What is Narcissism, really?

“Narcissist” has become an incredibly common word. You may hear it used to describe someone who is arrogant, selfish, attention-seeking, or simply difficult to be around.

But narcissism is more complicated than that.

There is an important difference between having some narcissistic traits and meeting the criteria for Narcissistic Personality Disorder (NPD). There is also an important difference between narcissism and abuse.

Someone does not have to have NPD to be emotionally abusive, controlling, or manipulative. And having NPD does not automatically mean that someone will abuse their partner.

If you have searched for information about “narcissistic abuse,” however, you may be trying to make sense of something very real: a relationship in which you increasingly feel controlled, criticized, confused, diminished, or unsure of yourself.

Understanding what is happening can be an important first step.

What Is Narcissism?

Narcissism is not simply being confident or liking attention.

People vary in the degree to which they seek admiration, feel entitled, focus heavily on themselves, or depend on external validation. Narcissistic traits exist along a continuum, and they can appear in different ways.

Some people are noticeably grandiose. They may appear highly confident, dominant, charismatic, or convinced that they are exceptional.

Others may be much more vulnerable in their presentation. They may be highly sensitive to criticism, preoccupied with how others perceive them, prone to shame, or intensely concerned with rejection.

These presentations are not necessarily completely separate. Research suggests that grandiose and vulnerable aspects of narcissism can coexist and may fluctuate depending on circumstances (Weinberg & Ronningstam, 2022).

Narcissistic Traits Are Not the Same as Narcissistic Personality Disorder

This distinction matters.

Narcissistic Personality Disorder is a clinical diagnosis involving persistent difficulties in personality functioning and characteristic patterns of grandiosity, need for admiration, entitlement, and impaired empathy. Contemporary approaches increasingly understand personality pathology dimensionally, meaning that clinicians consider the severity and nature of difficulties rather than treating personality disorders as simple yes-or-no categories (Miller et al., 2022; Weinberg & Ronningstam, 2022).

Someone can be self-centred, defensive, insensitive, or entitled at times without having NPD.

Similarly, someone can behave abusively without having any personality disorder.

This is particularly important when trying to understand a difficult relationship. You do not need a diagnosis for someone else in order to take harmful behaviour seriously.

When Narcissistic Traits Become Part of a Harmful Relationship

Being in a relationship with someone who has strong narcissistic traits can sometimes involve difficult interpersonal patterns.

A person may respond very strongly to criticism, need considerable reassurance or admiration, struggle to recognize a partner's perspective, or become defensive when their behaviour is questioned.

Research has found a small but significant association between narcissistic traits and intimate partner violence, with the strongest relationships found for psychological and cyber forms of abuse and for vulnerable rather than grandiose narcissism (Oliver et al., 2024).

That finding needs to be interpreted carefully.

It does not mean that narcissism causes abuse or that someone with NPD is destined to become abusive. Abuse is a complex behaviour influenced by many factors.

What matters most when you are living through a harmful relationship is not whether you can successfully diagnose the other person. It is what is actually happening to you.

What Does Narcissistic Abuse Look Like?

“Narcissistic abuse” is not a formal clinical diagnosis. It is a commonly used term for harmful relationship dynamics that people may associate with narcissistic traits.

These dynamics can include persistent criticism, humiliation, manipulation, blame, intimidation, controlling behaviour, isolation from friends or family, financial control, repeated denial or minimization of what happened, and pressure to accept the other person's version of events.

You may find yourself constantly trying to prevent an argument. You may begin monitoring the other person's mood before deciding what you can safely say. You may stop trusting your own judgment because disagreements repeatedly end with you questioning whether you misunderstood everything.

These patterns are more clinically important than whether the person involved fits the label “narcissist.”

What About Gaslighting?

Gaslighting is another word that has become widely used online, but the underlying behaviour is real.

In a relationship, gaslighting can involve repeated attempts to make another person question their memory, perceptions, judgment, or understanding of events. It can include denying things that happened, rewriting conversations, insisting that someone is irrational or “too sensitive,” or repeatedly shifting responsibility away from the person who caused harm.

A single disagreement about what happened is not necessarily gaslighting. Memory is imperfect, and people can genuinely remember an event differently.

The concern is the repeated pattern, particularly when one person's version of reality is consistently used to undermine the other's confidence and maintain control.

Denial, minimization, justification, and blaming are well-documented features of abusive relationship dynamics (Smyth et al., 2024).

Why Can It Become So Difficult to Leave?

People sometimes wonder why someone would stay in a relationship that is clearly hurting them.

The answer is rarely as simple as “they should just leave.”

Relationships can involve love, attachment, financial dependence, children, shared homes, social isolation, fear, and hope that things will return to the way they once were.

There may also be periods of genuine warmth alongside periods of cruelty or control. This inconsistency can make the relationship particularly confusing. You may find yourself holding onto the moments when the relationship felt loving while trying to understand the moments that felt frightening or degrading.

The term trauma bond is often used online to describe this kind of attachment. While the concept has received increasing attention, it is important not to reduce every difficult or abusive relationship to a single psychological mechanism.

What we do know is that coercive control can have substantial psychological consequences. A systematic review and meta-analysis found moderate associations between coercive control and both PTSD and depression (Lohmann et al., 2024).

If you find yourself struggling to leave, that does not mean you are weak. It means there may be powerful emotional, practical, and safety-related factors involved.

When the Relationship Becomes About Power and Control

One of the most important questions to ask is whether you are able to make ordinary decisions freely.

Can you spend time with friends without being punished for it? Can you disagree without fearing retaliation? Can you make decisions about your money, clothing, work, parenting, or social life without being controlled?

Can you say no?

Coercive control is characterized by patterns of domination and restriction rather than simply isolated arguments. It can include monitoring, intimidation, isolation, threats, financial control, and other behaviours that gradually reduce a person's freedom.

This kind of abuse has been associated with significant mental health consequences, including depression and post-traumatic stress symptoms (Lohmann et al., 2024).

That is why focusing exclusively on whether someone is a “narcissist” can sometimes distract from the more important question:

Am I safe, respected, and free to make my own choices in this relationship?

What If You Are Thinking About Leaving?

If the relationship involves abuse or coercive control, leaving may require more planning than simply deciding that the relationship is over.

In some situations, separation can actually increase risk. Abuse can continue after a relationship ends through harassment, financial abuse, legal processes, manipulation involving children, stalking, or attempts to discredit the former partner.

Research on post-separation abuse has documented psychological, legal, economic, and parenting-related tactics that can continue after separation (Spearman et al., 2024).

If you are concerned about your safety, consider speaking privately with an appropriate domestic violence or safety-planning service before announcing your plans to leave. A therapist can also help you think through your emotional needs and connect you with appropriate community, legal, or practical resources.

If you are in immediate danger, contact emergency services.

What Can Help You Recover?

Healing from an abusive relationship is not simply about “getting over” another person.

It may involve rebuilding trust in your own perceptions, understanding what happened, learning to recognize unhealthy relationship patterns, developing boundaries, reconnecting with supportive people, and rediscovering parts of yourself that became smaller during the relationship.

Therapy can provide a place to work through the emotional consequences of the relationship without having to defend or justify your experience.

Depending on your circumstances, therapy may involve trauma-focused work, emotional regulation skills, work on self-worth and boundaries, or simply having a safe place to begin making sense of what happened.

The goal is not to teach you how to control the other person.

It is to help you regain a sense of agency over your own life.

Can Someone With Narcissistic Personality Disorder Change?

This is a complicated question, and the answer is more hopeful than some online discussions suggest.

NPD has historically been described as difficult to treat, and the research base remains relatively limited compared with some other mental health conditions. However, contemporary reviews describe several psychotherapeutic approaches being used with narcissistic pathology, including psychodynamic approaches, transference-focused psychotherapy, schema therapy, and mentalization-informed approaches (Emmelkamp & Meyerbröker, 2025; Weinberg & Ronningstam, 2022).

Importantly, emerging research suggests that meaningful change is possible.

A qualitative case series examining eight people diagnosed with NPD found substantial improvements following approximately 2.5 to 5 years of psychotherapy, including improvements in personality functioning and close relationships. The study was small and cannot tell us how frequently this degree of change occurs, but it challenges the idea that NPD is simply something a person cannot change.

Change generally requires the person themselves to be willing to participate in treatment and examine their patterns.

You cannot do that work for someone else.

What If You Are the Person With Narcissistic Traits?

If you recognize yourself in some of what you have read here, that does not make you a bad person.

People can develop defensive ways of relating for many reasons. Narcissistic patterns can involve difficulties with self-esteem regulation, shame, emotion regulation, empathy, identity, and relationships (Weinberg & Ronningstam, 2022).

Recognizing a pattern is not the same as being defined by it.

Therapy can provide an opportunity to understand what happens when you feel criticized, rejected, ignored, or ashamed, and to develop different ways of responding. The aim is not to eliminate every uncomfortable emotion or turn someone into a completely different person. It is to build greater flexibility, self-awareness, empathy, and capacity for healthier relationships.

How Therapy Can Help With Narcissistic Abuse

If you have been affected by a relationship involving narcissistic traits or emotional abuse, therapy can give you a place to make sense of the experience without having to minimize it.

At Authentic Living London, Sandra Graham works with people affected by personality disorders and narcissistic relationship dynamics. Her work can support clients who are trying to understand unhealthy relationship patterns, rebuild self-trust, establish healthier boundaries, and recover from the emotional effects of difficult or abusive relationships.

Therapy can also be helpful for people who recognize narcissistic patterns in themselves and want to understand and change the ways those patterns affect their relationships.

The focus is not on assigning blame or deciding who is the “narcissist.”

It is on understanding what is happening and determining what needs to change.

If you have been affected by what is commonly called narcissistic abuse, you deserve support that takes your experience seriously while avoiding simplistic labels.

If you are looking for therapy for narcissistic abuse or personality disorders in London, Ontario, Authentic Living London offers in-person therapy in London and virtual therapy across Ontario. You can call or text 226-224-0301 or email info@authenticlivinglondon.com to learn more or arrange a consultation.

Sandra Graham, therapist specializing in personality disorders, including NPD and NPD abuse.

At Authentic Living London, Sandra Graham, Registered psychotherapist - qualifying, Bsc, MACP, specializes in working with people affected by personality disorders and narcissistic abuse. Sandra offers trauma-informed, compassionate therapy focused on safety, rebuilding self-worth, and practical coping skills.

References

Emmelkamp, P. M. G., & Meyerbröker, K. (2025). Psychotherapies for the treatment of personality disorders: The state of the art. Current Opinion in Psychiatry, 38(1), 66–71. https://doi.org/10.1097/YCO.0000000000000968

Lohmann, S., Cowlishaw, S., Ney, L., O'Donnell, M., & Felmingham, K. (2024). The trauma and mental health impacts of coercive control: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 25(1), 630–647. https://doi.org/10.1177/15248380231162972

Miller, J. D., Crowe, M. L., & Sharpe, B. M. (2022). Narcissism and the DSM-5 alternative model of personality disorder. Personality Disorders: Theory, Research, and Treatment, 13(3), 245–255. https://doi.org/10.1037/per0000534

Oliver, E., Coates, A., Bennett, J. M., & Willis, M. L. (2024). Narcissism and intimate partner violence: A systematic review and meta-analysis. Trauma, Violence, & Abuse, 25(3), 1871–1884. https://doi.org/10.1177/15248380231196115

Smyth, M. R., Teicher, S., & Wilde, D. J. (2024). How does denial, minimization, justifying, and blaming operate in intimate partner abuse committed by men: A systematic review of the literature. Trauma, Violence, & Abuse, 25(3), 1853–1870. https://doi.org/10.1177/15248380231196108

Spearman, K. J., Vaughan-Eden, V., Hardesty, J. L., & Campbell, J. (2024). Post-separation abuse: A literature review connecting tactics to harm. Journal of Family Trauma, Child Custody & Child Development, 21(2), 145–164. https://doi.org/10.1080/26904586.2023.2177233

Weinberg, I., & Ronningstam, E. (2022). Narcissistic personality disorder: Progress in understanding and treatment. FOCUS, 20(4), 368–377. https://doi.org/10.1176/appi.focus.20220052