Key Points

Pathological narcissism is a trait defined by its expression in maladaptive interpersonal relationships.

New research on personality disorders reveals the core conflict-filled themes that characterize relationships with pathological narcissists.

By understanding the core areas of conflict in pathological narcissists, you can help them develop healthier close relationships.

When you think about the core traits of narcissism, the two that might come to mind first are grandiosity and a need for attention. Perhaps less obvious is a sense of vulnerability, which is also part of the theoretical foundation of narcissism, which may fuel an inflated desire for recognition. As a personality trait, the quality of narcissism is one of many dimensions within personality along which people vary. However, as a personality disorder, narcissism reaches maladaptive dimensions, causing people who fit its diagnostic criteria to experience a range of symptoms that interfere with their daily lives.

Individuals with high levels of narcissism, as well as those with narcissistic personality disorder, do not live in a vacuum. The term “pathological narcissism” captures the relational aspects of narcissism. As David Kelly and colleagues from the University of British Columbia (2022) note, in pathological narcissism, an individual’s anger at not being liked enough by others—combined with a deep-seated sense of inadequacy—can lead them to become controlling, quarrelsome, and vindictive. Defining pathological narcissism as “a dysfunctional personality style that involves impaired adaptive regulation of a relatively positive self-image,” Canadian researchers suggest that it is linked to a whole range of maladaptive responses from “self-concealment to admiration-seeking and humiliation.”

If you’ve been in a relationship with someone with pathological narcissism, or even if you have one in your family, you know how difficult it can be to keep your balance. One day they may be belittling and demeaning you, but at other times they may be seeking to include you in their grandiose vision of themselves and your relationship. They may demand your attention, putting your needs second while insisting that their own needs be met as quickly as possible.

What Happens in a Relationship with Someone with Pathological Narcissism

The idea that pathological narcissism has a detrimental effect on others is what led Nicholas Day and colleagues from the University of Wollongong (2022) to investigate the specific ways in which relationships are affected by this personality type. The Australian team used the idea of ​​‘core conflictual relationship themes (CCRT)’ as a framework. These can be found in the ‘specific relationship narratives’ that people construct to describe the distinctive ways in which people interact in a relationship as well as the ‘desired outcomes of interactions’.

You can get a better idea of ​​what CCRT is like if you put yourself in the shoes of someone (perhaps yourself) who has a family member who is high in pathological narcissism, and you are asked to talk about a specific incident with that person. Your CCRT with that person will emerge as you recount the details of the incident starting with where and when it happened, who said or did what, and the outcome. What event comes to mind? Maybe it was the time when your relative asked you for a favor, such as making an entree for a special occasion. You fulfilled your part of the deal, and while everyone was gorging on your delicious dish, that family member got angry because you received too many compliments.

Relationship Topics in Pathological Narcissism

Participants in Day et al.’s study were 15 adults (mean age: 53) who reported 15 relatives (mean age: 55), and although the majority of participants were female (93%), the majority of relatives were male (73%). Most participants reported their spouses (33%) or ex-spouses (40%).

Related : When a Narcissistic Parent Goes Too Far

Day and colleagues used an approach called the Relational Narrative Paradigm (RAP) in which they asked participants to produce a set of narratives about their relatives. These narratives could be analyzed for the CCRT. Their focus, then, was on those in relationships with pathological narcissists, not the pathological narcissists themselves.

After completing a measure of pathological narcissism in which they answered in terms of “my relative,” participants then went on to complete RAPs for five separate incidents with that person, and five separate incidents with someone who was not their relative (for example, a coworker). The research team then analyzed the resulting 133 narratives in terms of three categories of specific units: desires, responses from others, and responses from the self. Each unit was in turn categorized as congruent or incongruent.

For example, the authors provide the following narrative:

I had dinner with my friend, and my relative called me nonstop during dinner, so I had to apologize constantly. I felt embarrassed and didn’t try to visit friends afterward.

In this example, the desire was to enjoy time with a friend, and the other’s response was discordant (being pressured by the relative), as was the self’s response (feeling embarrassed, avoiding friends).

Moving on to the results, the main findings involved comparisons between study participants with relatives and non-relatives. In general, relationships with relatives were rated as more discordant than relationships with non-relatives. In specific domains, the most discordant of these reactions included the five reactions from the other: unreliability, rejection, submission, annoyance, or attack. For their part, participants described interactions as least discordant in terms of rejection and withdrawal. In other words, pathological narcissists themselves behave in ways that lead to discord on the part of their closest relationship partners, who in turn react by withdrawing as much as possible.

These accounts, then, describe a frustrating perspective on what it might be like to be close to someone with pathological narcissism. As the authors concluded, “narratives with relatives with pathological narcissism involved escalating conflicts in the relationships, with both participants and relatives becoming increasingly conflicted and disconnected, and relationship desires to remain unfulfilled.” In contrast, relationships with non-relatives also had high levels of disharmony but were equally likely to involve harmony, and conflicts were resolved satisfactorily.

What This Means for the Pathological Narcissists in Your Life

The CCRT results may not surprise you, but they can still give you insight into the specifics of how relationships with pathological narcissists close to you go wrong. As the authors suggest, knowing that you’re more likely to react with rejection and withdrawal from someone close to you (compared to someone who isn’t close) can help you examine ways you might work to counteract these effects in real-time. You shouldn’t feel “bad” or “wrong” for feeling the way you do, the Australian researchers point out, but you can see how the reactions these individuals trigger can become, in their words, “a tragedy.”

In short, knowing that relationships with pathological narcissists are difficult may not make those relationships any easier, especially if these individuals aren’t engaged in therapy and therefore aren’t getting help from a more objective source. However, knowing what reactions they trigger in you may help you transform those “rejection and withdrawal” patterns into ones that might one day produce healthier, more fulfilling interactions.