Narcissism: why it matters so much to feel special

On a good day, a person with a narcissistic make-up can feel exceptional: cleverer, more gifted, more interesting than those around them. On a bad day, a passing remark from a colleague or someone else’s success is enough for that feeling to collapse into its opposite: “I’m worthless.” Keeping up a sense of their own worth takes constant effort, and when no admiration is coming in, life feels empty and dull.

These days the word “narcissist” often sounds like an accusation, and many people who recognise these traits in themselves are frightened by it. But behind the word is a person who often finds it very hard to live with themselves.

Healthy narcissism, a personality type and a disorder

In psychotherapy, narcissism means more than a set of traits: it describes the ways a person keeps up a sense of their own worth. In this sense everyone has some of it. In healthy narcissism, self-worth stays fairly steady. A person enjoys success without needing to be better than others, gets through criticism and failure, and can be genuinely glad for someone else.

In a narcissistic personality type, questions of self-worth take centre stage. Self-worth depends more on success, admiration and being special, and is more easily hurt. Yet such a person works, loves, feels guilt and makes amends. Many live full and successful lives.

Narcissistic personality disorder is diagnosed when this way of keeping up self-worth becomes rigid and shows up in most areas of life: close relationships keep breaking down, criticism feels unbearable, and other people’s feelings are hard to take into account. It is relatively rare: about 1% of adults, by some estimates up to 6%.

Roughly, the difference looks like this. A colleague is promoted. A person with healthy self-esteem feels a pang of envy, then congratulates them and thinks about what they want next. A person with a narcissistic personality type is stung, may privately decide the colleague was lucky, but settles within a few days. For a person with the disorder, it is a humiliation: either contempt (“they promoted an idiot”) or a collapse into “I’m worthless”, with shame or envy that lingers long afterwards.

Between “I’m exceptional” and “I’m nothing”

At the heart of narcissistic difficulties is self-worth that cannot hold itself up and needs constant confirmation from outside. It has two states. In one, the person feels exceptional, confident and above others. In the other, they feel worthless, full of shame, empty and envious. Many clinicians believe the first protects against the second: feeling exceptional keeps shame at bay. But it is a fragile defence, and the higher a person places themselves, the further they have to fall.

Psychologists call a blow to self-esteem, such as criticism, failure, rejection or a loss of status, a narcissistic injury. It may leave the person overwhelmed by shame, or it may provoke rage. This rage does not come from an argument or a disagreement: it is the person’s attempt to wipe out the humiliation and regain their dignity and a sense of control.

In 2024 researchers at the University of Pittsburgh in the US tested how this plays out. The study involved 437 students: for ten days, after every conversation with other people, they noted how superior and how vulnerable they felt. In the lab, they also played a computer game, supposedly against other players, although the wins and losses had been set in advance. After a defeat, just as after moments in daily life when they felt their status was under threat, their sense of superiority dropped and their sense of vulnerability rose. In other words, a blow to someone’s pride switches them from one state to the other.

The shame often stays hidden, even from the person themselves. Researchers in Berlin compared patients with narcissistic personality disorder, patients with borderline personality disorder and people without a mental health condition. Asked directly, the people with narcissistic personality disorder admitted to less shame than the patients with borderline personality disorder. But a computer test that uses reaction times to show what a person automatically associates with themselves found that they linked themselves with shame more strongly than either group.

Loud and quiet

Narcissism looks different in different people. Some are confident, dominant, talk a great deal and barely notice how others react. Others are shy, hypersensitive and quick to take offence, watch closely for signs of criticism, envy in silence and feel underappreciated. The first is known as grandiose narcissism, the second as vulnerable narcissism (also called covert narcissism).

These are less two kinds of people than two poles of the same difficulty. Research shows that people at the grandiose pole often go through periods of feeling vulnerable, ashamed and low. The reverse happens less often: people at the vulnerable pole mostly stay there.

Where does it come from?

Neglect in childhood, including when a child’s feelings went unnoticed, is linked mainly to the vulnerable pole. Being overvalued is linked to the grandiose one: in a Dutch study of 565 children, narcissism grew in those whose parents considered them better than others and deserving of special treatment. Either way, a child can be left feeling that their worth has to be earned, or that only being exceptional will do.

What it costs

Narcissism causes the person themselves a great deal of suffering. It is linked with depression, loneliness, perfectionism and chronic shame. It is especially hard when the usual sources of admiration fall away, after a failure or a loss of status.

Those close to them find it hard too. Many people with marked narcissistic traits make a good first impression, but close relationships with them can suffer from criticism and coldness.

Does it change?

On average, narcissism softens with age: in an American study that followed people from 18 to 41, it fell considerably, and only 3% became more narcissistic. Empathy, too, is often there but does not switch on by itself: in experiments by British researchers, people high in narcissism felt less for someone describing a painful experience, but when asked to imagine that person’s feelings, the gap narrowed.

With the disorder, change is slower, but some studies of long-term therapy show that it can happen. People rarely seek help because of narcissism itself: more often it is depression, an ultimatum from a partner, family or employer, or a crisis at work. Change looks like this: steadier work and relationships, more room for other people’s feelings and for ordinary imperfection, and a gradually weaker need to be exceptional.

What helps

For a person who recognises themselves here, it helps to notice the swing between “I’m exceptional” and “I’m worthless”, and what sets it off. Shame pushes people to justify and defend themselves. It is more useful to ask calmly what exactly hurt, and why so much. Psychotherapy can help, though it takes time.

For those close to them, it is important to pay attention to what the person does rather than what they say or promise, to set limits and stick to them, and to hold on to their own friends and support. If there is fear, control, isolation from other people or threats, that is abuse, whatever the diagnosis. In England and Wales, repeated controlling or coercive behaviour towards a partner, ex-partner or relative can be a criminal offence.

Narcissism is a way of coping with a fragile sense of one’s own worth, and it often takes shape very early. Understanding it does not mean putting up with harm, but it does leave room for change.