What Is Narcissistic Personality Disorder And How Can It Be Treated?

By: Sarah Fader

Updated May 04, 2021

Medically Reviewed By: Whitney White, MS. CMHC, NCC., LPC

We've probably all heard the word 'narcissist' and maybe we've even used it to describe someone that we know or that we meet but, just like with other personality disorders, the truth is something a little different from what most of us probably think. A narcissist isn't just someone who thinks about themselves, it is someone who has an extremely inflated view of themselves and a very strong need for others to accept and admire them. It's a disorder of contradictions.


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What is Narcissistic Personality Disorder (NPD)?

Someone with a narcissistic personality disorder tends to be extremely focused on their own importance. Where most people think of themselves as pretty important, a narcissist believes this to an even stronger degree. In fact, they believe it so strongly that they have little empathy or care for others because they believe those others are there only to make their life better or easier. At the same time, however, they have a very fragile sense of self-esteem which makes them crave admiration and attention from others and crumble at the first sign of criticism.

Symptoms of Narcissistic Personality Disorder

The only reliable means of diagnosis is through evaluation and assessment performed by a mental health professional, but knowing symptoms can help you consider if you or someone you know may be in need of help. Keep in mind that not all of these symptoms need to be present, and usually even just a few require some type of intervention from a licensed mental health professional. 

  • Overly exaggerated sense of self-worth and importance
  • Exaggerates their own achievements and talents
  • Expects recognition and treatment as a superior, even when it is not warranted
  • Belief in extreme superiority over others
  • Wants and needs admiration and praise constantly
  • Feels entitled to anything and everything they want when they want it
  • Takes advantage of other people to get what they want
  • Ignores or does not recognize needs or feelings of other people
  • Believes they are above the average person and can't be understood by them
  • Feels extremely envious of others
  • Believes self to be the subject of the envy of others
  • Acts arrogant or haughty towards other people
  • Requires the best of everything, even when it doesn't matter
  • Underneath the cover they are insecure, vulnerable, and easily humiliated
  • Belittles others to make self feel more important
  • Obsessed with achieving power and recognition
  • Reacts poorly to any sign of criticism
  • Tends to monopolize any conversation


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Arrogant or Narcissistic?

When is a person just arrogant and when have they crossed the line to be a narcissistic person? Well, usually it happens when they cross from having confidence in themselves to believing that they are more important than others. An arrogant person may have a little bit of an inflated sense of self-worth, but they generally acknowledge others for their actions (however grudgingly). They may also have difficulty with criticism, but they can recognize (and sometimes attempt to exploit) the feelings or needs of others.

In general, an arrogant person doesn't have a mental disorder and has cultivated their sense of superiority as a result of their achievements. A narcissistic person has an innate sense of their superiority that even they may not be able to fully explain, for them this is a simple fact and those that disagree are frequently viewed as being at fault for this. Narcissistic personality disorder, like other personality disorders, is thought to develop due to a mix of environmental and biological factors, or both nature and nurture. Specifically, early rejection during childhood is linked with development of narcissistic personality traits.


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How NPD is Diagnosed

Like other personality disorders, NPD is assessed through clinical interviews and formal assessments administered by a licensed mental health professional. A family history will be collected, and the patient will likely be referred for a medical evaluation to rule out underlying medical issues that may be resulting in certain behaviors. Formal diagnosis of this disorder is relatively rare, as very few people with NPD will report for treatment of the disorder.

The Treatment Process

Treatment will include psychotherapy, such as cognitive behavior therapy, that helps to uncover underlying beliefs that support the behaviors, thoughts, and feelings found to be upsetting to daily life with NPD. Therapy will also help provide support for a person in repairing and building relationships with loved ones, which are often damaged by the traits of NPD.

Medication can be a great way to help with the treatment process as well. It doesn't actually treat the disorder itself, but it is extremely effective at treating some of the underlying conditions that can make the problem worse. For example, medications are effective at treating depression and anxiety, which definitely go along with narcissistic personality disorder. It is important to look at all of your options for treatment and work out a path that works for you with your doctor.


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The Future with Narcissistic Personality Disorder

Just like other personality disorders, it's difficult to truly overcome the disorder. You won't ever 'cure' yourself of it because it's actually an innate part of you, but you can definitely succeed in treatment where you are able to live a healthy and productive life. The most important thing is to always be conscious of what's going on in your life and in your mind.


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BetterHelp is one way that you can seek treatment. With therapists at BetterHelp, you can be connected with licensed and professional counselors or psychologists who are able to help you begin learning skills needed to cope with NPD. BetterHelp allows you to get treatment in the privacy of your own home and from your favorite device via text, call, or video chat. There's nothing more important than your long-term health and wellbeing, and you can get started on it today privately and conveniently.

Online counseling can help narcissists with various aspects of NPD. According to the Mayo Clinic, talk therapy can help individuals with NPD learn to relate better with others, understand personal emotions, drives, and self-esteem related issues, better tolerate criticisms/failures, regulate feelings, and set attainable goals, just to name a few. A licensed professional will be familiar with NPD and can provide insight and guidance that you will be able to relate back to your life. They may be able to help you recognize patterns impacting your life and/or interpersonal relationships, as well as help develop skills and strategies to refine skills in these areas.

Online counseling is a highly accessible way to connect with someone that can shed light on NPD and is well equipped to help, especially if you think it may be creating challenges within your life. You’ll be able to talk to a licensed mental health professional via telephone, videoconferencing, messages, chat, or text, from anywhere those types of connections are available. In addition, it’s typically more affordable than traditional face-to-face sessions.

Following are user testimonials; read what others have to say about our counselors and get started on your own personal journey today.

“Jeffrey Owen has a wealth of knowledge and experience. He is clearly skilled in his guidance, enabling me to understand the complexities of narcissism and the impact of such lifelong abuse; that I had not fully understood. Reading on the subject matter is useful, but having counseling to explore in a different way is empowering for a survivor like myself. So thank you Jeff.”

“Busola is amazing, I've only had a few sessions with her but she makes me feel listened to. She understands what my primary needs are for each session and addresses them. Moreover, it doesn't feel like just time to talk and unload everything on someone, but she addresses negative behavioral patterns and helps create an action plan for them.”


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