Narcissism causes a person to be so preoccupied with their own needs that they don’t notice, or actively choose to ignore, the needs and feelings of others. Narcissism is closely linked to the need for admiration and outside validation. Almost everyone is narcissistic sometimes. For example, an otherwise loving parent might temporarily ignore a crying child because the parent is enjoying admiration and attention on social media.

When narcissism is a strong pattern of behavior that defines a person’s personality, they may be diagnosed with narcissistic personality disorder (NPD). People who love or work with a narcissist may experience abuse and neglect. Sometimes a person with NPD engages in gaslighting—attempting to make a victim of abuse question their own reality. This can be a toxic cycle that destroys relationships, self-esteem, and even entire workplaces or families.

NPD is difficult to treat because so few people with narcissism willingly seek treatment. Yet people dealing with the fallout of interacting with a narcissist can and do get better with appropriate support and strong boundaries. A therapist can help you understand how another person's narcissism affects your life, and then work with you to prevent that relationship from harming your mental health. Find compassionate help.

Narcissistic Abuse

Narcissistic abuse happens when a person with narcissism or NPD uses another person as a source of validation, self-esteem, or as a way to get their own needs met. Alice Miller’s influential book, The Drama of the Gifted Child, was one of the first to outline the hallmarks of narcissistic abuse.

Psychoanalyst Otto Fenichel developed the concept of “narcissistic supply” to refer to the self-esteem, support, and admiration children should get from a healthy environment. According to Miller, narcissistic abuse is an inversion of this phenomenon. So instead of providing the child with self-esteem, a parent attempts to derive self-esteem from the child. This can drain the child’s own sense of self-worth. Some examples of narcissistic abuse of children might include:

  • Offering love and affection that is conditional upon the child pleasing the parent or making the parent look good.
  • A parent neglecting the child’s needs so they can pursue their own.
  • Behaving warming and kindly toward the child in public, when doing so will earn the parent admiration, but coldly or abusively when no one is watching.
  • Lying to the child or causing the child to question their own sense of reality.

Narcissistic abuse can also happen in adult relationships when one adult uses another as a source of narcissistic supply. A person with NPD abusing another adult might:

  • Isolate them from friends and family.
  • Demand that their target devote their life, time, or money to pleasing the person with NPD.
  • Become abusive or angry when the victim does not give the abuser enough love or admiration.
  • Demand unconditional and unceasing love, while being unwilling to give it in return.

Sometimes narcissistic abuse becomes physical, especially when a person fails to meet the demands of a person with NPD.

Little research exists on narcissistic abuse. Much of the popular understanding of narcissism comes from self-help sites and message boards. This means that many people dubbed narcissistic abusers might not actually have NPD, or may be undiagnosed.

Narcissism and Relationships

People with narcissism fear rejection and continually seek outside validation. They struggle to sustain a sense of self-esteem independent of input from others. This can cause them to mistreat others. NPD can cause a person to prioritize trivial needs—such as the desire to get attention on social media—over another person’s most significant needs, such as the desire to feel safe or loved.

People with NPD can provide love and admiration to others only when it serves their own narcissistic needs to do so. So a person with NPD might be friendly and supportive to someone whose respect they desire, but abusive or negligent to someone who offers them nothing. This can make it difficult to have close, intimate relationships.

A common theme in relationships with narcissists is that the narcissist demands things they are not willing to give. They may also gaslight the other person. For example, a narcissistic husband might insist that his wife be prepared to entertain his friends and maintain the house in a perfect state of order. He may also continually demand praise. When she requests help with household chores or more praise, he might tell her that doing so is abusive or that she “owes” him because of something he once did for her. Over time, this distorted sense of reality can wear down a person’s self-esteem and even convince them that narcissistic abuse is normal.

Narcissism in the Family

Narcissistic tendencies by one person in a family can affect the entire family. It’s common for children of narcissists to be abused or neglected. Popular guides to narcissism suggest that family members fall into predictable, stereotyped roles. Those include:

  • Enabler: The enabler, who is often the spouse of a person with narcissism, excuses the behavior of the narcissist. They may think the narcissist has a valid reason for behaving the way they do, or they may enable the narcissist in an attempt to avoid abuse.
  • Flying monkey: Flying monkeys are enablers who abuse family members on behalf of a narcissist. For example, an adult child of a narcissist might eliminate contact with an abusive parent. But then a sibling acting as a “flying monkey” might guilt that person for cutting contact.
  • Scapegoat: The scapegoat is a person, usually a child, blamed for all that goes wrong with the narcissist and within the family. Scapegoats are often family members who identify narcissistic behavior for what it is, instead of lavishing a person with NPD with praise.
  • Golden child: A narcissist projects their own image onto a golden child. The golden child may receive special rewards, affection, or praise that other children and family members don’t get. This can create conflict between family members, and be used as a way to gaslight scapegoats and others who aren’t idealized. Sometimes the role of the golden child shifts. When golden children deviate from the idealized role their parents assign to them, the parent may become abusive or scapegoat the child.

Roles can shift with time and circumstances. People often fall into specific roles as a way to survive painful circumstances, not as a conscious decision.

Miller argues that children raised in narcissistic families who do not get a developmentally appropriate narcissistic supply may grow up to become narcissists.

In other cases, children of narcissistic parents become unusually attuned and sensitive to the needs of others. This allows the child to give the narcissistic parent the admiration and attention they desire, but at the expense of the child’s development. These children may grow into adults who seek parent figures from whom to receive love. This makes them vulnerable to further narcissistic abuse.

Narcissism in the Workplace

At work, narcissists seek admiration and acclaim at the expense of others. They may:

  • Take credit for others’ work.
  • Undermine coworkers in an attempt to gain admiration or attention.
  • Seek to gain the respect and trust of respected people at work, such as managers or a CEO.

A person with narcissism may change their behavior as they continually seek a narcissistic supply. This can have catastrophic effects on an entire workplace. Some workers may perceive the narcissist as a friendly and hard-working colleague, while others fear the same person as a source of abuse.

Some people with NPD are able to use their jobs as a narcissistic supply, enabling them to excel at work. Others refuse to work or are resentful about their jobs—especially if their jobs do not bolster their self-esteem.

Therapy for Dealing with Narcissism

People with narcissism are not sadists who enjoy harming others. Instead, they lack a coherent, consistent sense of self and attempt to seek self-esteem from admiration and attention.

Most people with narcissism don’t seek treatment. Some people with NPD create a detailed fantasy life, filled with hope for the future, to escape the disappointing reality they actually live. For instance, a teenager who drops out of high school may fantasize about his future as a famous writer. Pursuing treatment forces him to accept that this fantasy is not reality. Other people with NPD are able to achieve some success at work or in their home lives. They may be able to make others cater to their needs, obscuring the problematic realities of their behavior.

People in relationships with narcissists can get help from therapy even if the narcissist never changes. In fact, one of the main focuses of therapy may be helping the loved one of a narcissist to accept that they can lead a happy life even if the narcissist never changes their behavior. Therapy can help a person dealing with a narcissist to:

  • Understand and identify narcissistic behavior. Some people in relationships with narcissists think the abuse is their fault.
  • Identify the effects of the narcissist on their own thoughts and feelings. Children of narcissists may struggle well into adulthood.
  • Set clear boundaries with the narcissist. This may mean changing the “rules” of the relationship, changing how one responds to the narcissist, or ending the relationship.
  • Talk with others about the abuse. People who have survived narcissistic abuse sometimes struggle to tell others about the abuse or explain why they have chosen to end a relationship.
  • Rebuild self-esteem.

People with NPD may seek treatment when their behavior threatens something they care about, such as their relationship with a child or partner. In some cases, couples or family therapy may be appropriate—but only if the person with NPD also seeks individual counseling to deal with their diagnosis. When a relationship is abusive, couples or family counseling may not be effective.

Case Examples of Therapy for Narcissism

  • Rebuilding self-esteem to curb narcissistic behavior: Dennis, 59, is a successful executive who demands continual admiration and affection from his subordinates. Fearing his angry outbursts, they comply. Dennis is married, but has had a long string of affairs in an attempt to feel loved and important. When his wife discovers his affairs and threatens to leave, he agrees to go to therapy. Dennis initially presents the therapist with reasons his problems are someone else’s fault. He blames his wife for his infidelity and his subordinates for their incompetence. Slowly and compassionately, his therapist helps him see that his abusive single father did not give him the self-esteem he needed to have healthy adult relationships. This caused Dennis to seek admiration and love from others, but to never be satisfied with what he received. Through individual counseling, mindfulness, and couples counseling, Dennis is able to change his behavior and begin rebuilding his self-esteem. While he still sometimes has outbursts at work, he quickly apologizes. His employees no longer fear him, and his wife says he is finally attentive to her feelings and needs.
  • Exploring how parental narcissism shapes present relationships: Ava, 26, enters therapy after breaking up with her fiancé for the third time in six months. She is devastated, grief-stricken, and does not understand why he seems so incapable of showing her love. Though he was verbally abusive, Ava wants to be with him if only he can change. In therapy, Ava discloses that her parents never gave her love and affection, but constantly demanded unconditional love from her. Over several months, her therapist helps her see that her parents may have been narcissistic. This caused Ava to become unusually attuned to others, making her more vulnerable to narcissistic abuse. Though Ava still misses her fiancé, she understands that the relationship was not good for her. She says she will never go back to her fiancé because she understands the relationship was a continuation of the abuse she faced in childhood. She is working through her complex feelings of grief, and feels that she will eventually be able to choose a healthier, more loving partner.


  1. Caligor, E., Levy, K. N., & Yeomans, F. E. (2015). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5), 415-422. Retrieved from
  2. Hall, J. (2017, January 26). The narcissistic family: Cast of characters and glossary of terms. Retrieved from
  3. Miller, A. (n.d.). For Your Own Good [PDF]. Retrieved from
  4. Miller, A. (1979). The drama of the gifted child and the psycho-analyst's narcissistic disturbance. The International Journal of Psycho-Analysis, 60(1), 47-58. Retrieved from
  5. Warning signs & red flags. (n.d.). Retrieved from