When we think of someone we have heard described as narcissistic, we often think of selfish, attention-craving, or is notably conceited. It is a term many of us have listened to and used or maybe even misused. It can occasionally lead to generalizations regarding what constitutes a formal diagnosis of a narcissist. If you have ever wondered what defines a proper diagnosis of Narcissistic Personality Disorder, are looking for some clarity for you or someone you are close to, you have found the right place!

What is the difference between narcissistic behavior and pathological narcissism?

Differentiate the occasional “social pho-pa” from a narcissist by looking at the frequency, duration, and intensity of such actions. Narcissistic behavior is a lapse in good judgment where a person may show insensitivity to a person’s feelings or a lack of social awareness of those around them.  It is a short-term lapse in judgment that is typically regretted and remedied with apologies and acknowledgment. Examples of this can be found in Psychology Today. 

In contrast, someone who is a pathological narcissist diagnosed with Narcissistic Personality Disorder operates a little bit differently. While we see these same egocentric and conceited notions in behavior, the difference is a lack of accountability for these actions. Those with this disorder are said to seek out toxic relationships to exploit their partner for selfish gain. It typically accompanies defense mechanisms in conflict such as blame-shifting, portraying the victim, and recalling their behavior as mere reactions because of others’ thoughtless actions; a clear display of lack of empathy and inability to take criticism.  The narcissist needs to be sought after, and a need to be viewed as admirable, different, or worthy of special treatment. Their personality will often accompany grandiose actions to command attention. 

Formal Diagnosis DSM 5

Narcissistic Personality Disorder is under Cluster B Personality Disorders  For more information on the different clusters for personality disorders, Check out our Personality Disorders blog series written by one of our associates: Madeline Weinfeld, LMSW. According to the DSM 5, for a person to fall under this formal diagnosis, they must exhibit five or more of the following traits:

  • Grandiose sense of self-importance:  exaggerating achievements and talents and will expect to be recognized as superior even if their actual achievements do not measure up.
  • They are often preoccupied with fantasies of unlimited success, power, brilliance, or ideal love
  • They firmly believe they are “special” and should only associate with or be understood by other high-status people (or institutions)
  • They require excessive admiration
  • They have a sense of entitlement, such as the unreasonable expectation of special treatment or automatic compliance with his or her requests
  • It is interpersonally exploitive such as taking advantage of others to achieve his or their means
  • They lack empathy- are unwilling to recognize or identify with the feelings and needs of others
  • They are often envious of others or believes others are envious of them 
  • They Show arrogant, haughty behaviors or attitudes. 

How to manage relationships with someone who is a narcissist

If the information provided sounds like someone in your life and you find yourself negatively affected, here are some tips to help you learn to recognize these unhelpful patterns:

  1. Recognize the charm- A narcissist will often know how to manipulate a situation with charm, be aware of how they handle things when there isn’t someone watching, or they aren’t getting their way
  2. Remember that you matter- A narcissist will typically want to be the top priority and can push you to push your needs aside. Keep your goals, conditions, and desires in focus, and be sure to set time aside for self-care
  3. Set clear expectations and boundaries- Be clear about what is acceptable and not acceptable for you in your relationship. Be aware that a narcissist may look for a reaction, so try and keep a neutral expression and tone
  4. Expect Pushback- Remember that they do not accept accountability well and may shift blame onto you. Stay consistent, and remember you are not at fault
  5. Seek support- If being clear about your wants or needs and setting boundaries is a struggle for you, seek out help from our team here at Gateway to Solutions; and if you are unsure where to begin, check out my blog Five Easy Steps to Start Therapy at Gateway to Solutions.

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