How to Deal With Narcissistic Personality Disorder

Co-authored by Trudi Griffin, LPC, MS

Last Updated: April 29, 2022 References Approved

A person with Narcissistic Personality Disorder (NPD) often initially comes across as charming and outgoing, exuding self-confidence.^{[1]
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Research source} However, the magnetic personality is cast aside and replaced by a self-absorbed individual. ^{[2]
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Disarming the Narcissist: Surviving & Thriving With the Self-Absorbed (2nd ed) by Wendy T. Nehary (2013)} This person is often extremely difficult to deal with. NPD is one of the most difficult diagnoses for professionals to treat successfully. If the individual with NPD is a family member, a supervisor at work, or someone for whom you already care deeply, you might prefer to explore ways to survive close proximity.^{[3]
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Disarming the Narcissist: Surviving & Thriving With the Self-Absorbed (2nd ed) by Wendy T. Nehary (2013)} You can choose to make adjustments that facilitate co-existence with Narcissistic Personality Disorder, but it can be a difficult road.

Method 1

Method 1 of 3:

Interacting with Someone with NPD

1
Determine if it’s worth dealing with this person. This person probably has very little interest in listening to you and has a lack of interest in what your needs are.^{[4]
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Research source} Narcissists think they know more than others. Therefore, they see their decisions as the only logical answers to problems. Narcissists will expect that you will defer to their decisions. There will probably be power struggles or severe control issues in your relationship.^{[5]
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- Someone with NPD tends to seem uninvested in relationships and tends to react strongly to any perceived criticism. They probably have a history of severing relationships over trivial causes.^{[6]
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  Research source} If you are determined to maintain the relationship, how do you survive, and remain emotionally intact?
- Consider avoiding a relationship with a toxic person. If they show a pattern of disregard for you and/or others, it's probably best to walk away or limit contact.
2
Avoid confrontation. You won’t convince a person with NPD that they are wrong. Pick your battles and don’t waste effort in tackling an issue that centers on the person’s behaviors, as they are unlikely to change.
- If your spouse monopolized the conversation at last night’s family reunion and embarrassed you by telling tall tales, chalk it up as water under the bridge. Take a preventative approach before the next gathering, perhaps by arranging for them to sit next to a quiet family member who will greatly enjoy listening to someone else’s exploits.
- If the issue involves a decision you’ve made, such as not riding in the car with your brother driving if he drinks at the party tonight, state it simply and directly. Feel free to then walk away without trying to justify your decision. That is the behavior you will get from a narcissistic personality so they will understand it—and possibly accept it—better than any emotional plea.
Tip: Set clear boundaries in the format "if you X, then I will Y" and stick to them. For example, "if you start calling me names, I will walk away."

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3
Establish goal-oriented interaction. People with NPD like to achieve things and then brag about their achievements.^{[7]
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Research source} Set goals to meet your needs that provide a source of pride for your narcissist.
- If you cringe when thinking about asking your narcissistic husband to spring-clean the patio and backyard, suggest that he should host the season’s first barbecue. Narcissists see themselves as social leaders, so this type of event provides the audience he craves. Ask his opinion on what needs to be done then offer to ready the house and refreshments for the gathering. Appeal to his muscle in getting the outside ready. Ironically, you might accomplish even more than the spring cleaning you originally visualized by suggesting an outdoor project (i.e., building a pond, raised garden bed, or outdoor fountain). This would provide him with a bragging point during the party.
4
Learn what is important to the person. Remember that someone with NPD probably won’t understand or respect your emotional statements or gestures. They may actually reject them in a manner that feels callous and hurtful to you.
- Instead, study your subject and learn what is important to them. Then offer them a pragmatic gift of your time or wallet that their perception will translate as a genuine statement of affection.
5
Suggest talk therapy. The only effective way to treat this disorder head-on is through talk therapy. Psychotherapy can make inroads in reshaping how persons with NPD perceive themselves and their place in the world. Then they can develop more accurate views of their actual abilities. This can assist them to eventually accept themselves and incorporate opinions of others into their thought processes.^{[8]
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Mayo Clinic
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- However, because people with NPD see themselves as fairly flawless,^{[9]
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  Research source} they tend not to recognize any need to seek counseling or make changes in their behaviors.
- Psychotherapy can assist in helping narcissistic people learn to relate to others so that they have more rewarding personal and professional relationships.
- Convincing a person with Narcissistic Personality Disorder to see a therapist, participate in therapy, and remain in the process until real change occurs, is extremely difficult.^{[10]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
  Go to source} If someone with NPD seeks mental health help, it is generally to address depression or suicidal tendencies.^{[11]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
  Go to source} This person will likely be resistant to any discussions of personality overhaul or behavioral modification.
- There are no drugs to treat Narcissistic Personality Disorder, although treatment may include prescriptions to control symptoms or resultant problems such as depression.^{[12]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
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Method 2

Method 2 of 3:

Recognizing the Traits of Narcissistic Personality Disorder

1
Consider the person’s childhood. Narcissistic Personality Disorder (NPD) is typically found in males, beginning in adolescence or early adulthood.^{[13]
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Research source} Experts have not pinpointed causes but speculation includes certain types of parenting:
- Extremely critical parenting: Parenting that is extremely critical can lead to a growing need for the child to seek adoration. ^{[14]
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- Gushing parenting: On the other end of the spectrum, parenting that is gushing can give a child an unhealthy sense of entitlement or perfection.^{[15]
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  Mayo Clinic
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- It appears most likely that parenting that combines extreme elements of both coldness and admiration often produces a narcissist.^{[16]
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2
Identify if the person thinks they can do no wrong. A narcissistic personality may first appear to have a strong sense of self-esteem, confidence, and ability.^{[17]
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Research source} In time, this will be revealed to be steeped in self-belief that they can do no wrong and that they have greater value than those around them.^{[18]
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Mayo Clinic
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3
Consider if the person thinks they are the center of the universe. The narcissist will feel that the world revolves around them, and they will do what is takes to keep it that way.^{[19]
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Disarming the Narcissist: Surviving & Thriving With the Self-Absorbed (2nd ed) by Wendy T. Nehary (2013)} This might include monopolizing conversations.^{[21]
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Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
4
Consider if the person is easily angered or verbally abusive. When a narcissist doesn’t receive the special treatment to which they feel entitled,^{[22]
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Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source} they might become angry or verbally abusive.^{[23]
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Disarming the Narcissist: Surviving & Thriving With the Self-Absorbed (2nd ed) by Wendy T. Nehary (2013)}
- Differentiate from antisocial personality disorder (ASPD) by noting whether the person has incidents with the law. Someone with NPD may become verbally aggressive, but they typically don't become violent or engage in illegal activity, and they usually have good impulse control.^{[24]
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5
Identify if a person is arrogant or boastful. Persons with Narcissistic Personality Disorder will be seen by most as arrogant, boastful, and self-centered.^{[25]
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Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source} They tend to look down on their inferiors^{[26]
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Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source} (basically, everyone else), and may tear others down in order to build themselves up. They will manipulate others to get what they want.
6
Identify a person’s lack of emotional empathy. There are two major types of empathy: cognitive empathy (the ability to understand someone's emotions) and emotional empathy (the sharing of someone's emotions). Someone with NPD doesn't share in others' emotions and has no desire to learn to do so.^{[27]
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- Contrast this with autism, in which a person typically cares but struggles to understand. Unlike someone with NPD, autistics may spontaneously help others and get upset (sometimes to the point of needing to withdraw) when seeing someone in distress.^{[28]
  X
  Research source} Differentiate between the conditions by noticing how the person responds if you explicitly tell them that they hurt someone's feelings; an autistic person will typically become distressed and concerned, while someone with NPD is unlikely to care.
Tip: Empathy in narcissism can usually be summed up as "I can tell what you're feeling, but I'm not very bothered by it." Someone with NPD will typically notice and understand others' feelings but will not share them. And they may use this information to manipulate people.
7
Notice if a person overreacts to criticism. They will not try to meet the needs of others. In fact, they may react in anger to any request for such, as it may be perceived as a criticism. ^{[29]
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Mayo Clinic
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- It once was thought that the exaggerated sense of self-worth in NPD was in compensation for an actual lack of self-esteem. Experts now believe that narcissists are self-delusional in that they actually believe in their own grandiosity.^{[30]
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  Educational website from one of the world's leading hospitals
  Go to source} They feel entitled to adoration from others, despite any evidence of achievement.^{[31]
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  Educational website from one of the world's leading hospitals
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- Therefore, people with NPD may overreact, possibly even becoming aggressive, when they feel attacked by even the slightest of criticisms.^{[32]
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- Distinguish NPD from borderline personality disorder (BPD) by seeing whether they take criticism to heart. Someone with NPD may get angry, while someone with BPD may also panic and fall into a downward spiral of low self-esteem.
8
Consider if the person has unrealistic expectations. The person with NPD will have exaggerated beliefs of self-importance, superiority, achievement, and ability; manipulative behaviors as well as expectations of obedience, admiration, and entitlement; and preoccupation with “fantasies about success, power, brilliance, beauty or the perfect mate.”^{[33]
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Mayo Clinic
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- People with NPD often demand that the highest quality possible (“the best”) be expended or produced on their behalf.^{[34]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
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9
Recognize if the person takes advantage of others. People with Narcissistic Personality Disorder often tend to manipulate or exploit situations and people in their lives in order to get ahead or get away with their behavior.^{[35]
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Research source} If they can find a way to get what they want, they'll usually do whatever needs to be done.
- For example, say you're indecisive and tend to lack self-confidence. If you and the narcissist got into an argument about something they did wrong to you and you call them out on it a few days later, they may deny and dismiss it by saying "Don't be silly; that's not how it happened," knowing that it'll make you doubt your own point of view.
10
Look at the person’s relationships. It is almost always difficult to work or live with someone with Narcissistic Personality Disorder. People with NPD tend to have problems in their personal relationships as well as at work and/or school.^{[36]
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Mayo Clinic
Educational website from one of the world's leading hospitals
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- Some may note a real or perceived flaw in their perfection that leads to depression or moodiness.^{[37]
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  Educational website from one of the world's leading hospitals
  Go to source} Suicidal thoughts complicate matters further.
11
Notice if there is drug or alcohol abuse. When life does not run smoothly, someone with NPD may have issues with drugs or alcohol.^{[38]
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Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source} Examine how much the person is drinking alcohol or if they are abusing drugs.
12
Make the important distinction between a malignant narcissist and someone who is trying to be a good person. While having NPD makes it more challenging to be a good person, people with NPD aren't doomed to be evil.^{[39]
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Research source} People with NPD may choose to try to treat others with decency and respect, though their distorted viewpoints may make this difficult for them.
- The person must make this choice for themselves. You can't change them, and it's not your responsibility. Don't waste time trying to "fix" someone who doesn't see anything wrong with their behavior.
- Notice if the person is willing to reflect on their behavior, apologize when needed, show concern for others' emotions, and work on treating other people well.^{[40]
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  Research source} They can work on learning to behave better.^{[41]
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- Take verbal abuse seriously. Nobody deserves to put up with that, so distance yourself if the person mistreats you.

Method 3

Method 3 of 3:

Taking Care of Yourself and Others

1
Seek emotional support elsewhere. Accept right now that your emotional needs will not be met by this person.^{[42]
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Research source} Find a trusted friend or other confidante (a relative, counselor, or priest, for instance) who will provide a listening ear and understanding for those times you need to talk about your frustrations. Have a network of friends to fill the other emotional gaps left in your life.
- If your wife has NPD, she may not share in your enthusiasm when you get a commendation at work because it doesn’t concern her personally. She may even receive this commendation negatively if she doesn’t get regular atta-girls at her job. Be prepared for a ho-hum response from her.
- Post a happy note on your social media or call a couple friends who will give you the high-fives you deserve.
2
Educate yourself to improve your quality of life. Every individual is unique, so educate yourself about Narcissistic Personality Disorder but also do your best to learn how your specific person with NPD processes his world. The better you understand that lens, the more you can adapt your approach to him so that you get the results you seek more often than otherwise.
- Learn to anticipate how they will react given particular circumstances, then set up the scenario to obtain the results you want. Examine how they see you in their world, then try to fit that mold as comfortably as you can.^{[43]
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- Don’t bend so much that you break, but manipulate the setting so there’s a happy medium. Remember to employ the grandmotherly maxim given to brides: He’ll do anything you want if you make him think it was his own idea.
- The better you know and understand your person with NPD, the more likely you can reach beyond the wall separating you to show that you truly care, which will benefit you both.^{[44]
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3
Don’t forego making emotional gestures. You may find that a person with NPD responds well to the non-emotional favors you learn to do. This doesn’t mean, however, that you have to forego making emotional gestures from your own heart.
- In fact, they may appreciate being able to show off to co-workers that you put a love-note in their lunch box. Keep in mind, however, that you probably won’t get any expression of appreciation at home that night.
- Your expression of caring will meet your own need of giving love without pain as long as you don’t expect them to react emotionally or to reciprocate your gesture.^{[45]
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4
Seek advice from other resources. You’ve put yourself on the right track by starting to educate yourself about Narcissistic Personality Disorder. There are numerous support groups, books, and other resources with practical advice to help you survive this challenging relationship.
5
Share ideas with other people. Don’t forget that you aren’t the only person impacted by the narcissistic personality in your life. Share ideas with this person’s friends and co-workers who are trying to maintain a relationship with them.
6
Monitor any children the person has. If there are children living with this person, make sure they are safe with this parent. Narcissistic parents can often be verbally or emotionally abusive. Take note if the children are lacking certain social skills because of their parent's behaviors.^{[46]
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Research source}Consider ways you can compensate or re-teach certain social skills so the children don’t become adults with similar behaviors.

Warnings

If the person with NPD is having thoughts of suicide, get them to an emergency room immediately or call emergency services. In the USA, avoid calling the police, as they may kill the person instead of getting psychiatric help.

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