Sisters twins in hipster sun glasses laughing Two fashion modelsPeople loosely call others narcissists, but there are nine criteria, five of which are necessary to diagnose Narcissistic Personality Disorder (NPD). The following summary diagnosis is controversial:

Narcissism exists on a continuum, but someone with NPD is grandiose (sometimes only in fantasy), lacks empathy, and needs admiration from others, demonstrated by five of the following traits:

  1. A grandiose sense of self-importance and exaggerates achievements and talents
  2. Dreams of unlimited power, success, brilliance, beauty, or ideal love
  3. Lacks empathy for the feelings and needs of others
  4. Requires excessive admiration
  5. Believes he or she is special and unique, and can only be understood by, or should associate with other special or of high-status people (or institutions)
  6. Unreasonably expects special, favorable treatment or compliance with his or her wishes
  7. Exploits and takes advantage of others to achieve personal ends
  8. Envies others or believes they’re envious of him or her
  9. Has “an attitude” of arrogance or acts that way

There are several types of narcissists — ranging from the common “Exhibitionist Narcissist” to “Inhibited Narcissists” or closet narcissists. There are narcissists who aren’t vindictive and abusive. However, narcissists who exhibit all or most of the above characteristics intensely and/or frequently are considered malignant narcissists. Narcissists who have fewer and less severe symptoms, along with “narcissistic” people who don’t have full-blown NPD, can have insight, guilt, remorse, and an ability to emotionally connect, as well as love. (See Dealing with a Narcissist: 8 Steps to Raise Self-Esteem and Set Limits with Difficult People to determine if your loved one is capable of change and whether your relationship can improve.)

Anti-Social Personality Disorder

The labels sociopath and psychopath have often been used interchangeably. The clinical term is “Anti-Social Personality Disorder.” (APD) Like NPD, it’s long-lasting and affects all situations. Sometimes permanent, personality disorders are difficult to treat. Someone with APD must have had a conduct disorder by 15 years old, and show at least four of these traits:

  • Doesn’t sustain consistent work (or school)
  • Doesn’t conform to social norms, including unlawful behavior whether or not arrested
  • Disregards the truth, indicated by repeated lying, conning, using aliases, not paying debts
  • Impulsive or fails to plan ahead; moves around without a goal
  • Irritable and aggressive; e.g., fights or assaults
  • Recklessly disregards safety of self or others
  • Consistently irresponsible, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
  • Lacks remorse, and feels justified in having hurt, mistreated, or stolen from another
  • Doesn’t sustain monogamy for more than one year

Narcissists vs Sociopaths

Malignant narcissists are the most malicious and destructive and can look like sociopaths.

Shared traits. They both can be charismatic, intelligent, charming, and successful, as well as unreliable, controlling, selfish, disingenuous, and dishonest. They share exaggerated positive self-images and a sense of entitlement. For example, when they’re abusive, they believe they’re justified and deny responsibility for their behavior. They lack insight. Although they might feign appropriate emotional reactions, this is usually insincere due to their lack of empathy and emotional responsiveness.

Distinguishing traits. While sociopaths qualify as narcissists, not all narcissists are sociopaths. What drives them differs. But the main distinction is that a sociopath is more cunning and manipulative, because their ego isn’t always at stake. In fact, they don’t have any real personality. They’re the ultimate con artists and can take on any persona that suits them. Thus, they may be harder to spot, because they’re not trying to impress you or win your approval — unless it serves their agenda. Instead of bragging, their conversation might center on you rather than on themselves, and they can even be self-effacing and apologetic if it serves their goal.

A sociopath is more calculating and might premeditate aggression in advance. A narcissist is more likely to react sooner with lies and intimidation. Narcissists often work hard to achieve success, fame, and perfection, but may exploit others along the way. In contrast, sociopaths try to swindle, steal, or exploit others financially. Although both characters may be motivated to win at all costs, narcissists are more interested in what you think of them. They need others’ admiration. This makes them dependent and codependent on others, and actually capable of being manipulated.  They’re less likely to divorce their spouse than a sociopath, who might leave or vanish if they’re exposed or don’t get what they want.

Help and Treatment

If you’re in an abusive relationship, whether your partner is a narcissist or sociopath is irrelevant. You need help to set boundaries and restore your self-esteem and ability to trust yourself and others that becomes damaged in an abusive relationship.

Narcissists and sociopaths don’t usually seek treatment, unless, in the case of NPD, they’re experiencing severe stress, depression, or their partner insists. Those with APD are sometimes unwillingly court-ordered to therapy, which presents problems of trust and receptivity. Therapy should focus on helping them access their feelings and learn from the negative consequences of their behavior.

Many narcissists can improve with specific treatment, and those who have insight can benefit from psychodynamic psychotherapy. If you suspect you’re in a relationship with a narcissist, learn more about narcissistic relationships and get a checklist of narcissistic behaviors.

Everyone is unique, and people don’t always fit neatly into defined categories. Severe NPD resembles APD, and any differences are really irrelevant. If you’re being abused, get help immediately. Don’t be concerned with diagnosing; instead, heal yourself from trauma or PTSD and codependency. Whether you’re thinking of staying or leaving the relationship, neither will be easy. Focus on gaining awareness, protecting yourself, and getting help and support. Follow the steps in Dealing with a Narcissist to raise your self-esteem and set boundaries. Change and a better life is definitely possible.

©Darlene Lancer 2016