Here's How to Deal with Narcissists, According to a Psychotherapist

The term “narcissist” gets tossed around pretty loosely, but if you have a true narcissist in your life, you know how much havoc they can wreak. According to author Dr. Judith Orloff, in her book, The Empath’s Survival Guide, “Narcissists act as if the world revolves around them. They have an inflated sense of importance and entitlement. They need to be the center of attention and require endless praise. You must compliment them to get their approval.” They’re often persuasive charmers who know exactly what to say to manipulate you and mess with your emotions. To learn more about Narcissistic Personality Disorder (NPD), including how to cope with one in your life, I reached out to psychotherapist Dr. Elisabeth Crain.

Dr. Elisabeth Crain, PsyD, is a psychotherapist who takes a practical and contemporary approach to mental health. Coined the “Shrink for the Modern Human,” Crain earned her Bachelor of Arts from the University of Southern California (USC) and her Doctor of Psychology (PsyD) from The Chicago School of Professional Psychology. She operates a thriving private practice in Los Angeles, specializing in family and couples counseling, inner child work, modern parenting, maternal mental health support, narcissistic abuse recovery and other mental health challenges relevant to our modern society. She incorporates an array of therapeutic modalities into her work with each client.

“Narcissists are diagnosed with Narcissistic Personality Disorder (NPD) based on diagnostic criteria outlined in the DSM,” Crain tells me, adding that typically, there are eight criteria, and for a diagnosis of NPD, a person must meet five of these criteria. The most illuminating features are:

• Lack of or no regard for others' feelings. Narcissists don’t show remorse or compassion toward others.
• Little or no empathy. They don’t care about how other people feel or think.
• Exploitative and manipulative behavior. Narcissists are out for personal gain in ways that are exploitative and manipulative. They use others as a means to gain power or control.

Crain clarifies that someone who exhibits narcissistic traits does not necessarily have NPD. “NPD is a personality disorder defined in the DSM, and not everyone who shows some narcissistic traits meets the criteria,” she tells me. “Again, you must have five out of eight of the criteria to be diagnosed with NPD. If you have only two, you may show narcissistic traits but not have the personality disorder.”

NPD diagnoses are relatively uncommon. Per Crain, “It's something like 5 to 8 percent, or maybe even less.” Narcissistic traits, on the other hand, are more common, and it's important to differentiate between NPD and narcissistic qualities.

Lest you think narcissism is a one-size-fits-all situation, Crain tells me that there are four distinct types of narcissists. Here’s how to distinguish each one.

• Grandiose narcissists. They are often charismatic and charming. Many successful, glamorous individuals, Crain says, exhibit grandiose narcissistic traits.
• Vulnerable narcissists. These individuals may act like victims, can be socially awkward or irritable and are also known as covert narcissists who blame others or the world for their problems.
• Communal narcissists. “They seek to show how virtuous and good they are, often posting about their altruistic actions on social media (e.g. showing how much trash they clean up at the beach),” Crain tells me. “They want to showcase their humanitarian efforts and spiritual elevation. This is common in the spiritual/cult world. It's very much 'I’m so good, look at how elevated I am, look at the good I am doing.'”
• Malignant narcissists. This is the Machiavellian side of narcissistic abuse. These kinds of narcissists are highly manipulative, play mind games and are often persuasive and/or misleading, Crain explains. They’re particularly dangerous and should be approached with caution.

Here are a few things Crain recommends trying if there’s a narcissist in your orbit:

• Set boundaries. Setting strong, firm boundaries, Crain emphasizes, is key to protecting your energy and yourself. Here are 12 therapist-approved ways to set boundaries specifically with family.
• Be empathetic. Caveat here: This can have varying results depending on the type of narcissist you’re dealing with. Crain says, “Offering empathy can be effective for some, but it may run dry. For others, empathy can help maintain the relationship.”
• Keep things light. Some relationships are better off staying at surface level. Crain recommends avoiding deep conversations or anything with too much depth with narcissists.
• Take breaks. In some situations, you’re able to go no-contact with a narcissist; others are trickier. “If dealing with a narcissistic co-parent or parental figure that you can't totally ignore, take breaks for self-preservation and recharge as needed,” per Crain.
• Prioritize self-care. Amid the stress of a difficult relationship of any kind, make sure you’re keeping up your self-care routine (regardless of what it looks like). Crain tells me, “Ensure you’re not burning out from interactions with the narcissist.”

Dealing with a narcissist can be like walking through a minefield, and Crain tells me there are certain things to avoid bringing up with them. For example, she advises against pointing fingers, blaming or criticizing them. “They don’t respond well to criticism,” she notes. “Be very cautious with your wording. If you confront them, handle the situation delicately, as they don’t respond well to anything resembling criticism.” If you are providing feedback, ensure it’s constructive rather than critical, as perceived criticism can lead to explosive reactions and backfire on you.

Crain tells me it's also important to avoid using personal attacks like: 

• "You never take responsibility for anything. It’s always someone else’s fault." This places blame, which can trigger defensiveness and a strong negative reaction.
• "You’re so selfish." Labeling the narcissist as "selfish" can make them feel judged and lead to anger or denial.

She concludes that, in general, it’s best to avoid using “always” and “never” in whatever you are saying.

Crain gives it to me straight: It is possible, but it’s not likely. “Most people with NPD do not seek treatment or change,” she says. “While I believe that change is possible for anyone, it is unlikely and not very probable that someone with NPD will change.”

People diagnosed with Narcissistic Personality Disorder or those who aren’t fully diagnosed with the disorder but still display narcissistic traits, can wreak havoc on your life. They often don’t show remorse or compassion toward others, and they don’t care about how other people feel or think. Though Crain tells me it’s unlikely for a person with NPD to change, there are, as she explains above, ways to minimize the harm that can come from your interactions with them, from setting firm boundaries to taking breaks from the relationship when necessary and making sure to prioritize self-care.