Last winter, a friend told me she was considering divorce. “I really think my husband is a narcissist,” she said. Recently, over brunch, an acquaintance explained his family dynamics to me: “My aunt is so narcissistic, we don’t know why my uncle is with her.”

The term narcissist has been widely used to describe not just a group of difficult relatives and regrettable exes, but also presidential candidates and the entire generation known as millennials. Is narcissism really widespread or on the rise in the general population?

A growing consensus among psychologists says no, it’s not. True pathological narcissism has always been rare and remains so: It affects an estimated 1 percent of the population, and its prevalence hasn’t changed significantly since doctors began measuring it. Most (but not all) of today’s supposed narcissists are innocent victims of an overused label. They’re normal people with healthy egos who may even come across as taking the occasional selfie and talking about their accomplishments. They can be a bit vain. But while we diagnose friends, relatives, and our children’s classmates, true pathological narcissists may avoid detection because most of us don’t understand the many forms the condition can take.

WhatNarcissismIs(AndIsn’t)

Narcissism is a trait that all of us exhibit to a greater or lesser degree. However, because it has become such an undesirable trait, it has become necessary to add the qualifier “healthy” to define the socially acceptable type of narcissism. “It’s the ability to see ourselves and others through rose-colored glasses,” says psychologist Craig Malkin, a lecturer at Harvard Medical School and author of Rethinking Narcissism . This can be helpful, because it’s useful for all of us to feel a little special. Feeling special fuels the confidence that allows us to take risks, like seeking a promotion or asking an attractive stranger out. But feeling too special can cause problems.

The Narcissistic Personality Test is the most widely used measure of this trait. Developed by Robert Raskin and Calvin S. Hall in 1979, it asks an individual to choose between pairs of statements that assess levels of modesty, assertiveness, tendency to lead, and willingness to manipulate others. Scores range from 0 to 40, with the average tending to drop in early to mid-teens, depending on the group being tested. Those whose scores are reasonably high above those of their peers can be called narcissists. But a score anywhere along the broad range of the scale may still indicate a fundamentally healthy personality.

A diagnosis of pathological narcissism—a mental health disorder—involves different criteria. “Narcissistic personality disorder is an extreme manifestation of this trait,” says developmental psychologist Eddie Brummelman, a fellow at Stanford University. The disorder can only be diagnosed by a mental health professional and is suspected when a person’s narcissistic traits interfere with their daily functioning. The disorder may be related to identity or self-direction or cause friction in relationships due to problems with empathy and intimacy. It may also arise from pathological hostility characterized by grandiosity and attention-seeking.

“Narcissism is a continuum, and the disorder is at the end of it,” says Brummelman. The NPI can detect a person’s level of narcissism, but additional real-world influences are needed to diagnose narcissistic personality disorder.

“Personality disorder is a pervasive disturbance in a person’s ability to manage their emotions, maintain a stable sense of self and identity, and maintain healthy relationships in work, friendship, and love,” says Malkin. “It’s a matter of rigidity.”

A person who scores high on the Narcissistic Personality Test may indeed experience awkward or stressful social interactions from time to time, but for someone with NPD, Malkin says, “all the psychological defenses are at work against healthy functioning” all the time.

The Many Faces of Narcissism

Popular culture has long relied on narcissistic traits to portray problematic characters, from Dorian Gray to Don Draper. Gaston from Disney’s Beauty and the Beast provides a ridiculous but somewhat apt model of grandiosity, perhaps the most well-known trait of people with and without Narcissistic Personality Disorder. The braggart sings, “As a specimen, yes, I’m scary! … As you can see, I’ve got extra biceps! … I’m especially good at spitting! … And every last inch of my body is covered in hair.” Other narcissists may see themselves as in the top 0.1% in terms of talent, looks, success, or all of the above.

But it’s a mistake to assume that all narcissists will be these obvious arrogant types. “Not all narcissists care about looks, fame, or money,” Malkin says. “If you focus too much on the stereotype, you’ll miss warning signs that have nothing to do with vanity or greed.”

For example, he suggests that some narcissists may be “communal” types and devote their lives to helping others. They may even agree with statements like “I’m the most helpful person I know,” or “I’ll be known for the good deeds I do.” “Everyone has met great altruistic martyrs who have sacrificed themselves to the point where you can’t stand being in the room with them,” Malkin says.

Some narcissists are extremely introverted, or “vulnerable.” These individuals feel they are more sensitive than others. They react poorly to even gentle criticism and need constant reassurance. The way they feel special can be negative: They may see themselves as the ugliest person at the party or feel like an unfathomable genius in a world that refuses to acknowledge their talents.

What all subtypes of narcissists have in common, Malkin says, is “self-improvement.” Their thoughts, behaviors, and statements set them apart from others, and this sense of specialness is soothing to them since they otherwise struggle with an unstable sense of self.

“Narcissists feel superior to others, but they’re not necessarily satisfied with themselves as a person,” says Brummelman.

Link to Depression

This conflict is at the heart of a new concept of narcissism, one that focuses as much on depression as it does on grandiosity. “What people assume is that narcissists are prone to higher highs and lower lows,” says Seth Rosenthal, a research specialist at Yale University’s Program on Climate Change Communication, who conducted his doctoral research on narcissism. “They have this constant need to have their grandiosity validated by the world around them. When reality catches up to them, they may react with depression.”

When a clear setback, such as a job loss, divorce, or even a plan being thwarted, dents a narcissist’s carefully crafted self-image, “it’s a real attack on who they are,” says Stephen Haubrich, president-elect of the International Association for the Study of Personality Disorders and a professor at the University of Detroit Mercy. “The person they thought they could trust now hates them so much they don’t want to put up with them anymore. And it’s no surprise that they find themselves more depressed and depressed.”

Of course, even people with healthy mental states struggle to deal with such dramatic shifts, says Huprich, “but for narcissists and narcissistic personalities, loss is really hard, because it signals vulnerability and fragility. It signals that you’re not immune to life’s challenges and ups and downs.”

A narcissist may also display defensiveness and anger in such moments. “When they don’t get the admiration they crave, they feel ashamed and lash out,” says Brummelman. Others are unlikely to experience the same kind of aggressive outbursts.

When disappointment cuts through a narcissist’s thick layer of grandiosity and self-promotion and penetrates their core, the resulting grief or intense anger may prompt them to seek outside help. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) advises clinicians that individuals with narcissistic personality disorder may experience a depressed mood. Yet they rarely come to seek treatment for their narcissism. “I’ve never heard anyone say, ‘I think I’m a narcissist,’” Huprich says.

That doesn’t mean narcissists ignore their traits. A 2011 study in the journal Social Psychology and Personality—titled “You Probably Think This Paper Is About You”—reported that narcissists had insight into their personalities: They described themselves as arrogant and knew that others viewed them less favorably than they viewed themselves. But they generally didn’t see this as a problem, and debate continues over whether their arrogance reflects a deeply held belief in their superiority or masks an underlying lack of self-confidence.

Over years of research, Huprich and his colleagues have developed a concept that may be linked to narcissism. They call it “malignant self-esteem.” It’s a possible explanation for a group of personality disorders that are not entirely clinically diagnosable with overlapping traits, including depressive, self-defeating, and masochistic personality types.

Applied more broadly to the subtypes of narcissism, the theory suggests that a deep insecurity about oneself and an extremely fragile sense of self-worth can lead to maladaptive thoughts and behaviors. Extroverted narcissists display an exaggerated pursuit of attention. Vulnerable narcissists simply succumb to their damaged self-image. “They’re unable to maintain a coherent sense of who they are, so when they’re attacked, instead of fighting back, which is the first reaction of a grandiose narcissist, they have an immediate reaction of sadness, exhaustion, and depression,” Huprich says.

Huprich suggests that people may develop malignant self-esteem as children in the context of their relationships. These individuals may have had inconsistent experiences with their parents, particularly regarding how success and achievement were recognized. Parents may have refused to acknowledge accomplishments or discouraged bragging about them, removing the rose-colored glasses of healthy narcissism that might have smoothed the way when a child faced new challenges in life.

AreTheyMade or Born?

Childhood experiences may play a major role, but most experts agree that high levels of characteristic narcissism and NPD arise from the combined influences of nature and nurture that likely start in the genes. “There are personality traits that we bring into the world,” says Kali Trzesniewski, a social development psychologist at the University of California, Davis. And the environment in which one lives can either weaken or strengthen these traits, “although there are people who don’t seem to react to their environment; they just have a resilience to it.”

One study of twins found that narcissism is a highly heritable trait. It can also manifest early in life: Another study found that dramatic, aggressive, attention-seeking preschoolers are more likely to end up as narcissistic adults. But parenting styles, the influence of other relationships, and one’s social and cultural environments can encourage (or deter) its development. Culture matters, too: Lifetime rates of narcissistic personality disorder are about four times higher in competitive New York than in Iowa. But around the world, collectivist cultures tend to put the group before the individual: “You’re taught from a very early age that you have to care about other people and put their needs before your own,” says David Ludden, a psychology professor at Georgia Gwinnett College in Lawrenceville, Georgia. “Of course, there are narcissists in Japan and China, too, but they don’t manifest in quite the same way as here, where we say, ‘Hey, it’s okay to promote yourself.’”

High narcissism isn’t the same as high self-esteem. “They’re usually only weakly related,” says Brummelman, who has studied how parenting styles can foster both. He and his colleagues have found that when parents are warm and affectionate, spend time with their children, and show interest in their activities, “children gradually internalize the belief that they are worthy individuals—the core of self-esteem—and that doesn’t carry over into narcissism,” he says. By contrast, parents who overestimate their children—putting them on a pedestal—enhance narcissistic traits. To avoid raising narcissistic children, it’s best for parents to say to their children, “You did a good job,” rather than, “You deserved to win” or, “Why weren’t you as good as her?”

A clear early focus on success can lead to an insecure attachment between parent and child, in which the child learns to The daughter learns that a mother’s or father’s love and attention are only available if high expectations are met. Children who feel they can never live up to expectations may move into adulthood with fragile egos and cling to narcissistic thoughts and behaviors to support them. Parents who raise narcissists “present their children with a world where everything is a competition: There are winners and losers and you have to be a winner,” says Ludden. A healthier approach is to teach children that “they don’t have to be the best, they just have to be the best they can be.”

Mislabeled Millennials

No matter how hard parents try to steer kids away from all-or-nothing competition, many end up competing for college admissions, apprenticeships, and jobs. And the shrinking opportunities may be contributing to the perception of rampant narcissism among young people.

“When you set up highly competitive environments, you encourage the most ruthless people,” says Ludden. “And that’s where narcissists thrive because they’re willing to put in more effort to get ahead than the average person. We’ve created a society that encourages narcissists versus one that discourages that kind of behavior.”

That’s why young people are polishing their résumés, updating their LinkedIn profiles, marketing themselves online, and, of course, flooding social media with carefully placed, cropped, and filtered selfies. “We have so many more opportunities to express our narcissistic tendencies than we did in the past,” Ludden says. Many young people who might have been more modest in another time or environment are probably trying to keep up, and perhaps deserve more credit for it.

“Our standards have changed,” Trzesniewski says. “If you took someone from the 1960s and put them in today’s society, would they look any different? I would argue that they would.” Trzesniewski suggests a better question: “Why is there such a huge trend toward negativity toward the next generation?” She says the trend dates back to the time of Socrates: “Older generations are afraid when younger generations do things they don’t fully understand.”

The question of whether narcissism—the trait or the disorder—is on the rise is a hotly debated topic in the research community. For example, while scores on the Impersonal Performance Index have risen across generations, they haven’t risen as much as you would expect if there had been a major cultural shift. Experts also disagree about whether it’s fair to make generational comparisons: Would the Greatest Generation have become famous for its silence if soldiers had been able to tweet from the European or Pacific theaters?

People are always more narcissistic when they’re younger. “Everyone is more narcissistic at 18, 19, or 20 than they are at 40,” Trzesniewski says.

It’s a developmental trend that makes sense: Young adulthood is a time when people are largely free of responsibilities, either to their family of origin or the family they’ll eventually start. “It’s a self-centered stage of life when you’re trying to figure out who you are personally and professionally,” says Emily Bianchi, an assistant professor of organization and management at Emory University. Her research shows that generations exposed to hardships, such as recessions, tend to be less narcissistic than those facing less extensive challenges. “Recessions seem to leave a modest mark on people who were young at the time,” she says.

This could mean that millennials—still struggling to establish themselves in a slowly recovering economy—may end up being far less narcissistic than the data suggest before 2008.

On the World Stage

History offers many examples of figures who are thought to have suffered from narcissistic personality disorder. “The Napoleon complex is being a narcissist,” Rosenthal says. “If you watch a video of Mussolini, he has domineering body language and chest-thumping, which is a very physical manifestation of what we might think of as narcissism.”

Apparent self-confidence can propel a narcissist to power. “If you’re a great speaker and people are drawn to you, your ego may drive you to seek that out,” Rosenthal says.

In the beginning, people who are high in narcissism, and those with narcissistic personality disorder, can be very charming, easily attracting friends, lovers, and voters. Over time, however, their focus on themselves can become unbearable. People who are high on the narcissism scale tend to annoy friends and loved ones, at least occasionally, while those with narcissistic personality disorder may eventually drive them out, costing them jobs, friends, and spouses. “People figure out that’s not a big deal,” Rosenthal says.

Yet many people with healthy levels of narcissism are mislabeled as narcissists when interpersonal tensions rise. “The more conflicted a couple is, the more selfish they become,” Malkin says. “Anger makes us all narcissists.” When we feel hurt or angry, we tend to focus on our own psychological needs and fail to show empathy for others—two classic narcissistic behaviors. After a parent-teen conflict or a marital feud, the term narcissism may be thrown around, even if it didn’t seem appropriate before.

Another reason why partners might label each other as narcissists stems from how we connect in the first place. Narcissists are more likely to attract what Malkin calls “the ambivalent,” someone who suffers from a lack of natural self-enhancement. “They fear being a burden, so they can easily end up partnering with their opposite and falling into a relationship.”

There’s one clue that a potential partner might be a narcissist: Malkin says he or she claims to be “great at everything—except relationships.” Narcissists may declare that they don’t need anyone. They’ll admit to preferring the perfect spouse over true love. And they’re incapable of doing the basic repair work that every relationship requires.

EmpathySparks?

The weak empathy aspect of narcissistic personality disorder can confuse those who haven’t been trained to diagnose it. A complete lack of empathy would define a psychopathic personality, but people who are high in narcissism, or narcissistic personality disorder, show flashes of empathy. “High-functioning narcissists have the capacity for empathy,” says Huprich, but ultimately their own needs come first. “Empathy is often superficial and short-lived. They’ll acknowledge that someone else is suffering, but that quickly dissipates so they can get back to promoting themselves.”

In a relationship, narcissists may be able to show empathy until something upsetting happens and they reflexively move to soothe themselves by belittling their partner. “Even their partner is worth sacrificing if it makes them feel superior,” says Malkin.

If a fragile self is the true basis of narcissism, one way to bolster it is through self-compassion. A survey of more than 3,000 people found that self-compassion leads to more stable feelings of self-esteem, as opposed to self-esteem, which is more strongly associated with narcissistic traits. An emerging body of research suggests that “you can unblock narcissists’ blocked empathy by constantly focusing on relationships, community, and connection with others,” Malkin says. “It makes sense: Unhealthy narcissism is a way to cope with attachment insecurity. And by increasing that insecurity, narcissism goes down.”

This is perhaps the most positive conclusion from recent research on narcissism. “We used to think it couldn’t be changed,” Malkin says.

A Brief Cultural History of Narcissism

In “DSM-5 Girlfriends,” a sketch from the latest season of Inside Amy Schumer, a group of women gather to talk about recent relationships gone bad, each diagnosing their ex with increasingly pathological disorders, then attacking the one woman who suggests she might be wrong. Shaming personality disorders in casual conversation has never been more popular. It wasn’t always this way.

Narcissism was once a term used mostly in academic research and clinical diagnosis. Then in 1979, researchers developed the Narcissistic Personality Index, cultural historian Christopher Lasch published The Culture of Narcissism, and the term became mainstream. “In graduate school, we talked about our narcissism freely,” says psychologist Craig Malkin. In 2006, with the release of Jean Twenge’s book Generation Me, the idea that narcissism was on the rise nationwide, and perhaps particularly rampant among millennials, entered the public consciousness.

Now some researchers are refuting claims of mass narcissism, and expressing concern about using a label that is supposed to indicate a serious clinical disorder after every breakup, family feud, or selfie. “We might use the term a lot when someone is just a little bit of a show-off or ends up taking charge,” says psychologist Seth Rosenthal. These individuals may have personality traits that seem similar to narcissism, but “to qualify as narcissists, they have to have certain other motivations and behaviors.”

What’s more troubling to some experts is the idea that there’s a cultural rejection of healthy expressions of confidence or self-esteem. “Self-esteem is healthy,” says psychologist David Rosenthal.