5 Stages of Diagnosing a Narcissist


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Page last updated: 15/11/2022

5 Stages of Diagnosing a Narcissist

Hey Optimist Minds!

Have you heard people using the word “narcissist” for difficult, arrogant, and entitled individuals? The term is quite popular today and is being used for many political leaders and people in positions of power. 

It’s acceptable to use the adjective “narcissistic” to describe a behaviour pattern of being self-absorbed, controlling, manipulative, and lacking empathy. However, it comes with a lot of pushback due to stigma and lack of awareness.

Narcissism is a controversial topic as specific prerequisites need to be taken care of before one can be diagnosed. Without them, it’s unethical to do so, and it doesn’t really help anyone. 

This video will talk about five stages in diagnosing a narcissist. Only use this information for educational purposes as it is not designed to diagnose narcissists professionally or demean them.

Let’s begin.

Stage One

Understanding that narcissism isn’t a diagnosis.

The truth is that the words narcissism or narcissist are only nouns, and narcissistic is an adjective. Therefore, none of these qualifies as a diagnosis. Instead, they are descriptive terms that anyone can use to delineate a specific pattern of behaviour.

On the other hand, Narcissistic Personality Disorder, or NPD, is an actual diagnosis, which can only be done by a licensed mental health professional. 

So, if you come across someone who seems grandiose, self-centred, or obnoxious, you can use these n-words to depict them. But at the same time, you can’t make an official judgement about their mental health condition until the next stage.

Stage Two

Waiting for the narcissist to consult a therapist.

People with narcissistic tendencies seldom seek professional help. That’s because they lack the insight required to recognise their maladaptive behaviour. In reality, it’s the people involved with a narcissist who ends up in a shrink’s office to deal with the consequences of narcissistic behaviour.

Unfortunately, even professionals can’t diagnose the narcissist simply because they are causing trouble to these other people. A diagnosis can only commence once the narcissist feels like they’re facing significant impairment in life because of their mental health. Only when they show up for therapy can a psychiatrist or psychologist begin to diagnose.

Narcissists rarely take this step. However, it can happen if they start facing trouble in their romantic relationship or workplace because of their antagonistic ways.

Stage Three

Matching the latest diagnostic criteria.

The Diagnostic & Statistical Manual of Psychological Disorders is a handbook specifying the essential criteria for each mental disorder, including NPD. This text has been revised several times. Earlier, it was enough to display any five of the following nine behaviours:

  • Grandiose sense of self-importance
  • Unrealistic fantasies of success
  • Wanting to be associated with high-status people and places
  • Entitlement
  • Need for admiration
  • Taking advantage of others
  • Lacking empathy
  • Envy, and
  • Arrogance
5 Stages of Diagnosing a Narcissist

The latest version of the manual, the DSM 5, has changed the criteria for NPD to a model more focussed on the impairment caused by these behaviours. 

Today, to officially diagnose a narcissist, they have to be facing impairments in self-functioning and relationships in addition to antagonism characterised by grandiosity and attention seeking.

This makes the process of diagnosing more complicated because there may be people enabling the narcissist’s behaviour. For example, it’s easier to get away with mistreating others if you have money, power, and social influence. As a result, narcissists don’t see any problem in their life and may never be diagnosed.

Stage Four

Exploring interpersonal relationships.

If the narcissist does start seeing a therapist, the next stage is to look at their relationships with loved ones. 

It is typical for narcissists to have frequent conflicts in all their interpersonal relationships. That’s because their lack of empathy prevents them from making meaningful connections with others.

The therapist will investigate the narcissist’s ability to recognise or identify with the feelings and needs of others. 

Individuals with NPD can get excessively attuned to other people’s reactions as they think it’s all about them. Narcissism makes them believe that every joke, laugh, or casual comment is targeted at them. Consequently, their relationships are largely superficial and exist only to boost their self-esteem. In reality, narcissists don’t have a genuine interest in their partners.

Stage Five

Continued sessions to confirm a diagnosis.

Finally, it will require quite a few sessions for the therapist to confirm their diagnosis. Since most of the information has to be elicited from the narcissist, they will likely distort the truth. 

The narcissist might lie and portray themselves as a victim when talking about their problems. Only after multiple and regular sessions can the therapist be sure that their client has Narcissistic Personality Disorder.

If you have been a victim of narcissistic abuse, it’s best to get professional help for your mental health immediately. Don’t wait for the narcissist to be diagnosed, as that may never happen, and you’re severely affected regardless.

Do you think you or someone else you know is suffering from NPD? Which stage do you think describes the present situation best? Let us know in the comments as we’d love to hear from you.

A link for further reading and the studies & references used in the making of this video are mentioned in the description below.

Thanks for visiting optimist minds, take care. Until next time.