Am I Narcissistic? How to Know and What to Do About It

Are you concerned that you might be narcissistic? Keep reading to learn what narcissism actually is, signs to look out for, and what to do about it.

Learn more about our Clinical Review Process

“Narcissist” and “narcissism” are words that get thrown around a lot these days on social media, but what do they actually mean? The word “narcissist” is often casually used to describe someone who’s self-centered or cocky. However, true pathological narcissism is linked to a personality disorder: narcissistic personality disorder, or NPD. 

“Narcissism is a personality trait characterized by excessive self-focus, a sense of superiority, and a deep need for admiration,” says Anne Oeswein, a Licensed Professional Counselor Supervisor with Charlie Health. Some people may have narcissistic traits, but this doesn’t always mean they are a true narcissist with NPD.

If you find yourself wondering, “Am I narcissistic?” read on to learn more about narcissistic traits, the importance of self-awareness, and what steps you can take if you recognize these behaviors in yourself, and more.

Am I narcissistic? Understanding narcissistic qualities

Narcissism encompasses several specific traits, including:

• Grandiosity or an inflated sense of self-importance, Oeswein says. This is when someone thinks they’re better than others and often exaggerates their talents and achievements.  
• The need for excessive admiration. Narcissists have a strong desire for attention and validation from others, Oeswein says. 
• A lack of empathy is one of the most troubling of the key narcissistic traits, which means and indicates they have trouble understanding and caring about other people’s feelings.
• Going hand-in-hand with a lack of empathy, narcissists are also very manipulative. Oeswein says they tend to use others for personal gain without regard for their well-being.
• A sense of entitlement. Since they think they’re better than others, narcissists believe they deserve special treatment or privileges, Oeswein explains.
• Fragile self-esteem. Despite appearing overly confident, many narcissists are actually deeply insecure and sensitive to criticism, Oeswein notes. This is especially prevalent in “vulnerable narcissists” or “covert narcissism,” which is a NPD subtype.

However, exhibiting one or even multiple of these traits does not mean you definitely have a personality disorder. “There’s a spectrum, and not everyone with narcissistic traits has narcissistic personality disorder, which is a more extreme, clinically diagnosed condition,” Oeswein says. 

How is narcissistic personality disorder diagnosed?

Only a mental health professional (like a licensed therapist, psychologist, or psychiatrist) can diagnose NPD. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has specific diagnostic criteria that professionals consult to make a diagnosis. 

To receive a diagnosis, someone must exhibit at least five of the key narcissistic traits, and their narcissism must be causing problems with their relationships and impairments in their life, such as difficulty holding a job and chronically unstable relationships. 

Narcissism vs. self-esteem: What’s the difference?

Many people find themselves confused about the difference between narcissism and having high self-confidence and self-esteem. However, there are key differences. 

“Narcissism and healthy self-esteem can look similar on the surface — confidence, assertiveness, and pride, but the foundation is very different,” says Bree Williams, a Licensed Professional Counselor Associate. “Healthy self-esteem allows someone to feel secure without needing to be superior. Narcissism, however, often requires the person to feel ‘above’ others to feel okay within themselves.”

According to Williams, some key differences are that healthy self-esteem is grounded in genuine self-worth, allows for accepting feedback, includes empathy for others, and stems from internal confidence, whereas narcissism is rooted in fear of inadequacy, reacts defensively to feedback, lacks empathy, and relies on constant external validation.

In addition to how these make you feel, healthy self-esteem and narcissism have very different effects on your relationships. “Healthy self-esteem fosters genuine confidence, resilience, and positive relationships, whereas narcissism can lead to strained relationships, emotional distress, and an inability to accept personal flaws,” says Oeswein.

Narcissism and self-awareness

Narcissists often lack self-awareness when it comes to their personality disorder. “Many individuals with NPD don’t view their behavior as problematic,” Williams says. “Instead of seeing an issue within themselves, people with NPD often externalize blame — believing that others are the problem or that people simply don’t understand them.”

In general, it’s typically the people in a narcissist’s life who will point out their troubling behavior. “It’s usually close family members, partners, coworkers, or friends who begin to notice the emotional harm or manipulation that comes with narcissistic behavior,” says Williams. “These concerns from others may be dismissed or minimized by the individual with NPD, reinforcing the cycle of denial and defensiveness.”

In cases where a narcissist is defensive and in denial, they’re unlikely to acknowledge their behavior or even attempt to change. 

“Self-awareness is crucial because it’s the first step toward meaningful change,” Williams says. While narcissism can limit insight, it’s not impossible for someone to recognize their behaviors, especially if they’re open to feedback, feeling stuck in repeated conflicts, or noticing patterns in their relationships that are painful or isolating.” 

Oeswein says building self-awareness can help a narcissist:

• Understand how their behavior impacts others 
• Recognize patterns of manipulation
• Understand others’ feelings 
• Identify emotional triggers
• Set healthy boundaries
• Manage emotional responses 
• Recognize the need for personal growth and change 

How to increase self-awareness as a narcissist 

“Someone can realize they have narcissistic traits or even NPD, but it typically takes a willingness to reflect without defensiveness,” says Williams. “This may come from therapy, a major life event, or feedback from trusted loved ones. Self-awareness helps a person move from denial into exploration, allowing them to examine the root causes of their behavior and begin developing healthier relational patterns.”

Here are seven ways to improve your self-awareness.

1. Seek honest feedback

Ask trusted friends and family members how they experience your behavior, especially during conflict or emotional moments, Williams suggests. 

2. Reflect on your behavior

Check in with yourself and assess how you interact with others. For example, Oeswein says you should ask yourself, “Do you seek excessive validation? Struggle with empathy? Feel entitled?”

3. Look out for patterns

When you reflect on your behaviors, see if you notice any patterns, Williams suggests. For example, do your relationships tend to end the same way? Do people say you’re dismissive or hard to talk to? “If relationships frequently end due to conflict or manipulation, it may indicate narcissistic tendencies,” Oeswein adds.

4. Journal regularly

“Writing down thoughts, reactions, and feelings can help you recognize themes in how you see yourself and treat others,” Williams says. 

5. Practice mindfulness

Mindfulness is a great tool for developing emotional awareness. “Being present in the moment can help recognize emotional reactions and thought patterns,” Oeswein says.

6. Learn about narcissism

Psychoeducation plays a large role in mental health care, regardless of the disorder you’re dealing with. It’s helpful to research and learn about personality disorders like NPD. 

7. Work with a therapist

“A therapist can help you unpack your past, increase your emotional insight, and develop healthier ways of relating,” Williams says. You can also learn ways to be a better partner in a relationship. 

Treatment for narcissistic personality disorder

“Treatment is often a long-term process requiring patience and commitment, but with consistent effort, individuals with NPD can learn to manage their symptoms more effectively and lead more fulfilling lives,” Oeswein says. “Psychotherapy (also known as talk therapy) is the most effective treatment, helping individuals develop healthier relationships, improve emotional regulation, and gain self-awareness.”

Various types of psychotherapy can help people with NPD.

1. Cognitive behavioral therapy (CBT)

CBT helps individuals recognize harmful thought patterns and replace them with more constructive ones, Oeswein says. It can also help you develop healthier behaviors, which can help your mood. Additionally, CBT allows narcissists to build healthy self-esteem and develop greater self-awareness. 

2. Psychodynamic therapy

“Psychodynamic therapy helps explore unresolved childhood wounds that may have led to narcissistic defenses, such as shame, neglect, or emotional invalidation,” Williams says. Adverse childhood experiences (ACEs) are a top contributing factor of developing NPD as an adult. If you have suffered from ACEs or any type of childhood trauma, processing this in therapy is key to healing.  

3. Transference-focused psychotherapy

This unique modality focuses on transference, which is how someone redirects their feelings for people in their life onto their therapist. Oeswein says transference-focused therapy can address deep-seated emotional wounds and improve your interpersonal relationships. 

4. Schema therapy

“Schema therapy targets long-standing core beliefs and unmet needs that drive narcissistic behavior,” Williams says. Schema therapy helps people uncover any deep emotional wounds or patterns — AKA “schemas” — that started in childhood. Once you uncover these patterns with your therapist, you can recognize them and work on changing them. 

5. Medication for NPD

There is no specific drug to treat narcissistic personality disorder directly, Oeswein says. However, a provider might prescribe psychiatric medications if there are co-occurring mental health disorders. Symptoms of other disorders can also cause trouble with daily functioning and interpersonal relationships. 

Mental health conditions that commonly co-occur with NPD are:

• Major depressive disorder
• Bipolar disorder
• Substance use disorder
• Anxiety disorders
• Borderline personality disorder
• Antisocial personality disorder
• Body dysmorphic disorder

The specific medication will depend on your diagnosis or diagnoses.

How Charlie Health can help

If you think you might be a narcissist, self-awareness is the first step, and Charlie Health can help. Our virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for people dealing with mental health conditions, including personality disorders like NPD. Plus, we provide treatment for co-occurring disorders like anxiety, depression, or bipolar disorder.
Our compassionate clinicians incorporate evidence-based therapies, such as CBT and trauma-informed therapy, into individual counseling, family therapy, and group sessions. With this kind of support, you can build self-awareness, develop healthy self-esteem, improve relationships, and boost overall well-being. Fill out the form below or give us a call to start your journey today.