It’s best to think of narcissism as a normal pervasive human trait that exists, to a greater or lesser degree, in all of us: the drive to feel special, “exceptional or unique,” (https://pubmed.ncbi.nlm.nih.gov/22205623/) to stand out from the rest of the 7 billion people on the planet.

Narcissism isn’t a disorder, but you can think of narcissists as people well above average in the trait; people who are extremely high on the trait begin to show signs of disordered narcissism, or narcissistic personality disorder (NPD). Not all narcissists have NPD, but all people with NPD are narcissists (high in the trait).

Recently, narcissism has been largely equated with loud, grandiose, vain qualities, but there are several types of narcissism, including introverted (aka vulnerable, hypersensitive, or covert narcissism), which presents (https://www.psychologytoday.com/us/blog/tech-support/201605/the-communal-narcissist-another-wolf-wearing-sheep-outfit) as shy, anxious, and even self-deprecating, and communal narcissism, in which people regard themselves as more helpful, giving, or caring that the rest of humanity. Contrary to popular images of narcissism, neither communal nor introverted narcissism imply anything about vanity, inflated self-esteem, or greed. There are many ways to feel special, and they often have nothing to do with feeling good about ourselves, pursuing recognition, or seeking the limelight. Many introverted narcissists, for example, feel uniquely misunderstood or ugly or distressed, compared to those around them, as if no one could possibly fathom their depth of suffering.

Since the beginning of the concept, starting with Freud’s description of narcissism as an overvaluing of the self, part of normal development (and necessary to becoming person), we’ve had a notion of healthy narcissism (https://goop.com/the-goop-podcast/healthy-narcissism-with-craig-malkin/). You can think of it as a slightly overly positive view of the self, also known as “self-enhancement” (https://books.google.com.au/books?hl=en&lr=&id=qMpqiv8u_d0C&oi=fnd&pg=PR1&dq=handbook+of+self-enhancement+and+self-protection&ots=U4S7mhNiV7&sig=kyTdoX0SXy9VD8JjyoNye3Y80Qc&redir_esc=y#v=onepage&q=handbook%20of%20self-enhancement%20and%20self-protection&f=false) in the research—a bit like having subtly rose-colored glasses, tinted just enough to create something of a rosy glow but not so opaque that they blind us to reality. Healthy narcissism is not simply self-esteem or confidence or “self-love” (narcissism is only moderately correlated with self-esteem because people too high in it tend to demonstrate fluctuating or low self-esteem).

Cross-culturally, people who moderately self-enhance (https://psycnet.apa.org/buy/2002-08440-014) persist in the face of failure, can maintain their dreams, enjoy happy healthy relationships, and may even be physically healthier. Healthy narcissism has long been an empirical fact. There are 4 measures to date, including Wink’s autonomous narcissism (a combination of warmth and ambition), leadership/authority from the NPI (https://psycnet.apa.org/record/1987-14430-001), healthy narcissism from our group’s NSS (http://www.drcraigmalkin.com/the-narcissism-test), and most recently, the admiration scale on the NARQ. All measures of healthy narcissism are connected to positive, healthy behaviors, like the ability to seek and form healthy close relationships and repair relationships when things go wrong (ex, apologize).

There’s strong evidence (https://onlinelibrary.wiley.com/doi/book/10.1002/9781118093108) that narcissism has a genetic component, especially the loud vain brand of narcissism (extraverted, aka grandiose, willful, overt, or obvious). But it’s best to think of unhealthy or pathological narcissism (extreme versions of the normal trait) as a character disorder borne of a combination of difficulty temperament and challenging or traumatic environments.

Psychologist Phebe Cramer conducted a longitudinal study (https://www.sciencedirect.com/science/article/abs/pii/S0092656610001467?via%3Dihub) over 21 years, measuring pre-schoolers with an instrument that captured early pre-cursors to unhealthy narcissism, including a melodramatic style, bullying, and attention-seeking. Not surprisingly, these tykes were more likely by early adulthood to show signs of unhealthy narcissism. But only if they didn’t receive a kind of parenting called authoritative (a blend of warmth and structure). Those that had authoritative parents tended to show more signs of healthy narcissism as they grew older. The kids who’s parents were punitive, invalidating (ignoring feelings) and shaming tended to raise difficult toddlers to become extremely narcissistic adults.

This doesn’t mean that all parents who’s children become extremely narcissistic were harsh and abusive; many simply had a child with a difficult temperament that no parent, without proper professional support and guidance, would have been able to shape into a healthier adult. Some children simply require more support and understanding than others, and for parents without the proper resources, this can easily—and tragically— outstrip their coping abilities.

It’s absolutely possible to prevent pathological narcissism, and the key is something called attachment security (https://books.google.com/books/about/Hold_Me_Tight.html?id=jPLaqKhumPQC) --a comfort with mutual care, support, and closeness.

Securely attached adults are raised with the trust that when they’re sad, scared, lonely, angry or just blue, they can turn to to at least one special person and know that, when push comes to shove, they’ll love them and be there for them. Insecurely attached people, who don’t feel this trust, turn to other ways of feeling safe in the world and relationships, continually avoiding closeness altogether (avoidant attachment), or tenaciously and fearfully chasing intimacy (anxious attachment). Instead of depending on people for comfort and care, the insecurely attached may self-soothe with drugs or alcohol or food; narcissists, especially in the extreme, rely on feeling special as their drug of choice—addictively so, in the case oof NPD.

It’s impossible to be highly narcissistic and securely attached at the same time. To the extent that we can emotionally depend on people, in mutual healthy ways, we won’t depend on feeling special.

So the best way to prevent pathological narcissism, is to foster attachment security.

Too much praise by itself won’t do much of anything (https://www.psychologytoday.com/us/blog/romance-redux/201506/how-avoid-raising-narcissist). Praising children isn’t what promotes unhealthy narcissism. It’s praising them only when they do great things (and not, say, for effort or creativity or compassion). It’s fostered by praising them sometimes and at others never at all. Or only ever offering praise rather than words of comfort, understanding, and sensitive guidance (sensitive to their autonomy).

In short, too much praise is less the problem than conditional praise (https://youtu.be/Ie3u_Bdh2U0) or only praise and no other forms of supporting a child's self-worth. Children who learn that it’s safe to be close and share emotions—in other word, kids who become securely attached—can enjoy praise without becoming addicted to it because they feel seen in many ways, not just one.

Even adults with NPD can be helped back to health, in therapy, if they can truly and deeply feel what it’s like to be seen as person, not a performance. The hard work of that is helping them feel enough trust to let in such an experience when it’s happening now, in the present; they long ago gave up on the possibility and often can’t see it—or allow it—when it’s in front of them.

Narcissism is neither high nor low self-esteem. Narcissists may or may not have high self-esteem, but what they all have in common is that they’re dependent on or addicted to feeling special, whether they feel like the most misunderstood person in the room (introverted narcissists) , the most attractive (extraverted narcissists) or the most helpful (communal narcissists). One study (https://doi.org/10.1016/j.jrp.2011.09.006) suggests even narcissists who report high self-esteem, if they think they’re connected to a lie detector, suddenly adjust their view of themselves downward.

Given that their sense of self is so contingent on an unsustainable need to be special at all times (whether for admirable qualities like intelligence or less coveted ones like self-doubt), it’s likely that no one who’s extremely narcissistic has high self-esteem. We have to take it with a grain of self when extroverted narcissists, who claim they’re great at just about everything, also report feeling great about themselves; they tend to exaggerate all their positive qualities (and downplay negative ones) and it's likely that high self-esteem is yet another inflated self-view—a fact supported by the related finding that people with NPD generally have fluctuating or low self-esteem.

What unhealthy narcissism looks like in children varies with age, but pre-school signs, identified by psychologist Phebe Cramer, include excessive attention-seeking, showing off, impulsivity, aggression, and chronic rule breaking. Bear in mind, though, that even toddlers who tip towards narcissistic behaviors can get better over time with parents who listen to, and talk about, feelings, encourage healthy help-seeking, and balance structure in the home with warmth and responsiveness.

As children approach their teens, narcissism spikes according to research, and that’s a normal part of development. Much of this has to do with children wanting and needing to feel more independent, but having strong needs nonetheless, so rather than openly asking for what they need, they become demanding and entitled or overly dramatic (partly due to hormones of course as well). Extreme narcissism is all about getting what we want without the risk of asking for anything or feeing vulnerable to rejection.

Still another reason for the narcissistic spike in teens likely has to do with a slightly inflated ego helping kids deal with the typical blows of fate they face as they mature (being dumped, not making varsity, rejection by the “cool kids.”) A little swagger, according to research helps kids fare better with these challenges. In that sense, the type of narcissism matters; more introverted teen narcissists (“no one understands my pain!”) tend to struggle more with depression and anxiety and relational problems than the more outgoing narcissistic teens.

Research suggests (https://dx.doi.org/10.1177/1745691609357019) that for most of us, narcissism drops as we leave our teens and early twenties and enter adulthood. And Dr. Cramer’s research shows that securely attached children will become more balanced and caring even if they start out life high on the narcissistic spectrum.

It’s worth pointing out that because narcissism changes across development, no one can be diagnosed with disordered narcissism (NPD) until they turn 18

While teens tend to be narcissistic due to age, some patterns will be more destructive than others. If your teen seems little more arrogant than you’d like, don’t fret, but if you see signs that they’re alienating friends, treating their siblings or you cruelly, or actively rejecting help and support (or worse, denigrating it as "stupid"), the normal self-absorption has given way to something more troubling, especially if you see EEE (https://youtu.be/YqV_QIvDeqA), the core of pathological narcissism: exploitation, entitlement, and empathy-impairments.

The main signs of trouble you want to look for really center on one question: when they’re sad, scared, lonely, blue, or anxious, can they turn to you or someone close to them in open, caring, and open-hearted (with genuine vulnerability and tears that soften your heart, not “I don’t want anything!” rage-crying) at least sometimes? If so, lean heavily into that, express appreciation for their sharing in that way, and be there for them.

Attachment security, which prevents pathological narcissism, can only emerge when we treat our children as though what happens inside them truly matters to us (their full emotional life). But as parents, we also have to model that everyone deserves respect care and understanding. So if your teen slips into demeaning, nasty behaviors, including name-calling or put-downs, make sure they know you love them, but they can’t treat you or anyone else that way. Statements like “If you’re angry or upset just say so," or "It’s never OK to show your anger by name-calling or put-downs” go along way towards preventing normal narcissism from sliding into darker territory.

The core of echoism isn’t care-taking--it’s a fear of seeming narcissistic in any way.

While narcissists have a strong drive to feel special, echoists fear special attention of any kind.

Echoism flourishes when children feel like it’s dangerous to ask for help, attention, recognition, support or understanding. When they’re left feeling that they’re a burden in some way, or the less room they take up the better (usually because they face criticism for expressing disappointment or anger or asking for more). Most often this occurs with narcissistic parents who demand that others submit to their will or face attack, criticism, or physical abuse.

When parents are especially fragile—acting easily hurt, bursting into tears, or seeking reassurance from their kids that they're attractive or witty or smart—they train their children that if they want closeness with their parent, they have to take care of them. This is a recipe for a parentified child, and that’s certainly a form of echoism. But not all echoists will become chronic care-takers.

Sadly, some more introverted or emotionally sensitive children give up on closeness altogether. This is especially true for people who grow up with an echoistic parent who rarely shows emotion or need, and sends the message that needing anything at all simply burden others. “I don’t like to put people out; they have their own problems to deal with" is the mantra of the withdrawn echoist.

The most reliable way of preventing children from becoming extremely narcissistic is to model attachment security. According to research, as long as they have one parent they feel secure with, they’ll have everything they need to remain in the healthy range of the narcissism spectrum: they have you.

When your child learns with at least one parent that any feeling can be openly acknowledged, shared, and understood, that help can always be sought, without fear of reprisal or judgment—that it’s safe, in short, to turn to others in mutually caring and connected ways—they’ll never develop NPD or attachment difficulties. And the best way of guaranteeing attachment security is to show them that no matter what challenge they face—even if it’s one of their parents, including you!—you’ll be there to listen and help them.

The rule here is feelings first. Don’t get into the whole “your mom or dad does that to me, too” conversation. It isn’t necessary to talk about your own difficulties with your ex to help your child; it’s enough that they’re bringing their feelings to you about anything upsetting that happens. Let them talk about it. And if they need help that only an adult can provide—say, protecting them from a harsh outburst—step in and do that. “OK—let give Daddy Or Mommy some time to cool down. We’ll go for walk.” 


If it’s really bad—name-calling, criticism, insults—step in and protect your child. “I know you’re angry, but I can’t allow this.”

“I’m sorry Mom isn’t listening right now, sweetheart. I know how awful that feels. It makes sense that you feel sad and angry. I would, too.”

With little children, it’s less about talk and more about action: remove them from emotional harm, then talk. Leave the room, go for a walk, or just go outside with them.

To the extent that we can depend on others, we won’t depend on feeling special (or fear it, in the case of echoism).

If your child can depend on you for care and safety, they’ll be just fine. That doesn’t mean you can prevent upset from ever happening. It means that you’ll acknowledge when it does happen---you'll see when they’re hurt and show that you care, deeply, about how that feels.

I highly recommend any research or writing on attachment. Sue Johnson’s Hold Me Tight is wonderful, even if you don’t have a partner currently. If you can become more securely attached, you’ll have a much easier timing changing narcissistic coping patterns. You won’t need them anymore.

I also highly recommend anyone trained in AEDP or other experiential approaches. It took deeply felt experiences to develop your habits; it’ll take deeply felt experiences to change them. And for that, you need therapy that creates experiences that change you from the inside, focused less on correcting your thoughts and behaviors and more on changing how you nervous system responds.

There’s no evidence that maternal and paternal narcissism have greater or lesser impacts on children.

People who are securely attached can “effectively depend” on people they’re close to. They value love and closeness and relationships. ] Extreme narcissism is an attempt to bypass dependency altogether. If I’m special enough, I can just expect my needs to be met, whether for attention or care or praise. I never have to worry about being turned down, so I never have to feel dependent at all. I can demand. I can bully. I can secretly arrange events to get what I want.

This is why on self-report, narcissists openly admit to favoring trophy wives and husband over caring, loving partners. They’d rather feel special to the world than special to their partner; they’re more performance than person. Status matters more than intimacy.

This is the exact opposite of attachment security. The reason it’s such a powerful buffer against pathological narcissism is that when we can depend on each other in these mutual caring ways, we don’t need to depend on feeling special to feel like we matter.

There’s one study (https://doi.org/10.1016/j.chb.2012.05.012) that found some evidence of a causal link between type of social media use in college students and minor increases in state narcissism (that is changes, in narcissism over time). 


Students who spent all their time polishing photos of themselves and designing provocative profiles (say, selfies in skimpy clothes) were slightly more narcissistic after spending 15 minutes preening away online than they were before they started, agreeing with statements like “everybody likes to hear my stories” and "I always know what I’m doing”; but more interestingly, students who spent their time on Facebook, reaching out to friends and sharing themselves, only felt better about themselves in healthy ways (their self-esteem rose).

The rule of thumb based on all the research appears to be "share don’t compare." It’s not social media itself that boosts narcissism, but how we use it, and if we spend all our time posting selfies, tagging ourselves, or changing our profile image, we’re not likely to come out of the activities healthier.

But of course, if children are more prone to sharing than comparing online, they’re already living life in a way that values relationship and closeness instead of status and appearance. In that sense, what matters most is how much your parenting fosters attachment security. If they’ve got that, they’ll play with their image instead of becoming hooked on it

There are three types of narcissism. Just think of narcissism as the drive to feel special, and remember there are many ways to achieve that, not all of them based on feeling good about ourselves.

Obvious or grandiose narcissism (extroverted) is the version we all know and loathe: loud, vain, pompous, and arrogant. Extroverted narcissists agree with statements like “I like to look at myself in the mirror” and “I won’t stop until I get the respect that’s due me.”

Introverted narcissists are shy, anxious, self-doubting, and sometimes depressed, and tend to agree with statements like “I feel that I’m temperamentally different from most people” and “I have problems most people don’t understand.” The feel they’re special because they’re uniquely misunderstood or troubled. They’re also often called covert.

Finally, communal narcissists feel special by virtue of their desire to help others and do good in the world (not that everyone around them would agree, of course). They agree with statements like “I’m the most helpful person I know” and “I will be well known for the good deeds I’ve done.”

All three of these are trait descriptions, not disorders. The higher someone scores on tests that measure them, the more likely they are to be narcissists.

But for all three, to reach the level of disorder, people have to be so attached to feeling special that they demonstrate EEE (https://youtu.be/YqV_QIvDeqA), the core of pathological narcissism, where they’d lie, steal, cheat, bully, and hurt others to feel special.

Narcissistic personality disorder the official diagnosis for disordered narcissism, has always far too heavily emphasized more extroverted forms of narcissism. But it’s highly likely that all three forms of narcissism can be expressed as NPD, and eventually, those descriptions will become a part of the NPD diagnosis as well.