There are so many articles about Narcissism on the internet. It is easy to lump someone into a category when “narcissistic traits” may seem to be prevalent in many other diagnoses. This is the reason why it is inappropriate to diagnose someone who is not in the room. Often times, I will hear people talking about their partner and I realize they may have TBI or PTSD. They may also have Depression or some other mental health condition. Addicts DO seem to be narcissistic but this is because they are putting the addiction before the family, job or partner. Below are some things to be aware of. No one should diagnose anyone unless they are a psychological professional and they are in the room with this person. Even then, we don’t necessarily tell the person, unless we are going to do treatment on them or they seem open to listening.

1. Narcissistic traits vs. personality disorder – As mentioned above, the traits can be seen in a myriad of diagnoses and so it might not be the personality disorder. We are all egotistical and so there are times when we can seem like narcissists to others.
2. Another personality disorder. In my practicum, I worked with a woman who had Histrionic Personality Disorder. Now, I can recall her narcissistic traits, but it was way more drama. The men who have begun to see me for a Narcissistic partner, generally seem to be Borderline. Anti-Social Personality Disorder is really what is going on in the movie “Gaslight.”
3.  I have had people tell me that a mentally ill person was a “narcissist” or that the addict was a “narcissist,” for example. Those traits will surface from these types of other diagnoses. Which comes first though? What will they be like on medication or clean and sober? This is something that we can’t answer until it happens. I try to empathize with the mentally ill person – who is not in treatment – when explaining to my clients or to people in general. With an addict, I will say “Oh, they are an addict. And the fix is their priority, not you or anyone else, which makes them seem like a narcissist.” Mentally ill people often feel bad about the strain caused on their families by their illness.
4. Is the man/woman angry due to undisclosed sexual abuse or because of a traumatic brain injury or PTSD? I try to dig deep when I hear a man come into my office who says he was told he was a narcissist. Women aren’t generally told this for some reason. If we find out what is really going on, then we can treat the problem and find a solution. If a man is coming into my office and addressing his own narcissism by taking responsibility for this, that is usually a good sign. I would like to say that most likely they are not as the narcissist does not take responsibility. It is always everyone else’s fault.
5. Women will often ask “Am I a Narcissist,” thinking it is genetic or maybe it wasn’t my mom or maybe it wasn’t my husband/boyfriend, maybe it was me. There is a study that I have read but I am not convinced yet, I have seen it re-enacted but not inherited.
6. There are walls put up by the person with PTSD. I specialize in this, and I prepare for the defensiveness when they have it (not always), sometimes they can be quite angry. I never take it personally; they aren’t angry at me or at us as psychotherapists. Their behaviors sometimes can be narcissistic because they are protecting themselves from assumed tragedy, crisis, pending danger. They are angry at all men or all women. They are angry at the perpetrator and their ego shows us a very cocky, know it all, in charge, protector – or a very strong person who is trying to be in control of the world around them. They know this. The narcissist is not aware that they are doing these behaviors, some are conscious though and this is a whole other level.

The narcissist is not aware of their behaviors and how it impacts others. The parent is not concerned about how their children will turn out as adults and how it correlates to the way they raised them. They will talk about their children’s outcomes and will approve or disapprove but do not correlate with themselves and their spouse. They are “bad children”, “they became drug addicts,” “they are a horrible parent,” “they live in the basement because they can’t make it on their own.” I have heard a parent say, “I don’t want them to leave, because I don’t want to be alone.” That is, at least, some acknowledgement of responsibility.

In conclusion, don’t assume the person is a narcissist. If the articles you are reading online, make sense, talk to a therapist to discuss this further. The most important thing is not their diagnosis but how you are handling this relationship, yourself, and what steps should you take to heal and move on in your life. Take a look at my workshop on the “Survivors” page above, which can be found on Udemy.