Do Narcissists Exist?

Those who have dealt with a narcissistic ex-husband or been hurt by a narcissistic business partner know deep down that such people are alive and well. Think of someone difficult, selfish, self-promoting, who claims to think of others but always does what is best for them. Does anyone come to mind? We call these selfish people narcissists every day. Yet the authors of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, almost ruled out narcissistic personality disorder, only to drop it at the last minute.

So What’s Going On?

First, let’s look at the evidential value of personality disorders as a whole.

When your orthopedist looks at a broken femur, he has a relatively simple task. You only have two femurs, so it’s either your right femur or your left femur. The fracture could be simple or more complex. But most of us have the same anatomy surrounding the femur, the same joints, and the same muscle and ligament structure. There are thicker femurs and thinner femurs, but the basic anatomy is the same. The doctor can easily see the damage. A physical exam often makes the diagnosis obvious. X-rays confirm the diagnosis in most cases. If the injury is subtle, an MRI can reveal what’s going on.

Personality disorders don’t have the diagnostic certainty of a broken femur, a sore throat, or breast cancer. Each of these has signs and symptoms, along with well-established lab tests that can verify what you’re dealing with. While it’s possible to get any of these symptoms wrong—breast cancer might turn out to be benign, or a broken femur might turn out to be a side effect of steroid abuse—there’s strong evidentiary value to each label. Narcissistic personality disorder doesn’t have that kind of diagnostic certainty, and that’s the crux of the argument.

After all, calling someone a narcissist is a pretty damning understatement.

The brain contains more than 100 billion neurons and countless connections between them. So every brain is remarkably unique. Think of a face. It’s a very simple structure. You have two eyes, a nose, a forehead, cheekbones, a mouth, two ears, some hair (or no hair), and a chin. It sounds simple, but with a few minor differences, you find that no two faces are the same—with over 7 billion unique faces on the planet. Every brain has an infinite number of differences that help make a person who they become. The femur model doesn’t apply to personality.

In the world of psychiatric diagnosis, we have disorders that come close, though. Most people with OCD, schizophrenia, or panic attacks have a lot in common with each other. Our mental health screening and psychological evaluation come close to an orthopedist and a broken femur. Neuropsychological testing reveals a consistent pattern of thinking that indicates whether a person is psychotic or just overly anxious. Here psychiatry comes close to the femur model—but it’s still a long way off. That’s a good thing because the human psyche is difficult to assess and very unique—back to the 100 billion neurons problem.

So what about narcissism?

As most of you know, narcissism falls under a psychological category called personality disorders. These people have a maladaptive way of functioning in the world that can hurt them or others. Here’s a brief overview of narcissism (with a few minor tweaks to make this personality type more clear):

• An exaggerated sense of one’s talents and importance
• Grandiose romantic fantasies, great insight, or great accomplishment
• An excessive need for admiration and attention
• A strong sense of entitlement—can justify selfish actions as perfectly normal
• A tendency to use people as objects
• Lacks genuine empathy; but can often fake empathy quite well
• Hurts others easily—and hurts others easily (sometimes badly)
• Is self-obsessed
• cannot be self-critical

We all have elements of these traits. Some might argue that this list describes most healthy teens beautifully! However, what if an adult truly falls into this personality trap? This can lead to problems for them, their spouses, their business partners, and their children.

Diagnosing Narcissistic Personality Disorder, despite its flaws, has real value. You need to know what you’re dealing with. And if you’re a narcissist, you’ll ultimately benefit from understanding why you go from one failed relationship to another—and why you never get enough, despite your looks, money, or success.

TheHoleInsideYourLife is different.

Every narcissist is different. Each has a separate set of 100 billion neurons. Each had a different upbringing and each has the above traits to varying degrees. The last criterion is one I’ve added because, in my experience, it’s the most important. Most personality disorders cannot look at themselves critically, as if from the outside. Criticism is too easily seen as an attack rather than a helpful insight. Narcissists are, in this way, psychologically primitive. They can’t be wrong.

Good therapy is about metacognition, the ability to observe yourself while you think. Great therapy helps the patient move one step further. You ask the patient to connect with the patient, and then ask her if she wants to continue behaving the way she is. It’s not easy, but we have options.

The narcissist will try to please the therapist with her wit, warmth, and charm. She will find out all how others have let her down and justify all the hurt she might have done. In the world of divorce, for example, the narcissist might simply walk away from the marriage because “the love wasn’t good enough” and then get angry because her husband won’t approve. After all, “Wouldn’t it be better if we were happy together?”

She fails to see him as a person and just assumes that he must feel the way she does. Then she gets angry at him because he’s upset, avoids any criticism, and may even go so far as to feel justified in poisoning the children against their father. “The kids are better off without him.” Once she’s cut the bait, she doesn’t care how it ends up—relationships are ultimately chess pieces to be moved. The loyalty you sometimes see in a good divorce is found only in her words, not in her actions.

One scary point: People with NPD can be vicious when they feel down. Divorce makes them more regressive and sometimes domestic violence is possible. Whether or not you believe in the diagnosis of NPD, it is dangerous to be in a vulnerable position with someone who feels justified in hurting you because they have lost control. Many women (and some men) can’t wrap their heads around the fact that someone they once loved could hurt them (or their children). Get help if you think this is your problem.

The downside of being diagnosed with NPD is that it can become a cheap catchphrase you can throw around whenever you don’t like someone. It makes you feel superior because you’re labeling him or her. It can be a sign of your self-importance if you put someone down. I believe it.

So, are there narcissists?

In the ever-changing world of psychiatric classification, I believe the term narcissist has value.

Here are some lessons that might help:

1. Narcissists are remarkably selfish to the point of exploitation.
2. A narcissist may be so self-deserving that he or she doesn’t see themselves hurting others.
3. Narcissists are easy to fall for. They often have impressive talents and looks. In my experience, many people love romance—but not long-term love.
4. If you have a lover, spouse, or ex-girlfriend with these traits, know that you may not be as important to them as you think. Knowing this can help protect you.
5. Yes, he or she probably loves you. He or she may be incredibly handsome, a great lover, and an interesting person, but notice how much of what he or she does is self-centered. He or she is far from selfish.
6. When it comes to love, most narcissists love love more than they love you.
7. Once the relationship is over, your history with him or her is irrelevant.

8. Many of these people have difficulty aging, and good therapy can help them transition into becoming better people. This usually happens when their beauty, wealth, or accomplishments no longer help them.
9. A narcissist’s midlife crisis can be one of the most satisfying psychological treatments. They need love like no one else; it’s better late than never.
10. Narcissists as a group have a strong sense of urgency. They want a lot out of this life. Some make real contributions to the worlds of acting, academia, religion, politics, science, literature, and yes, psychology. Their pain is often both internal—as in the constant lack of satisfaction—and external—as in the wreckage of so many failed relationships.

Narcissism is a useful term, even if it can be misused. It’s good to have words that can help you figure out what you’re dealing with. If you have these traits, knowing the full picture of narcissism may help you wake up to why you’re chronically demanding—or empty. And if your lover, friend, parent, or spouse is a narcissist, you’ll have a better picture of what’s going on.

Warning: Not every toxic person is a narcissist. Sometimes they’re just plain idiots. There’s a difference.

Bottom line: People with narcissistic personality disorder are problematic. They miss a lot of the subtle beauty of life.