Narcissism exists on a spectrum. If you take accountability, have insight, and establish reciprocal relationships, you may have some narcissistic traits but not a personality disorder.
The concept of narcissism refers to a continuum where you may believe in your superiority and prioritize your needs, sometimes at the expense of others. These tendencies may be mild or situational, or they can become evident across most situations and persistently over time.
When narcissistic traits and behaviors span multiple areas of your life for an extended period of time, a therapist may formally diagnose narcissistic personality disorder (NPD).
Narcissism refers to a sense of self-importance. It can be seen as a personality trait that most people live with to some degree. This trait, as any other trait, exists on a spectrum.
At one end of the spectrum is what some refer to as healthy narcissism. This is considered a positive sense of self often associated with the greater good, says Dr. Kristi K. Phillips, a licensed psychologist in Wayzata, Minnesota.
“Individuals with healthy self-image can balance high self-esteem with prosocial behaviors that nurture reciprocal relational dynamics,” she explains.
At the other end of the spectrum, narcissism may negatively impact how you see and interact with yourself and the world.
Pathological narcissism can lead you to experience friction in relationships and great distress. When this becomes persistent in your life, it may lead you to receive a narcissistic personality disorder diagnosis.
In sum, on the spectrum of self-interest, healthy narcissism appears on one side. In the middle, you’ll have some narcissistic traits that range in severity. On the other side, there’s clinical narcissism, where you might find the most severe narcissistic behaviors that cut across multiple areas of your life.
“It is characterized by authoritarianism, envy, grandiosity, shallowness, and a deficit of empathy and remorse. It tends to serve the individual with little or no respect for the greater good,” says Phillips.
For example, in a job interview, you may put down previous employers, embellish credentials and accomplishments, take credit for projects that weren’t yours, or make promises you can’t keep.
Narcissistic personality disorder is a formal condition listed in the reference guide that therapists use to make mental health diagnoses, called the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).
To receive an NPD diagnosis, a health professional will want to determine if you experience at least five of nine formal symptoms across different situations and persistently for more than 6 months.
These symptoms affect your relationships, occupation, sense of identity, and lifestyle. They may cause great distress whether you’re aware of it or not.
The nine formal symptoms of narcissistic personality disorder are:
- grandiosity or a sense of self-importance
- fantasies about power and success
- a sense of entitlement
- limited insight
- a constant need for admiration and praise
- use of manipulation tactics to take advantage of others
- limited or poor empathy
- competitiveness, distrust, and jealousy
- scorn and arrogance toward others
There are at least five types of narcissism, but only one recognized mental health diagnosis.
Personality traits involve patterns of thoughts and behaviors that may manifest in random situations. Narcissistic traits may show up once in a while at work, for example, when you firmly believe and act like you’re the best in your team.
Symptoms of a narcissistic personality, on the other hand, may point to a health challenge that may need professional support. Narcissistic symptoms may impact your quality of life because they appear in most situations.
Only a trained mental health professional can accurately diagnose narcissistic personality disorder or identify narcissistic traits.
Besides the main list of symptoms, these are other differences between narcissism and narcissistic personality disorder:
“A fundamental difference between possessing narcissistic traits versus meeting a full diagnosis is that the person with NPD may not accept responsibility for their behaviors. Someone with narcissistic traits may be able to recognize and take ownership when hurting people they care about,” says Rachel Ann Dine, a licensed professional counselor in Chesapeake, Virginia.
Stability in relationships
“There is typically an exploitative component of the relationship, which can occur in any relational dynamic — romantic, familial, workplace,” says Dine. When someone is no longer considered useful or, perhaps, a threat, a person with NPD may be quick to discard them.
On the other hand, “A person who has narcissistic traits may be resistant to admitting faults or receiving constructive criticism, but does have the capacity to do so, albeit limited in some cases,” she explains.
Context and duration
“An additional difference between NPD and narcissistic traits is that for NPD to be present, symptoms must manifest across most areas of a person’s life and remain stable over time,” says Dine. Narcissistic traits, though, may only appear in certain contexts or at times.
The answer is going to be different for everyone.
Your individual narcissistic traits may be nuanced or context-dependent. For example, you may strive to get ahead at work by any means necessary while still being able to accept constructive criticism from your spouse. That’s an example of the gray zone.
In this way, narcissism doesn’t necessarily develop into a diagnosis of narcissistic personality disorder, says Phillips. “NPD is a long-standing diagnosis. Traits can be seen in childhood or adolescence but not confirmed until after that time,” she explains.
Traits of narcissism can negatively impact a person’s life depending on the severity level, says Dine.
If someone lives with narcissistic personality disorder, the need for help may not be as evident for them.
“Recognizing the need for therapeutic intervention can be difficult, as there is usually a deeply engrained belief they are special,” she explains. “There is a refusal to take responsibility for behavior or accept personal flaws or areas for improvement.”
However, if you or someone you love recognizes the need for treatment, cognitive behavioral therapy (CBT) can be a great place to start, says Dine.
“Seeking a mental health provider who offers a specialization in narcissistic personality disorder is paramount. Empathy-building techniques, such as journaling and identifying emotions, can also be helpful,” she adds.
Narcissism is a personality trait many live with and only becomes evident occasionally. Narcissistic personality disorder is a formal mental health condition with persistent symptoms that significantly impact the quality of life.
You may have some narcissistic traits without meeting the diagnostic criteria for narcissistic personality disorder.
“For a diagnosis of NPD to occur, there must be a pervasive and long-term pattern of grandiosity, lack of empathy for others, inflation of a person’s own abilities, and symptoms generally must be present across most areas of life,” says Dine.