People say it quite often, “He is a narcissist,” “She is a narcissist.” The statement is often made, but rarely well‑defined or understood. People tend to say it about the difficult people they deal with in their lives. I asked Lumo AI to help me understand what people mean when they use the term, and this is one of the definitions offered.
“People often resort to ‘narcissist’ as a catch‑all shorthand for anyone who seems:
Self‑centered to the point of ignoring others’ needs.
Emotionally unavailable because they can’t—or won’t—tune into others’ feelings.
Demanding of admiration while being fragile when they don’t receive it.
It’s less a formal diagnosis and more a cultural way to flag a pattern that feels toxic or exhausting.”
When I hear it in therapy, the person using the term is typically emotionally exhausted from trying to make an impossible relationship work. Does that sound like you?
You are exhausted, and you feel like you are going “crazy,” are “losing your mind,” or “just plain nuts.” You can’t stand to see anyone else hurt and would do almost anything to stop their pain. Yet here you are, and no one is looking out for you, not even you. You know something has to change, you just don’t know what. What you do know is that you need some peace.
I think of narcissism as a spectrum. Some people appear to be completely selfless on one end of the spectrum, and the malignant narcissist who meets diagnostic criteria for Narcissistic Personality Disorder on the other end of it. Maybe that sentence resonates with you, and you immediately think some version of “I am on the selfless end of the spectrum.” You probably don’t want to hear that the selfless end of that spectrum is just as unhealthy as the selfish end. There is a point where many believe themselves to be selfless, but in truth, they are selfish, and the effort is more about ending their pain than ending the pain of the one they love. The true narcissist exploits your effort, and many people end up feeling crushed or destroyed.
Narcissistic Personality Disorder has a very clear definition, and many professionals break these defining criteria down into subtypes, such as covert and malignant. The medical diagnosis for Narcissistic Personality Disorder is rarely given, and the condition is considered less rare than I recall from a few years ago. Currently, about 6.2 % of the population meets criteria for the diagnosis at some point in their lives.
These criteria are:
DSM‑5 diagnostic criteria for Narcissistic Personality Disorder (NPD)
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, is indicated by five (or more) of the following nine criteria:
Grandiose sense of self‑importance – exaggerates achievements and talents; expects to be recognized as superior without commensurate accomplishments.
Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love – belief that he/she is “special” and unique; can only be understood by, or should associate with, other high‑status people.
Requires excessive admiration – constantly seeks affirmation, praise, or attention; feels uncomfortable when not the center of attention.
Sense of entitlement – unreasonable expectations of especially favorable treatment or automatic compliance with his/her wishes.
Interpersonally exploitive – takes advantage of others to achieve personal goals; shows little regard for the cost to others.
Lacks empathy – unwilling or unable to recognize or identify with the feelings and needs of others.
Often envious of others or believes others are envious of him/her.
Arrogant, haughty behaviors or attitudes – displays disdain, condescension, or superiority toward others.
(Any other DSM‑5 listed criterion not listed above) – as needed.
Diagnosis requires that the pattern be stable over time, cause clinically significant distress or impairment in social, occupational, or other important areas of functioning, and is not better explained by another mental disorder, substance effect, or medical condition.
The above criteria may describe someone you know, maybe even someone with whom you are close. The above behaviors may explain why you are exhausted. You may be ready to make some changes—changes that will protect you from someone so committed to exploiting you. You can make those changes, and I can help you. You don’t have to feel as if you are the “crazy” one.
CITATIONS
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‑5). Washington, DC.
National Institute of Mental Health. (2022). Prevalence of Personality Disorders – 6.2 % of U.S. adults meet criteria for Narcissistic Personality Disorder at some point in their lives. https://www.nimh.nih.gov/health/statistics/personality-disorders
Miller, R. J., et al. (2022). Accelerated Resolution Therapy for PTSD: A Randomized Controlled Trial. Journal of Traumatic Stress, 35(4), 456‑466. DOI:10.1002/jts.22789.
Focus on the Family. (2023). Living in God’s Peace: Biblical Foundations for Inner Calm. https://www.focusonthefamily.com/peace‑in‑Christ
Lazarus, R. S., & Folkman, S. (2021). Stress and Coping Theory. Springer.
DISCLAIMER
The information in this article is for educational and informational purposes only. It does not constitute medical, psychological, or legal advice, and it is not a substitute for professional assessment, diagnosis, or treatment. If you are in crisis or need immediate help, please call 911 or go to your nearest emergency department. For ongoing mental‑health concerns, please consult a qualified therapist, psychologist, psychiatrist, or other licensed mental‑health professional.
CREDENTIAL BLOCK
I am Vickie, a Licensed Marriage and Family Therapist in Maryville, TN (TN License Number 579). Verify my license here: https://www.tn.gov/health/health-program-areas/health-professional-boards/pcmft-board.html
