Labelling anybody who displays even a small degree of self-confidence as narcissistic seems to be common practice these days. Especially on social media. Narcissistic personality disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as an over concern with self-love and an idealised self-image, a persistent and pervasive pattern of grandiosity, a constant need for admiration and attention, a lack of empathy, a strong sense of entitlement and constant feelings of self-loathing, emptiness and boredom.
NPD can only be diagnosed by a licensed and accredited mental health professional and only after a comprehensive psychological evaluation with questionnaires and assessment tools such as the Narcissistic Personality Inventory for example. Even then, the assessed individual must display a certain percentage of the traits outlined in the DSM-5 to meet the criteria for NPD. It is crucial to note that it is only the treating mental health professional who has the capacity to administer the questionnaire and assessment tools and make a subsequent formal diagnosis. An individual cannot be formally diagnosed as suffering from NPD by any mental health professional who has not personally evaluated and spent time with the individual in question.
Contrary to popular belief, there is a very big difference between someone who a) displays healthy narcissism, b) someone who, from time to time, displays unhealthy narcissistic traits and c) somebody that suffers from full blown narcissistic personality disorder (NPD). What most people fail to understand however is that narcissism, in its healthy form, is a core component of healthy personality development. Narcissism exists on a spectrum and without narcissism, one cannot adequately develop self-esteem or self-worth. Children are inherently narcissistic. This is the way that we are born. To survive as a new born requires us to be narcissistic. We must do everything that we can to draw the attention of those around us if we wish to be fed, sheltered, etc. It is through the process of ego development and healthy identity formation that we lose our pathological narcissistic traits.
This is why I favour ego development as a way of understanding narcissism. The framework of ego development allows us to see full blown NPD as a form of arrested development. The ego development framework also allows us to see how and why people engage in unhealthy narcissistic traits from time to time. Rather than the unhealthy traits being a result of full-blown NPD, the unhealthy traits are the consequence of temporarily regressing into earlier, immature, ego states. Finally, the ego development framework shows us how healthy narcissism is essential even in our most mature states. The more mature the ego is within ego development theory, the more self-actualised the individual is. Let’s look now at how narcissism can be manifested in a healthy way.
We all need to love and appreciate ourselves when we look in the mirror. The same applies when we think of ourselves. We are generally in a better state of mind when we think of ourselves in positive, life affirming ways. This manifestation of narcissism is normal and healthy. It is only when our sense of self-worth and self-esteem becomes persistently over and hyper inflated, and not representative of reality, that narcissism becomes unhealthy. Additionally, it is by looking into a mirror as a child that we, in part, develop our identity. How else do we learn what we physically look like? How else do we learn about our physical image and realise that we are a separate entity from others? It is only when you start spending hours in front of the mirror admiring yourself and telling yourself how fantastic you look does this narcissistic tendency become unhealthy.
In simple terms, grandiosity within the context of narcissism refers to a sense of being better than others among other things. Believing that you are better than another, in its healthy form, can foster competition and motivate and empower oneself before a sporting event for example. It becomes unhealthy however if this belief of being better than others extends beyond the specific competition or without recognition that we are randomly born with physical or mental capacities which naturally, due to no conscious input of our own, makes us ‘better’ than others at certain things and that we should be appreciative and humble of that. Or maybe we just put in longer training time than our competitors which gives us the capacity to perform better in that specific event and thus ‘makes us better’.
We all have a sense of entitlement. This can be healthy. We are entitled to be loved by others. We are entitled to request that we are treated a certain way by others. We are entitled to request that our needs, wants and desires be met. We are entitled to request that we receive a certain income based on our skills, service, knowledge etc. Entitlement becomes unhealthy however when we disregard other people’s feelings and individuality and thus impose ourselves upon others. For example, your entitled beliefs to be loved or treated in a certain way does not entitle you to physically, mentally or emotionally force someone into loving you or treating you a special way. If the other chooses not to cooperate with your requests, then you have the choice to respect their free will and individuality by finding someone who will happily and willingly treat you the way you feel you are entitled to be treated.
Heinz Kohut characterised healthy narcissism in the following ways; 1.Strong self-regard, 2. Empathy for others and recognition of their needs, 3. Authentic self-concept, 4. Self-respect and self-love, 5. Courage to abide criticism from others while maintaining positive self-regard, 6. Confidence to set and pursue goals and realize one's hopes and dreams, 7. Emotional resilience, 8. Healthy pride in self and one's accomplishments, 9. The ability to admire and be admired.
It is important to remember that narcissism is not evil and dangerous. Healthy narcissism is critical for personality development and it can enhance and empower us in our daily lives. Healthy narcissism helps us to achieve the goals that we set for ourselves. Healthy narcissism can provide us with the love and respect we desire independent of what others may think of us. It is unfortunate that healthy narcissism is rarely discussed. The problem with always talking about unhealthy narcissism is that people displaying healthy narcissism will begin questioning their healthy manifestations. This is obviously problematic as healthy people will begin regarding themselves as ‘sick’ which only intensifies the mental health problem.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA:
Falkenbach, D. M., Howe, J. R., & Falki, M. (2013). Using self-esteem to disaggregate psychopathy, narcissism, and aggression. Personality and Individual Differences, 54(7), 815-820.
Pincus, A. L., & Lukowitsky, M. R. (2010). Pathological narcissism and narcissistic personality disorder. Annual review of clinical psychology, 6, 421-446.
Vaknin, S. (2001). Malignant self love: Narcissism revisited. Narcissus Publishing.