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"It is deep,dark,destructive,and deadly"

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Life challenges and Setbacks :'(

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As with many personality disorders, the exact cause of narcissistic personality disorder (NPD) is unknown. It is probably a mixture of genes, early childhood experiences and psychological factors.

Early childhood risk factors include:

insensitive parenting

over-praising and excessive pampering - when parents focus intensely on a particular talent or the physical appearance of their child as a result of their own self-esteem issues

unpredictable or negligent care

excessive criticism

trauma

extremely high expectations

Other possible factors include:

abnormalities in the genes that affect the connection between the brain and behaviour

being over-sensitive

Although there is no one answer to the question of what causes NPD, professionals agree that the sooner treatment begins, the better a person's chance for an improved quality of life.

Where to get help

If you need help, talking to your doctor is a good place to start. If you'd like to find out more or talk to someone else, here are some organisations that can help:

SANE Australia (people living with a mental illness) - call 1800 187 263.

beyondblue (anyone feeling depressed or anxious) - call 1300 22 4636 or chat online.

Black Dog Institute (people affected by mood disorders) - online help.

Lifeline (anyone having a personal crisis) - call 13 11 14 or chat online.

Suicide Call Back Service (anyone thinking about suicide) - call 1300 659 467.

Last reviewed: December 2018

Need more information?

These trusted information partners have more on this topic.

Healthdirect Australia is not responsible for the content and advertising on the external website you are now entering.

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Causes of narcissistic personality disorder (NPD)

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As with many personality disorders, the exact cause of narcissistic personality disorder (NPD) is unknown. It is probably a mixture of genes, early childhood experiences and psychological factors.

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Last winter, a friend told me she was considering a divorce. "I really think my husband is a narcissist!" she said. More recently, over brunch, an acquaintance explained his family dynamics: "My aunt is such a narcissist, we're not sure why my uncle is with her."

The term narcissist has been widely deployed to describe not only a passel of difficult relatives and regretted exes, but also both nominees for president and the entire generation known as Millennials. Is narcissism really so widespread or on the rise in the general population?

A growing consensus among psychologists says no, it isn't. True pathological narcissism has always been rare and remains so: It affects an estimated 1 percent of the population, and that prevalence hasn't changed demonstrably since clinicians started measuring it. Most (but not all) putative narcissists today are innocent victims of an overused label. They are normal individuals with healthy egos who may also happen to indulge in the occasional selfie and talk about their accomplishments. They may even be a bit vain. But while we're diagnosing friends, relatives, and our kids' classmates, true pathological narcissists may be evading detection because most of us don't understand the many forms the condition may take.

What Narcissism Is (And Isn't)

Narcissism is a trait each of us exhibits to a greater or lesser degree. As it has become trait non grata, though, it's become necessary to add the qualifier "healthy" to specify the socially acceptable type of narcissism. "It is the capacity to see ourselves and others through rose-colored glasses," says psychologist Craig Malkin, a lecturer at Harvard Medical School and the author of Rethinking Narcissism. That can be beneficial, because it's helpful for all of us to feel a bit special. It fuels the confidence that allows us to take risks, like seeking a promotion or asking out an attractive stranger. But feeling too special can cause problems.

The Narcissistic Personality Inventory (NPI) is the most commonly used measure of the 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, inclination to lead, and willingness to manipulate others. Scores range from 0 to 40, with the average tending to fall in the low to mid-teens, depending on the group being tested. Those whose score is a standard deviation above that of their peers could reasonably be called narcissists. But a score anywhere along a wide range of the scale might still indicate a fundamentally healthy personality.

A diagnosis of pathological narcissism-which is a mental health disorder-involves different criteria. " Narcissistic Personality Disorder is an extreme manifestation of the trait," says developmental psychologist Eddie Brummelman, a fellow at Stanford University. The disorder can be diagnosed only by a mental health professional and is suspected when a person's narcissistic traits impair his or her daily functioning. The dysfunction might be related to identity or self-direction or cause friction in relationships due to problems with empathy and intimacy. It might also arise from pathological antagonism characterized by grandiosity and attention-seeking.

"Narcissism is a continuum, and the disorder sits at the very end," Brummelman says. The NPI can detect a person's level of narcissism, but additional real-life effects are necessary for a diagnosis of NPD.

"A personality disorder is a pervasive disturbance in a person's ability to manage his or her emotions, hold onto a stable sense of self and identity, and maintain healthy relationships in work, friendship, and love," Malkin says. "It's a matter of rigidity."

Someone who scores high on the NPI may indeed encounter occasional awkward or stressful social interactions, but for someone with NPD, Malkin says, "all the psychological defenses are working against healthy functioning" all the time.

The Many Faces of Narcissism

Popular culture has long relied on narcissistic traits to sketch problematic characters in sharp relief, from Dorian Gray to Don Draper. Gaston from Disney's Beauty and the Beast presents a silly but fairly apt model of grandiosity, probably the most recognizable feature of people high in narcissism and those with NPD. That brawny braggart sings, "As a specimen, yes, I'm intimidating!...As you see, I've got biceps to spare!...I'm especially good at expectorating!...And every last inch of me's covered in hair." Other narcissists may indeed perceive themselves as being in the top .1 percent in terms of talent, appearance, success, or all of the above.

But it's a mistake to assume that all narcissists will be such obvious preeners. "Not all narcissists care about looks or fame or money," Malkin says. "If you focus too much on the stereotype, you'll miss red flags that have nothing to do with vanity or greed."

For example, he suggests, some narcissists can be of the "communal" variety and actually devote their lives to helping others. They might even agree with such statements as "I'm the most helpful person I know," or "I will be known for the good deeds I have done." "Everyone has met grandiosely altruistic martyrs, self-sacrificing to the point where you can't stand to be in the room with them," Malkin says.

And there are highly introverted, or "vulnerable," narcissists. These individuals feel they are more temperamentally sensitive than others. They react poorly to even gentle criticism and need constant reassurance. The way they feel special might actually be negative: They may see themselves as the ugliest person at the party or feel like a misunderstood genius in a world that refuses to recognize their gifts.

What all subtypes of narcissist have in common, Malkin says, is "self-enhancement." Their thoughts, behaviors, and statements set them apart from others, and this feeling of distinction soothes them, because they're otherwise struggling with an unstable sense of self.

"Narcissists feel superior to others," Brummelman says, "but they are not necessarily satisfied with themselves as a person."

A Link to Depression

That struggle is at the core of a new conception of narcissism, one focused as much on depression as on grandiosity. "What people hypothesize is that narcissists are prone to higher highs and lower lows," says Seth Rosenthal, a research specialist at Yale's Program on Climate Change Communication, who did his doctoral research on narcissism. "They have this constant need to have their greatness verified by the world around them. When reality catches up with them, they may react by becoming depressed."

When a clear setback, such as a job loss or divorce or even a plan being scuttled, dents the carefully burnished self-image of a narcissistic individual, "this is a real attack on who he is," says Steven Huprich, the president-elect of the International Society for the Study of Personality Disorders and a professor at the University of Detroit Mercy. "Somebody he thought was going to trust him now very much dislikes him and is unwilling to put up with him anymore. Not surprisingly, he finds himself a little more down and depressed."

Of course, even people with healthy mental states struggle to deal with such dramatic turnarounds, Huprich says, "but for narcissists and narcissistic personalities, loss is really very difficult, because it suggests vulnerability and weakness. It suggests that you actually aren't immune to life's challenges and ups and downs."

The narcissist might also exhibit defensiveness and anger at such moments. "When they don't get the admiration they crave, they feel ashamed and lash out aggressively," Brummelman says. Others are unlikely to have the same sort of aggressive outbursts.

When a disappointment cuts through narcissists' thick layer of grandiosity and self-promotion and breaches their core, their resulting melancholy or boiling rage might motivate them to seek outside help. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), in fact, advises clinicians that individuals with NPD may present with a depressed mood. They rarely, however, come in seeking treatment for their narcissism. "I've never heard anyone say, 'I think I'm a narcissistic personality,'" Huprich says.

That doesn't mean narcissists are oblivious to their trait. A 2011 study in the Journal of Personality and Social Psychology-titled, with a wink, "You Probably Think This Paper's About You"-reported that narcissists did have insight into their personality: They described themselves as arrogant and knew that others saw them less positively than they saw themselves. But they generally didn't see this as a problem, and the debate continues over whether their grandiosity reflects an ironclad belief in their superiority or masks an underlying absence of self-confidence.

Over years of research, Huprich and colleagues have developed a concept that may be related to narcissism. They call it "malignant self-regard." It's a potential explanation for a constellation of not-quite clinically diagnosable personality disorders with overlapping features, including depressive, self-defeating, and masochistic personality styles.

Applied more widely to narcissistic subtypes, the theory suggests that deep-seated insecurity about the self and an exceedingly fragile sense of self-esteem can lead to maladaptive thoughts and behavior. Extraverted narcissists exhibit grandiose attention-seeking. Vulnerable narcissists, meanwhile, simply succumb to their damaged self-image. "They're not able to keep a coherent sense of who they are, so when they are attacked, instead of fighting back, which is the first reaction of the grandiose narcissist, they have an immediate reaction of sadness and depletion and depression," Huprich says.

People may develop malignant self-regard as children in the context of their relationships, Huprich proposes. These individuals may have had inconsistent experiences with their parents, related in particular to how success and achievement were recognized. Parents might have refused to acknowledge achievements or discouraged bragging about them, taking away the rose-colored glasses of healthy narcissism that could have eased the way as a child encountered new challenges in life.

Are They Made or Born?

Childhood experiences may play a major role, but most experts agree that both high levels of trait narcissism and NPD arise from the combined influences of nature and nurture that likely begin in the genes. "There are personality traits we come into the world with," says Kali Trzesniewski, a social-development psychologist at the University of California, Davis. One's environment can either weaken or strengthen those traits, "though there are always people who don't seem to react to their environment; they're just kind of resilient to it."

One twin study found that narcissism was a highly heritable trait. It can also manifest early in life: Another study found that dramatic, aggressive, attention-seeking preschoolers were 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 as well: Lifetime rates of NPD are about four times higher in notoriously competitive New York when compared with Iowa. But across the globe, cultures with a more collectivist tradition tend to put the group before the individual: "You're taught from a very early age that you have to pay attention to other people and put their needs before your own," says David Ludden, a professor of psychology at Georgia Gwinnett College in Lawrenceville, Georgia. "Of course, there are narcissists in Japan and China as well, but they don't show up quite the same way as here, where we say, 'Hey, it's OK for you to promote yourself.'"

High narcissism is not the same as high self-esteem. "They are typically only weakly related," says Brummelman, who has studied how parenting approaches can foster each. He and his colleagues found that when mothers and fathers are warm and affectionate, spending time with their kids and showing interest in their activities, "the children gradually internalize the belief that they are worthy individuals-the very core of self-esteem-and this doesn't spill over into narcissism," he says. By contrast, parental overvaluation-placing children on a pedestal-does promote narcissistic traits. To avoid raising narcissists, it's better for parents to say to children, "You did a good job," rather than, "You deserved to win" or "Why weren't you as good as she was?"

An early pronounced focus on success can lead to an insecure attachment between parent and child, as a son or daughter learns that a mother's or father's love and attention are available only if high expectations are met. Children who feel they can never measure up can move into adulthood with a fragile ego and latch onto narcissistic thoughts and behaviors to shore it up.

Parents who raise narcissists, Ludden says, "present to their kids a world where everything is a competition: There are winners and losers and you've got to be a winner." A healthier approach would be to teach children that "they don't have to be the best, just the best that they can be."

Mislabeled Millennials

No matter how hard parents try to steer children away from all-or-nothing competition, many eventually have to vie for college admission, internships, and jobs. Shrinking opportunities may be what's contributing to a perception of raging narcissism among young adults.

"When you set up highly competitive environments, you're really encouraging people who are more ruthless," Ludden says. "That's where the narcissists are going to flourish, because they are willing to do more to get ahead than the average person would. We've set up a society that encourages the narcissist as opposed to one where that kind of behavior is discouraged."

And so young people polish their résumés, update their LinkedIn profiles, brand themselves online, and of course, flood social media with carefully posed, cropped, and filtered selfies. "We have a lot more opportunities to express our narcissistic tendencies than we once did," Ludden says. Many young people who might have come across as quite modest in another time or milieu may just be trying to keep up and may deserve more of a pass for it.

"Our norms have changed," Trzesniewski says. "If you took somebody from the '60s and put them in today's society, would they look any different? I would argue that they would be the same." A better question, she suggests, is "Why is there such a huge trend to be negative about the next generation?" This tendency goes back to the time of Socrates, she argues: "Older generations get fearful when younger ones are doing things they don't fully understand."

The question of whether narcissism-the trait or the disorder-is on the rise is a subject of fierce debate in the research community. For example, while NPI scores have risen across generations, they have not done so as much as might be expected if a major cultural shift had taken place. Experts also disagree on whether it's fair to make cross-generational comparisons: Would the Greatest Generation have become as notable for its reticence if soldiers had been able to tweet from the European or Pacific theater?

What is clear is that 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 logical developmental trend: Young adulthood is a time when people are largely free of responsibilities, either to their family of origin or the family they will eventually establish. "It's a self-absorbed 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 end up less narcissistic than those that face fewer large-scale challenges. "Recessions seem to leave a humbling imprint on people who were young adults at the time," she says.

That may mean that Millennials-still struggling to establish themselves in a slowly recovering economy-might actually end up far less narcissistic than pre-2008 data would suggest.

On the World Stage

History offers many examples of figures presumed to have had narcissistic personality disorder. "A Napoleon complex is essentially being narcissistic," Rosenthal says. "And if you look at video of Mussolini, he has a dominant, chest-thumping body language, a very physical manifestation of what we might think of as narcissism."

Apparent self-assurance can propel a narcissist into power. "If you're a great talker and people gravitate toward you, then your ego might drive you to seek that out," Rosenthal says.

At first, people high in narcissism, and those with NPD, can be quite charming, easily attracting friends, lovers, and voters. Over time, though, their self-focus can become insufferable. People high on the narcissistic scale tend to annoy friends and loved ones, at least occasionally, while those with NPD may ultimately send them fleeing, serially costing themselves jobs, friends, and spouses. "People figure out that this isn't so great," Rosenthal says.

However, many people with healthy levels of narcissism are wrongly labeled as narcissists when interpersonal tensions rise. "Whenever couples are in high conflict, they become more self-centered," Malkin says. "Rage makes narcissists of us all." And when we feel hurt or angry, we tend to focus on our own psychic needs and fail to show empathy towards others-both classic narcissistic behaviors. After a parent-teenager conflict or a feud between spouses, the term narcissist might be thrown out, even when it never seemed applicable before.

Another reason partners may label each other as narcissistic stems from how we pair off in the first place, a narcissist being more likely to attract what Malkin calls an "echoist," someone who suffers from a lack of normal self-enhancement. "They fear being a burden, so they can easily end up partnering with their opposite and getting stuck in the relationship."

One clue that a potential partner might be a narcissist: He or she claims to be "great at everything-except relationships," Malkin says. Narcissists might announce that they don't need anybody. They'll admit to preferring a trophy spouse to true love. And they're unable to do the fundamental repair work every relationship demands.

Sparks of Empathy?

The impaired-empathy aspect of Narcissistic Personality Disorder can confuse those who haven't been trained to diagnose it. A complete lack of empathy would identify a psychopathic personality, but people high in narcissism, or with NPD, exhibit flashes of compassion. "The higher functioning narcissists have the capacity and ability to empathize," Huprich says, but ultimately their own needs come first. "The empathy is often shallow and short-lived. They'll acknowledge that someone else is suffering, but that will quickly dissipate so they can get back to their own self-promotion."

Within a relationship, narcissists might be able to show empathy until something upsetting occurs and they reflexively move to soothe themselves by putting a partner down. "Even a partner is worth sacrificing if it makes them feel superior," Malkin says

If a fragile self is the true underpinning of narcissism, one way to strengthen it is with self-compassion. A survey of more than 3,000 people showed that self-compassion led to more stable feelings of self-worth, as opposed to self-esteem, which has a stronger association with narcissistic traits. An emerging body of research suggests that "you can unblock the blocked empathy of people who are narcissistic by constantly focusing them on relationships, community, and connection to others," Malkin says. "It makes sense: Unhealthy narcissism is a way of coping with attachment insecurity. By increasing that security, narcissism drops."

That may be the most promising takeaway from the recent research on narcissism. Malkin says: "We used to think it couldn't be changed."

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 her ex with increasingly pathological disorders, and then attacking the one woman who suggests they might be off base. Slinging personality disorders in casual conversation has never been more in vogue. 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 went mainstream. "In grad school, we talked about our narcissism freely," psychologist Craig Malkin says. In 2006, with Jean Twenge's book, Generation Me, the idea that narcissism was on the rise nationwide, and might be rampant among the Millennial generation in particular, entered the public consciousness.

Now some researchers are debunking claims of mass narcissism, expressing concern that a label meant to refer to a serious clinical disorder is being wielded after every breakup, family dispute, or selfie encounter. "We might throw around the term too much when someone is just a little bit of a show-off or ends up in charge," psychological researcher Seth Rosenthal says. Such individuals may have personality traits that seem similar to narcissism, but "to really qualify as a narcissist, they have to have certain other motivations and behaviors."

Most concerning for some experts is the thought of a cultural rejection of healthy expressions of confidence or self-esteem. "Self-esteem is healthy," psychologist David Ludden says. "Narcissism is something different."
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Meet the Real Narcissists (They're Not What You Think)

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The label is everywhere, but it's widely misused to describe anyone who offends us. The truth? A little narcissism is good for you. Even for those high in the trait, it's not all about vanity-new research may be uncovering a connection to depression.

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Traits of this disorder is shown over time in a persons life. 0.5-1% of people are diagnosed with Narcissistic Personality Disorder in the general population

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Exaggerated self-importance, Needs constant admiration and praise,Demean and belittle people constantly,No guilt or shame for exploitation

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Tips for Spotting and Coping with a Narcissist
Are you in a frustrating relationship with someone who expects constant attention and admiration, but doesn't seem able to take your needs and feelings into consideration? Someone who thinks they're better than everyone else and should be treated accordingly? Who dishes out insults and condescension, but flies off the handle at the slightest disagreement or whiff of criticism? If so, you may be dealing with a narcissist. Learn what you need to know about narcissistic personality disorder (NPD) so you can spot the narcissists in your life, protect yourself from their power plays, and establish healthier boundaries.
What is narcissistic personality disorder?

The word narcissism gets tossed around a lot in our selfie-obsessed, celebrity-driven culture, often to describe someone who seems excessively vain or full of themselves. But in psychological terms, narcissism doesn't mean self-love-at least not of a genuine sort. It's more accurate to say that people with narcissistic personality disorder (NPD) are in love with an idealized, grandiose image of themselves. And they're in love with this inflated self-image precisely because it allows them to avoid deep feelings of insecurity. But propping up their delusions of grandeur takes a lot of work-and that's where the dysfunctional attitudes and behaviors come in.

Narcissistic personality disorder (NPD) involves a pattern of self-centered, arrogant thinking and behavior, a lack of empathy and consideration for other people, and an excessive need for admiration. Others often describe people with NPD as cocky, manipulative, selfish, patronizing, and demanding. This way of thinking and behaving surfaces in every area of the narcissist's life: from work and friendships to family and love relationships.

People with narcissistic personality disorder are extremely resistant to changing their behavior, even when it's causing them problems. Their tendency is to turn the blame on to others. What's more, they are extremely sensitive and react badly to even the slightest criticisms, disagreements, or perceived slights, which they view as personal attacks. For the people in the narcissist's life, it's often easier just to go along with their demands to avoid the coldness and rages.

Signs and symptoms of narcissistic personality disorder

Grandiose sense of self-importance

Grandiosity is the defining characteristic of narcissism. More than just arrogance or vanity, grandiosity is an unrealistic sense of superiority. Narcissists believe they are unique or "special" and can only be understood by other special people. What's more, they are too good for anything average or ordinary. They only want to associate and be associated with other high-status people, places, and things.

Narcissists also believe that they're better than everyone else and expect recognition as such-even when they've done nothing to earn it. They will often exaggerate or outright lie about their achievements and talents. And when they talk about work or relationships, all you'll hear is how much they contribute, how great they are, and how lucky the people in their lives are to have them. They are the undisputed star and everyone else is at best a bit player.

Lives in a fantasy world that supports their delusions of grandeur

Since reality doesn't support their grandiose view of themselves, narcissists live in a fantasy world propped up by distortion, self-deception, and magical thinking. They spin self-glorifying fantasies of unlimited success, power, brilliance, attractiveness, and ideal love that make them feel special and in control. These fantasies protect them from feelings of inner emptiness and shame, so facts and opinions that contradict them are ignored or rationalized away. Anything that threatens to burst the fantasy bubble is met with extreme defensiveness and even rage, so those around the narcissist learn to tread carefully around their denial of reality.

Needs constant praise and admiration

A narcissist's sense of superiority is like a balloon that gradually loses air without a steady stream of applause and recognition to keep it inflated. The occasional compliment is not enough. Narcissists need constant food for their ego, so they surround themselves with people who are willing to cater to their obsessive craving for affirmation. These relationships are very one-sided. It's all about what the admirer can do for the narcissist, never the other way around. And if there is ever an interruption or diminishment in the admirer's attention and praise, the narcissist treats it as a betrayal.

Sense of entitlement

Because they consider themselves special, narcissists expect favorable treatment as their due. They truly believe that whatever they want, they should get. They also expect the people around them to automatically comply with their every wish and whim. That is their only value. If you don't anticipate and meet their every need, then you're useless. And if you have the nerve to defy their will or "selfishly" ask for something in return, prepare yourself for aggression, outrage, or the cold shoulder.

Exploits others without guilt or shame

Narcissists never develop the ability to identify with the feelings of others-to put themselves in other people's shoes. In other words, they lack empathy. In many ways, they view the people in their lives as objects-there to serve their needs. As a consequence, they don't think twice about taking advantage of others to achieve their own ends. Sometimes this interpersonal exploitation is malicious, but often it is simply oblivious. Narcissists simply don't think about how their behavior affects others. And if you point it out, they still won't truly get it. The only thing they understand is their own needs.

Frequently demeans, intimidates, bullies, or belittles others

Narcissists feel threatened whenever they encounter someone who appears to have something they lack-especially those who are confident and popular. They're also threatened by people who don't kowtow to them or who challenge them in any way. Their defense mechanism is contempt. The only way to neutralize the threat and prop up their own sagging ego is to put those people down. They may do it in a patronizing or dismissive way as if to demonstrate how little the other person means to them. Or they may go on the attack with insults, name-calling, bullying, and threats to force the other person back into line.

Don't fall for the fantasy

Narcissists can be very magnetic and charming. They are very good at creating a fantastical, flattering self-image that draw us in. We're attracted to their apparent confidence and lofty dreams-and the shakier our own self-esteem, the more seductive the allure. It's easy to get caught up in their web, thinking that they will fulfill our longing to feel more important, more alive. But it's just a fantasy, and a costly one at that.

Your needs won't be fulfilled (or even recognized). It's important to remember that narcissists aren't looking for partners; they're looking for obedient admirers. Your sole value to the narcissist is as someone who can tell them how great they are to prop up their insatiable ego. Your desires and feelings don't count.

Look at the way the narcissist treats others. If the narcissist lies, manipulates, hurts, and disrespects others, he or she will eventually treat you the same way. Don't fall for the fantasy that you're different and will be spared.

Take off the rose-colored glasses. It's important to see the narcissist in your life for who they really are, not who you want them to be. Stop making excuses for bad behavior or minimizing the hurt it's causing you. Denial will not make it go away. The reality is that narcissists are very resistant to change, so the true question you must ask yourself is whether you can live like this indefinitely.

Focus on your own dreams. Instead of losing yourself in the narcissist's delusions, focus on the things you want for yourself. What do you want to change in your life? What gifts would you like to develop? What fantasies do you need to give up in order to create a more fulfilling reality?

Set healthy boundaries

Healthy relationships are based on mutual respect and caring. But narcissists aren't capable of true reciprocity in their relationships. It isn't just that they're not willing; they truly aren't able. They don't see you. They don't hear you. They don't recognize you as someone who exists outside of their own needs. Because of this, narcissists regularly violate the boundaries of others. What's more, they do so with an absolute sense of entitlement.

Narcissists think nothing of going through or borrowing your possessions without asking, snooping through your mail and personal correspondence, eavesdropping on conversations, barging in without an invitation, stealing your ideas, and giving you unwanted opinions and advice. They may even tell you what to think and feel. It's important to recognize these violations for what they are, so you can begin to create healthier boundaries where your needs are respected.

Make a plan. If you have a long-standing pattern of letting others violate your boundaries, it's not easy to take back control. Set yourself up for success by carefully considering your goals and the potential obstacles. What are the most important changes you hope to achieve? Is there anything you've tried in the past with the narcissist that worked? Anything that hasn't? What is the balance of power between you and how will that impact your plan? How will you enforce your new boundaries? Answering these questions will help you evaluate your options and develop a realistic plan.

Consider a gentle approach. If preserving your relationship with the narcissist is important to you, you will have to tread softly. By pointing out their hurtful or dysfunctional behavior, you are damaging their self-image of perfection. Try to deliver your message calmly, respectfully, and as gently as possible. Focus on how their behavior makes you feel, rather than on their motivations and intentions. If they respond with anger and defensiveness, try to remain calm. Walk away if need be and revisit the conversation later.

Don't set a boundary unless you're willing to keep it. You can count on the narcissist to rebel against new boundaries and test your limits, so be prepared. Follow up with any consequences specified. If you back down, you're sending the message that you don't need to be taken seriously.

Be prepared for other changes in the relationship. The narcissist will feel threatened and upset by your attempts to take control of your life. They are used to calling the shots. To compensate, they may step up their demands in other aspects of the relationship, distance themselves to punish you, or attempt to manipulate or charm you into giving up the new boundaries. It's up to you to stand firm.

Don't take things personally

To protect themselves from feelings of inferiority and shame, narcissists must always deny their shortcomings, cruelties, and mistakes. Often, they will do so by projecting their own faults on to others. It's very upsetting to get blamed for something that's not your fault or be characterized with negative traits you don't possess. But as difficult as it may be, try not to take it personally. It really isn't about you.

Don't buy into the narcissist's version of who you are. Narcissists don't live in reality, and that includes their views of other people. Don't let their shame and blame game undermine your self-esteem. Refuse to accept undeserved responsibility, blame, or criticism. That negativity is the narcissist's to keep.

Don't argue with a narcissist. When attacked, the natural instinct is to defend yourself and prove the narcissist wrong. But no matter how rational you are or how sound your argument, he or she is unlikely to hear you. And arguing the point may escalate the situation in a very unpleasant way. Don't waste your breath. Simply tell the narcissist you disagree with their assessment, then move on.

Know yourself. The best defense against the insults and projections of the narcissist is a strong sense of self. When you know your own strengths and weaknesses, it's easier to reject any unfair criticisms leveled against you.

Let go of the need for approval. It's important to detach from the narcissist's opinion and any desire to please or appease them at the expense of yourself. You need to be okay with knowing the truth about yourself, even if the narcissist sees the situation differently.

Look for support and purpose elsewhere

If you're going to stay in a relationship with a narcissist, be honest with yourself about what you can-and can't-expect. A narcissist isn't going to change into someone who truly values you, so you'll need to look elsewhere for emotional support and personal fulfillment.

Learn what healthy relationships look and feel like. If you come from a narcissistic family, you may not have a very good sense of what a healthy give-and-take relationship is. The narcissistic pattern of dysfunction may feel comfortable to you. Just remind yourself that as familiar as it feels, it also makes you feel bad. In a reciprocal relationship, you will feel respected, listened to, and free to be yourself.

Spend time with people who give you an honest reflection of who you are. In order to maintain perspective and avoid buying into the narcissist's distortions, it's important to spend time with people who know you as you really are and validate your thoughts and feelings.

Make new friendships, if necessary, outside the narcissist's orbit. Some narcissists isolate the people in their lives in order to better control them. If this is your situation, you'll need to invest time into rebuilding lapsed friendships or cultivating new relationships.

Look for meaning and purpose in work, volunteering, and hobbies. Instead of looking to the narcissist to make you feel good about yourself, pursue meaningful activities that make use of your talents and allow you to contribute.

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Narcissistic Personality Disorder Tips for Spotting and Coping with a Narcissist Are you in a frustrating relationship with someone who expects constant attention and admiration, but doesn't seem able to take your needs and feelings into consideration? Someone who thinks they're better than everyone else and should

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Dr. Robin Smith on Dangerous Narcissists | The Oprah Winfrey Show | Oprah Winfrey Network

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Narcissism can possibly be caused through childhood experiences: trauma, insensitive parenting(over-pampering,excessive pampering, negligent),or excessive criticism. Biologically,it could be caused through genes.