In order to be diagnosed with narcissistic personality disorder (NPD), someone must meet 5 out of the 9 listed criteria in the DSM5, which is the diagnostic and statistical manual for mental disorders used by health care professions. It helps them to guide the diagnoses of mental disorders including narcissism.

Diagnostic Criteria for NPD are:

1. Lacks empathy: unwilling to recognize or identify with the feelings and needs of others
   
2. Has a grandiose sense of self-importance. Exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements.
   
3. Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
   
4. Requires excessive admiration
   
5. Believes that he or she is unique or special and can only be understood by, or should associate with, other special or high-status people (or institutions)
   
6. Has a sense of entitlement; unreasonable expectations and favorable treatment or automatic compliance with his or her expectations
   
7. Interpersonally exploitative – takes advantage of others to achieve his or her own needs
   
8. Shows arrogant, haughty behaviors or attitudes
   
9. Often envious of others or believes that others are envious of him or her

Many professionals that have a deep understanding of narcissism would agree that we need some changes made to this list to resemble our current understanding.

Now some of you may look at that list and feel confused. You are experiencing many of the symptoms of narcissistic abuse but the person you’re dealing with just doesn’t match this list of criteria. They may not demonstrate some of the traits like feeling superior and better than others, taking advantage of other people, or requiring excessive admiration and they do seem to demonstrate empathy.

I said the same thing at one point too. On one side, I saw the guy I loved and he was none of those things but there was a dark and troubled side to him that I started seeing more and more as time went by. These two very different sides kept me so confused that I didn’t know if I should stay or go. The good side of him made it extremely hard for me to let go of the relationship.

There are two things you should understand. First narcissism exists on a continuum, from low traits all the way up to pathological, and second there are different types of narcissists and they operate very differently. Opposite of each other’s traits and behaviors. 

While one type might be easy to point out, another is not, and if you are experiencing the symptoms but not connecting with these traits, then you may very well be dealing with a more covert narcissist. 

Not everyone’s experience is going to look the same, but the lack of emotional empathy, exploitation, and the need for constant attention or admiration in one form or another are usually present in all narcissists.

But, covert narcissism is very hard to detect. They are some of the most skilled individuals at successfully manipulating people to believe they are one thing when they are quite the opposite. 

In order to get you to believe in their fake persona, they have to be skilled at manipulation. It’s extremely important for them to hide their disorder and agendas.

My therapist explained it to me that it was similar to drag queens. Because they don’t possess certain features, they have to exaggerate their looks. 

More covert narcissists still lack empathy and are exploitative but it looks and feels very different and most survivors early in learning about narcissism have a hard time seeing it, but they sure did feel the effects of it.

Expressing empathy is different than feeling empathy. Someone can possess cognitive empathy but not have emotional empathy. So they can understand what makes people react in certain ways and what emotions they should express, but they do not FEEL the empathetic emotions.

Cognitive empathy is used a lot in marketing. It’s what influences consumers to make a purchase on a product. It’s not always genuine or comes from the heart, but it works in getting a result. This is the same as a relationship with a narcissist.

Narcissists do not accept their true selves and therefore they project an unrealistic self-image that they need to force people into accepting and supporting. Therefore, they need to be skilled at manipulation and lies. This means they must understand how other people feel and see things and what makes them vulnerable so they can use that to their advantage.

What most people neglect is to give narcissist credit for is their unbelievable skillset to manipulate others. They have been doing it probably most of their life and by the time they are an adult, they are pretty seasoned and most people will fall for the character they play.

It’s understandable that you can’t see someone going through such great lengths to trick you. It just doesn’t make sense why it would be worth their time or how doing this can benefit them.

If narcissists were to show their true character, they would never obtain the things that are important to them, therefore they are hardwired to manipulate others.

So they can look like the arrogant bully that we are used to seeing, or they can look like a caregiver with a huge heart, or they can look like the introverted, shy, gentle, humble good guy or girl.

We must accept that people can be wired differently and we are unable to relate to their mindset, but we do need to learn about personality disorders so we can protect ourselves and others.

The perfect recipe for abuse, destruction, and heartbreak is a narcissist’s manipulation skills combined with the lack of a target knowledge around their personality disorder. This is the type of destruction that destroys people’s lives.

And most narcissists are not diagnosed and will probably never be. That’s why it’s even more important for people to be educated because not everyone will experience their personality disorder. Often it’s the people closest to them at home or work.

There are several reasons narcissist are not diagnosed

• They don’t recognize their behaviors as problems and therefore do not go to therapy to be diagnosed
• Many doctors and therapists are not trained around narcissism and can often be charmed by them.
• They are misdiagnosed because symptoms can resemble other disorders
• They often have co-occurring disorders and addictions such as bipolar, antisocial, histrionic, depression, anxiety, porn, drugs, and alcohol addiction
• The court system is not trained around NPD therefore generally does not ask for evaluations. Even with a diagnosis, many do not understand the effects it has on people they target.
• Many people in authority roles are narcissistic themselves and either do not care or can’t see the problems

But, let’s also be clear.  Just because someone is not diagnosed, does not mean they do not have NPD and it does not mean you are not being abused.

In my opinion, it’s the survivors on the battlefield with a narcissist that usually have a better understanding of their character than most therapists or doctors, at least when they wake up and start learning about narcissism. They will see and go through so much more than the narcissist will ever reveal to others or the public.

These are the types of behaviors you would have to get on camera to prove to people because they just don’t believe it. And even then, some of their enablers will still make excuses for them.

The change we need is not going to come from the narcissist, is going to come from everyone else. The victims, the survivors, the ones helping to raise awareness, and the professionals that understand this type of abuse.

Photo by Alec Favale

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