Does Your Massachusetts Spouse Exhibit Narcissistic Personality Disorder Behaviors?

by | Apr 26, 2022 | Divorce |

Narcissistic personality disorder (NPD) is a mental health condition that causes Massachusetts spouses to rely on others for praise, admiration, and self-esteem. 

While there’s only one official diagnosis for NPD, some researchers have identified several different types of narcissistic personality disorder. Learn more about narcissistic traits, symptoms, and treatment, as well as the different narcissistic personality disorder types.

Narcissistic Traits

NPD is one of the 10 personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). 

A personality disorder is a mental health condition that causes someone to think and act in ways that harm themselves and their relationships with others. Personality disorders cause impairments in functioning at work, in school, with self-esteem and identity, and in relationships. 

NPD is one of the cluster B personality disorders. Cluster B personality disorders are associated with dramatic, emotional, irrational, and erratic behavior. Other examples of cluster B personality disorders include borderline personality disorder (BPD), histrionic personality disorder (HPD), and antisocial personality disorder (ASPD).

While many people have narcissistic traits, researchers estimate that up to 5% of the population meets the criteria for NPD.

The main hallmarks of narcissism include grandiosity, extreme self-focus, an inflated sense of self-worth, and a strong need for praise and recognition.2

Grandiose Feelings

A person with NPD might exhibit grandiosity or a sense of superiority. They may believe they’re entitled to special favors, praise, or admiration from others. They might also come off as condescending or arrogant. People with NPD might also be overly focused on impressing other people, whether through outward displays of wealth, status, intelligence, or beauty.

Extreme Self-Focus

Extreme self-focus is another common narcissistic trait. While many people are self-absorbed to an extent, someone with NPD will focus almost exclusively on themselves and their own personal gain. They might talk about themselves constantly or have a hard time feeling empathy for other people. This can lead many people with NPD to face challenges in areas of intimacy and relationships, as they relate to others only superficially. They might even exploit others to get what they want.

Inflated Sense of Self-Worth

An inflated sense of self-worth is another common narcissistic trait. People with NPD might expect special treatment for no reason at all. They might brag about or exaggerate their accomplishments and see themselves as uniquely gifted and deserving.

Strong Need for Praise and Recognition

People with NPD usually struggle with their self-esteem and sense of identity. They often rely on others to maintain a positive view of themselves, resulting in an overwhelming longing for praise and recognition. This leads many people with narcissistic traits to require constant external ego-stroking. They might also feel obsessively jealous about someone else’s positive traits or accomplishments.

What Are the Narcissistic Personality Disorder Types?

NPD is the only official diagnosis related to narcissism in the DSM-5.

However, many mental health therapists who have worked with patients with NPD, as well as researchers who study personality disorders, have identified various possible narcissistic personality disorder types. They include overt narcissism, covert narcissism, antagonistic narcissism, communal narcissism, and malignant narcissism. Some experts also distinguish between adaptive and maladaptive narcissism.

Overt narcissism, also called agentic narcissism, is what you might think of as the “classic” and most obvious form of NPD.

Covert Narcissism (Closet Narcissism, Vulnerable Narcissism)

Covert narcissism, also known as closet narcissism or vulnerable narcissism, isn’t as obvious as overt narcissism. Like other people with NPD, someone with covert narcissism has an inflated sense of self-importance and craves admiration from others. 

However, someone living with covert narcissism might display more subtle and passive negative behaviors. Rather than bragging about themselves or demanding respect, a they might engage in blaming, shaming, manipulation, or emotional neglect to get what they want and keep the focus on themselves. They also might see themselves as a victim.

Antagonistic Narcissism

While all people with narcissistic traits might be overly concerned with how they appear to others, antagonistic narcissists are particularly concerned with coming out “on top.”

Antagonistic narcissism is defined by a sense of competitiveness, arrogance, and rivalry.

Someone with antagonistic narcissism might try to exploit others to get ahead. They might also put others down or start arguments in an attempt to gain the upper hand or appear dominant.

Communal Narcissism

Like someone living with covert narcissism, someone experiencing communal narcissism might not appear to be ego-driven at all. They might initially come across as selfless or even as a martyr. But their internal motivation is to earn praise and admiration, not help others. 

To that end, these people often place themselves at the forefront of social causes or communities, usually as the leader or the face of a movement. People with communal narcissism see themselves as more empathetic, caring, or selfless than others and often display moral outrage.

Malignant Narcissism

Malignant narcissism is often seen as the most severe or potentially abusive form of NPD.

Someone with malignant narcissism has the same egocentric self-absorption and sense of superiority as other narcissists. They also have traits associated with antisocial personality disorder (ASPD), such as aggression, paranoia, and a lack of empathy. They might even have a sadistic streak.

Narcissistic Traits and Violent Crime

Narcissistic traits may be associated with a higher likelihood of violent crime. In one study, over 21% of inmates in a single prison met the diagnostic criteria for NPD.

Adaptive Narcissism vs. Maladaptive Narcissism

It’s important to recognize that not all people with NPD will look, act, or behave the same way. 

For example, a person with NPD might be a very well-dressed, charming overachiever who cultivates a certain image to impress others. Another person with NPD might be an underachiever who sets low expectations for themselves because of a sense of entitlement. 

Some researchers refer to narcissistic traits like a sense of authority and a drive to become self-sufficient as “adaptive narcissism.”

These traits can actually help someone succeed in certain areas of life, such as their career, education, or finances. 

Meanwhile, narcissistic traits like exploitativeness, condescension, and aggression are called “maladaptive narcissism.” These traits negatively affect both the person who exhibits them and those around them.

Treatment and Outlook for All Narcissistic Personality Disorder Types

Because personality disorders are complex mental health conditions, someone who appears to have NPD might actually have another cluster B personality disorder, such as HPD. They might also have a mood disorder, such as bipolar disorder. That’s why it is important to be diagnosed with NPD by a licensed mental health professional.


To diagnose you or your loved one with NPD, a psychotherapist will use the diagnostic criteria for NPD in the DSM-5 as laid out by the American Psychiatric Association (APA). They might use diagnostic tools such as surveys and ask you questions about your life, identity, past, and relationships.

According to the DSM-5, a person with NPD must have chronic, long-term impairments in social and personal functioning due to their narcissistic traits.

They must also display pathological personality traits that affect their relationships and well-being. Also, the challenges faced by a person with NPD can’t be attributed to their developmental stage (such as adolescence) or other issues with their mental or physical health, such as substance abuse.


Someone with NPD might not seek treatment because they may not realize they have a problem. Instead, their loved ones might notice their symptoms before they do. Other people with narcissistic traits may realize that they are struggling but might feel sensitive to criticism from a therapist. However, people with NPD can seek out and benefit from treatment.

Researchers don’t entirely understand what causes someone to develop NPD, but it’s likely due to a combination of neurobiological factors, childhood trauma, genetics, and/or environment and upbringing.

The mainline treatment for NPD is psychotherapy. People with NPD might also benefit from couples’ counseling, family counseling, and support groups. 

Psychotherapy can help people with NPD in several areas, such as:

  • Developing a sense of self that doesn’t rely so heavily on outside recognition
  • Setting realistic goals 
  • Dealing with and healing from past traumas
  • Improving relationships with partners, friends, colleagues, and relatives
  • Developing a greater sense of empathy for others


NPD is a mental health condition that causes someone to exhibit traits like grandiosity, self-absorption, and an excessive need for praise and admiration. There’s only one official diagnosis related to narcissistic traits: NPD. 

However, researchers have identified several possible subtypes of NPD, such as overt narcissism, covert narcissism, antagonistic narcissism, communal narcissism, and malignant narcissism. People with NPD and their loved ones can benefit from psychotherapy, including family counseling, support groups, and couples’ counseling.

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