Narcissism 101: Types & Treatment

In my previous article, Narcissism: The Invisible Entanglement, we introduce what Narcissism is and how devistating it can be for everyone involved. Now, let’s dive into the many types of Narcissism and their avaialble treatment options.

How Many Types of Narcissism Are There?

Research conducted by Dr. Ramani Durvasula resulted in her identifying 8 types of narcissism. Each of these has specific patterns of behaviors that are important to recognize, more so than the name of each type. Narcissists use different defenses and tactics to ensure their needs are met, no matter if they hurt others. 

1. Entitled Narcissism

The entitled narcissist feels they should receive special treatment because they are more important than other people. During the COVID pandemic, it seemed like the number of people displaying entitled narcissistic behaviors increased. Even today, encountering entitled narcissists is highly probable because they cannot process situations when they are told “no.” 

Entitlement is a learned behavior that children will develop when they are not taught, they do not always get what they want and how to regulate their emotions. When children see their parents displaying entitlement, the behavior is reinforced. 

Another way entitled narcissism can develop is when children are exposed to situations where they are rewarded for simply participating. This creates a sense of entitlement because the child believes they deserve special treatment because they participated, so they should be rewarded.  

2. Grandiose Narcissism

This type of narcissism is underscored by charisma, vanity, boldness, and a lack of empathy. People who have grandiose narcissism seek attention and are often extroverts. They want people to give them praise and will exploit others for their own benefit without any regard for another’s feelings. 

They can also become aggressive and physically abusive when they feel they are not getting the attention they deserve. They also can be domineering and will engage in playing games to ensure they maintain power over others. 

3. Neglectful Narcissism

The neglectful narcissist only has interactions with other people when they want something from them. They do not view people as individuals, nor do they have to have an actual relationship with them. Rather, they are a convenience. Once they have what they want from the person, they discard them without any regard for their feelings. Neglectful narcissists also use gaslighting to get what they want and are quick to deny any wrongdoing whatsoever. 

4. Covert or Vulnerable Narcissism

Covert or vulnerable narcissism behaviors are usually learned in children as a result of an abusive and neglectful childhood. Cover narcissists can come across as being modest or shy while viewing others as hostile. Their vulnerability comes from these related characteristics:

• Hypersensitivity
• Entitlement
• Passive aggressiveness
• Low self-esteem
• Lack of empathy
• Insecurity
• Resentment towards others

Most covert or vulnerable narcissists use projection to regulate how they feel about themselves. For example, they may feel hostility and will project that onto others. As a result, they will feel like others are being hostile to them and will respond in a hostile manner. 

Another characteristic associated with covert or vulnerable narcissists is a sense that others owe them something. They can also be very resentful towards others they perceive as having a better life than they do. 

5. Malignant Narcissism

Malignant narcissism is a combination of the symptoms associated with antisocial personality disorder and NPD. A malignant narcissist demands admiration and praise, is unsympathetic, and has an over-inflated sense of self-worth. They can also exhibit these behaviors:

• Aggressiveness
• Paranoia
• Abusiveness
• Manipulation
• Feeling like others are out to get them

The malignant narcissist comes across as charming but will exploit and manipulate others without any remorse for their actions. They tend to view people as a means to get what they want and treat them more like objects that can be disposed of when they are no longer useful. 

Additionally, when they have positions of power, they will bend and break the rules to suit their needs. They will also abuse their power to ensure they get what they want. 

6. Communal Narcissism

This type of narcissism is characterized by an inflated sense of self in community settings. Communal narcissists will behave one way in public and another in private. They often come across as being caring and altruistic but instead have their own agenda. Through their actions, they want validation and praise because they often come across as being self-sacrificing. 

However, they still have no regard for others’ feelings and will become condescending when others do not give them the praise and validation they believe they deserve. They still believe they are entitled even though it may not always be apparent due to their behaviors in social settings.

For example, they may use social media posts to show how much they are helping others. Then, they will expect praise and validation from others through the number of likes, shares, and comments they receive.  

7. Benign Narcissism

Benign narcissism is when the individual with this type of narcissism has narcissistic traits, but they are not as intense or severe as other narcissism types. They can still have a sense of entitlement, lack empathy, and display grandiosity. 

However, they often come across as being superficial or immature. They can seem preoccupied and lacking a filter. People with benign narcissism usually only talk about themselves and will take what others are discussing and attempt to make it about them. 

8. Generational Narcissism

This type of narcissism is influenced by parents, grandparents, cultural beliefs, and environmental factors. They can be exposed to intergenerational traumas, neglect, and other types of behaviors that reinforce narcissism. They can feel a sense of entitlement, lack empathy for others, and can even dehumanize others so they can be treated as objects and be disposed of when they are no longer wanted or needed. 

Those around generational narcissists will often excuse their behaviors because they are familiar with their family history and the traumas they have undergone. Additionally, generational narcissism often overlaps with another type of narcissism and co-occurs. 

What is Narcissistic Personality Disorder (NPD)?

NPD is characterized by a persistent pattern of grandiosity, a need for admiration, and a lack of empathy. For someone to be diagnosed with NPD, they must meet specific criteria outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). 

According to the DSM-5, the nine key signs of Narcissistic Personality Disorder (NPD) include: a grandiose sense of self-importance, preoccupation with fantasies of success or power, believing they are “special” and unique, a need for excessive admiration, a sense of entitlement, exploitative behavior towards others, lack of empathy, envy of others, and arrogant or haughty attitudes; a diagnosis requires exhibiting at least five of these traits consistently across various situations. This means that the person must exhibit these traits throughout their life: work, family, friends, society, etc. 

Some signs of narcissistic personality disorder (NPD) include:

• Sense of entitlement

Narcissists believe they deserve special treatment and privileges that others do not. 

• Lack of empathy

Narcissists have a limited or nonexistent ability to care about the feelings of others. 

• Excessive need for admiration

Narcissists crave constant praise and validation to reinforce their self-esteem. 

• Exploitative

Narcissists use others for their own personal gain. 

• Grandiosity

Narcissists have an exaggerated sense of self-importance and feel superior to others. 

• Gaslighting

Narcissists may lie, falsely accuse others, or distort reality to manipulate and emotionally abuse others. 

• Identity disturbance

Narcissists have a fragile sense of self that is highly superficial and rigid. 

• Difficulty with attachment

Narcissists rely on feedback from others to shore up their self-image. 

• Chronic feelings of emptiness
• Tendency to range when things or people don’t go their way. 

Treatment Options

Can Narcissism Be Treated?

Yes, while NPD is challenging to treat, progress is possible with the right approach. Change requires a willingness to confront deeply ingrained patterns of thought and behavior, often rooted in early emotional wounds.

How is Narcissism Treated?

Psychotherapy (Talk Therapy): Long-term therapy can help narcissists develop greater self-awareness, address insecurities, and build healthier patterns of relating to others. The issue here is 99 perfect of narcissist will not acknoledge that they have the traits of characastics much less identify with the criteria to be dianosed as a NPD. They sincerely believe they are better, smarter, wiser, —–than anyone else, yet inside, they are weak and insecure but you more than likely never see this.

Cognitive Behavioral Therapy (CBT): Helps identify and change harmful thought patterns and behaviors.

Group Therapy: Provides opportunities to practice empathy, receive feedback, and understand others’ perspectives.

Mindfulness Practices: Encourages emotional regulation and self-reflection.

Family Therapy: Can help repair damaged relationships if the narcissist is open to change.

Medications for NPD

The U.S. Food and Drug Administration (FDA) has not approved any medications to treat narcissistic personality disorder. 

However, various prescription meds can ease some NPD symptoms. Medication can also ease the impact of co-occurring mental health disorders such as anxiety, depression, bipolar disorder, and post-traumatic stress disorder (PTSD).

Depending on a patient’s specific needs, they may be helped by mental health medications including:

• Antidepressants such as fluoxetine (Prozac) and bupropion (Wellbutrin)
• Mood stabilizers such as aripiprazole (Abilify) and lurasidone (Latuda)
• Antipsychotics such as lamotrigine (Lamictal)