- Pathological narcissism damages relationships and is bad for the health of the narcissist and those around them.
- Research has characterized narcissism well, but less attention has been directed toward the experience of intimate others.
- Qualitative research opens a window into the experience of people in relationships with narcissists to define core relationship dynamics.
- Narcissistic relationships are characterized by abuse, financial deception, sexual issues, and a roller-coaster of interpersonal confusion.
Narcissism is a source of ever-increasing attention because of the suffering and helplessness that arise routinely in relationships where pathological self-interest and personal vulnerability dominates. These traits are typically in our blind spots and so are hard to change even when the need for change is recognized and desired.
Narcissism isn't all bad, though, and in fact healthy narcissism is key to well-being. It is through having a good sense of self1 that we develop personal capacities for self-regard and the pursuit of life goals. It is through having a good sense of self that we learn to recognize situations which may not be healthy for us and to identify and pursue those that are more likely to work out well for all involved, grounded in good self-relationship.
Hazardous to your health?
Those in relationships with people with pathological narcissism exhibit reduced well-being, chronic feelings of low self-esteem, stress, loneliness, guilt, and an array of day-to-day worries about the relationship and their own safety. Narcissism is one of the "dark traits", which also includes Machiavellianism, sadism, and psychopathy. Looking out for those traits, in addition to pathological narcissism itself, may prevent relationships from being even more destructive.
Getting the behind-the-scenes story from partners and relatives
There is limited research on how narcissism impacts close others—from their perspective—and how that plays out. Narrative analysis, in which partners and relatives of people with pathological narcissism respond free-form, is a useful tool to identify patterns from subjective information. Narrative responses are then analyzed and coded by a team of trained reviewers to extract consistent overarching patterns.
Researchers Day, Townsend and Grenyar (2021), in the journal Personality and Mental Health, recruited relatives and partners of narcissistic people through requests on narcissism support, mental health websites, and related groups. Screening a large pool of volunteers, they identified 436 people who met the study criteria. They either had a close family member (15.4 percent), a current partner or spouse (57.3 percent) or an ex (21.1 percent) with pathological narcissism.
Participants rated the identified partner or relative's narcissism using a 12-item adaptation of the Pathological Narcissism Inventory, quantifying the other's narcissistic traits, such as grandiosity (“My relative often fantasizes about performing heroic deeds”) and vulnerability (“My relative finds it hard to feel good about themselves unless they know other people admire them”). They also responded via text box to the prompt, “What is your relative like, how do you get on together?”
Responses ranged from 70 to 1,279 words, and were analyzed for recurring major and subsidiary themes. Responses were analyzed for content using the Psychiatric Content Analysis and Diagnosis (PCAD-3), which scours data for indicators of reduced well-being: total anxiety, total depression, outward-directed hostility, inward-directed hostility, somatic (bodily) concerns, sickness, dependency strivings and frustrated dependency.
Basic patterns in dysfunctional narcissistic relationship
There were 795 recurring themes, which clustered into four main dimensions.
- Abusive behaviors. This pattern included emotional abuse, physical abuse, sexual abuse and verbal abuse. Abusive behaviors were identified by 43.9 percent of participants, physical abuse by 20.6 percent, 16-17 percent for emotional and verbal abuse, and 5.7 percent reporting sexual abuse.
- Imposition of financial burden. This pattern included debt, stealing, being controlling with money, and dependent and irresponsible behaviors, reported by 32 percent of participants. Prior research by Mong and colleagues (2021), for example, found that “financial infidelity”—financial decisions made without sharing them with partners,—was a significant source of relationship strain. Such decisions included filing for bankruptcy, gambling, covering up debt, furtively spending savings, keeping a secret bank account, paying for pornography on the sly, and hiding raises or bonuses.
- Imposition of unwanted sexual behaviors. This included infidelity, addiction (sex, pornography, etc.), selfishness during sex, and being demanding, inappropriate and withholding, reported by 34.2 percent. on unwanted sex. Prior research has shown that both men and women experience unwanted sex in close relationships, due to frank coercion, as well consenting to unwanted sex either to avoid conflict or to make the other person feel better or help the relationship.
- Mutual idealization and devaluation. Described by 31 percent, this pattern is distinctive. At the beginning of the relationship, each sees the other as impossibly wonderful, irresistibly alluring, with flaws lost in the glow of mutual preoccupation. Participants reported the relationship “felt like a fairy tale”, and that narcissistic partners were adoring, complimented them effusively (and in retrospect, inauthentically), and expressed love “early on in the game”—simultaneously a seductive appeal to vanity as well as a distraction from what the person is really about. Devaluation followed idealization, after a honeymoon period, and kindness turned sour. Under increasing demands, criticism and blame, and a variety of harsh behaviors and overtly coercive tactics betraying the underlying pathological traits, relationships took heavy damage.
Psychiatric Content Analysis and Diagnosis findings. Scores for all items of the psychiatric assessment were elevated, showing higher rates of anxiety, depression, hostility, unhealthy dependency, and physical complaints for those in close relationships with pathologically narcissistic people. Of note, for partners and ex-partners of narcissistic people, depression, sickness and frustrated dependency scores were especially significant.
For family members of narcissistic individuals, sickness and frustrated dependency were particularly high, while anxiety and depression, while elevated, were less so. The difference suggests that family members accommodate to manage anxiety and depression in relationships with pathologically narcissistic individuals given the life-long nature of most family relationships. It’s more common, and much easier, for romantic partners to end relationships than for people to disown a narcissistic family member.
Moving on from pathological narcissism
All in all, the findings of this blended quantitative-qualitative analysis, using both narrative review as well as standard measurements, is consistent with and extends understanding of maladaptive relationship dynamics where pathological narcissism is in the mix. Such narcissism is often partially rooted in negative, even traumatic experiences, typically with one's own caregivers. Such experiences lead to difficulty being available to others later in life, with tension between the need for closeness and fears of what intimacy would actually mean.
Familiar dynamics were identified: abusive behaviors, financial burden, negative sexual behaviors, and the hallmark back-and-forth between idealization and devaluation. The pendulum between idealization and devaluation, can be conceptualized as the DNA of narcissistic interpersonal dynamics. It is also common in cases of Borderline Personality, which shares some features with Narcissistic Personality Disorder, including problems with sense of self, the ability to empathize with others, and various developmental problems.
The day-to-day unpredictability whether one is in big trouble or in the other’s good graces not only undermines self-esteem and contributes to psychological and physical problems but also creates constant disorientation and tension, making it very challenging to focus on positive change. Helping people caught in such relationships to adopt effective ways of getting their needs met, starting with recognition of destructive patterns, is a desirable goal2 (see below for resources).
Regardless, recognizing what is happening, focusing on one’s own well-being, working out what boundaries need to be set and kept, and what conversations and actions need to happen increase the chances of a mutually safe and satisfying relationship grounded in intimacy and mutual respect. Easier said than done! Change in these areas may take time and practice, even though it sometimes feels like time is running out.
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1. Babies are born able to recognize human faces, and read emotion to an extent. Somewhere between 1.5 and 2 years old, the majority of kids start recognizing themselves in the mirror. From then on, relationship with oneself and relationship with others reverberate with one another. Through growing self-recognition we more fully related to others, and in doing so we learn about ourselves, and so on. In pathological narcissism, we don’t see our own blind spots though others often do. The nature of narcissism thereby shapes how relationships unfold. When pathological narcissism is present, depending on the particulars, such relationships take sadly familiar shape. While many people avoid pathological narcissism, it can be hard to sense at first, and once a bond is formed it is much more difficult to change or end relationships.
2. For people already in relationships involving pathological narcissism, it’s important to shift the focus toward one’s own healthy needs in order to work out what may be required. In some cases, such relationships may work out well, if the narcissism is not too severe, if there are protective factors including genuine love, compatibility and the capacity for personal growth, and first and foremost the capacity for both partners to get on the same page about what's happening in the relationship. In other cases, more austere measures are required including ending the relationship, serious considering doing so, or sharply limiting contact if the relationship cannot be ended.
Often, we don't see ourselves as needing help, seeking help only under duress when we "hit rock-bottom" or are forced into therapy under threat of relationship or professional failure. It's very hard to discover pathological narcissism in oneself, and far easier to see it in others. More pronounced narcissists consciously don't see the need for change while unconsciously they are frightened, avoiding facing personal and relationship challenges—and commonly becoming distressed and externalizing hostility when flaws are revealed.
Day, N. J. S., Townsend, M. L., & Grenyer, B. F. S. (2021). Pathological narcissism: An analysis of interpersonal dysfunction within intimate relationships. Personality and Mental Health, 1–13. https://doi. org/10.1002/pmh.1532.
Mong, M. D., Stadthagen, H., Noguchi, K., & Jeanfreau, M. (2021). When Your Partner Cheats: Financial Infidelity in Committed Couples. Journal of Financial Therapy, 12 (1) 7. https://doi.org/10.4148/1944-9771.1248.
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