WOMEN’S SPECIALIST PSYCHOTHERAPIST Private Online Therapy · Worldwide · Brisbane-Based Client resources. Charming, then cruel, never their fault? Narcissistic personality disorder.
“Narcissist” gets used for anyone who’s hurt us. Narcissistic personality disorder is more specific, and loving someone with it can leave you feeling small and confused. Here’s what it is, and how to encourage help without triggering rage or getting pulled into the fight.
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PART 1WHAT IT IS
What is narcissistic personality disorder?
Narcissistic personality disorder (NPD) is a long-standing pattern of grandiosity (in fantasy or behaviour), a need for admiration, and a lack of empathy.
Not everyone with NPD is loud and arrogant. Some people have a more “vulnerable” or covert style: hypersensitive, resentful, shame-prone and quietly entitled. It’s diagnosed more often in men, and belongs to Cluster B, the “dramatic, emotional or erratic” group.
Cluster BDramatic, emotional or erratic
What it can look like from the outside
- An inflated sense of importanceExaggerates achievements and expects to be seen as superior.
- Needs constant admirationFishing for praise, and wounded when it doesn’t come.
- EntitlementExpects special treatment and automatic compliance.
- Uses peopleTakes advantage of others to get what they want.
- Lacks empathyCan’t or won’t recognise how others feel, especially when it’s inconvenient.
- Envy and arroganceEnvious of others, or convinced others envy them; contemptuous when challenged.
WHAT’S UNDERNEATH
The agenda that doesn’t change.
Dr Gregory Lester teaches that every personality disorder is organised around an agenda: a core need that stays the same whatever the situation, and drives how the person sees you and responds to you. Once you can see the agenda, the behaviour starts to make sense, and you can stop taking it so personally.
Here’s how I’d sum up the agenda in narcissistic personality disorder: To protect a special self-image. Underneath, there’s usually a fragile sense of worth that can’t tolerate shame, so anything that threatens the image is pushed away, often onto you.
Where it comes from. It seems to come from a mix of temperament and early experience: being idealised, being coldly criticised, or both, and learning that worth depended on performance. Early shame is a common thread.
Easily confused with
- Healthy confidenceConfidence includes empathy and can tolerate being wrong. NPD usually can’t.
- Bipolar maniaGrandiosity that comes in episodes, with less need for sleep, is different from a lifelong pattern.
- Antisocial personality disorderThere’s overlap. Antisocial traits are driven more by gain and control than by admiration.
PART 2IF YOU SUSPECT SOMEONE YOU LOVE HAS IT
How to raise it without the drama.
Before you say anything
The single most important thing: never tell them they’re a narcissist. To someone with these traits, it’s an attack on the self-image they’re protecting, and the usual responses are rage, contempt or cold withdrawal.
People with narcissistic traits usually only consider help when life hits a wall: depression, a breakup, burnout, a career setback. That’s the window. And before anything else, check whether what’s happening to you is abuse. Read about narcissistic abuse.
What tends to help
- Wait for the window
A loss, a setback or a low patch is when motivation is highest. Raising it when they’re riding high rarely works.
- Lead with respect, not criticism
Shame shuts everything down. Respect keeps the door open.
- Frame help around their goals
Performance, stress, being at their best, relationships that work. “A lot of high achievers have someone in their corner to help them stay on top of things.”
- Name the impact once, briefly
In “I” terms: “When I’m spoken to like that, I pull away.” Then stop. Don’t build a case.
- Let it become their idea
Offer the information, then step back. Ownership matters more here than almost anywhere.
- Expect pushback, and don’t take the bait
Blame, contempt or a sudden change of subject are common. Stay calm and end the conversation if it turns nasty.
Drama traps to step around
Most of these traps are a corner of the drama triangle: rescuing, attacking or collapsing. Seeing which corner you’ve been pulled into is the first step out.
The trap
Diagnosing themInstead
Even if you’re right, the label becomes the fight.The trap
Debating your version of eventsInstead
You may be told it didn’t happen, or happened because of you. You don’t need them to agree to know what you saw. Read about gaslighting.The trap
Waiting for their empathyInstead
You may never get the acknowledgement you deserve from them. Get that support elsewhere.The trap
Justifying, arguing, defending and explainingInstead
The more you explain, the more there is to pick apart. Short and calm wins.
You can offer help. You can’t make an adult take it. For more on staying out of the drama, read Do you suspect someone you love has a personality disorder?
PART 3WHAT HELP LOOKS LIKE
Help for them, and where to start.
NPD is harder to treat than some personality disorders, but change is possible when the person is motivated. Therapies used include schema therapy, transference-focused psychotherapy and mentalisation-based treatment, usually over the longer term.
Most people with narcissistic traits start therapy for something else: depression, anxiety, a relationship ending or burnout. Their GP can refer them to a psychiatrist or psychologist experienced with NPD.
WHERE I COME IN
They need their own help. You deserve yours.
This is a big part of my work. I help women recover from relationships with narcissistic partners, parents and bosses: the self-doubt, the shame, the hypervigilance and the way you slowly disappeared. Together we resolve what happened and rebuild a sense of self that no one can talk you out of.
I help women who are experiencing abuse from someone with a personality disorder, and women who need help managing a relationship with someone who has one. These relationships often bring a great deal of anxiety, trauma and drama into your life. I don’t diagnose or treat personality disorders. My work is with you: resolving the impact on your nervous system, your confidence and your sense of self, and helping you step out of the drama for good.
You don’t need a referral or Mental Health Treatment Plan to see me. I’m a private practice, so you can book a private 15-minute consultation directly. If I’m not the right fit for what you need, I’ll tell you honestly, and point you to who is.
You can’t make them see you. You can start seeing yourself again.
THE PERSONALITY DISORDERS SERIES
Read about each type.
What is a personality disorder? · The 10 types at a glance · Do you suspect someone you love has a personality disorder?
WHERE THIS INFORMATION COMES FROM
Sources.
This page draws on Australian health services, the diagnostic manual clinicians use (DSM-5-TR), and Dr Gregory Lester’s training on personality disorders.
- Personality disordershealthdirect AustraliaWhat personality disorders are, the main types, and where to get help in Australia.
- Project Air Strategy for Personality DisordersUniversity of WollongongAustralian information, guidelines and family and carer resources for personality disorders.
- SANESANE AustraliaInformation, peer support and counselling for people affected by complex mental health issues, including personality disorders.
- Gregory Lester, PhD: speaker profilePESIDr Lester’s background, including his 2,000+ personality disorder trainings and his role as an original research site for the DSM-5 personality disorders revision.
YOUR NEXT STEP · BRISBANE AND WORLDWIDE
Whenever you’re ready...
Want to talk it through?
If we’re already working together, bring this to our next session, or email me any time between sessions.
If a relationship with someone who has a personality disorder is taking a toll on you, you’re welcome to book a private 15-minute consultation. No referral or Mental Health Treatment Plan needed. No pressure and no obligation – just an honest conversation about whether I’m the right fit, and if not, who is.
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