One of the common questions is this: Is narcissistic personality disorder the same as narcissism or narcissist? Calling someone a narcissist is a common thing in society now. However, some of the labels are misguided. Let us start with what narcissistic personality disorder (NPD) is.

Narcissistic personality disorder is a mental health diagnosis and pathology that is classified as a cluster B personality disorder. Cluster B personality disorders tend to have the following characteristics:

unstable relationships
difficulty regulating emotions.
difficulty regulating impulses.
an emotionally explosive nature.

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For a person to be diagnosed with narcissistic personality disorder, they must seek consult with a psychologist or psychiatrist. Often people with NPD do not seek medical attention for their mental health because they often attribute issues to others around them. However here are the criteria for diagnosis for NPD as taken from the DSM-5. “A pattern of grandiosity (in fantasy or behaviour), need for admiration, and a lack of empathy, beginning in early adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following”:

has a grandiose sense of self importance. For example, exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements.
Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
Believes that he or she is special and unique and can only be understood by, or should associate with, other special or high-status people or institutions.
Requires excessive admiration.
Has a sense of entitlement, for example unrealistic expectations of especially favourable treatment or automatic compliance with his or her expectations.
Is interpersonally exploitive, for example takes advantage of others to achieve his or her own ends.
Lacks empathy and is unwilling to recognize or identify with the feelings in needs of others.
Is often envious of others or believes that others are envious of him or her.
Shows arrogant, haughty behaviors or attitudes.

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For those who want to know what the difference is between narcissistic personality disorder and narcissism or narcissist. Here is where the difference lies. People often use the label narcissist and narcissism to describe someone who has wronged them or done things that seem self serving and self centered or inappropriate. However, these terms are meant to reflect the diagnosis of NPD. Narcissism is a trait where the person has an erotic love for oneself, their appearance, or they are conceited, haughty, arrogant, self absorbed and egocentric. Every person possesses the capacity to have certain narcissistic properties. However, NPD is much different from being over inflated or a jerk the odd time.

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As a therapist, I hear from many clients who are logically hurt by a certain negative behavior or treatment. Its normal to want to comprehend it and understand why it happened. The label “narcissism” or “narcissist” provides a container to explain self serving or odd behavior. It creates a sense that someone else has a problem or defect. It absolves the person from the conflict, and places ownership elsewhere. However, the label may be erroneously applied to a person’s normal flaws for being human and making a mistake.

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For reference, some popular and famous characters who are classic narcissists are:

Don Draper from Madmen
Frank Underwood from House of Cards
Tony Soprano and his Mother Livia Soprano from the Soprano’s
Marie Barone from Everybody Loves Raymond.
Cercei Lannister from Game of Thrones
Donald Trump, upcoming president of the USA.

Many people take the liberty to diagnose someone with NPD but there may not be enough evidence to back that up. It is often the ex-partner, in laws or family. Its understandable how people assume that individuals who are abnormally into themselves, a cheater, a thief or are conceited to be narcissistic.

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Some overlapping events, issues or personality disorders that may seem like narcissism:

Cheating and Chronic Infidelity. People step out on their partner for many reasons, a lack of sexual compatibility, low self esteem, attachment issues, addictions, and so on.
Substance Use Disorders. People may be manipulative, arrogant and lack empathy with addictions. They may do things whilst under the influence of alcohol or drugs that they would not otherwise do, steal, cheat, lie etc.
People with addictions that are not related to substance abuse may cause people to do unusual things, such as engaging in risky sex , pornography, gambling etc.
Major Depressive Disorder with psychotic features.
Bipolar, with mania. When people are manic, they can seem grandiose and full of confidence with little reality to back it up.
Obsessive compulsive personality disorder, OCPD. These types can present as controlling and rigid. They may be perfectionist, easily displeased with people or things, judgemental. They often want things their way and lack empathy. Their behavior makes it appear that they care more about something or someone that is not “just right” in their mind, rather than others at times.
Other personality disorders, borderline, antisocial or histrionic. However, obsessive compulsive personality disorder is the closest match to OCPD. Personality disorders often have over lap.
Kleptomania, a disorder where people steal.
An overly indulged, aka spoiled child, who grows up, not knowing how to navigate other people’s needs because this person is not accustomed to things like sharing, compromising, or considering others. It may at times apply to people who are older and have lived alone a long time.

However, the criterion for NPD is above, and it is quite definitive. People with NPD can have overlapping conditions. Some people are accurately diagnosed with NPD by an armchair psychologist, people can be off the mark. However, calling someone a narcissist who is not, not only is using the term as a negative label but it also invalidates those people who have experienced narcissistic abuse. Which can be very damaging and traumatizing.

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Heather Caruso is a registered psychotherapist, narcissistic abuse treatment clinician, trauma counselor and art therapist. She offers art therapy, trauma counselling, brainspotting, mindfulness, talk therapy, CBT and DBT. Sessions are online and in person therapy sessions. If you are interested in booking an appointment, book a free get acquainted chat where you can ask questions and see if it’s a good fit. Reach out today.

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