Narcissism: A Trait or Personality Disorder?

Narcissism is a hot topic! It’s important to talk about and super helpful to understand, but we often use these terms out of context, which is quite confusing. Let’s take a deeper look at what narcissism really is!

What is Narcissism?

If you look at the literature regarding narcissism, there is no consensus on what it really is - no one can agree. But we do know some things. Narcissism is a trait. I like to think about it as a continuum with ‘normal’ narcissism on the healthy side and pathological narcissism on the unhealthy side. However, there are some researchers who split normal and pathological narcissism into two different continuums (Pincus and Lukowitsky, 2010, p. 424). We actually all need some narcissism, but excessive narcissism leads to all kinds of personality disorders, including narcissistic personality disorder. Kind of like salt. We need salt to bring out flavors in a recipe, but too much salt is gross! Have you ever licked a salt block? Accidentally inhaled ocean water? No thank you! Another piece to understand about narcissism is that it has low stability, meaning that it can go up and down like a rollercoaster depending on whether the narcissism is being supplied or not. Basically, narcissists need ego cookies. If fed, they don’t necessarily act out, but if they aren’t being fed, you’ll know right quick they’re jonesing for some ego juice!

How Does Narcissism Develop?

Healthy Narcissism in Early Childhood
Infants are little narcissists, and they should be! They’re completely dependent. In fact, they don’t know they exist outside of their mother. They think, “I am mom, and mom is me.” They need mom, the almighty being in order to survive, and that’s healthy. It’s necessary. A bit later on, they LOVE to look at themselves in the mirror. It’s technically narcissistic, but its purpose is to start to gain a sense of identity and otherness (i.e. This is MY nose. I have a mouth, not mama’s mouth, MY mouth). It’s not healthy for an adult to enmesh with another, merging their identity so that they can’t differentiate whose perspective, emotions, and needs are whose. Thus, early on in development, narcissism is adaptive and healthy.

Self-talk in toddlers is also narcissistic. I’ve watched my child across the table spill their milk, look directly at me, and state, “Mama, you spilled the milk!” I looked confused, and the follow up was, “Mama, I didn’t spill the milk. YOU did.” What a great example of denying “badness” and projecting (blaming) it onto someone else. In toddlerhood, this is acceptable. They’re still learning and separating the self from the other. They’re building their sense of confidence and power. As an adult, it’s not healthy, for example, for a boss to mess up a meeting time and blame it on the innocent secretary.

Egocentrism is also something that is part of normal development in early childhood (approximately between ages 2-7 depending on the theory). Have you ever FaceTimed a 3-year-old who started talking about something THEY saw, assuming you could see it as well, but all you can see is their cute little face? Or ask a 3-year-old what they want to get [an adult] for Christmas. Chances are it will be what THEY like. Not because they are self-centered, but because they can’t yet understand someone else’s perspective. They like the object, so the adult must like the object too. I’ve received lovely “prizes” of crayon wrappers, cardboard from under a Walmart shelf, and rocks…so many rocks… It’s actually beautiful. But if another adult gave me the leopard print skirt they wanted, I’d have a great example of unhealthy narcissism.

Healthy Narcissism in Adolescence and Adulthood

Adolescent egocentrism also happens during the teenage years, but it looks different. During this time, teens are so concerned about themselves that they feel like they’re on a stage with an imaginary audience. They think all their peers are looking at them and noticing that one small zit they popped the night before. Another expression of egocentrism is their false sense of invincibility. For example, a driving teenager might speed because THEY are special and invincible, and a crash wouldn’t happen to them - only others.

Even as an adult, narcissism can be on the healthy, functional end. Confidence and assertiveness can be placed on a narcissistic spectrum from others’ perspectives, but there’s a HUGE difference between saying, “I’m a good clinician…(and so is she)…(and I can always be better)…” versus, “I’m the best clinician…(and she isn’t)…and (I’m superior with no room for growth).” Healthy narcissism falls somewhere in the middle of being a doormat with no narcissistic protection and being a total jerk.

How Does Narcissism Become Unhealthy?

Otto Kernberg (1984/1988)

Kernberg discussed how developmentally appropriate narcissism happens when a child sees the self and world as ‘all good’ or ‘all bad.’ However, if this process continues into later development, it becomes grandiosity - a defense against any realistic ‘badness.’ Moreover, it creates a person who can’t tolerate threats to their perfection, but because humans are imperfect, it leads to severe distress and often depressive episodes. Kernberg believes that people with high narcissism had cold, harsh parents who held high, unrealistic expectations. The child then had to cope by being perfect and rejecting any imperfection/badness. It’s like “fake-it-til-you-make-it,” but they could never stop faking it.

Heinz Kohut (1971/1977)

Kohut hit on appropriate narcissism a little later in development than Kernberg, viewing it as normal and functional to help a child feel secure and stable, as well as to learn to tolerate distress. Ideally, it’s teaching a child using their own narcissism (“Mama, I didn’t spill the milk. YOU did.”) to develop into a more realistic self (“Mama, I spilled the milk. But it’s okay. I’ll clean it up.”). According to Kohut, unhealthy narcissism can develop when parents neglect (lack of support or mirroring) or enmesh (overinvolved, excessive support), which results in losing opportunities to tolerate and regulate the self when facing realistic ‘badness.’ Think of the excessive parent who starts blaming the referee for their child’s mistake in a sports game. At some point, children have to learn that they are not all-powerful or all-good (usually the cause of toddler tantrums). If that grief process is skipped, it hinders development of a realistic self.

Social Learning (Millon, 1981; Benjamin 1993)

Theorists stemming from social learning have noted that overindulgent and permissive parenting (entitlement) on parents’ part results in the child being conditioned to receive praise, gifts, and rewards with no effort. The child learns to expect rewards regardless of performance. They never learn that they are imperfect and that they have to tolerate and regulate themselves when faced with their own ‘badness.’ This would capture the child who believes they deserve an A even though they didn’t do any of their homework the entire semester.

In sum, narcissism is a trait we can map on a continuum from normal (healthy) to pathological (unhealthy). We all need some narcissism to function well. It’s part of healthy development, especially when we’re little. It’s like salt, bringing out the flavors of our personality so we’re not a doormat. However, in excess, it can be too salty, and possibly even repulsive! Are you concerned about your levels of narcissism? Maybe you’ve even been affected by a narcissistic relationship? Therapists can help with that! If in the state of Virginia or Pennsylvania, reach out to see if we would be a good fit: https://www.questpsych.org/dr-cheyenne-fisher. Another wonderful resource is www.psychologytoday.com to find a therapist near you!

References

• Benjamin, L. S. (1993). Interpersonal and treatment of personality disorders. Guilford Press.
• Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. Yale University Press.
• Kernberg, O. F. (1988). Object relations theory in clinical practice. Psychoanalysis Quarterly, 57, 481-504.
• Kohut, H. (1971). The analysis of the self. International University Press.
• Kohut, H. (1977). The restoration of the self. International University Press.
• Millon, T. (1981). Disorders of personality: DSM-III, Axis II. John Wiley & Sons.
• Pincus, A. L., & Lukowitsky, M. R. (2010). Pathological Narcissism and Narcissistic Personality Disorder. Annual Review of Clinical Psychology, 6(1), 421–446. https://doi.org/10.1146/annurev.clinpsy.121208.131215