Does healthy narcissism exist? Why experts say there are positives to this personality disorder

When most people picture narcissists, we think of self-centered, awful people who lack empathy. But it's a real mental disorder that is more than just an insufferable personality trait — and in some cases narcissism may even have some benefits.

Clinically speaking, narcissistic personality disorder is "a pattern of grandiosity, need for admiration, and lack of empathy," according to the Diagnostic and Statistical Manual of Mental Disorders. Psychologists and armchair critics alike enjoy warning the public about narcissists in their midst. This can be seen in the realm of politics, like Donald Trump's refusal to concede in the 2020 presidential election, and popular culture, such as the infamous defamation trial involving actors Johnny Depp and Amber Heard. Most people have also had to experience terrible narcissists, whether it's family, friends or people at work.

Certainly no medical expert would defend narcissistic behavior like violent outbursts, malicious deception or petulant refusals to admit defeat. At the same time, some experts observe that some narcissistic traits can be healthy. To understand why, one must start with comprehending that narcissism does not make a person totally lack like the ability to be concerned with how others perceive them. If one defines "good" as "caring about other people," narcissists can still be good people up to a point.

"'Psychopath' is a clinical term that is used to describe a person who lacks remorse or has a cold, calculating kind of interpersonal style and exploits interpersonally," says Dr. Ramani Durvasula, a licensed clinical psychologist and professor of psychology who talks about narcissistic abusers. "They are exploitative with a tendency towards a parasitic lifestyle. But the big thing with psychopathy is that, again, there is a very cold calculated piece to everything. There is a willingness to use other people for their ends, and we often see a complete and utter lack of anxiety."

By contrast narcissists "care about what looks good to the world. A sociopathic person isn't driven by that. And as a result, they will violate social norms and rules. Relationships with them are characterized by a lot of betrayal, and they also tend to be a lot more reactive and hotheaded," Durvasula said.

Narcissists are not defined by these types of behaviors. Hannah Alderete, a PhD student who specializes in narcissism among other psychiatric disorders, explained why this is the case.

"Narcissistic personality traits can absolutely be healthy, given that they are innate inside all of us, and do help us take action toward bettering ourselves," Alderete says. "Most of us would not likely get out of bed if we did not possess a healthy degree of narcissism."

Narcissistic traits are only harmful when they are fix and rigid; if balanced by self-awareness, an ability to change and a humble willingness to express compassion for others, "it stays in the realm of healthy," Alderete says.

Harvard Medical School lecturer Dr. Craig Malkin, a clinical psychologist and author, told Salon that "narcissism" itself is not an official diagnosis and never has been, but is rather a "trait" defined as "a pervasive universal human tendency called 'self-enhancement'" or "the drive to feel special — to stand out from the other nearly 8 billion people on the planet in some way."

Since happy and healthy people usually don't feel average or boring, regardless of whether that is true, it makes sense that having a degree of narcissism can be healthy. Why not feel like one is exceptional or unique and therefore persist in ambitious plans despite persistent failure, if a person is happier and lives longer as a result?

"This moderate self-enhancement is healthy narcissism," Malkin says. "It’s not self-confidence or self-esteem or self-love. Think of it instead as slightly rose-colored glasses for self (world and future). It’s at the heart of all narcissism and in moderation it’s completely healthy."

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Narcissism is not just healthy for individuals in small doses; it can only benefit human civilization as a whole.

"Societies benefit from connection and cooperation among individuals, which seems antithetical to possessing narcissistic traits," says Alderete. "However I believe that when we can acknowledge and endorse our strengths and skills as individuals (which requires healthy narcissism), we are giving ourselves opportunities to grow and flourish."

In other words, humans need narcissism in the same way that they need most of their basic personality traits — in moderation.

"We need both," says Alderete. "The ability to take care of ourselves and the ability to tend to the community at large by taking in the needs and perspectives of others. Both are valuable traits to keep in balance."

By contrast, people who talk about "narcissism" today are usually describing people who act in deliberately cruel and self-centered ways, which is completely separate from more innocuous narcissistic behavior.

"Most of what people describe is 'narcissism' is either [narcissistic personality disorder] or psychopathy," Malkin says, describing a pattern of remorseless lies and manipulation to maintain power over others. "Narcissism has become a stand in in for every attribute people don’t like and every dangerous behavior imaginable. I saw a post about Hitler being a narcissist. I dare say that was the least of his problems," he added.

In addition to just being clinically inaccurate, it is also deeply harmful to use terms like "narcissist" against people without having clinically diagnosed them. Just ask Dr. Jessica January Behr, a licensed psychologist who practices out of New York City.

"While it is positive that stigma related to mental health — and even Axis II personality disorders seems to have reduced drastically — and as a society we are more comfortable talking about it and bringing it to light, [but] the tides may have shifted too far in the other direction," says Behr. "The term 'narcissism' seems to have become a colloquial catch-all for anyone you don't like or anyone that does something to upset you. Not every inconvenience is trauma, not every person you have difficulty with is a narcissist and not all trouble focusing is ADHD." 

Dr. David Reiss, a psychiatrist and expert in mental fitness evaluations, argued that "if I am being attacked, I really don’t give a damn if the attacker is narcissistic, psychopathic, sociopathic or acting out of some disability – the important issue is to protect oneself based upon the specific nature of the toxic/abusive/attacking behaviors, not any psychodynamic, psychological or even neurological factors contributing to 'why' the person is acting dangerously/abusively."

Yet even though one should not tolerate harmful or abusive behavior from narcissistic people, that does not mean that we should rule out the possibility of benefiting from their more positive traits. You can still be narcissistic and capable of helpful traits like compassion — and being a narcissist does not mean that you are incapable of caring about others, a point that Dr. Durvasula emphasized.

"As a clinician I have to spend a good chunk of time with a person to be able to adequately discern between narcissism, sociopathy and psychopathy," Durvasula said. "Keep in mind too, there's a lot of overlap between these terms, and so that could, that also muddies the water. But I think again, they're rather nuanced terms and it takes a while to get some sort of mastery of them. I think people can use them because they kind of sound cool and descriptive, but I'm not convinced everyone's using them correctly."