Your partner cancels dinner plans again because something “more important” came up. When you express disappointment, they turn it around, making you feel guilty for being “too needy.” Later, when they need support, they expect you to drop everything. You find yourself constantly walking on eggshells, wondering if this time you’ll get warmth or coldness.
If this sounds familiar, you might be dealing with someone who has narcissistic traits or narcissistic personality disorder (NPD). While the term “narcissist” gets thrown around casually, true NPD is a complex mental health condition that profoundly affects relationships and causes real suffering for everyone involved.
What Is Narcissistic Personality Disorder?
Narcissistic personality disorder isn’t about someone who takes too many selfies or loves getting compliments. It’s a pattern of behavior and inner experience that causes significant problems in relationships, work, and daily life.
Research published in the Journal of Clinical Psychiatry found that about 6% of adults in the U.S. will experience NPD at some point in their lives, with rates higher among men than women. The disorder typically emerges in early adulthood and affects how someone sees themselves, relates to others, and responds to life’s challenges.
People with NPD have a pervasive pattern that includes:
Grandiosity: An inflated sense of their own importance, talents, or achievements. They might exaggerate accomplishments or expect recognition without corresponding achievements.
Need for admiration: A constant requirement for praise, validation, and special treatment from others. This need can feel insatiable.
Lack of empathy: Difficulty recognizing or caring about how others feel. They may intellectually understand emotions but struggle to genuinely connect with others’ experiences.
Interpersonal exploitation: Using others to achieve their own goals without guilt or remorse.
Entitlement: Expecting favorable treatment and automatic compliance with their wishes.
The Two Faces of Narcissism
Recent research has identified two main presentations of narcissistic personality disorder that can look quite different on the surface.
Grandiose Narcissism
This is what most people picture when they think of narcissism. Someone with grandiose narcissism appears confident, charming, and socially dominant. They’re often charismatic and easily attract people. They may pursue status, engage in social comparison, and feel envious when others succeed.
Grandiose narcissists typically:
- Show off achievements and expect admiration
- Dominate conversations and redirect focus to themselves
- React with anger when criticized or challenged
- Take credit for others’ work or ideas
Vulnerable Narcissism
This presentation is less recognized but equally problematic. Research from Harvard Medical School shows that people with vulnerable narcissism appear anxious, insecure, and hypersensitive to criticism. They may seem shy or withdrawn, but beneath the surface, they harbor the same sense of entitlement and lack of empathy.
Vulnerable narcissists typically:
- Play the victim and seek sympathy
- Feel easily slighted or misunderstood
- Hold grudges and express resentment
- Experience depression and anxiety alongside narcissistic traits
Many people with NPD alternate between these presentations depending on the situation and whether their needs are being met.
How Narcissistic Personality Disorder Affects Relationships
Sarah had been dating Mark for eight months when she started noticing concerning patterns. Early in their relationship, Mark was attentive and generous, making her feel special. But gradually, he began criticizing her clothes, her friends, and even how she loaded the dishwasher. When she got a promotion at work, instead of celebrating with her, he spent the evening talking about his own career ambitions. When she tried to discuss her hurt feelings, he accused her of being “overly emotional” and “always starting drama.”
Sarah felt confused. The charming man she’d fallen for now seemed cold and dismissive. She found herself apologizing constantly, even when she wasn’t sure what she’d done wrong. Her confidence eroded as she tried harder and harder to make him happy.
This pattern is common in relationships with someone who has NPD.
Warning Signs in Your Relationship
Emotional manipulation: You find yourself constantly second-guessing your own feelings and perceptions. Conversations get turned around so you’re always the problem.
Lack of accountability: They rarely apologize genuinely or take responsibility for their actions. When they do apologize, it often feels hollow or comes with conditions.
Boundary violations: Your needs, time, and feelings consistently matter less than theirs. They may invade your privacy, ignore your requests, or demand access to you whenever they want.
Shifting dynamics: The relationship may feel like an emotional rollercoaster, with periods of warmth followed by coldness or criticism. You never quite know which version of them you’ll get.
Isolation tactics: They subtly or overtly discourage your relationships with family and friends, especially those who might question the relationship dynamic.
Understanding the Internal Struggle
While NPD behavior can be harmful to others, people with this disorder often experience significant internal pain. Dr. Elsa Ronningstam, a clinical psychologist at Harvard Medical School who specializes in narcissistic personality disorder, explains that these individuals struggle with unstable self-esteem and difficulty regulating emotions.
Beneath the grandiose exterior or victim presentation lies profound insecurity. Their need for constant validation stems from an inability to maintain a stable sense of self-worth internally. When that external validation disappears, they may experience intense shame, anxiety, or depression.
This doesn’t excuse harmful behavior, but it helps explain why change is so difficult. Their defensive strategies, while damaging to relationships, feel necessary for psychological survival.
What to Do If You’re in a Relationship With Someone Who Has NPD
If you recognize these patterns in your relationship, you have options.
Set Clear Boundaries
Decide what behavior you will and won’t accept. Communicate these boundaries clearly and follow through with consequences when they’re violated. People with NPD often test boundaries repeatedly, so consistency matters.
Don’t Engage in Circular Arguments
When someone tries to provoke you into an argument or make you feel guilty, recognize the pattern and disengage. You don’t have to defend yourself against unreasonable accusations.
Maintain Your Support System
Keep your relationships with friends and family strong. Having outside perspectives helps you maintain reality when you’re dealing with someone who distorts it.
Focus on Observable Facts
In conversations, stick to observable facts rather than feelings or interpretations that can be twisted. “You cancelled our dinner plans” is harder to argue with than “You don’t care about me.”
Consider Professional Support
Individual therapy can help you develop coping strategies, rebuild your self-esteem, and figure out whether the relationship is salvageable. A therapist can also help you recognize patterns and regain your sense of power in the relationship.
Can Someone With NPD Change?
Change is possible but requires genuine motivation, which is rare in NPD. Most people with narcissistic personality disorder don’t seek treatment because they don’t see their behavior as problematic. When they do enter therapy, it’s often to address depression, anxiety, or other issues rather than the personality disorder itself.
Treatment typically involves long-term psychotherapy focused on developing empathy, improving emotion regulation, and building more stable self-esteem. Progress is usually gradual and requires the person to tolerate significant discomfort as they examine behaviors they’ve used to protect themselves.
When to Consider Leaving
Not every relationship with a narcissistic person needs to end, but some situations warrant serious consideration of leaving:
- Physical, emotional, or verbal abuse
- Refusal to acknowledge problematic behavior
- Patterns that worsen over time despite your efforts
- Negative impact on your mental health, self-esteem, or well-being
- Involvement of children who are being harmed
Trust your instincts. If the relationship consistently leaves you feeling diminished, anxious, or worthless, those feelings are telling you something important.
Understanding the Full Picture
Recognizing narcissistic personality disorder is just the beginning. If you’re in a relationship with someone who shows these patterns, it helps to understand how the relationship cycle typically unfolds and why it can feel so confusing.
We explore those patterns, manipulation tactics, and how to protect yourself in our next post on the narcissistic relationship cycle, scheduled to go live on December 11.”
“Understanding what narcissism looks like is just the first step. If you’re in a relationship with someone who shows these patterns, it helps to understand how the relationship cycle typically unfolds and why it can feel so confusing. We explore that in our next post on the narcissistic relationship cycle, scheduled to go live on December 11.”
At Firefly Therapy Austin, we understand the complex emotional toll these relationships can take. Our therapists can help you sort through your experiences, rebuild your confidence, and develop strategies for healthier relationships moving forward. Reach out today to start that conversation.