Understanding Narcissism: Why We Shouldn’t Villainize or Pathologize It

Understanding Narcissism: Why We Shouldn’t Villainize or Pathologize It

By:  Jennifer Youdom, LCSW-C

EMDRIA Consultant In Training

The term “narcissism” has become another buzz word these days, often wielded as an insult or shorthand for selfishness and manipulation. This caricature of narcissism paints a simplistic, villainous picture that can influence how we, as therapists, view and work with clients who exhibit narcissistic traits. But the uncomfortable truth is narcissism, as with most mental health terms and diagnoses we use in our field, lies on a spectrum. 

In fact, brain structures such as the Default Mode Network (DMN) hardwire us to engage in self-referential thinking in order to create a separate sense of self and protect it. In a healthy attachment childhood environment we can develop a sense of self while also learning to be attuned, empathetic, and compassionate toward others. 

While extreme cases may meet the criteria for NPD, many individuals display narcissistic traits without crossing into pathological territory. These traits - such as a strong need for validation or difficulty empathizing with others - are often adaptive responses to early life experiences, particularly those involving emotional neglect, criticism, or unmet needs for love and safety.  

In extreme cases, an individual who meets criteria for NPD can still be treated, though their survival mechanisms require them to have an unrealistic view of themselves and to have extreme resistance to accepting one’s own faults and failures which makes therapeutic work challenging. Validation, a key component of therapy, can actually reinforce a client with NPD to feel justified in their skewed point of view so that they continually blame others and avoid accountability, also further challenging therapeutic work. If you find yourself working with such a client, it is best to seek training or refer to a therapist who specializes in working with NPD. You may find you get frustrated working with such clients, in which case you may want to address this in your own therapy (also see the Tip Video “Do Your Own Therapeutic Work” in The Circle).

True therapeutic work requires nuance, compassion, and a deeper understanding of narcissism - not as a character flaw but as a complex and often deeply rooted survival mechanism. Looking at narcissism through a trauma-informed lens can help us better understand it as a protective strategy.

For further understanding of narcissism and how to work with clients who exhibit narcissistic traits, check out: 

“The Wizard Of Oz and Other Narcissists” by Eleanor Payson

Books and You Tube videos by Ramani Durvasula

If you are a therapist who wants to learn more about personality disorders through a trauma-informed lens, consider Trauma Specialists Training Institutes trainings on Borderline Personality: BPD through a Trauma Lens (no EMDR training required as a prerequisite) and EMDR as an Effective Treatment Modality for Borderline Personality Disorder (must have completed an EMDRIA approved EMDR Basic Training).