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The term ‘narcissistic’ refers to people whose personalities are organised around maintaining their self-esteem by getting affirmation from outside themselves.  

‘Narcissism’, ‘narcissist’, ‘narcissistic personality disorder’ are now commonly used terms referenced by today’s discourse and usually describe individuals’ controlling, manipulative and abusive behaviour.  On the one hand, the term, ‘narcissistic,’ can be useful when describing a person’s character referring to a self-idealising, manipulative, controlling, and other-abusive personality type. However, it's over-use can make amateur psychologists of us all, and can easily validate blame and disregard our responsibilities in interaction with others.  It is useful, therefore, to think of narcissism as being on a continuum because doing so appreciates its variations and complexities.

Healthy Narcissism


Healthy narcissism describes the ‘part’ of our character responsible for our self-esteem, our self-image, our sense of who we are, our ability to feel good about ourselves. In that specific sense, narcissism can be thought of as the foundation of emotional development. Healthy narcissism helps us to assert ourselves within the various social contexts of our lives.  


The development of a healthy narcissistic state of mind is dependent on experiencing benign child-parental relationships.  Parents who validate us, tell us we are good at things, attune themselves to our emotional needs will most likely raise children who have a positive image of themselves and their abilities. When ‘good enough’ parenting is absent and the child is not validated, shamed, and emotionally abused, our sense of ourselves can be seriously undermined, with lasting effects.  Our wounded childhood narcissism manifests in adulthood in the devaluing, abusive manner we relate to and behave with others. 

Narcissistic Wound


Given narcissism’s role in healthy psychological development, we begin to understand its fragility and the impact on us when our narcissism is wounded in childhood. We might say that we are all narcissistically wounded to some degree, if only in the sense that we all become disappointed in our parents in one way or another. 


We experience narcissistic wounds in adulthood too.  Situational factors such as rejection by a loved one, failing an exam, not getting the job we wanted can result in us feeling hurt and saddened. Because we are prone to feel insecure, vulnerable, and powerless, we seek ways to cope and manage such feelings. So, for example, we may become angry, abuse drugs including alcohol, treat others harshly, binge and / or become promiscuous.  We may become irritated with others, judgemental, dismissive, envious, and devalue those closest to us because we are experiencing a heightened sense of insecurity and vulnerability.  All such behaviours are ways of coping with our everyday narcissistic life-wounds, and when our wound heals, we slowly return to our more settled state and look back in horror at how we have behaved.

The Narcissism Continuum

Nancy McWilliams has described the narcissism continuum in this helpful way:

‘All of us have vulnerabilities in our sense of who we are and how valuable we feel, and we try to run our lives so that we can feel good about ourselves.  Our pride is enhanced by approval and injured by disapproval from significant others.  In some of us concerns with ‘narcissistic supplies,’ or supports to self-esteem, eclipse other issues to such an extent that we may be considered excessively self-preoccupied.  Terms like ‘narcissistic personality’ and ‘pathological narcissism’ apply to the disproportionate degree of self-concern, not to ordinary responsiveness to approval and sensitivity to criticism.’

Narcissistic Personality Style / Disorder


When narcissism becomes embedded within an individual’s way of functioning in interaction with others, a narcissistic wound of a recalcitrant nature is the consequence.  I use ‘narcissistic personality style’ in this context because it captures the embeddedness of a particularly depreciating and manipulative way of relating to others in the absence of formal psychiatric diagnosis. 


From lengthy clinical experience as a psychotherapist, I have learned that many people experience abusive relationships with people exhibiting behaviours aligning with embedded narcissism.  Many clients have reported the lack of empathy, the sense of entitlement, interpersonally exploitative conduct and envy shown by their significant others, all of which are DSM-IV-listed criteria for narcissistic personality disorder (NPD). 

Clinical Presentations


My clients are often people who present with co-dependent personality styles.  They are the fixers, the carers, the helpers, the pleasers.  Most often, these personality characteristics have been constructed in childhood within families where parents were, to some significant degree, emotionally unavailable and invalidating.  As a way of responding, the child learns coping strategies which seek continual validation. However, because the sought-after validation is unforthcoming, the cycle of seeking validation / in-validating parental response becomes perpetuated.  Developmentally, this way of relating to the other becomes a fixed relational position in adult relationships, with the result that clients’ healthy narcissism is severely compromised.   


The most common themes presenting within my clinical practice are as follows:

1. The current long-term, ongoing marriage / relationship

I often work with individuals who begin to talk about their current and longstanding relationship feeling in some way unhealthy. They describe relationships where they feel controlled, un-heard, trapped, and confused.  They have often spent years trying to make their relationship better and have found themselves going round and round in circles.  They feel blamed by their partners and are often told by them to seek therapy—as if they were ‘the problem’.  They have experienced ongoing devaluation and criticism and have taken on the responsibility for the relationship problem. The people I work with are also often financially dependent on their partner, which makes it very difficult for them to see a way out.  They have run out of ideas of how to ‘fix’ the problem, are emotionally exhausted and arrive in therapy in the hope of understanding what has been going on. 


With further exploration it becomes clear that the person’s partner is unable to engage in meaningful conversation and share the responsibility for problems in the relationship. It also becomes clear they have assumed all responsibility, allowed themselves to be controlled, and have grown used to having their perceptions and feelings dismissed as invalid. 

2. Separation / Divorce & Children

Often, I see clients who have recently separated or divorced and are experiencing extreme difficulties in maintaining communication with their ex-partners regarding co-parenting their children. These scenarios fluctuate from outright parental alienation to more subtle manipulations and interference with the quality and coherence of parent-child contact.

3. Managing the malignant narcissistic parent 

A combination of the presentations already mentioned can be present in client-narratives, and much of the time a narcissistic parent is part of it. Narcissistic abuse can vary from the outright abusive and emotionally sadistic to the subtly devaluing and controlling.  The child was, and remains, an extension of the parent’s narcissism to the extent that s / he is positioned by the narcissistic parent to supply him / her with ongoing validation. There is no sustaining love or care for the child as such; rather, the child is exploited for the purpose of providing the parent’s narcissistic supply.  

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