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What is Pathological Narcissism?: A Primer for the Layperson

This article first appeared in the author’s own blog, From Andrea’s Couch at

What is narcissism? We have all heard the word being thrown about all over the place. It’s in the news, on social media, it describes an ex boyfriend/girlfriend, the arrogant jerk who cuts you off on the freeway, the diva boss. Male or female, purple or pink-polka-dotted, narcissists are all around us. But what really is a narcissist?

Well, I am here to tell you all about what a narcissist is and why it’s a problem. I am a therapist who provides psychotherapy (mental health counseling) for every day people like you and me. People come in for therapy to get emotional support to recover from challenges like depression, anxiety, stress, grief/loss, relationship issues, life transitions, and trauma and abuse. Any person who has been on the planet for any length of time will encounter some dark nights of the soul, and that’s what we therapists are for…to help our clients return back to their prior level of joy and optimal functioning (and hopefully an even newer and better version of themselves). Most therapists, like myself, take our training and our calling very seriously — it is tough work, we work hard, to hold a safe emotional environment for our clients to heal and recover, and we earn every penny we work for. Most ethical therapists consider their work to be a spiritual calling and find great meaning and purpose, having great honor to bear witness to another’s transformation in healing.

I work with a wide range of clients who are hurting. One area in which I specialize in my practice is narcissistic abuse recovery. And that’s what I am going to talk about now.

Pathological narcissism has become pandemic in our larger society. We are seeing narcissists in politics, in boardrooms, in love relationships, at home, in religious institutions,  in friendships…it’s all over the place. And I can tell you that in the Greater Los Angeles area where I live and work, L.A. is the hotbed of narcissism. It’s enough to make the whole lot of us spin with dizziness.

In an nutshell, one could call being a narcissist as someone who: 1) is entitled, 2) has grandiose thoughts of themselves, 3) has limited capacity for empathy and how others are impacted by their actions, 4) has a lack of reciprocity (give and take) in relationships, 5) often has a history of lying and dishonesty, 6) has a pervasive sense of lack of self identity and must extract what we call “narcissistic supply” from others, 7) shows a “false self” to the world ( a fake mask of who they want to appear) (DSM-5).  I am basically translating from the Diagnostic and Statistical Manual what a person with NPD (or Narcissistic Personality Disorder) looks like.

Now, a person with narcissistic personality features can really exist on a continuum.

narcissistic —–> NPD—–> malignant narcissism——-> psychopathy

A person who has just a smattering of narcissistic traits might actually show some ability to make some changes in therapy IF they have some elements of empathy, accountability and insight. HOWEVER, most individuals who have NPD or beyond on the spectrum will not be able to change….because the disorder is a pervasive (long-lasting) pattern of fixed personality characteristics. Experts in the field (myself included) feel that if a person is a malignant narcissist or psychopath, the ability to change  is miniscule.

Someone who is NPD or beyond on the above spectrum engages in emotional abuse tactics, which I have written about extensively in my blog, From Andrea’s Couch, for and The Minds Journal, as well as Psych Central. Also in my ebook Soul Vampires: Reclaiming Your LIfeBlood After Narcissistic Abuse 

So I work with the survivors of narcissistic abuse. I work with the woman or man who suffered in a romantic relationship with a narcissist who emotionally abused them. I provide therapy for the person who is dealing with a tyrannical boss. I counsel the adult child of a narcissistic parent who doesn’t feel like they will ever amount to anything worthy. I support the survivor of sexual abuse, rape, or persecution of any shape or form by a malignant narcissist/psychopath. I provide therapy for the individual who was emotionally abused by a pastor who is running a cult in her community, the man whose therapist tried to sexually assault him. All of the perpetrators in the above scenarios were at minimum NPD and at worst, psychopaths…and NO ONE is immune from being a target. In fact, toxic pathological people actually seek out intelligent, beautiful, altruistic, highly empathic people because the narcissist is lacking in those very qualities and they want to consume that person like a vampire to fill their empty void of a psyche (Schneider, 2015). The target of a narcissist generally serves as the “mirror” to the ego of the narcissist, providing fuel to the narcissist to inflate their ego (attention, appreciation, adulation, sex, disgust, reactions of any kind all serve as forms of narcissistic supply). A malignant narcissist/psychopath will attempt to extract narcissistic supply from their targets in a premeditated fashion, preferably by causing harm and pain to their victims. An extreme narcissist/psychopath is a sadist. They get pleasure by causing pain.

People can heal from narcissistic abuse. But it is hard work. And it takes a good amount of time, with a skilled, trained, ethical, trauma-informed psychotherapist. Healing is very complex but very possible. I have had the honor and privilege of bearing witness to many survivors move into a place of thriving in their lives — when they reclaimed their power and pulled some very persnickety weeds…their garden of life opened up to new, healthy growth and healing. I am one lucky woman to be able to see before my very eyes that kind of personal strength and fortitude that my clients near and far manifest as they heal. The saying, “sometimes things fall apart before they can be reassembled” is very apropos. And in the reassembly, the new construction of healing often times generates an evern healthier and more whole person, thriving in the new chapter of their life.

For further reading, please see my ebook:

Soul Vampires: Reclaiming Your LifeBlood After Narcissistic Abuse (2015) (available on most ebook platforms)


Photo by Nina A. J. G.

What is Pathological Narcissism?: A Primer for the Layperson

Andrea Schneider, MSW, LCSW

Andrea Schneider, MSW, LCSW is a licensed clinical social worker in private practice in the San Francisco Bay Area. She is currently the Lead Counselor at Cal State Maritime Academy, where she counsels college students and leads Counseling and Psychological Services (CAPS) at the integrated Student Health Center. In her private practice, Andrea provides psychotherapy for individuals experiencing trauma and loss. She is also a writer, educator, and podcaster. Website:

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APA Reference
Schneider, A. (2018). What is Pathological Narcissism?: A Primer for the Layperson. Psych Central. Retrieved on September 25, 2020, from


Last updated: 7 Feb 2018
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