Narcissism and Narcissistic Abuse

By Team Felicity
Wed Jun 30 2021

Narcissism and Narcissistic Abuse 

By Shreya Durve, MBBS Student


A narcissistic personality disorder is a mental health disorder in which the person involved has an inflated sense of self and an intense need for attention and affection. Such individuals tend to be involved in problematic relationships (romantic and otherwise) and exhibit a lack of empathy for the other person.


The 9 Traits of a Narcissist

The DSM manual has given 9 traits or core characteristics for an individual with the personality disorder to aid diagnosis.

  1. Grandiosity: An over-inflated sense of self, feelings of superiority over others.
  2. Need for admiration and affection: They need to be the centre of attention and tend to make conversations about themselves.
  3. Superficial and troublesome relationships: Build relationships with individuals only based on surface attributes and the benefit they can derive from them.
  4. Inconsiderate: Lack of understanding and empathy for others further creating a drift in relationships.
  5. A skewed sense of identity: While such individuals usually have an inflated sense of self, their grandiosity is easily threatened, and have very fragile self-esteem underneath it all.
  6. Not committed: Intimacy issues, superficial attachments, and lack of ability to form meaningful relationships.
  7. Unproductive: Increased feelings of boredom, loneliness, and depression.
  8. Unadaptable: Inability to adjust to the environment and keep up with personal and work-based goals.
  9. Self-harm: Increased incidence of suicide and depression. Usually associated with other psychiatric conditions.


The DSM- Criteria

A person has to have 5 of the 9 symptoms and signs to be diagnosed with a narcissistic personality disorder. 

  1. Grandiosity
  2. Preoccupation with fantasies of power
  3. The belief that they are unique and should be associated only with people of great candour
  4. Excessive need for attention and admiration
  5. Strong sense of entitlement
  6. Takes advantage of others and their relationships
  7. Lack of empathy
  8. Extreme jealousy and feeling that others are jealous of them
  9. Arrogant attitude



While there may be a set criterion to diagnose the individuals, the actual scenario is much more complex. Not only do such individuals have poor insight, but those around them also cannot identify the signs very easily due to conditioning to toxic patterns.

Not all people with personality disorders present the same way – many appear extremely charismatic, confident and show a sense of power which may draw individuals to them – thereby perpetuating unhealthy patterns.


The risk factors and causes

  1. The disease presents itself more commonly in men than women: The presentation of men and women is also different. While males primarily present with inflated self-esteem, exploitative behaviour-based goals, and entitlement; women tend to show extreme signs of jealousy, competitiveness with other women, and insecurities. 
  2. Genetic and environmental influences: Individuals who have a relative with the disorder are more likely to develop it later in life. The way parents raise their children also influences the likelihood of the development of the disorder. Some reports say that individuals who have been overly pampered during childhood are more prone to the same.
  3. Extreme punishments and criticisms and equally extreme praising for behaviours is also a risk factor.
  4. Manipulative parents and friends: Learning is a primary mode of development of the disorder. Children with manipulative parents and friends will develop similar patterns. 
  5. Child abuse.
  6. Parents who have excessive expectations from children.
  7. Other unhealthy parent-child interactions.


Narcissistic Abuse

Many of the coping mechanisms employed by narcissists gravitate towards abusive patterns. Such patterns usually do not allow them to have fulfilling, healthy, and deep relationships – romantic and otherwise.

A person stuck in an abusive relationship usually has difficulty recognizing signs of abuse – due to conditioning. In such a situation, the most important aspect is identifying abusive patterns, building support, and moving forward with minimal harm to your mental health.


Identifying Narcissistic Abuse


1. Verbal abuse

A partner who is narcissistic (or even a parent for that matter) tends to pull their significant other down by their choice of words. Belittling accomplishments, insulting or berating, playing blame games, continuously shaming them for their choices, and not allowing them to think freely – can all lead to low self-esteem among the victims. Even excessive use of sarcasm has been highlighted as a common pattern. However, not every time a partner yells at your, or calls you a name points towards narcissistic behaviour.


2. Manipulative behaviour

Narcissists usually display a very loving and confident persona when you first interact with them – which draws people towards them. This also makes it difficult to identify abuse from an outsider’s point of view – due to their belief that the individual is “too good to hurt anyone”. However, such individuals tend to display manipulative behaviour and only show their dysfunctional patterns once comfort has been built, and attachment has already formed on the other side. 


3. Isolation and loneliness

A partner who shows narcissistic traits is also likely to be emotionally unavailable. In such a situation, owing to increasing dependency on the abuser, the victim may feel isolated and experience a sense of loneliness. The concept called hoovering states that the partner grooms you in such a way that you don’t believe that the abuse is truly happening, and forgive it all. Unsincere apologies, acts of love, and kindness after abusive interactions are what lead the victim to question themselves and wonder if the relationship is abusive or not. 


4. Poor decision making and self-doubt

Due to the constant berating and insults being thrown the victim’s way, they may have very low self-esteem thereby leading to their lag of ability to make decisions. They may also lead you to question the existence of the abuse, thereby perpetuating the situation. Gaslighting the victim can also lead to a further drop in self-esteem. 


5. Self Blame

A narcissistic partner may lead you to believe that all the disagreements and arguments are ultimately your fault. All arguments are geared towards the victim leading them to believe that it is their fault. Victims tend to apologize for no fault of their own, just to appease the other. 


6. Trouble setting boundaries

An individual who has suffered narcissistic abuse has difficulty setting their boundaries as the abuser usually manipulates their way into getting what they want. This would lead the victim to give up on their boundaries to appease the other person. 


7. Other psychological conditions 

Individuals who suffer from narcissistic abuse usually have other psychiatric comorbidities like depression, anxiety, or panic disorder. Some may resort to substances and develop a disorder.


Treatment for the Victim and Perpetrator


1. Care for the victim

The most important step in caring for the victim is identifying the abuse. Narcissistic patterns are often very difficult to identify owing to their nature. The abuser displays a false persona externally, leading people to not believe the victim.

The next step is forming a support system to lean on, and who will ground you to reality. Breaking up with a narcissist is tough because they create a fuss and try to manipulate their way into making your stay. In such a situation, it is important to take help from the support system you have built.

Moving forward, a victim should seek help in the form of therapy to build back what they have lost. It is not their responsibility to fix another individual, especially at the cost of their own mental health.


2. Treating the disorder

This has always been a tricky subject – with therapy and psychological help showing poor results. One of the major reasons for poor treatment outcomes is a lack of insight. Owing to their inflated sense of self, a person with the disorder may not believe that they need help with anything.

Cognitive-behavioural therapy is the treatment of choice for individuals diagnosed with NPD. However, it is also important to recognize that not a lot of individuals suffering from the same actually come to seek help. The victim’s safety and mental health must be cared for before you can work on treating the disorder.

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