You Got a Narcissism Diagnosis: Now What?

How to work with the diagnosis and replace stigma with compassion.

If you learned that you may have a narcissism diagnosis or narcissistic traits, or you believe a loved one has issues with narcissism, you need more than scary online headlines. What does narcissism actually mean, and how many types are there? How does diagnosis work? How does narcissism connect with your unique experience?

Online content on narcissism is a tsunami of scary headlines that paint people in a nefarious light, ranging from “Narcissists are trying to control you” to “How to end a relationship with a narcissist” or “Narcissists are sociopaths” and the worst: “Psychotherapy doesn’t help narcissists.” While this content is often appropriate because we do encounter people with this kind of character, it shouldn’t represent the entire range of narcissistic experiences. Just because someone may have used gaslighting doesn’t mean they can’t ever emotionally connect.

To help you cut through the noise, get your feet on solid ground, and gain a sense of where to start, here are 10 points of resilience:

1. Don’t panic.

The majority of online content about narcissism addresses a particular kind of narcissism: an overt or malignant narcissistic personality disorder. While a large percentage of narcissistic people have grandiose traits (which can be obvious or hidden), not all narcissists are malignant. They just get the most online attention.

2. Don’t fall prey to stigma.

Just because you have a narcissism diagnosis or narcissistic traits doesn’t make you a malignant or overt narcissist. Much of what you read online may not apply to you. Plus, an overt narcissism diagnosis doesn’t mean you can’t change. A good start is the fact that you’re reading this right now!

3. It’s more complicated than what you see online.

The world of narcissism includes a broad spectrum of types, traits, and severity. For example, types of narcissism include overt narcissism, covert narcissism, malignant narcissism, and communal narcissism (though not all of these are officially recognized by psychiatry at this time). Even with a diagnosis, you have to think about the severity, as well as which traits you may have.

4. Getting a diagnosis is not as simple as advertised.

A mental health diagnosis is not like getting a physical health diagnosis. Physicians use categorical diagnosis, which is an either/or label with no nuance. It’s like having measles: You either do or you don’t. Many in the mental health field are pushing to change diagnosis from categorical to dimensional. A dimensional diagnosis means you may score on a spectrum of a group of certain traits. Many clinicians are uncomfortable with diagnosing a personality disorder at all, as they see it as harmful for a client to hear and prefer to focus on therapy goals.

5. Look at narcissism through a schema therapy lens.

Schemas are ways we learn to see the world early in childhood, a kind of program that runs in our brain about how to view ourselves and relationships. People diagnosed with narcissistic traits often test high with certain schemas, including vulnerability, entitlement, emotional deprivation of empathy and unconditional love, and defectiveness schema. It may actually be more accurate to understand yourself as having one of these schemas in a powerful way: for example, “I have a strong vulnerability schema.” It can be an alternative to the stigma-laced term “narcissism.”

6. Take ownership of your diagnostic process in collaboration with your therapist.

This isn’t about letting yourself be labeled by a book. Work with your therapist and loved ones to review your unique experience: How do narcissistic traits play out in your life challenges?

Put together a traits list to inform therapy goals. But don’t forget to be open-minded and humble. It’s difficult for everyone to get frank feedback on their personality. For this reason, it’s important to have patience, avoid being combative or defensive, and give it time.

7. Grief and self-criticism are common responses.

Receiving a diagnosis can be a blow to your ego, raising negative thoughts and feelings and internal stigma, thinking you are flawed and feeling worthless. However, grief actually helps with acceptance: You feel sadness about letting go of the person you thought you were, and you start accepting new challenges. Trust me, you will also learn new ways to appreciate yourself and your loved ones.

8. Focus on building empathy and be wary of self-absorption.

If you received this diagnosis or have traits, it’s likely that empathy can be more of a challenge for you. It’s important to keep in mind that empathy is a skill you can learn and, with practice, develop. Curiosity is the magic ingredient for empathy. Be curious about others’ POVs and how they may be different from yours, especially around shared experiences. Ask open-ended questions and use your imagination.

9. Build new self-care skills and use a planner.

As discussed in my book, Your Coping Skills Aren’t Working, successful behavior change is about putting yourself in an ecosystem of growth. The key elements of this ecosystem are a brief daily practice, including self-talk, mindful meditation, and journaling. The most effective way to set yourself up for success is to use a planner and your phone to manage your time. A planner helps you remember to engage in activities that may not come naturally.

10. Take a break from your own story and focus on others.

It can be a relief to walk away from your troubles for a bit. Try applying your talents in group situations that are about sharing and giving, such as volunteer work or group-based hobbies like hiking, knitting, or book clubs.

The diagnostic process in the mental health world has been in a state of slow-motion transition for years. The best elements of a diagnosis help you see yourself with clarity, compassion, and acceptance; the worst parts of the diagnostic process are the ways it can pathologize. The mental health profession has a long way to go to make the process more supportive and less shaming. Until then, these 10 points of resilience can help.

photo credit: Shutterstock/Cast of Thousands