Is the Label of Narcissist Being Overused?

I was wrapping up a session with "Sally", a 13-year-old client who had started seeing me earlier this year. A clear example of a scapegoat for a family's problems, she had been brought to my office to "fix" after she was found to be problematic in her communication and behaviors within the family. Her family had refused family therapy themselves, insisting that Sally was the problem.

"I have a question," she said, with the eager curiosity that comes from being young in a world made for grownups. We had been coloring while we talked, and had started the cleanup ritual that marked the ending of our session.

"Yes?" I asked, always hungry to explore further.

"What's a nar- narcis- ... narcist?

"Do you mean 'narcissist"? I asked slowly, knowing where this conversation was headed and not sure I was ready for it.

"Yes, that word. What is a narcissist?"

It was one of those moments that therapists call a "doorknob confession" — a statement said in the last moment of therapy, sometimes when your hand is on the doorknob ready to go. It is that moment in which clients tend to drop a bombshell of information at your feet as they exit, leaving you with barely enough time to take a breath and prepare for the next person to enter. In this case it was a "crayon confession," said in the last few seconds as I shifted the waxy coloring tools into their storage box.

This one actually made me remove my hand from the box, giving up the precious five minutes that I had between clients to gain clarity.

"Why, where did you hear that word?" I asked, fearing the answer.

"My dad said I am a narcissist," she replied, with the soft innocence of a child who does not know the meaning of what they've said.

A moment of complete countertransference took over as I experienced my own internal struggle. Where should I even start with this one?

Like all therapists practicing in the digital age, I have had many clients use that word, albeit usually adults. Sometimes they are correct, while other times not, but the accuracy does not matter. We start with their experience and perspective, as that is the most important element of the therapeutic process.

The use of the word in itself is not alarming, as I welcome the exploration it brings, and I remind clients that they are all always the expert on themselves and their situation. Many of my clients have suffered immense psychological harm from a caregiver or partner who has traits of this personality disorder, and having a term to define their experiences has been both empowering and liberating for so many as it afford them the distance they need to heal and move forward. But the flagrant overuse of this word to describe every person who acts selfishly, posts too many selfies, or who one disagrees with is trivializing the harm that was done to those who suffered. And its use to demean people, especially young people, who are acting in age appropriate ways speaks to its incorrect use as a tool to inflict harm. "It puts the person who is diagnosing in power, whether they want to deem someone pathological or not." (Fan, 2020)

According to the DSM-5, or the Diagnostic and Statistical Manual of Mental Disorders, a "narcissist", or a person with Narcissistic Personality Disorder, must meet several criteria, including grandiosity, a need for admiration, and a lack of empathy, (APA, 2013).

One glance at the diagnostic criteria for this diagnosis will show us that any healthy preteen could meet several of the criteria; this is a healthy stage of their development. Most of us will meet some of the criteria for this diagnosis at some point in our lives, especially in our younger years.

It exists on a spectrum, with only those on the far end of the spectrum meeting criteria for the pervasive cruelty that is capable of inflicting psychological malice. "Equating these behaviors by tagging the people who display the former as narcissists is a bit like comparing a pickpocket to an armed bank robber," (Malkin, 2015)

But we all know that this word was not told to this little girl as a clinical analysis. It was said to be mean, to put her in her place, and to tell her that she was a bad person. She was shamed for most likely acting the same as any child her age. She did not know the meaning but knew it meant she was bad somehow. As many will not be surprised to learn, the father who threw this cruel label at her scored high on traits of NPD himself. A clear example of the projection that characterizes this disorder. In this case, his projection is causing damage to an impressionable child.

Narcissism Essential Reads

3 Ways Narcissists Objectify Their Children

Why Do Narcissistic Parents Gaslight Their Adult Children?

We have continued our work on self-esteem, and I now have a clearer picture of where and why the work was needed.

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