There are three basic ways that pathological narcissism, or Narcissistic Personality Disorder (NPD), manifests: the Grandiose/Oblivious type, the Vulnerable/Hypervigilant types, and the High-Functioning type. (Gabbard, 2019) Each type is distinct, but the role of others’ perceptions of the individual and the role of shame in influencing behavior are shared across types. There’s no clear understanding of how or why narcissism develops, so there isn’t a clear path to prevention. Unfortunately, while most people believe they can identify a narcissist, narcissists themselves are generally unable to recognize how their narcissistic behavior is a problem. Because they are living “in the story” of their exaggerated claims of entitlement and success, they are unable to take an objective perspective which help them see that the “extraordinary world” they live in doesn’t leave much room for ordinary relationships. In my own practice, I’ve found that it’s the partners, lovers, friends, and relatives of narcissists who seek counseling about the struggles they have in their relationships with the diagnosable and subclinical narcissists in their lives.

Narcissists seldom seek mental healthcare themselves and so, when faced with exposure or threats to their self-worth, they may not have the necessary coping strategies to deal with the stressors. This can lead to significant dissonance and shame if their false representations of their accomplishments or specialness are pierced by the truth. The shame they feel when this happens has been linked to a risk of suicidal ideation and a rate of attempts higher than in the general population. This increased risk has been found in both clinical and subclinical levels of narcissism (Jaksic et al., 2017; Sprio et al., 2024). Ronningstam (2022) noted that narcissists may attempt or complete suicide without any alerts or threats as they are fully set on the goal to end their lives.

What is Narcissistic Injury? While a narcissist may come across as exceptionally self-confident and egotistical, when confronted with evidence of their shortcomings and failures, they may experience what is termed a narcissistic injury. The........

© Psychology Today