The label is everywhere, but it’s widely misused to describe anyone who offends us. The truth? A little narcissism is good for you. Even for those high in the trait, it’s not all about vanity—new research may be uncovering a connection to depression.

Last winter, a friend told me she was considering a divorce. “I really think my husband is a narcissist!” she said. More recently, over brunch, an acquaintance explained his family dynamics: “My aunt is such a narcissist, we’re not sure why my uncle is with her.”

The term narcissist has been widely deployed to describe not only a passel of difficult relatives and regretted exes, but also both nominees for president and the entire generation known as Millennials. Is narcissism really so widespread or on the rise in the general population?

A growing consensus among psychologists says no, it isn’t. True pathological narcissism has always been rare and remains so: It affects an estimated 1 percent of the population, and that prevalence hasn’t changed demonstrably since clinicians started measuring it. Most (but not all) putative narcissists today are innocent victims of an overused label. They are normal individuals with healthy egos who may also happen to indulge in the occasional selfie and talk about their accomplishments. They may even be a bit vain. But while we’re diagnosing friends, relatives, and our kids’ classmates, true pathological narcissists may be evading detection because most of us don’t understand the many forms the condition may take.


What Narcissism Is (And Isn’t)

Narcissism is a trait each of us exhibits to a greater or lesser degree. As it has become trait non grata, though, it’s become necessary to add the qualifier “healthy” to specify the socially acceptable type of narcissism. “It is the capacity to see ourselves and others through rose-colored glasses,” says psychologist Craig Malkin, a lecturer at Harvard Medical School and the author of Rethinking Narcissism. That can be beneficial, because it’s helpful for all of us to feel a bit special. It fuels the confidence that allows us to take risks, like seeking a promotion or asking out an attractive stranger. But feeling too special can cause problems.

The Narcissistic Personality Inventory (NPI) is the most commonly used measure of the trait. Developed by Robert Raskin and Calvin S. Hall in 1979, it asks an individual to choose between pairs of statements that assess levels of modesty, assertiveness, inclination to lead, and willingness to manipulate others. Scores range from 0 to 40, with the average tending to fall in the low to mid-teens, depending on the group being tested. Those whose score is a standard deviation above that of their peers could reasonably be called narcissists. But a score anywhere along a wide range of the scale might still indicate a fundamentally healthy personality.

A diagnosis of pathological narcissism—which is a mental health disorder—involves different criteria. “Narcissistic Personality Disorder is an extreme manifestation of the trait,” says developmental psychologist Eddie Brummelman, a fellow at Stanford University. The disorder can be diagnosed only by a mental health professional and is suspected when a person’s narcissistic traits impair his or her daily functioning. The dysfunction might be related to identity or self-direction or cause friction in relationships due to problems with empathy and intimacy. It might also arise from pathological antagonism characterized by grandiosity and attention-seeking.

“Narcissism is a continuum, and the disorder sits at the very end,” Brummelman says. The NPI can detect a person’s level of narcissism, but additional real-life effects are necessary for a diagnosis of NPD.

“A personality disorder is a pervasive disturbance in a person’s ability to manage his or her emotions, hold onto a stable sense of self and identity, and maintain healthy relationships in work, friendship, and love,” Malkin says. “It’s a matter of rigidity.”

Someone who scores high on the NPI may indeed encounter occasional awkward or stressful social interactions, but for someone with NPD, Malkin says, “all the psychological defenses are working against healthy functioning” all the time.

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