behavior that may not seem unusual to someone living with the condition. Because of this, people who have covert narcissism, or any NPD subtype, will probably seek treatment for a co-occurring mental health issue. A therapist who recognizes traits of narcissism may then be able to help a willing individual begin working to change problematic patterns of behavior.

Some therapies show particular promise in helping address NPD. Schema therapy and psychodynamic therapy are two approaches considered most helpful. Therapists who offer compassion, validation for negative emotional experiences, and empathy for distress may be able to help clients uncover reasons for their vulnerability and address problematic behaviors, which may lead to change. People with covert narcissism may do better in therapy than those with malignant narcissism, which is often characterized by manipulative and sadistic behavior.

It’s generally accepted in the mental health field that people who want to change can improve if they seek support and are willing to make an effort. If you’d like to seek support for yourself or a loved one, begin looking for a compassionate counselor at GoodTherapy today.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association.
2. Behary, W. T., & Dieckmann, E. (2011, July 20). Schema therapy for narcissism: The art of empathic confrontation, limit-setting, and leverage. In W. K. Campbell and J. D. Miller (Eds.), The handbook of narcissism and narcissistic personality disorder: Theoretical approaches, empirical findings, and treatments. Hoboken, NJ: John Wiley & Sons.
3. Caligor, E., Levy, K. N., & Yeomans, F. E. (2015, April 30). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5), 415-422. Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14060723?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
4. Dickinson, K. A., & Pincus, A. L. (2003). Interpersonal analysis of grandiose and vulnerable narcissism. Journal of Personality Diosrders, 17(3), 188-207. Retrieved from https://pdfs.semanticscholar.org/8db5/d181e5ec85fd61de162d3c43e70611eaf4a4.pdf
5. Jauk, E., Weigle, E., Lehmann, K., Benedek, M., & Neubauer A. C. (2017, September 13). The relationship between grandiose and vulnerable (hypersensitive) narcissism. Frontiers in Psychology, 8. doi: 10.3389/fpsyg.2017.01600
6. Luchner, A. F., Mirsalimi, H., Moser, C. J., & Jones, R. A. (2008). Maintaining boundaries in psychotherapy: Covert narcissistic personality characteristics and psychotherapists. Psychotherapy, 45(1), 1-14. doi: 10.1037/0033-3204.45.1.1
7. Mayo Clinic Staff. (2017, November 18). Narcissistic personality disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662
8. Poless, P. G., Torstveit, L., Lugo, R. G., Andreassen, M., & Sutterlin, S. (2018, March 12). Guilt and proneness to shame: Unethical behaviour in vulnerable and grandiose narcissism. European Journal of Psychology, 14(1), 28-43. doi: 10.5964/ejop.v14i1.1355

Narcissistic personality (NPD) and histrionic personality (HPD) are both cluster B personality disorders. These personality disorders are characterized by the following:

• Patterns of thinking and behavior that seem erratic or unpredictable
• Actions or thoughts that others consider dramatic
• Patterns of thinking and behavior that seem too emotional for a specific situation
• Behaviors are persistent and inflexible and lead to impairment and distress

Some mental health experts consider HPD and NPD the most similar of the four cluster B personality disorders. Similarities between these conditions may include attention-seeking behavior, flirtatiousness that’s often inappropriate, behavior that seems shallow or uncaring, and a need for approval and admiration from others.

Some researchers have even suggested HPD is a manifestation of NPD rather than a unique condition, but the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists HPD as a separate diagnosis. However, it’s possible to have both conditions, or any combination of personality disorders, and this may sometimes complicate diagnosis.

Some people believe those with personality disorders will never change their behavior. It’s true these behavior traits often respond less readily to therapy than symptoms of other mental health conditions, but treatment is still possible.

What’s the Difference Between Histrionic Personality Disorder and Narcissistic Personality Disorder?

These two conditions may present similarly, but they differ in several ways.

Prevalence

Estimates suggest HPD only occurs in about 1.8% of people, while NPD is more common. Diagnostic criteria can vary, and the actual prevalence isn’t known for certain, but recent estimates suggest about 5% of the general population could meet diagnostic criteria for NPD. Among people diagnosed with NPD, between 50 and 75% are men. Research suggests HPD is more commonly diagnosed in women.

Ability to Show Empathy

A main characteristic of NPD is a failure to show empathy for the feelings of others. Lack of empathy, however, is not a primary characteristic of histrionic personality. The behavior of people with HPD may seem shallow or self-centered at times.

One study from 2018 suggests people with any cluster B personality disorder may have a hard time identifying emotions—those of others as well as their own. Being unable to clearly recognize emotions can make it challenging to know when to offer compassion or support, which could seem like a lack of empathy.

Different Types of Attention-Seeking Behavior

Grandiosity, or feelings of superiority or exaggerated self-importance, is a primary feature of narcissism. This trait is not a significant feature of other personality disorders. People who have NPD think highly of themselves and their abilities and may, out of this superiority, tend to keep themselves apart from others in a group. People living with HPD, on the other hand, tend to want to belong and fit in.

This desire for belonging and approval marks another distinction between narcissistic and histrionic personality disorders. Both involve a deep-seated need for attention, and people living with either condition may manipulate others in order to get this attention. People with NPD don’t only need attention, however. They need admiration, praise, and recognition.

People with HPD may care less about the type of attention they receive and allow themselves to be seen in a vulnerable or even negative way, so long as attention is centered on them. They’re more likely to have a low sense of self-worth and seek approval from others to build up their self-esteem.

With HPD, efforts to get attention may seem excessively emotional or dramatic. People living with this condition may become upset easily and shift rapidly between moods. This extreme emotionality, a hallmark of histrionic personality, is less common with narcissism. People with narcissism usually show less emotion and tend to be more reserved and self-possessed.

Why Do These Differences Matter?

Narcissism and histrionic personality affect personal relationships and general well-being in different ways. Both issues are characterized by unstable or impaired personal relationships. People with HPD may struggle to be emotionally intimate with others, while people with NPD are more likely to cause significant emotional harm.

The words and actions of people with NPD are often hurtful since they generally have little regard for the feelings of others. In relationships, people with narcissism may require complete focus on their own needs and feelings. A partner who attempts to share feelings or get their own needs met will usually face emotional rejection or complete withdrawal. The person with narcissism may accuse the partner of being selfish or not caring for them enough.

Narcissism can make it difficult to do well in the workplace, as a fear of shame or failure can lead people with NPD to leave jobs when they face criticism. They also tend to react with outrage or disdain when facing embarrassment or criticism. Persistent feelings of shame can lead to withdrawal or depression. Other issues linked to narcissism include substance abuse and anorexia.

People with HPD may struggle in relationships for different reasons. A desire for gratification and excitement can lead to boredom in long-term relationships, and they may seek new partners frequently. Histrionic personality is also marked by a tendency to consider relationships more intimate than they actually are. Having to face the true nature of a relationship may lead to distress.

In relationships, people with HPD often depend very strongly on partners and may act in manipulative ways in order to get attention or comfort. However, people with HPD can and do show empathy and compassion for the needs and feelings of others. They may experience depression and feelings of emptiness when they lack attention or affection and make suicidal gestures or threats to increase the attention or care they receive.

Because people living with HPD often struggle with boredom, they may struggle to keep the same job and change positions or careers frequently. They may be more successful in jobs that are less routine and involve varying duties.

Somatic symptoms and conversion disorder both commonly occur with HPD. People living with the condition may seem to be in poor health or report a variety of health symptoms to get attention, but they may also truly experience the health symptoms.

Existing research on the two conditions suggests people with HPD are more likely to eventually get help, either for symptoms of depression or anxiety or when their behavior causes difficulties like friendship or relationship issues. Behaviors associated with histrionic personality are more likely to improve than those associated with narcissism.

Treatment for HPD and NPD

Personality disorders are diagnosed when behavior patterns are unyielding and persistent over a long period of time. Some people believe those with personality disorders will never change their behavior. It’s true these behavior traits often respond less readily to therapy than symptoms of other mental health conditions, but treatment is still possible.

For treatment to succeed, a person must be able to recognize harmful patterns of behavior and want to make changes. People with HPD and NPD often don’t feel they need treatment and may not seek therapy on their own. It may be particularly challenging for people with narcissism to understand how their actions harm others, so they may see nothing wrong with their behavior.

Research on treatment for narcissism is very limited since people with narcissism rarely seek treatment. When they do, therapy can help them realize how their behavior impacts others. Skills training can teach how to relate to people in positive ways and how to accept and cope with personal flaws, failures, and criticism from others. The root of NPD is often a deep sense of self-loathing and low self-esteem, so when therapy can address these concerns, some behaviors associated with narcissism may improve.

Schema therapy is one specific approach that has shown promise in treating narcissism. This approach helps people identify and address maladaptive schemas, or patterns, that affect their behavior. Through therapy, people may be able to heal these schemas and learn to get needs met in healthier ways that don’t cause harm.

Several approaches can have benefit in treating histrionic personality. Therapy often focuses on helping people develop self-esteem and learn to meet emotional needs in healthier ways.

Cognitive behavioral therapy may help people learn to challenge thoughts that lead them to desire attention and replace attention-seeking behaviors with other actions. Psychodynamic therapy can help people understand the reasons behind the interpersonal challenges they experience, which can help contribute to positive change. Family counseling may also help, since involving loved ones in counseling can help people realize the impact their behavior has on others. Skills training and group therapy helps people learn to relate to others who deal with similar challenges.

In some cases, couples counseling can help people with personality disorders address relationship issues. But keep in mind that narcissism in particular often involves patterns of deceit, manipulation, and emotional abuse, and many therapists don’t recommend relationship counseling for abusive relationships. It’s important to first address and change long-standing patterns of manipulation and other harmful behavior. Good progress in individual therapy could indicate relationship counseling may help in the future.

Therapy typically also addresses co-occuring issues, including depression, anxiety, or substance abuse. Some people might also have more than one personality disorder. If this is the case, a combination of therapy approaches may be most helpful. If it’s not possible to address all presenting concerns at the same time, therapy generally aims to treat the most serious or harmful issue first and then continues to help the person work through other challenges.

Getting Help

Traits of any personality disorder can lead to serious emotional distress and impact your life, relationships, and the people close to you. If you or a loved one have signs of any personality disorder, reach out to a qualified counselor today. Therapy is the best way to address symptoms and learn new methods of coping and behaving.

The stigma surrounding personality disorders can be discouraging. You may have heard that some therapists won’t work with people who are living with a personality disorder, particularly narcissistic personality disorder.

But contrary to what many people believe, personality disorders are treatable, and there are skilled therapists who can offer support. If you want to make changes in your life, begin your search for a trained, compassionate therapist at GoodTherapy.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association.
2. Behary, W. T., & Dieckmann, E. (2013). Schema therapy for pathological narcissism: The art of adaptive reparenting. In J. S. Ogrodniczuk (Ed.), Understanding and treating pathological narcissism (pp. 285-300). Washington, DC, US: American Psychological Association.
3. Caligor, E., Levy, K. N., & Yeomans, F. E. (2015, April 30). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5). Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14060723?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
4. Dieckmann, E., & Behary, W. (2015). Schema therapy: An approach for treating narcissistic personality disorder. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26327479
5. Ekselius, L. (2018). Personality disorder: A disease in disguise. Upsala Journal of Medical Sciences, 123(4). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327594
6. Histrionic personality disorder. (2018, January 23). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9743-histrionic-personality-disorder
7. Mayo Clinic Staff. (2016, September 23). Personality disorders. Retrieved from https://www.mayoclinic.org/diseases-conditions/personality-disorders/symptoms-causes/syc-20354463
8. Mayo Clinic Staff. (2017, November 18). Narcissistic personality disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662
9. Ritzl, A., Csukly, G., Balázs, K., & Égerházi, A. (2018, September 13). Facial emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders. Psychiatry Research, 270. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30248486
10. Teen drama vs. histrionic personality disorder. (2018, July 18). Newport Academy. Retrieved from https://www.newportacademy.com/resources/mental-health/histrionic-personality-disorder-in-teenagers

Narcissistic personality disorder (NPD), or narcissism, as it’s often called, is one of the cluster B personality disorders, or emotional/impulsive personality disorders.

Narcissism is one of the least studied personality disorders. Different subtypes of narcissism present with varying features, making diagnosis challenging. People with narcissism may also see no need for counseling and consider it pointless or beneath them. If they do begin therapy, they may react angrily when faced with challenges, try to manipulate their therapist, or find it hard to consider things from other perspectives. They often leave therapy early, especially if they don’t see any benefit in it.

Recent research aims to identify new therapy approaches that can help people living with personality disorders achieve lasting change. Schema therapy, one such treatment, is considered helpful for people who don’t respond well to other types of therapy. It’s proven effective in treating borderline personality, another condition long considered difficult to treat.

Research looking at schema therapy for narcissism is still in the early stages, but existing clinical data suggests it has promise.

People living with narcissism have a deep need for admiration and recognition and draw self-esteem from the praise and positive regard of others.

The Roots of Narcissism

Personality disorders are characterized by rigid, long-lasting patterns of behavior that affect life and relationships, causing distress and making it difficult to function. People living with personality disorders may not always recognize that some of their behaviors cause problems or affect others negatively.

Like other personality disorders, narcissism is a serious mental health issue. Many consider it more serious and harmful than most other personality disorders, since people with narcissism generally lack empathy and may not care about the effects of their actions.

The causes of narcissism aren’t fully understood. Some potential factors in development may include:

• Having a parent who is extremely adoring or overly critical, or a parent who switches between these modes
• Having a parent with narcissism
• Inheriting certain traits that increase risk for personality disorders
• Experiencing trauma, abuse, neglect, or indifferent parenting

People living with narcissism have a deep need for admiration and recognition and draw self-esteem from the praise and positive regard of others. Since connecting with people on an intimate level requires a level of vulnerability, people with narcissism may avoid meaningful relationships in order to protect their illusion of grandiosity and keep an unstable self-identity from being revealed.

Researchers have identified four main subtypes of NPD. It’s possible to have features of multiple subtypes or shift between subtypes at different points in life.

• Overt narcissism most often involves entitled, attention-seeking behavior. A primary feature is an exaggerated sense of self-importance. People with this subtype tend to be charming and arrogant and often exploit others. They may do fairly well in the workplace but struggle to get along with others or do tasks they consider demeaning or otherwise beneath them.
• Covert narcissism may include anxiety, significant emotional distress, and extreme sensitivity to criticism or perceived insults. This subtype is often characterized by shyness, even social isolation. People with covert narcissism tend to have an internal sense of superiority and fantasize about their talents being recognized while speaking modestly about themselves, even putting themselves down.
• High-functioning narcissism involves similar traits to overt narcissism, but people with this subtype can generally function well in society and may not appear to have a personality disorder. They are often able to adapt narcissistic traits such as charm and competitiveness in order to achieve success and may have relationships that are shallow but lasting. Criticism, perceived failure, or age-related challenges such as poor health or perceived loss of attractiveness may cause distress or crisis.
• Malignant narcissism, considered the most severe subtype, involves overt narcissism traits along with traits of antisocial personality and paranoia. People with this subtype may lie and manipulate others easily, behave in aggressive ways, enjoy intimidating others, and avoid any work or task unless it benefits them in some way. They often have no desire to change, so treatment may be very difficult.

Narcissism often involves symptoms that are less known than grandiosity and lack of empathy, including:

• Feelings of emptiness and boredom
• Low self-esteem and vulnerability
• Persistent irritable mood

Most people with narcissism struggle to maintain employment and personal relationships, changing partners readily when they don’t receive the admiration they need. It’s also common for people to fantasize about being recognized for their superiority and humiliating people who have “wronged” them.

When therapy can help address these concerns, particularly vulnerability and self-esteem, narcissistic behaviors may improve.

Schema Therapy: An Effective Treatment for Narcissistic Personality?

Even when people with narcissism do seek therapy, whether for distress related to narcissism or other mental health symptoms, treatment can be complicated. Believing a therapist has insulted them, failed to recognize their specialness, or isn’t skilled or reputable enough to treat them leads many people with narcissism to quit therapy early in treatment. Research suggests therapy progresses more slowly for people with narcissism, leading to slower improvement of symptoms.

Schema therapy, however, may have increased potential to treat NPD. Schema therapists offer support and validation while helping people work to understand and address the emotional mindsets causing problems in their life. For narcissism, this is often the persistent, private sense of inferiority and fear of failure.

Schema therapy combines elements of cognitive behavioral therapy, emotion-focused therapy, Gestalt therapy, and psychodynamic therapy, among others. The idea behind this approach is that schemas, or patterns of thought and behavior, develop as a result of unmet emotional needs and other early childhood experiences. These schemas are reinforced throughout life by challenges, abuse, trauma, and other negative or harmful experiences. Unless they’re addressed in positive ways, they contribute to the development of harmful or unhealthy methods of coping. These coping styles can affect behavior throughout life, often in ways that cause distress.

Schema therapists offer support and validation while helping people work to understand and address the emotional mindsets causing problems in their life.

The goal of the approach is to help people identify needs that weren’t met in childhood and learn how to get them met in healthy ways that don’t cause harm, either to themselves or to others. To help clients achieve this goal, schema therapists group schemas and coping responses into modes and use a range of strategies to address them, including roleplay, interpersonal techniques, and cognitive behavioral approaches. Therapists may set limits, as a parent would, within the bounds of the therapeutic relationship to help clients confront schemas.

The schema modes commonly associated with narcissism are:

• Detached Protector/Self-Soother: This avoidant mode involves behaviors that are soothing, stimulating, or distracting—anything that helps turn off emotions. These behaviors might include substance abuse, risky sex, gambling, fantasizing, or overwork. It’s also common to shut out or reject people as well as emotions. Typical function isn’t always affected, but it may seem almost mechanical and lack any personal investment.
• Self-Aggrandizer: A mode in the overcompensation category, this involves many behaviors typically associated with narcissism—superiority, entitlement, and manipulative tactics. People in this mode tend to show little interest in anyone but themselves, boast of real or inflated achievements, and openly seek admiration to avoid revealing hidden vulnerabilities and insecurities.

By confronting these modes and working through them with the help of the schema therapist, people in therapy can begin to access the Healthy Adult mode, which helps heal the vulnerabilities of early childhood and fosters healthier modes of coping. After reaching this mode, people may be able to begin functioning at a more typical level and be more able to take responsibility for their actions and see how they affect others.

Schema therapy has been successful in the treatment of other personality disorders, including borderline personality. Clinical trials on its use with narcissism are still forthcoming, but research and clinical observations suggest schema therapy could help people with narcissism have more success in treatment.

Why Do Narcissists Seek Therapy?

People living with NPD often believe themselves superior and struggle to consider the feelings and needs of others. This can make their actions particularly hurtful. Narcissism also often involves intentional manipulation or emotional abuse—behaviors that cause significant pain to partners of people with narcissism. In fact, many therapists specialize in helping the partners of people with narcissism heal.

The typical traits linked to narcissism, along with the tendency of many with NPD to see nothing wrong with their behavior, have contributed to the belief that therapy can’t treat narcissism. But therapy can help people with narcissism improve—if they want to change.

Andrea Schneider, LCSW, a therapist in San Dimas, California, explains what might prompt a person with NPD to seek counseling. “Typically,” she says, “Someone … with narcissistic personality may have some flexibility with some behavioral change when they are confronted with significant stressors (like a relationship ending or other crisis).”

People with NPD may not ever seek therapy for symptoms associated with narcissism. Instead, they might decide to get help for other symptoms or issues. These could be co-occurring conditions or long-term mental health effects associated with narcissism. In many cases, it’s these challenges that contribute to the desire for change.

People with narcissism may seek help for:

• Substance abuse or addiction
• Somatic symptoms
• Health issues
• Anorexia nervosa
• Depression or anxiety (may relate to the failure of others to see them as important or superior)
• Workplace or school challenges
• Relationship or parenting challenges (often seeking therapy at the urging of a partner)

Narcissistic personality and associated conditions can significantly impact quality of life and emotional well-being. Addiction and stress can cause health concerns, for example, while the inability to sustain a relationship could lead to complete isolation.

To date, few studies have looked at treatment for narcissism because people with NPD don’t seek therapy often. If they do, they may only do so because someone else has urged them into it. Therapy can still have benefit, but the person with narcissism must recognize the problems with their behavior and make efforts toward change.

Finding a Schema Therapist

People who don’t see a need to address their behavior are unlikely to be able to make lasting change. But research on schema therapy suggests the approach could benefit people living with narcissism when other types of therapy don’t help. Experts do agree that narcissism often poses treatment challenges for therapists and can make progress in therapy difficult.

Schema therapy involves validation and empathy for a person’s difficulties and distress. When people with narcissism approach therapy with a willingness to change, or at least to make an effort to address harmful behaviors, the mode work involved in schema therapy may help them learn to confront the vulnerabilities they fear in a healthier way.

It can be difficult to find a schema therapist, especially if you live in a smaller city. But many therapists may be trained to incorporate elements of schema therapy into treatment. If you or a loved one has symptoms of narcissistic personality disorder, consider reaching out to a therapist who offers schema therapy or practices mode work. Don’t be discouraged by the myths about narcissism—change is possible for anyone. Begin your search for a trained, compassionate counselor today.

Author’s Note: If you’re involved in a relationship where there is intimate partner abuse of any kind—physical, emotional, or sexual—relationship therapy is usually not recommended. We encourage you to review our crisis page and reach out for support.

References:

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association.
2. Behary, W. T., & Dieckmann, E. (2011, July 20). Schema therapy for narcissism: The art of empathic confrontation, limit-setting, and leverage. In W. K. Campbell and J. D. Miller (Eds.), The handbook of narcissism and narcissistic personality disorder: Theoretical approaches, empirical findings, and treatments. Hoboken, NJ: John Wiley & Sons.
3. Behary, W. T., & Dieckmann, E. (2013). Schema therapy for pathological narcissism: The art of adaptive reparenting. In J. S. Ogrodniczuk (Ed.), Understanding and treating pathological narcissism (pp. 285-300). Washington, DC, US: American Psychological Association.
4. Caligor, E., Levy, K. N., & Yeomans, F. E. (2015, April 30). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5). Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14060723?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
5. Dieckmann, E., & Behary, W. (2015). Schema therapy: An approach for treating narcissistic personality disorder. Fortschritte der Neurologie-Psychiatrie, 83(8), 463-477. doi: 10.1055/s-0035-1553484
6. Ekselius, L. (2018). Personality disorder: A disease in disguise. Upsala Journal of Medical Sciences, 123(4), 194-204. doi: 10.1080/03009734.2018.1526235
7. Mayo Clinic Staff. (2017, November 18). Narcissistic personality disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662
8. Ritzl, A., Csukly, G., Balázs, K., & Égerházi, A. (2018, September 13). Facial emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders. Psychiatry Research, 270, 154-159. doi: 10.1016/j.psychres.2018.09.017
9. Young, J., & First, M. (2003). Schema mode listing. Retrieved from http://www.schematherapy.com/id72.htm
10. Young, J., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. New York City, NY: Guildford Press. Retrieved from https://www.guilford.com/excerpts/young.pdf?t