9 Big Myths About Narcissism
Even among those of us who’ve studied personality disorders for years, narcissism has a way of slipping through the cracks of consensus. And that’s not because it’s especially elusive—it’s because the term has been hijacked. Between pop psychology, viral posts, and well-meaning but oversimplified therapy-speak, narcissism has become a catch-all insult rather than a clinical construct.
This wouldn’t matter so much if it didn’t bleed into real-world practice. But I’ve seen clinicians dismiss vulnerable narcissists as merely shy, or mistake grandiosity for mania, or avoid treating clients altogether because they’ve “got narcissistic traits.” When the myths become normalized—even among experts—we risk missing the mark in both diagnosis and treatment.
And let’s be honest: most of us were trained on pretty dated models. It’s time we took a closer look at how far the science has come, and where we might still be clinging to ideas that just aren’t holding up.
What we get wrong in clinical practice
Narcissism isn’t one thing
Let’s just say it out loud: there is no one “type” of narcissist. This binary of “overt” versus “covert” is only a tiny sliver of the complexity. When we talk about narcissism like it’s a personality slot machine—“Oh, this one’s vulnerable!”—we overlook how much context and developmental history shape narcissistic expression.
Take, for example, the client who appears humble, even self-effacing, but becomes intensely reactive when receiving feedback. They might not fit your textbook NPD profile, but you’re looking at someone who’s protecting a very fragile sense of self. That is narcissism—just not the showy kind.
Studies like Pincus & Lukowitsky (2010) have outlined this spectrum beautifully, highlighting grandiosity and vulnerability as coexisting dimensions, not opposites. And yet, I still hear seasoned clinicians refer to them as two different disorders.
The DSM gives us a narrow lens
The DSM-5’s definition of Narcissistic Personality Disorder is, frankly, kind of a straitjacket. It’s heavily skewed toward grandiose traits—fantasies of unlimited power, interpersonal exploitation, arrogance—which means a huge subset of narcissistic presentations just doesn’t get captured.
This isn’t just a theoretical problem. It’s a real barrier to care. Vulnerable narcissists, in particular, are often misdiagnosed with dysthymia, avoidant personality disorder, or borderline—especially if the clinician’s only framework is the DSM.
What’s worse, those clients often know they don’t feel right, but they can’t articulate the narcissistic injury behind their shame or social withdrawal. So they bounce from therapist to therapist, never getting a name for what’s actually going on.
Self-loathing isn’t the opposite of narcissism
One of the most persistent myths I hear—even among psychodynamic folks—is that narcissists “hate themselves deep down.” And look, I get where it comes from. The defensive structure of narcissism implies some level of internal insecurity. But self-loathing and narcissistic shame aren’t the same thing.
What I’ve seen (and research backs this up) is that many narcissistic individuals don’t feel inadequate in the way depressed clients do. Instead, they feel wounded by not being admired. The injury isn’t about failing to meet their own standards—it’s about not being seen, recognized, or respected.
That might sound like splitting hairs, but it matters. It changes how we approach empathy-building, resistance, and even basic rapport. A client who’s angry because the world doesn’t “get” them needs a very different therapeutic frame than one who’s quietly drowning in worthlessness.
Cultural context changes everything
Let’s talk about cultural blind spots for a second. Western clinicians—myself included—are often trained to interpret narcissistic traits through an individualist lens. But in collectivist cultures, narcissistic behaviors can look very different.
You might see narcissism play out through familial control, extreme sensitivity to perceived disrespect within social hierarchies, or exaggerated emphasis on “saving face.” None of that screams “look at me” in the Western sense, but it’s narcissism all the same.
Ignoring these nuances doesn’t just limit our diagnostic accuracy—it reinforces Eurocentric bias in our entire personality framework.
Case example: the underachieving narcissist
I once worked with a 30-something client who presented as chronically underemployed, socially anxious, and “lacking motivation.” No grandiosity. No entitlement. Just lots of complaints about being overlooked and misunderstood.
At first glance, I considered dysthymia. But as we unpacked his early experiences, something else emerged: a deep, persistent belief that he was meant for greatness—but also that the world had failed to recognize his genius. He resented authority, saw peers as inferior, and fantasized about being discovered rather than doing the hard work of progress.
That’s not just depressive passivity. It’s vulnerable narcissism with passive-aggressive withdrawal. And if I hadn’t been attuned to those dynamics, I’d have missed it.
Research is finally catching up
Thankfully, newer models like the Pathological Narcissism Inventory (PNI) and dimensional frameworks in the ICD-11 are beginning to reflect this complexity. They incorporate both self and interpersonal dysfunction, and they allow us to code for severity, not just presence.
But this progress hasn’t trickled down evenly. I talk to clinicians all the time who’ve never even heard of the PNI, let alone used it in practice. And that tells me we’re still playing catch-up between research and applied work.
We need to get better at integrating these tools into training, supervision, and assessment—not just because it’s more accurate, but because it makes therapy better for the people we’re trying to help.
Let’s stop treating narcissism like it only comes in one flavor, or that it’s easy to spot from across the room. The truth is more layered, more subtle, and way more interesting. And once you see it that way, you won’t unsee it.
Nine big myths about narcissism
Let’s get into the juicy stuff. These are the myths I hear constantly—not just from pop psychology accounts, but sometimes even in supervision groups and clinical consults. Each of these ideas sounds plausible on the surface, which is exactly why they’re so sticky. But if we dig deeper, they start to fall apart.
And spoiler alert: many of these myths actually serve our discomfort more than they serve clinical truth. Let’s unpack them.
Myth 1 — Narcissists secretly hate themselves
This is probably the most popular “deep take” about narcissism. And yeah, there’s something satisfying about imagining the arrogant person in your life actually crying in the mirror. But clinically? Self-hatred isn’t a defining feature of narcissism.
People with NPD or high narcissistic traits often maintain a rigid, inflated self-image—not because they hate themselves, but because they can’t afford to doubt themselves. That’s not the same thing.
Research on narcissistic self-esteem shows a split: explicit self-esteem is high, but implicit self-esteem is fragile. They don’t feel worthless, they feel wounded when the world doesn’t reflect their grandiose image back to them. That’s not masochism—it’s self-protection.
Myth 2 — Narcissists lack empathy altogether
This one drives me nuts because it leads to such dehumanizing narratives. Empathy isn’t a binary switch. It has dimensions—cognitive, emotional, and motivational.
Many narcissistic individuals can understand another’s emotional state (cognitive empathy), but may not feel emotionally moved (affective empathy), or may not want to act empathically (motivational empathy).
Think about surgeons, politicians, or CEOs with high narcissistic traits. They can read a room perfectly well—but that doesn’t mean they care, or that it emotionally lands. It’s not an absence of empathy—it’s a distortion of how it gets used.
Myth 3 — All narcissists are extroverts
Absolutely not. If you’re only looking for the flashy, performative type, you’ll miss a whole category of introverted narcissists—the ones who stew in resentment, fantasize about revenge success, or feel chronically under-appreciated.
Covert or vulnerable narcissists are often socially withdrawn, self-conscious, and deeply insecure. They might look like avoidant or depressive types, but their internal narratives are soaked in grandiosity: “No one sees my greatness.”
Don’t let the quiet fool you—introversion doesn’t cancel out narcissism.
Myth 4 — Narcissism is always toxic
This one gets tricky. Narcissism can absolutely be harmful, especially when it spills into manipulation, exploitation, or emotional abuse. But narcissistic traits exist on a continuum, and some of them can be adaptive in the right contexts.
Healthy narcissism—yes, it’s a thing—includes confidence, ambition, leadership, and resilience. We need a bit of that to succeed in demanding environments.
The danger comes from rigidity and defensiveness, not the presence of self-regard. The clinical issue isn’t narcissism itself—it’s the inability to regulate it flexibly.
Myth 5 — Narcissism is a male issue
There’s a gendered stereotype here that doesn’t hold up. While studies do suggest men are slightly more likely to exhibit grandiose traits, women often present with vulnerable narcissism, which tends to go unnoticed.
Plus, cultural norms shape how narcissism is expressed. A man showing off in a meeting might be read as confident. A woman doing the same could be labeled narcissistic. There’s bias both in expression and in perception.
We need to stop treating this like a “male disorder” and look closer at how gender expectations mask or magnify traits.
Myth 6 — Social media is making everyone narcissistic
Social media didn’t invent narcissism—it just gave it a louder microphone. What’s actually happening is a shift in how self-expression and validation-seeking show up.
Narcissistic individuals may thrive on platforms like Instagram or TikTok, but that doesn’t mean social media is causing NPD. Longitudinal data doesn’t support a massive spike in narcissistic personality traits.
It’s more accurate to say that social media is a performance space that favors narcissistic behaviors, not necessarily a breeding ground for full-blown pathology.
Myth 7 — Narcissists never go to therapy
This one’s especially damaging, because it leads to therapeutic nihilism: “Why bother? They won’t change.” But here’s the truth: narcissistic clients do seek therapy—just often for other reasons.
They might come in for anxiety, depression, work stress, or relationship problems. The narcissistic dynamics surface over time, often when the therapeutic alliance hits a rupture.
With the right relational approach—particularly using transference-focused or schema-informed methods—many narcissistic clients can experience meaningful change, especially in how they relate to others.
Myth 8 — Narcissism and psychopathy are the same
Sure, there’s overlap—especially around manipulation and lack of empathy—but the motivations are totally different. Psychopathy is characterized by impulsivity, callousness, and thrill-seeking. Narcissism is more about validation-seeking, shame avoidance, and control.
Most narcissistic individuals do have a conscience. They care how they’re seen, even if it leads them to behave poorly. Psychopaths, by contrast, often don’t care at all.
Lumping them together erases critical distinctions that matter for risk assessment, treatment, and ethical judgment.
Myth 9 — Narcissism can be cured
Let’s stop talking about “cures” like we’re erasing some parasite. Narcissism is a deeply ingrained personality structure, not a virus. You don’t get cured—you learn to adapt, to reflect, to regulate.
Therapy can absolutely help narcissistic individuals reduce harm, form more reciprocal relationships, and develop more nuanced self-concepts. But there’s no magic switch. What we’re treating is rigidity, not identity.
How these myths affect what we do as professionals
We misdiagnose—and underdiagnose
Let’s be real—narcissistic personality disorder is chronically underdiagnosed in clinical settings. And it’s not because it’s rare. It’s because we don’t always know what we’re looking at.
When a client shows up angry, self-centered, or critical, we’re quick to label them “difficult.” When they show up anxious, withdrawn, or depressed—but with hidden grandiosity—we often miss the narcissistic structure altogether.
These myths blind us to the full spectrum, and that leads to treatment plans that miss the target.
We avoid working with narcissistic clients
If we believe narcissists can’t change, or that they’ll drain us, or that they’re beyond repair—we’re going to unconsciously push them away.
I’ve seen therapists subtly disengage, set stricter limits, or even refer out prematurely—not out of malice, but out of internalized bias. But if we want to grow as clinicians, we have to do our own work around narcissism too.
That means challenging our emotional reactions, staying in the room, and seeing the person behind the defenses.
We miss the cultural and systemic dynamics
Let’s not forget—narcissism is also shaped by cultural values, trauma histories, socioeconomic conditions, and systemic dynamics.
In some environments, narcissistic traits are rewarded. In others, they’re punished. A marginalized person using grandiosity to survive systemic erasure is not the same as a wealthy executive exploiting others to climb a corporate ladder.
Context matters. When we pathologize traits without understanding the social environment that produced them, we risk turning therapy into judgment.
We fail to intervene early
Narcissistic patterns often begin forming in adolescence, especially in the context of unstable attachment, inconsistent mirroring, or chronic invalidation.
But because we’re so focused on adult manifestations, we miss the signs in younger clients. Early intervention—especially using relational models—could shift developmental trajectories before those patterns harden.
We need to be looking at shame sensitivity, self-regulation difficulties, and relational entitlement in teens and young adults long before it calcifies into a full-blown disorder.
We don’t teach new clinicians how to work with it
Most graduate programs barely touch NPD. When they do, it’s often through outdated psychoanalytic frameworks or pathologizing lenses. The result? A generation of clinicians who are afraid to work with narcissistic presentations, or who label them prematurely without understanding them.
We need better training on:
- Differential diagnosis between narcissism, BPD, and trauma responses
- Relational approaches that balance boundaries with attunement
- How to tolerate narcissistic injury and rupture without retaliating or shutting down
Narcissism isn’t a red flag—it’s a clinical invitation. But only if we know how to read it.
Final Thoughts
Here’s the deal: narcissism isn’t going anywhere. And it’s not just living in your clients—it’s in our institutions, our relationships, even in ourselves.
But when we stop reducing it to tropes and start understanding it as a rich, multidimensional pattern of human adaptation? That’s when the work gets interesting.
Let’s ditch the myths and make space for nuance. Because behind every narcissistic defense is a very human attempt to matter. And that, my friends, is something worth working with.
