The word narcissism is incredibly overused these days. People will use it to refer to selfish, arrogant, entitled, self-absorbed people. (I would posit that most if not all people who use the word narcissist so easily have never personally experienced narcissism themselves.) And, while it is true that narcissists do have all of these traits, the reverse is not true that all people who have these traits are narcissists. It is also true that narcissism itself presents on a spectrum. And where someone falls on the narcissism spectrum has the potential to give us clues as to what we are really dealing with.
As a general rule, the narcissism spectrum can tell us whether a person has narcissistic tendencies or full blown Narcissistic Personality Disorder. Test results give a range of how high or low someone falls on a spectrum. Interestingly, nearly everyone shows up somewhere on the scale–likely because human nature has a necessary element of self-protection.
While no test exists that communicates a specific number as whether a person is a narcissist or not, there is a gradual scale that shows levels of tendency all the way up to full narcissism. Interestingly, nearly everyone shows up somewhere on the scale–likely because human nature has a necessary element of self-protection.
Let’s go ahead and take a look at how the narcissism spectrum works, how it relates to other spectrum disorders, how it also relates to the numbers and results of narcissism tests, and how a possible cure for narcissism plays into all of this.
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How the Narcissism Spectrum Works and is Treated
The narcissism spectrum is determined by a few different tests, but psychologists and therapists generally already know that someone is a narcissist from the time they have spent in the counseling office, for the few that ever get there. Just about the only two reasons narcissists go to a therapist are to show how their spouse is such a bad person and to further control them or because they are under court orders. Neither way has historically been beneficial to the healing of the narcissist.
The narcissism spectrum is not an exact science. But it really doesn’t need to be. Upon diagnosis, treatment for narcissism, whether narcissistic behaviors or actual Narcissistic Personality Disorder, is generally talk therapy, the concentration will be on working through it with various talk therapy techniques rather than a certain dosage of medication or other more measured treatments. Specific behaviors will be dealt with in their therapy sessions.
The biggest factor in working with the spectrum is the knowledge that those who fall lower on the narcissism scale will have narcissistic traits, while those who fall higher on the scale will be closer to full-blown Narcissistic Personality Disorder. The therapy will, of course, be more aggressive with less hope of recovery and healing the higher on the spectrum the narcissist is.
Talk therapy is usually in the form of cognitive behavioral therapy. Once in a while, therapists will attempt EMDR therapy for narcissism. But it is rarely if ever effective. It is far more effective for treating the effects of long term narcissistic abuse of the narcissist’s victims.
There is a growing number of therapists that now believe even talk therapy is unhealthy for narcissists. Unfortunately, narcissists can use the techniques they learn in therapy to pretend they are changing and further abuse their victims. The more they learn from the therapists, they more they will use it against others to bolster their narcissistic supply.
No medications will specifically help narcissism. But medications can be prescribed for other accompanying issues of narcissism, such as depression or anxiety.
The Confusion of the Narcissistic Spectrum With Other Spectrum Disorders
I’m sure you’ve been in conversation with someone at some point when they talk about someone being “on the spectrum.” Of course, that usually means on the autism spectrum. Nobody really thinks you’re talking about the narcissism spectrum. But, there are times when narcissism and other spectrum disorders can have some overlap and even get misdiagnosed because the overlap is misread. Let me give you a couple of examples.
The Narcissism Spectrum vs. the Autism Spectrum
There is some overlap in the narcissism and autism spectrums. But they are far more different than they are similar. First, narcissism is a personality disorder, while autism is a neurodevelopmental disorder.
According to Cross River Therapy, autism “affects social interaction, communication, and behavior.” Further, they say, “People with autism may have difficulty understanding social cues, making eye contact, and engaging in reciprocal conversation. They may also have repetitive behaviors, such as rocking or hand-flapping, and a strong attachment to routine.”
None of this sounds like the gaslighting, bullying, manipulating, lying, controlling, love-bombing, entitled, non-empathetic, admiration-seeking behavior of the narcissist. So then, how do they get confused, even by professionals? Because sometimes each of their respective behaviors can become very similar, especially as they become frustrated, fearful, or otherwise.
They can both have difficulties interacting in social situations in healthy ways. But their reasons and though processes are vastly different. They may both lash out in anger when life gets too hard for them to handle. But again, their reasons and though processes are worlds apart.
Probably the biggest difference is that even though an autistic person cannot be “cured,” they can make great strides in healing and moving ahead. The narcissist will rarely if ever heal or recover. They may want you to think they can or will, but it is a very short time before they are back up to their usual tricks and deception.
One final thought: because both narcissism and autism appear on a spectrum, they manifest more highly in some than in others. And, of course, the more highly on the spectrum people rank, the more difficult it will be to get through it.
The Narcissism Spectrum and Bipolar Disorder Spectrum
Bipolar disorder is very different than autism spectrum disorder. But there are also some striking similarities (both in symptoms and genetic causes according to Verywell Health). Because there are similarities in these two disorders, there are also crossovers and misdiagnoses between Bipolar Disorder and Narcissistic Personality Disorder. In fact, there are more similarities between the two causing this dilemma than with autism (but also some huge differences). Let’s explore some of those.
First, let’s talk about the differences. Bipolar, like the name suggests, is a battle between manic and depressive moods. It is driven by genetics and brain chemistry rather than genetics and nurture, which is narcissism’s source. Someone with bipolar can be raised in a perfectly healthy home, whereas someone with narcissism is almost never raised in an emotionally healthy home, but is and outcome of early childhood in an deeply abusive or neglectful situation (or an incredibly spoiled situation). Here are some more differences:
- Social interactions for bipolar people happen frequently when they are in a manic state and feel like spending time with others. Narcissists are largely anti-social and avoidant, but they will go out of their way to be social for the sake of narcissistic supply.
- Narcissists will always have a lack of empathy, although they may feign it for narcissistic supply from time to time. Those with bipolar, however, will go through a depressive state, feel like they are the victim, and lash out with a lack of empathy. But, once they get back to a manic state (or at least not a depressive state), they will often deeply regret their lack of empathy and work to heal the relationship.
- Those with bipolar are keenly aware of their behavior issues, although they may not always have the strength to deal with it correctly. But narcissists are never “aware” of their narcissism. At least not verbally. I believe they know exactly what they are doing. They have to know if they are playing people in so many different directions so much of the time. My point here is that the narcissist is intentionally unempathetic, where the person with bipolar may not realize it at the time when they are not thinking clearly through their depression.
Here is where things get similar: both narcissistic personality disorder and bipolar disorder come to fruition in the late teens/early 20’s. They both can look very unempathetic, even though the sources and end result will often be very different.
They are both highly goal oriented, often setting goals that are almost superhuman, then being devastated that it didn’t result in superhuman displays. And they can both have major mood swings, just for very different reasons. The narcissist’s mood swing is because he wasn’t treated like the royalty he thinks he is. And the bipolar’s mood swing is because things didn’t turn out the way they had planned it in their head or because others couldn’t see their vision.
In conclusion, occasionally even a professional will mistake one for the other. Amber Heard was diagnosed with Bipolar Personality Disorder in her very public trial with Johnny Depp in 2022, but other psychologists said they believed she had Narcissist traits at the very least, and full-blown narcissistic personality disorder at the greatest. I think it could be somewhere in the middle of those spaces for sure.
How the Numbers Work on Narcissistic Personality Disorder Tests
There are several Narcissistic Personality Disorder Tests. Here are some of the major ones along with how the scores work for them:
- Personality diagnostic questionnaire-4 (PDQ-4). This test consists of 99 true or false questions, making it one of the most popular tests because of its ease of use. Once scored, it can be followed up with a clinical severity scan if the therapist finds that necessary to get a more complete picture. It also gives you a personal introductory test (not true and false like the official one, but multiple choice depending on how much you resemble the statement). It was fun to take and nice that I didn’t score in the range of any possible disorders, lol.
- Millon clinical multiaxial inventory III (MCMI-III). This test was used for my husband and me when we were seeing a therapist, so I can speak a lot more to this one. We were both given the test in order to not single out either one of us for diagnosis. My therapist said they were having me take it because they suspected my ex’s narcissism. I kind of feared that maybe they thought I was the crazy one to test and they were just telling me that to get me to submit to the test. But it turned out to be what they said. While my ex was testing, they counseled me on how to handle things upon him being positive for NPD. It had 175 true or false questions. My only concern about it was that it requires that everyone who takes it ranks in some disorder. This came out when they gave me my results and the first page said that my results were elevated to put me into a disorder. My ex then said from then on that I had cheated the test. He didn’t want to talk about his own results, which showed that he ranked high in narcissistic behaviors. No surprise. Anyway, if I had known that it requires everyone to be on the spectrum of some disorder, I definitely wouldn’t have agreed. But it did say that I was only on the spectrum because they artificially raised my score to put me there. That’s enough for me to be secure in my own emotional health.
- International personality disorder examination (IPDE). The IPDE was developed by a collaboration between the World Health Organization (WHO) and the U.S. National Institutes for Health (NIH). It consists of a screening questionnaire and a semi-structured interview that helps detect 11 different disorders. The questionnaire consists of a forced choice response style. The test determines disorders based on a probable, definite, or negative diagnosis based on the questionnaire results combined with the following interview.
None of these tests have a magical number that determines an individual to be either a narcissist or not. In fact, if you are a living, breathing person, you have at least a tiny bit of narcissism in you in the form of self-preservation. And we are all at least a little bit selfish from time to time. But that is a far cry from full blown narcissism.
Can a Narcissist be Cured at any Point on the Narcissism Spectrum?
If you do a quick Google search of “cured narcissist,” you will be hard pressed to actually find one. There have been a few reports. Actually, there are several people claiming to be self-aware and somewhat recovered narcissist, all of whom run websites and sell books, conferences, and other things, allowing them to profit off their narcissism. Which makes me unsure of whether they are healed and helping others through it, or just using it to make a pretty penny.
But, that being said, while finding a cured, full blown narcissist is pretty impossible, finding a healed person with narcissistic traits is not such a huge leap. Even the most kind, docile person can behave in a narcissistic manner on occasion. But that certainly isn’t narcissism or a cure for Narcissistic Personality Disorder.
The truth is that Narcissistic Personality Disorder itself cannot be cured. Narcissists who choose to believe what people tell them about their narcissism if they remain under vigilant supervision and trust the process can be cured. But that level of trust is generally impossible for a full blown narcissist. So they will never be able to come to a point of admitting to someone else that they are flawed, especially to that degree. And they will never be able to make themselves vulnerable enough to realize that healing.
Thus, the best thing you can do if you are in any sort of relationship with a narcissist is run the other way. The sooner the better. If you have children with the narcissist, it will not be so easy, but eventually you will be able to go no contact. And you will finally be able to see the world in a much clearer, brighter light.
Understanding the narcissism spectrum can be daunting at first. But once you see the levels of narcissism in the many people you meet over the course of your life, you will find it easier over time. Victims of narcissism who find healing and emotional health become pretty adept at picking up on narcissistic behavior immediately. And with that, they find they no longer have to deal with narcissistic relationships in their later years.
What has your experience been like? Were you able to identify and avoid narcissists who were on the lower end of the spectrum? Could you tell over time how high or low they fell on the narcissism spectrum? If you could warn a friend or other person, how would you do it? I would love to hear your thoughts. And if you need prayer or guidance from your difficult relationships with a narcissist, let us know so we can pray for you and offer some encouragement and strength!
Are you just now in the beginning stages of recognizing narcissistic abuse in your life and not sure where to go or what to do next? Marie helps people start to put the pieces together to get quickly on the pathway of healing. She has many resources you can check out here, but if you would like quicker, more direct guidance specific to your situation, a direct consultation with Marie may be more helpful to you. You can check out the various consultation options here.
Blessings and hugs,
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