Do Narcissistic People Know They Are Narcissistic? Seeking Help For Narcissism

When someone you know or love exhibits narcissistic behaviors, it may seem obvious to you that they are a narcissist. However, you may wonder whether they’re cognizant of these traits within themselves. People with narcissistic personality disorder (NPD) may not always be self-aware, so they may not realize that anything needs to be addressed. Their heightened sense of self-importance may prevent them from seeking help. Whether you believe you may be living with NPD or know someone who seems to exhibit narcissistic traits, online therapy can be an excellent resource and source of support.

Please note that the use of the words “narcissist” and “narcissism” in this article refers to individuals living with narcissistic personality disorder.

Signs of narcissism

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), narcissistic personality disorder is typically characterized by long-term patterns of abnormal behavior stemming from exaggerated feelings of self-importance, an excessive need for admiration, and a lack of empathy. 

These traits can cause individuals with this disorder to take advantage of the people around them. Despite the common belief that people with NPD have enormous self-esteem, these individuals may feel insecure and empty inside due to an inability to relate to others and a lack of genuine self-worth.

Some traits that people with NPD typically exhibit may include the following:

• An excessive need for admiration from others
• An enormous sense of self-importance
• Continual thoughts about being more powerful, successful, attractive, intelligent, or loved than other people
• A sense of entitlement
• A willingness to take advantage of others to achieve their own goals
• An arrogant attitude toward others
• A lack of understanding or consideration toward other people’s feelings or needs
• A sense of superiority and a tendency to only want to associate with high-status individuals

Some associated features of NPD can include behaviors like monopolizing conversations, becoming disdainful when others speak about themselves, and becoming disproportionately angry if they are corrected or called out on maladaptive behavior. 

Many narcissists view hurt feelings in others as a sign of weakness and may treat them with contempt as a result. They may attempt to control others and insult or blame them if their own ego is wounded. 

Risk factors for narcissism

Signs of narcissism typically show up by early adulthood and may affect up to 5% of the population. Though there may be no agreed-upon cause of NPD, research suggests that it may result from a combination of the following factors: 

• Dysfunction in early relationships with parents, family members, or other loved ones
• Genetics
• Childhood traumas, like physical, verbal, or sexual abuse*
• Sensory sensitivity (such as sensitivity to light, noise, or textures) in childhood
• Predisposed personality or temperament

NPD is often comorbid (occurs at the same time) with other mental disorders. A narcissist’s life may include bouts of depression, and they may also live with bipolar disorder, substance use disorder, or other personality disorders, such as borderline, histrionic, antisocial, and paranoid personality disorders. 

If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.

Diagnosing narcissism

The challenge in helping someone with NPD is often getting the individual to admit they could benefit from help. Because of the narcissist’s potentially fragile ego and intense avoidance of criticism, it can be difficult for them to admit that there may be a need for help. 

Treatment can be possible for people with NPD if they recognize that they can benefit from it. Mental health professionals commonly employ a combination of medications and long-term therapy for treatment. Never start or stop any form of medication unless under the guidance of a licensed medical professional.

Therapy for narcissism

Therapy can help people with NPD learn positive strategies for relating to others. With the guidance of a licensed therapist, they can work on developing a healthier sense of self-esteem, learning to have more realistic expectations of others, cultivating self-awareness, and developing coping mechanisms to manage depression or anxiety symptoms.

A friend or family member of someone with NPD may also benefit from therapy, even if they are otherwise healthy. This can be especially true for those who have experienced abuse from an individual with NPD. 

Often, those in a relationship with a narcissist have been a source of narcissistic supply, a term that generally refers to the attention required by the person with NPD. Being a source of this supply can be emotionally exhausting and can be seen as a form of payment that the person with this disorder requires for you to be in a relationship with them. 

Talk therapy can help an individual connected to someone with NPD by teaching them more about the disorder and how to interact with someone who has NPD, potentially guiding them toward more effective ways to communicate and offering strategies for setting boundaries to protect their mental health. 

When exploring therapy for NPD, it may be advisable to try online therapy. Since care can be administered via the Internet, online therapy may offer easier and more convenient access to mental health care. With online therapy platforms, you can be matched with a therapist by filling out a simple online questionnaire. You may then participate in sessions over video conference, personal message, or phone from the comfort of your home or office. This can be a helpful option for both those with NPD and their loved ones.

While there is no research that shows how online therapy is effective specifically for people with narcissistic personality disorder or people affected by a narcissistic person, studies do show that online therapy may be effective in treating personality disorders. A review of 11 randomized clinical trials explores preliminary research on the effects of internet-based therapy in treating symptoms of borderline personality disorder and personality disorder. Of the 11 studies, 45% of the studies showed a reduction in symptoms. These results suggest that, while further research is needed, internet-based therapy may be an effective treatment option for personality disorders.