What is Narcissistic Personality Disorder & How to Spot It.

To understand what Narcissistic Personality Disorder is and how to spot it, we must first position the disorder within the larger context of mental disorders. Narcissistic Personality Disorder is housed within the Personality Disorders section of the Diagnostic and Statistically Manual of Mental Disorders (DSM-5), including Paranoid Personality Disorder, Antisocial Personality Disorder, Borderline Personality Disorder, and Obsessive-Compulsive Personality Disorder (for a fully comprehensive list, see the DSM-5).

personality disorder is “…an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment” (DSM-5).

Although Narcissistic Personality Disorder and even the words “narcissistic” and “narcissism” have become widely sensationalized by mainstream media, it is essential to remember that there are critical criteria to meet the official diagnosis.


According to the DSM-5, the diagnostic criteria for Narcissistic Personality Disorder require the presence of five or more of the following:

  1. Grandiose sense of self-importance. For example, one might exaggerate their achievements to seem superior to those around.
  2. Preoccupied with fantasies about unlimited power, success, brilliance, beauty, or ideal love. One can become hyper-focused on “long-overdue” admiration of their strength or privileges.
  3. Believes that they are “special” and “unique and can only be “understood” by those with elite social status. For example, one may describe the people in their life as “ordinary.”
  4. Requires excessive admiration. As a result, one may have fragile self-esteem.
  5. Has a sense of entitlement. For example, one may become frustrated by waiting in line because “they should be allowed to skip to the front.”
  6. Is interpersonally exploitative. Often, one may form friendships to advance their own needs or desires.
  7. Lacks empathy. For example, one may be preoccupied with their concerns and have difficulty recognizing the needs or feelings of others.
  8. Is often envious of others and believes others are envious of them. As a result, one may imagine everyone is always looking at them or wishing they could be just like them.
  9. Shows arrogant behaviors. For example, one may complain about a retail worker being clumsy or stupid for making an understandable mistake or error.



Covert Narcissism: The Quiet Counterpart to Narcissistic Personality

Codependency and Narcissism May Have More in Common Than You Think

The Arduous Work of Treating Narcissism: A Therapist’s Guide

Practice Attunement to Feel Seen and Nurtured in Your Relationships?

There’s a very important factor that determines whether one or both parties in a relationship feel seen and nurtured. It applies to relationships across the board, from romantic to platonic, therapeutic to familial. And without it, miscommunication, fights, and hurt feelings are common. That factor is attunement. I’ll give the clinical definition first because it’s a word we often use in the field of psychotherapy and so you have a full picture of what attunement is and then I’ll describe attunement in layperson’s terms.

Attunement is a “kinesthetic and emotional sensing of others knowing their rhythm, affect, and experience by metaphorically being in their skin, and going beyond empathy to create a two-person experience of unbroken feeling connectedness by providing a reciprocal effect and/or resonating response,” according to clinical psychologist Dr. Richard Erskine.

A lot is happening in that sentence. However, some keywords are “sensing,” “empathy,” and “connectedness.” Putting them together, you could say attunement is sensing another person’s experience and using empathy (as well as action) to create a connection. Another way of putting it is reading the “emotional room” of another person. It’s sensing when another person needs comfort versus space. It’s understanding when to support your partner versus when to let them flounder. If that sounds difficult, it is! It is a learned skill that takes conscious practice.

The first place we experience attunement (or not) is childhood. An infant is not able to express with words when they are hungry, tired, or have a poopy diaper. It’s up to the caregiver to make that assessment and do something about it. This is where pediatrician and child psychotherapist D.W. Winnicott’s principle of the “the good enough [parent]” comes into play, meaning, reacting to an infant responsively and sensitively over time allows the infant to be appropriately dependent and to transition to an increasingly more autonomous position. But attunement doesn’t stop in infancy – it’s relevant throughout a person’s life. The key is not just becoming aware of another person’s feelings, it’s also taking appropriate action.

It’s one thing if a caregiver hears their kid cry and says, “Oh, they’re hungry,” and another thing to actually feed them. The same is true with adults. Empathy is an excellent first step that invites curiosity about another’s experience, but it only goes so far. Action, even if it’s just listening, is what creates attunement. I’m not saying you have to be a mind reader and intuit what another person needs. Nor should you assume someone else’s feelings. Checking in and communicating are always important in mature, adult relationships.

A word of caution: There is such a thing as going too far with attunement and becoming codependent or turning into someone who relies on being needed. A codependent is someone who likes to swoop in and give to others, compulsively. With codependency there’s a sense of sacrifice – the person is sacrificing their time, their energy, or even their sense of self. That’s not what I’m advocating. Healthy boundaries are important for successful, safe relationships and that means recognizing each person has limits, including you.

Instead, emotional attunement involves the perspective that you’re on the same team as your partner. You are working together, supporting one another as you navigate your emotions, both pleasant and unpleasant. When this isn’t done, it’s a form of abandonment and it erodes trust in the relationship. Attunement builds trust and rapport. So how then do you create emotional attunement? Keep reading.


Find your safe space

One step required for emotional attunement is safety. If you don’t feel safe expressing your emotions, attunement will be difficult. Safety is created with both verbal and nonverbal cues. For instance, if the person you’re in relationship with – a friend, a coworker, a parent – shuts down and emotionally withdraws whenever you express anger, you’ll quickly learn they are not a safe person for you to be angry around. You won’t want to clue them in to how you’re feeling because it’s worse than keeping your anger bottled up.

Related to safety is also expressing your own emotions in a safe manner. If you punch the wall when you’re mad, you’re not a safe person to be around either. Emotional attunement requires feeling your feelings, even when you want to push them away, and doing so in a non-harmful manner. That could mean taking space when you need it and communicating that with your partner. It could also mean working with a trained professional.

Listen before you speak

Instead of thinking about what you’re going to say next, really listen to what the other person is saying. By giving someone your full attention, you’re letting them know you care about their experience, which is crucial for emotional attunement. You’re also signaling that they matter because you’re not centering yourself in the conversation, meaning you’re not making the conversation about you and what you can contribute. (By the way, I have a PDF about this if you’re interested.)

Ask questions

Attunement may sound like mind reading, but I promise, it’s not! Ask questions if you don’t understand something the other person is saying. That helps them feel seen and known. It indicates you’re present with them because you’re really trying to learn what’s going on for them.

Notice nonverbal cues

The reality is sometimes we don’t know how we’re feeling, or our outsides don’t match our insides. You’ve likely had the experience where someone says they’re fine and clearly, they’re not. Nonverbal cues like posture, facial expressions, and energy levels will help you discern how the other person is feeling and act accordingly. It’s also important to ask questions here when you notice the nonverbal cues to ensure you’re not making assumptions. For example, “I’ve noticed you’re lying down a lot. Are you tired? Or is there something else going on?”

Share reality

A huge part of emotional attunement is being on the same wavelength with someone, or in other words, sharing their reality. If your partner is sad about losing the job they hated, reflect back that sadness: “I hear you. It sounds like you feel sad.” If you respond with, “That’s great, babe! You didn’t like that job anyway!” your partner won’t feel seen, heard, or understood. You don’t have to agree with them, but demonstrating you understand how they’re feeling will go a long way.

Spot your triggers.

Every person has something they are sensitive about. It could be physical, like going bald, or something related to past trauma like being cheated on. Whatever it is, it’s important to be aware of what your triggers are so you can communicate that to your partner. Doing so will support you in not becoming reactive and together, you can potentially avoid an emotional landmine. Identifying triggers goes both ways – encourage your partner to share their triggers as well (if that’s appropriate) so you know what to avoid or how to support them in feeling safe.

Emotional attunement is a process and a skill that takes practice. It’s not something learned overnight but there are actions you can take today to feel closer to the people in your life and vice versa. Share this article with them, and together, build the sort of relationship that is satisfying to you both.