Narcissistic Personality Disorder: Testing and Treatments

In Greek mythology, the Narcissus myth describes a man who fell in love with himself while looking at his reflection in a pond.

He was so fixed on his beauty that he couldn’t take his eyes off the image and died admiring himself.

The narcissistic personality gets its name from the Narcissus story. This is because people who have this characteristic tend to have an inflated ego, extolling their own qualities.

Despite appearing harmless at first, the narcissistic personality, in some cases, may be related to a mental disorder, including causing psychological damage to those who live around them.

Keep reading and learn more about the problem


What is narcissistic personality?

The narcissistic personality is one characterized by a great sense of self-importance, in which the person believes to be more relevant than the others.

It is marked by the excessive need for self-admiration and attention from the people with whom it lives, in addition to the lack of empathy.

Narcissists often have problems in their relationships, as they do not care about the feelings of others, only their own, and can become offensive companies if they are not to receive recognition the way they expect.

However, despite appearing confident, people with narcissistic personality are often vulnerable and have a fragile self-esteem .

Thus, they need flattery all the time, in addition to demeaning other people to make them feel good.

According to released data, it is estimated that people with this disorder represent less than 1% of the general population. In addition, the prevalence of the problem varies between 2 and 16% in the clinical population, that is, in people who suffer from psychological problems.

It is worth mentioning that, in general, narcissistic personality is considered a disorder, that is, a mental condition, when there are extreme deviations from the way a person thinks and relates to society.

In addition, a disorder is characterized only when the narcissist’s actions cause damage to the person’s life and those who live with him .

In such cases, treatment may be necessary. In addition, it is necessary to check conditions associated with the disorder, such as depression and anxiety . If these symptoms are present, the use of antidepressant or anxiolytic drugs can help in the treatment.

On the other hand, when the individual has a healthy relationship with other people and does not cause harm, whether psychological or physical, it is considered that there are only some traits of that personality.

Does narcissistic personality disorder have ICD?

-Yeah . Narcissistic personality disorder is classified in the ICD – International Statistical Classification of Diseases and Related Health Problems.

It is a tool developed by the World Health Organization and aims to monitor the incidence and prevalence of different diseases in the world, in addition to standardizing the nomenclature of pathologies.

Through it, an overview of the population’s health situation is revealed. In ICD-10, narcissism is listed under the code F60.8 – other unspecified personality disorders.

In the DSM.V (Diagnostic and Statistical Manual of Mental Disorders), a document with criteria and information on the diagnosis of diseases, it is found by code 301.81 .

Symptoms: how is the behavior of a person with narcissistic disorder?

The behavior of people who have narcissistic personality disorder is generally similar, and may vary in the intensity of each symptom.

In general, the characteristics are:

Inflated sense of importance

Narcissistic people have an inflated sense of importance. They consider themselves superior and unique, and believe that they should receive special treatment for that.

They demand extreme admiration and appreciation for their achievements and can exhibit arrogant behavior when their expectations of attention are not met.

Overestimation of skills

Overestimating their personal abilities is one of the behavioral characteristics of narcissistic people.

They think that their abilities and achievements are always better than other people’s and hope that the individuals around them will also recognize this.

They often expose their qualities and expect to be admired by them, creating irrational expectations.

Lack of empathy

Lack of empathy is a hallmark of narcissistic personality disorder.

People who suffer from the problem are not sensitive to the feeling of others and are always focused only on their own desires and well-being.

They generally do not mind hurting other people, including friends and family, to achieve their goals and believe that their needs are the center of attention.


In general, narcissists tend to think, because of their sense of superiority, that everyone else is jealous of themselves.

However, they are generally envious themselves and do not accept that other people are recognized for their deeds.

Convenience approach

Narcissistic people aim only at their own benefit and, therefore, create relationships out of interest.

Generally, they choose who can provide something in their favor to approach, acting out of convenience.

In addition, they tend to be manipulative, creating beneficial situations for themselves, thus taking advantage of interpersonal relationships.

Aversion to criticism

Criticisms are generally not well accepted by narcissistic people.

Even if they are constructive, when they are criticized, they become extremely defensive, justify themselves and even attack those who criticized them.

In addition, they can be very judgmental people who repair and exalt the mistakes of others.

Causes: what are the risk factors for the disorder?

The causes of narcissistic personality disorder can be diverse, and specific reasons for the problem have not yet been discovered.

What is known is that, in general, a set of factors can trigger the condition, which are: biological, environmental and psychological.

In general, the most common causal model is one that relates the three conditions, combining genetic predisposition, treatments received in childhood and behaviors that have been cultivated over time.

However, it is worth remembering that these characteristics do not necessarily describe a potentially narcissistic person, since there is currently no scientific evidence on the origin of the problem, only assumptions.

Biological factors

Biological dysfunctions in the body may be related to the development of the disorder, according to some studies.

This is because it is believed that people with narcissistic personality have a lower amount of gray matter (bodies of neurons) in the part of the brain related to empathy and emotional regulation.

In addition, some research indicates that genetic conditions can influence the appearance of the problem, such as hereditary characteristics.

Environmental factors

Generally, narcissism tends to develop in early adulthood, however, its justification may be linked to childhood environmental factors, such as the treatment received by those responsible.

Girls or boys who have suffered excessive criticism or overvaluation are more likely to develop the clinical picture.

Psychological factors

The difficulty in dealing with responsibilities and demands in adulthood may be related to the development of narcissistic personality disorder.

The feeling of not being enough and low self-esteem can cause the narcissist to create a defensive block, in which he needs to be approved by other people to feel good.

What are the criteria for diagnosis?

To diagnose a person with narcissistic personality disorder, the Diagnostic and Statistical Manual of Mental Disorders V (DSM) lists some characteristics and criteria.

In order for the person to be diagnosed with the disorder, they must complete at least 5 of the items:

  • Great feeling of own importance;
  • Concern with fantasies of unlimited success, power, beauty or ideal love;
  • Belief of being special and unique, which can only be understood by other special people;
  • Excessive admiration requirement;
  • Irrational expectations of receiving special favorable treatment;
  • Take advantage of interpersonal relationships to achieve your own goals;
  • Absence of empathy;
  • Feeling jealous of other people or believing that you are the envy of others;
  • Has arrogant and insolent behaviors and attitudes.

Despite the information listed, it is worth mentioning that the diagnosis can only be made by a professional in the field. The similarity to 5 or more items on the list does not necessarily mean that the person suffers from the disorder.

Narcissism in a loving relationship

Having a loving relationship with a narcissistic person may not be easy. In general, after a while, the relationship can become abusive, causing emotional damage to the victim.

Usually, this type of relationship goes through different phases. Between them:

Pedestal phase

The first phase – also called a pedestal or idealization – is that of passion. It is when the person is enchanted by the narcissist and the relationship is full of love.

At this point, the narcissistic person usually presents only his pleasant and conquering side.

The name pedestal refers to the way that the narcissist treats the person, placing him in an environment of constant praise, unexpected surprises and the valorization of his qualities, making him feel very special.

In general, the feeling in this phase is that of a perfect relationship and can last as long as necessary to completely conquer the victim.

Devaluation phase

The second phase is devaluation. It is at this point that narcissistic signs are usually noticed most explicitly in the relationship.

This stage is characterized by small or large actions that devalue the other person.

In this way, qualities that were previously praised can be criticized, achievements are minimized or ignored and the virtues often begin to be pointed out as defects.

It is also at this moment that critical comments disguised as caution begin to be made, talking about appearance, for example.

In addition, the narcissistic partner shows signs of disinterest in matters related to the victim, in addition to often being jealous and repressing her relationships with other people, whether with family members or friends.

From that point on, it is normal for discussions and disagreements to occur frequently in the relationship. It is when the narcissist begins to blame the victim for all the problems that are occurring.

He / she also tries to justify his / her abusive actions in response to the victim’s actions and mistakes.

Discard phase

The discard phase is the one that culminates in the breakdown of the relationship and takes its name from the coldness with which the victim is rejected by the narcissist.

At that moment, the victim’s blaming occurs even more intensely, for all the problems faced in the relationship and also for its end.

In addition, accusations of lack of emotional control and defamation for people close to you are also common.

Thus, the victim believes that he is guilty of destroying the coexistence between the partners.

In general, the discard phase can occur in the midst of intense discussions or simply with the narcissist’s removal from the victim’s life, without satisfactions.

Narcissistic mothers

Several people can have narcissistic personality disorder, and sometimes some of them become mothers.

The figure of the narcissistic mother is characterized by an oppressive motherhood. In general, the symptoms of the disorder affect the children, resulting in a problematic and abusive relationship.

Usually the signs of this type of relationship are made explicit when the children reach the adolescence phase, when they tend to have more autonomy and often disagree with their parents, which does not please the narcissistic mother.

In general, the main signs of a narcissistic relationship between mother and child are:


Oppression is one of the main characteristics of the relationship of narcissistic mothers.

In general, they use their title of mother to oppress and control their children.

In this way, any trace of independence or action that represents autonomy and is done by the offspring is strongly repressed.

They also constantly recall past mistakes made by their sons and daughters, especially in the midst of discussions.

In addition, narcissistic mothers often project their own negative traits and behaviors on them, punishing them for it.

Thus, they deny these traits in themselves and put all the bad character (belonging to themselves) under someone else.

Lack of affection

The idea that mothers are beings who naturally feel love and compassion for their offspring is not a reality for narcissistic mothers.

In such a condition, these women generally do not and do not show affection. On the contrary, they are extremely harsh and build relationships with indifference.

For them, the feelings and needs of their sons and daughters, as well as that of other people, are of little importance. Often, there is a devaluation of any attitude or victory won by the offspring, not having the least compassion.

This action results in the development of children (as) extremely needy and with traumas that can extend throughout their lives.


Narcissistic mothers do not admit that their children make mistakes and, if they do, often emphasize this.

If the offspring does something that she does not like, the narcissist can stay as long as she deems necessary without speaking to her, emphasizing the feeling of guilt for her children.

That way, she decides when the relationship returns to normal, demonstrating that things should go the way she wants.


Narcissistic mothers are generally very manipulative. They use this mechanism so that everyone can do whatever they want, in any circumstance.

In this way, she makes her sons and daughters feel guilty for the way she treats them.

In addition, it manipulates people so that their circle of coexistence thinks that the actions taken by them are the fault of their children’s actions.

Thus, it encourages the view that you are a victim of malicious offspring (as).

When there is more than one child, narcissists tend to constantly set themselves against each other, causing disagreements.


Often, the narcissistic mother does not admit the progress, whether physical or intellectual, of her sons and daughters.

In this way, it creates a competitive climate, in which no one can be better than her.

In general, daughters are the ones who suffer the most in this regard and the situation becomes more noticeable during adolescence.

This is because it is usually at this stage that girls have the most intense changes due to puberty.

Thus, the narcissistic mother often envies the vitality presented by the daughter, causing conflicts in the relationship.

Thus, it is common for her to offend her daughter and direct hateful words, especially related to her appearance.

Considering that puberty is a delicate process, of formation and emotional structuring of the adolescent, this relationship can have severe impacts on the girl’s self-confidence and self-esteem.

Ungrateful children

Often, children who are not subjected to narcissistic abuse are classified as ungrateful.

In general, when they complain about the mother’s attitudes, she victimizes herself and blames her offspring for all the problems in the relationship.

The matriarch creates a situation in which all people, even their own sons and daughters, believe that she is being wronged by the ungrateful and cruel family.

It usually emphasizes all the mistakes made by the offspring over time and how much it affects them. Blames the family for their emotional imbalance and disseminates this idea to other people, such as family members and even neighbors.

Golden child

In general, when the mother has more than one child, one is chosen as the most special.

For this child, the narcissistic mother provides all the good experiences that were not given to the other, and is usually called the golden child.

Despite this, the symptoms of the disorder also appear in this type of relationship, as soon as the children serve only to exalt the mother, like a trophy.

In general, the narcissist does not allow them to have a will of their own. Thus, they are just an extension in the mother’s life and must meet her expectations and act in the manner expected by her.

How to deal with a narcissistic person?

Living with narcissistic people, whether at work, in friendships or even in the family can be challenging.

In general, those who suffer from the disorder do not resort to medical help spontaneously, which makes living more difficult.

To deal with this type of personality, there are some precautions that can help. Between them:

Have patience

Narcissistic people, despite being confident, are often vulnerable and emotionally sensitive.

Thus, care and patience are needed in the midst of conversations. It is important to speak calmly and avoid conflicts, as the narcissist believes he is always right.

In addition, it is worth trying not to diminish the superiority complex created by him / her, but rather to encourage him / her, progressively, to think about other people as well.

Impose limits

It is important to impose limits on the narcissist from the beginning of any relationship.

Generally, people with this disorder tend to be manipulative and, in this way, will encourage their circle of coexistence to think like her.

Thus, it is relevant that the person explain, from the beginning, their conditions and wishes in a frank and confident way.

It is also worth not being afraid to upset the person who suffers from the disorder, making it clear that there are different opinions from her.

Emotional detachment

Having an emotional distance from narcissistic people is one of the points that can help in a minimally pleasant relationship.

This involves avoiding showing weaknesses, which is important so that the narcissist does not take advantage of such vulnerability.

Before giving praise, one should always consider and make this type of comment only when the narcissist deserves it.

In addition, for those who live with people who have this clinical picture, therapy sessions can also help to avoid becoming a narcissistic victim.

Is there a cure?

There is currently no specific treatment to cure narcissistic personality disorder.

As with other mental disorders, there are resources such as therapies and the use of medications aimed at improving symptoms.

How is the treatment?

The treatment of narcissistic personality disorder usually consists of methods such as psychotherapy and medication administration, which may vary according to each clinical picture.

More specifically, treatment can be:


The main way to treat people with narcissistic personality disorder is through psychotherapy.

This resource, known as psychological therapy, has speech as its main tool, in which, through conversations that address emotional issues, the professional and the patient discover together the origin and ways of treating problems.

There are different types of therapy. Between them:

  • Cognitive behavioral therapy: aims to analyze the person’s behavior pattern, identify the origins and reasons for this behavior and indicate techniques that replace negative behaviors with positive ones.
  • Group therapy : group therapy aims to contact the patient with people who have conditions similar to theirs, being a place to expose anxieties, thoughts and experiences. It is a way to stimulate a better relationship between the patient and other people.
  • Family therapy : family therapy is carried out in conjunction with family members. It aims to explore existing conflicts between family members and identify ways to solve these problems, to make living together more harmonious.

Although there are several types of therapies, in general, they aim at improving interpersonal relationships and better understanding of their own feelings.


There are no specific drugs for narcissistic disorder. However, it is common for patients to have other psychological conditions, such as anxiety and depression. In that case, treatment may resort to remedies.

Therefore, there must be a specific diagnosis for pharmacological guidance.

They serve to control these other conditions, promoting a better quality of life for the patient, being a first step towards the attenuation of narcissism.

Prevention: how can you avoid a narcissistic disorder?

There are no specific resources to prevent the development of the disorder.

In general, diagnosing and starting treatment as soon as possible can prevent the problem from getting worse, but it is not a belief.

Is testing to identify narcissistic disorder reliable? How is done?

There are currently some tests available online, which theoretically identify narcissistic traits in a person.

They consist of a series of questions that, once answered, will indicate whether a person is narcissistic or not.

Despite this, it is worth mentioning that they serve only as entertainment and cannot be taken into account for a real diagnosis .

The analysis of the presence or absence of the problem can only be done by a professional in the area , who uses several criteria such as behavior, psychological assessment and childhood history to diagnose the disorder.

Thus, tests to indicate narcissistic disorder should not be taken into account, only medical and psychological guidance.

Personality disorders are problems that can affect not only those who present the clinical picture, but also the people around them.

Therefore, it is very important to seek medical help, so that the diagnosis and treatment of symptoms is made.

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