What Are the Nine Traits of a Narcissist?

Narcissistic people often have trouble forming deep relationships because of their lack of empathy and the superficial way in which they assign value to people.

Symptoms of narcissism — called core features — of narcissistic personality disorder (narcissism) include:

1. Grandiosity
   • Exaggerated sense of self-importance
   • Feeling superior to others and that one deserves special treatment
   • Feelings are often accompanied by fantasies of unlimited success, brilliance, power, beauty, or love
2. Excessive need for admiration
   • Must be the center of attention
   • Often monopolize conversations
   • Patients feel slighted, mistreated, depleted, and enraged when ignored
3. Superficial and exploitative relationships
   • Relationships are based on surface attributes and not the unique qualities of others
   • People are only valued only to the extent they are viewed as beneficial 
4. Lack of empathy
   • Severely limited or lacking the ability to care about the emotional needs or experiences of others, even loved ones
5. Identity disturbance
   • Sense of self is highly superficial, extremely rigid, and often fragile
   • Self-stability depends on maintaining the view that one is exceptional
   • Grandiose sense of self is easily threatened
   • Patients retreat from or deny realities that challenge grandiosity 
6. Difficulty with attachment and dependency
   • Relies on feedback from the environment
   • Relationships only exist to shore up a positive self-image
   • Interactions are superficial
   • Intimacy is avoided 
7. Chronic feelings of emptiness and boredom
   • When attention and praise are not available, patients feel empty, bored, depressed, or restless
8. Vulnerability to life transitions
   • Difficulty maintaining reality-based personal and professional goals over time
   • Compromises required by schools, jobs, and relationships may feel unbearable
   • Young adults may have a “failure to launch” 
9. Narcissistic personality disorder is a significant risk factor for suicide and suicidal attempts.

What are the 5 types of narcissism?

Experts have identified five different types of narcissism.

1. Antagonistic narcissism - It is a subtype of overt narcissism.
2. Covert narcissism - It is the contrast to overt narcissism.
3. Communal narcissism - It is another type of overt narcissism.
4. Overt narcissism - It has several names including grandiose narcissism and agentic narcissism.
5. Malignant narcissism - It is more closely to overt narcissism with a more severe form.

Narcissistic personality disorder (narcissism) is diagnosed using The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. A person must meet five of nine of the following traits for a diagnosis of narcissistic personality disorder.

1. A grandiose sense of self-importance 
2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. The belief that he or she is “special” and unique and can only be understood by or should associate with, other special or high-status people or institutions
4. Requires excessive admiration
5. Has a sense of entitlement
6. Is interpersonally exploitative — take advantage of others
7. Lacks empathy
8. Envies others or believes others are envious of him or her
9. Shows arrogant, haughty behaviors and attitudes

Treatment for narcissistic personality disorder (narcissism) can be difficult but therapy can often help. Types of therapy include: 

• Supportive psychotherapy that uses both psychodynamic and cognitive behavioral techniques, often combined with psychopharmacologic management
• Structured psychotherapies
  • Mentalization-based therapy
    • Patients are taught to self-reflect
  • Transference-focused psychotherapy
    • Identifies patient’s treatment goals and established a treatment contract between therapist and patient
  • Schema-focused psychotherapy 
    • Uses cognitive-behavioral therapy, attachment theory, and psychodynamic therapy to treat negative perceptions of self, others, and one places in the world that are established in early life
  • Dialectical behavioral therapy
    • A form of cognitive behavioral therapy (CBT) that combines individual therapy with group treatment, has core principles of acceptance and change

Medications may also be used to treat narcissistic personality disorder, particularly in patients who have severe symptoms and may be a risk to themselves or others, and patients who have other, treatable psychiatric conditions. 

Medications that may be used to treat narcissistic personality disorder include:

• Mood stabilizers
• Antidepressants 
• Antipsychotics