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  • Writer's pictureDr. Maura Ferguson

What You Need to Know about Narcissism: An Overused and Misunderstood Word

Updated: Nov 8, 2023

A Guide to Understanding Narcissism



Narcissism is an evocative word that gets attention, raises eyebrows and creates powerful feelings. You may find that the word conjures an image of a particular person or memory. You are not alone if the word narcissism creates an emotional reaction. Narcissism has long captivated and fascinated people and, in recent years, has increasingly appeared in the media as social movements such as #metoo have exposed malignant forms of narcissism in influential people in the media and politics. Meanwhile, there is evidence that factors such as social media contribute to higher rates of problematic narcissism in the general public. Commonly, rhetoric about narcissism is also often vague and inflammatory. You have only to look to Greek and Roman mythology, such as the myth of Echo and Narcissus, to see how long humans have grappled with self-esteem, love and obsession issues. You might wonder if you are a narcissist or if someone in your life is. If you want to understand narcissism better, this is an excellent place to start.


Why is it valuable to understand narcissism?


Chances are that if you are reading this, you have someone in your life, a parent, a spouse, a boss, etc., that is too self-centred. If you have narcissistic people in your life, you may find it challenging to balance your needs with those of others. Uncertainty may lead you to overcorrect by being self-sacrificing. A better understanding of narcissism can allow you to aspire and strive toward your goals of achievement and ambition while maintaining rich and close relationships with others. Too much or too little will put you out of balance in how you relate to people, from your partner or spouses to friends, colleagues and bosses. If you are too narcissistic, you may harm people in your life or push people away. If you have a deficit of healthy narcissism, you may be taken advantage of and find yourself stuck or languishing and feeling resentful.


Pathological Narcissism vs Healthy Narcissism


It is important to know that there is such a thing as healthy narcissism. Narcissism, like many human traits, is on a spectrum. A surplus of narcissism or self-centredness is at one extreme and, at the other end, is someone who lacks self-regard or belief in themself. Another way of thinking about narcissism is self-love. You have likely heard about the importance of loving and valuing yourself: Whitney Houston famously sang about how loving yourself is the greatest love of all; RuPaul ends episodes of his show Drag Race with the quote: If you can't love yourself, how in the hell you gonna love somebody else?

Without a balanced amount of love for yourself and regard for your inherent value, you are unlikely to take steps to care for and nurture yourself, to learn and develop your talents and interests. The word narcissism needn't send you running for the hills. Like many things, it is a question of the ‘just right’ amount. While it is possible to have too much narcissism, it is also possible to lack enough and to be a pushover or someone who can't advocate for themselves or their rights in relationship to others.

You may ask yourself: what does healthy narcissism look like? A person with a healthy amount of narcissism can balance their interests while also being able to empathize with others; they can work collaboratively and form long-lasting mutual and non-exploitative relationships. People with a healthy level of narcissism can consider other people's experiences and perspectives while establishing reasonable and healthy boundaries.


An excessively narcissistic person may consistently behave in entitled ways, require constant validation or admiration from others, have an exaggerated sense of importance, and act in ways that are harmful to people around them due to their inability to empathize with others. Such a person may or may not meet the criteria for a diagnosis of Narcissistic Personality Disorder (NPD). NPD is a complex diagnosis that should only be made by a licensed mental health clinician such as a psychologist. A person can have problematic characteristics or traits without meeting the full criteria for NPD.


Example: A student with healthy narcissism might ask a professor why they received a low mark on an essay they worked very hard on. If the professor can explain to them why the grade is lower than they expected, the student may consider the explanation and learn from it or continue to advocate (without insisting) for the professor to consider reviewing their grade.

An excessively narcissistic student who doesn’t feel satisfied with their grade on an essay may try to charm or manipulate or otherwise insist that they deserve a higher mark, be unable to take the professor’s constructive criticism into account and likely denigrate the professor either to their face and/or behind their back.


How to feel empowered around someone narcissistic?

You can benefit from being let in on something psychologists and other therapists understand: at the core of narcissism are intense and disavowed feelings of emptiness and inadequacy. These feelings are unconscious, meaning that the person may or not be aware of the feelings or may only experience these uncomfortable emotional states intermittently or infrequently. Disavowing feelings is a great deal of work: having an insatiable appetite for validation and needing to project the disavowed feelings into other people through a process known as projective identification. In other words, the narcissistically oriented person is never the problem; everyone else is the problem. Everyone else is stupid or incompetent or just not good enough. It is exceptionally challenging to remain calm and confident when confronted with intense forms of verbal attack and devaluation. Patterns of approval and validating seeking while denigrating others come at a steep price over time to the narcissistic person and the people around them.


Essential things ways to cope with someone problematically narcissistic:


Educating yourself about what narcissism is and how it affects the person and those around them (you can find some helpful links below).


Expect it to be challenging: This is not meant to be discouraging but to support you to take the challenge seriously and to establish and practice a range of essential coping skills. Intensely Narcissistic people evoke powerful emotions in the people around them that can undermine your sense of well-being.

Boundaries, boundaries, boundaries: Establishing limits is essential to taking care of yourself, which goes double or triple when dealing with someone narcissistic. Boundaries can include setting limits around your own time and what behaviours are unacceptable.

Practice Radical Self-care: This can involve establishing a robust support network for yourself that may consist of psychotherapy and other forms of coping that can help. Know when you must leave or avoid a person or situation harming you emotionally or otherwise.


Unhealthy or Pathological Narcissism - What it's not.

Narcissism sometimes gets confused with other personality disorders, including Antisocial Personality Disorder or sociopathy. Antisocial Personality Disorder is associated with criminal and other aggressive behaviours. Narcissistic Personality Disorder (NPD) is less associated with impulsivity, manipulativeness and deceit than sociopathy. People with NPD often are unaware of the extent of their harmful impact on others.

The pathologically narcissistic person may not be aware that at the core of their narcissism is a deep sense of shame, emptiness and/or inadequacy. Understanding the context and factors that contribute to problematic narcissism can help us to manage the overwhelming feelings that can arise when confronted by a person with unchecked narcissistic tendencies.


Can Pathological Narcissism be Treated?


Treating excessive or problematic narcissism is possible but is not straightforward. Part of what makes it complex to treat is that the person with this condition often does not see themselves as the source of difficulty and is not usually willing or able to work on themselves to bring about change. Narcissistic people go to therapy when they find themselves in a crisis resulting from their patterns of seeking external validation and denigration of others.

Psychoanalysis and psychoanalytic psychotherapy, including a distilled form of psychoanalytic treatment called Transference Focused Psychotherapy, effectively treat problematic Narcissism.

Although the person with narcissistic traits may not be interested or amenable to treatment, the families and people impacted by the person’s narcissistic behaviours can benefit significantly from psychotherapeutic treatment. It is not uncommon for children of narcissistic parents to suffer from mental health difficulties and often seek therapy for themselves.


You can find more information about narcissistic personality disorder here:


Here is a video about the spectrum of Problematic Narcissism:


McLean Hospital in Massachusetts has some helpful information about transference-focused Psychotherapy (TFP). TFP was created to treat Borderline Personality Disorder (BPD) and has been found to be highly effective in treating pathological narcissism as well:



Coming soon, How Pathological Narcissism Affects Relationships.




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