OCD Therapist Vancouver: Finding Specialized Care
September 27, 2026
The word narcissist has escaped the clinic. A psychological term-turned-buzzword, it’s become a catch-all to describe anyone perceived as selfish, arrogant, or manipulative. Yet historically, the term related more to pathology than vanity: a clinical narcissist is someone with patterns of grandiosity and self-importance that persist across situations and time. (Centre for Addiction and Mental Health [CAMH], n.d.)
Still, the term’s casual usage has become so commonplace that some are left wondering: what is a narcissist, really?
This question only becomes more relevant if you’re trying to make sense of a parent, partner, or family member’s behavior. Below, we’ll discuss how to differentiate clinical narcissism from simple rudeness or self-absorption.
What is a Narcissist?
While the APA Dictionary of Psychology and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) do not define “narcissist,” the term does appear in mental health literature and can be used by clinicians. In these contexts, it’s often used to describe an individual who displays a pathological pattern of narcissistic traits and behaviours, typically severe enough to meet the diagnostic criteria for NPD. Meanwhile, “narcissist” has developed an alternate definition that’s used in casual conversation, appearing as a viral hashtag, often for pop psychology content.
Narcissist definition (everyday use)
An informal term for someone perceived as self-centered, entitled, attention-seeking, or otherwise preoccupied with themselves.
Narcissist definition (clinical contexts)
Although narcissist is not a formal mental-health diagnosis, clinicians, researchers, and writers may use the term as shorthand for someone diagnosed with narcissistic personality disorder (NPD).
Narcissus, Caravaggio, c. 1597–1599. Oil on canvas. Wikicommons public domain image.
Narcissist Meaning: Origins to Present Day
Narcissus, Freud, and more recently, TikTok have each shaped the various understandings of the term narcissist. The concept of narcissism entered psychological writing before narcissist itself, first appearing in the mid-1890s (Mitra et al., 2024). The term narcissism was inspired by the Greek myth of Narcissus, a beautiful young man who became so captivated by his own reflection in a spring that he could not look away. In Ovid’s 8CE narrative poem, Narcissus remains by the water until he perishes; later, the nymphs find a narcissus flower in his place (University of Oxford, n.d.).
In 1914, Austrian neurologist and psychoanalyst Sigmund Freud developed narcissism into a central psychoanalytic concept in his essay On Narcissism: An Introduction (Freud, 1914). The earliest known print record of the term narcissist was in a 1917 issue of the Journal of Philosophy, Psychology & Scientific Methods (Oxford English Dictionary, 2024). In 1980, narcissistic personality disorder was added to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III). While the term appeared mostly in clinical contexts for decades, its fame spiked on social media in the early 2020s. “NarcTok” content gave the term massive exposure and drew in 3.9 billion views by November 2022. (Gupta, 2023).
Clinical Narcissist Meaning
Narcissistic Personality Disorder vs Narcissistic Traits and Behaviours
Narcissistic personality disorder is not a diagnosis anyone can hand out. In B.C., a formal assessment will typically be carried out by a psychiatrist, registered psychologist, or nurse practitioner—not a registered clinical counsellor or registered social worker. It is also impossible to diagnose an individual without meeting them first.
Still, a person doesn’t need to be a clinical narcissist to engage in recurring, harmful behaviours. Narcissism exists on a continuum and can present in the following ways.
Narcissistic Traits
These are behaviours associated with narcissism. These include self-importance, entitlement, and a desire for admiration. These qualities can vary across the population and can appear in people who do not have narcissistic personality disorder. Narcissistic traits only constitute narcissistic personality disorder when they persist across contexts, are maladaptive, and result in functional impairment (APA, 2022).
Narcissistic Behaviour
A pattern of narcissistic actions within a particular relationship or situation. Someone may behave in self-centered, entitled, manipulative, or dismissive ways without having NPD. The behaviour itself does not establish a diagnosis.
Narcissistic Personality Disorder
A pathological condition that appears in the DSM-5-TR. Diagnostic criteria include qualities such as self-absorption, entitlement, and grandiosity. Paradoxically, some individuals with NPD may also experience low self-esteem, engaging in self-criticism, alongside feelings of inferiority, shame, and envy.
The 9 Traits of Narcissistic Personality Disorder
The following points are paraphrased from the DSM-5-TR. The diagnostic criteria for NPD include the presence of at least five of the following:
Grandiose perception of self
In everyday life, this can look like consistently inflating achievements, expecting recognition, or assuming they deserve more credit than other people.
Fantasizes about brilliance, power, or idealized love
Their inner world may revolve around being extraordinarily successful, powerful, admired, beautiful, brilliant, or perfectly loved.
Feels that they are intrinsically unique
Individuals with NPD may feel that they can only be understood by other unusually accomplished, powerful, or high-status individuals or institutions, and may avoid associating with people they perceive as being outside this group.
Need for excessive admiration
Praise is not just a pleasantry. Rather, it can become a form of validation they feel entitled to and actively seek out.
Feels entitled to special treatment
The rules that apply to everyone else are treated as an inconvenience. They may expect special treatment or automatic compliance from others.
Exploits others for personal gain
Interpersonal relationships may be treated as resources to use for achieving personal goals, with little concern for whether the arrangement is reciprocal.
Unwilling or unable to empathize
They may have difficulty recognizing or identifying with another person’s feelings and needs, particularly when those feelings conflict with their own wants.
Envious of others; believes others envy them
Someone else’s success may feel threatening or unfair, or ordinary admiration and competition may be interpreted as evidence that other people envy them.
Arrogant, condescending behaviours and attitudes
This can include talking down to people, acting as though certain rules or people are beneath them, or treating their own judgment as inherently superior.
While the above criteria remain the standard, the Alternative Model for Personality Disorders (AMPD), included in Section III of the DSM-5-TR, offers an alternative, dimensional framework for six specified disorders, including NPD (Oldham, 2015). For NPD, the model may offer a broader framework that addresses vulnerable patterns in addition to grandiose ones.
Narcissistic behaviour alone doesn’t prove NPD
Exhibiting five or more of the above features does not, on its own, mean someone meets the diagnostic criteria for NPD. Narcissistic traits can appear temporarily in many people as a response to stress, insecurity, grief, or going through any number of difficult periods in life.
A clinician assessing someone for NPD will also look at the duration of narcissistic qualities—not just their presence. While many people may behave in a narcissistic way, the defining characteristics of NPD include at least five of the outlined traits, beginning in early adulthood, that persist across contexts. They will also result in impaired functioning and subjective distress. (APA, 2022)
What Are Grandiose and Vulnerable Narcissism?
NPD can present differently across individuals. Psychologists and researchers use descriptive language to discuss some of its more prominent expressions.
Grandiose narcissism and vulnerable narcissism are two broad dimensions commonly discussed in narcissism research. While a grandiose presentation aligns more closely with the common perception of NPD, covert narcissism can help explain why some individuals with NPD may appear outwardly self-effacing, rather than aggrandizing.
The following descriptions are not diagnoses. Rather, they are research-informed concepts that may help describe different presentations of narcissistic pathology.
NPD Dimensions Are Not Necessarily Categorical
An individual with NPD can display characteristics associated with one, several, or all of the presentations covered below. Their patterns and outward appearance may change, but the underlying NPD characteristics and motivations will remain the same. In their 2021 article, Elizabeth A. Edershile and Aidan G. C. Wright note that these dimensions of narcissism have been discussed in clinical literature as fluctuating states that can appear within a single person.
Some research also focuses on the mask model of narcissism. This theory suggests that narcissistic traits may sometimes function as compensatory strategies that protect against a fragile sense of self-esteem (Vater et al., 2016).
The Grandiose Narcissist
Grandiose narcissism, or overt narcissism, can read as charming and visibly self-assured. Often, the individual is comfortable taking up space, seeking admiration, and emphasizing their achievements. They may also expect special recognition (Miller et al., 2011).
When someone functions well professionally, grandiose narcissism can be somewhat difficult to spot. Confidence, ambition, charisma, and assertiveness are often rewarded at work, meaning a person can build a successful career while narcissistic behaviours go largely unchecked.
Colleagues may view a grandiose narcissist as an impressive leader. Magnetism and charisma may be obvious in public settings, only to vanish in situations where there is less incentive to maintain a polished image. In these cases, an excessive need for admiration, a sense of entitlement, or other interpersonal difficulties may emerge.
The Covert Narcissist
While people with NPD are often characterized as boldly self-assured and domineering, covert narcissism takes a subtler approach. This dimension can involve a reserved, humble, outward appearance, paired with feelings of shame, hypersensitivity to criticism, insecurity, withdrawal, and fragile self-esteem. At first glance, these qualities seem directly opposed to the traits typically associated with NPD, such as chronic self-absorption and grandiosity. Yet, the underlying motivations driving these behaviours, such as expectations of special treatment (Miller et al., 2011) and a sense of entitlement (Weinberg & Ronningstam, 2022), remain.
Covert narcissism can also involve martyrdom, manipulative tendencies, an insecure attachment style, and passive aggression. In practice, this can involve subtle reminders about favors done for others, subtly shifting blame onto a friend or relative, responding in a noticeably underwhelmed way to someone else’s achievement, or making pointed comments that appear, on the surface, as compliments. When these situations happen repeatedly over time, a partner or family member may begin to question their own perceptions.
This quieter, subtler dimension of narcissism has raised questions among researchers about the diagnostic criteria and their emphasis on grandiosity over vulnerability (Pincus & Lukowitsky, 2010; Green & Charles, 2019).
The Communal Narcissist
Communal narcissism is not a dimension of narcissism or a diagnosis. Rather, it is a clinical construct developed to explain patterns of behavior related to apparent selflessness and virtue. Communal narcissism is expressed through alleged selflessness or service to the community. Like all presentations of clinical narcissism, its underlying motivations remain the same.
Communal narcissists do want to be perceived as exceptional and worthy of admiration, but pursue this by constructing an image that focuses on “goodness” or moral superiority in favor of career achievement or leadership roles.
Communal narcissists will gravitate more towards domains such as charities or caregiving. (Gebauer et al., 2012). They may be perfectly comfortable lacking any form of traditional “power,” so long as they are viewed as the most generous, compassionate, or morally admirable person in the room.
Note: True generosity is not narcissistic. The distinction comes down to whether helping others serves as a stepping stone to status or validation. That said, people high in communal narcissism traits viewed themselves as high in communion. However, others did not see them that way (Gebauer et al., 2012).
The Malignant Narcissist
Malignant narcissism is a clinical construct and a severe form of narcissistic pathology (Goldner-Vukov & Moore, 2010). Conceptualized by psychoanalyst Otto Kernberg (Chicago Psychoanalytic Institute, 2026), it is associated with disproportionate rage and hostility in response to perceived threats, as well as a lack of regard for the well-being of others. Kernberg theorized that, alongside NPD, this pattern shares features with antisocial personality disorder and involves an intensely paranoid outlook and a lack of remorse in response to destructive behaviour.
While not a diagnosis, malignant narcissism is discussed and studied by researchers. Like other presentations of NPD, it can involve a pathological need for admiration and a strong sense of entitlement. But where people with NPD may manipulate others to achieve their goals, malignant narcissism may take this further, favouring intimidation and control.
When behaviour involves threats, coercion, stalking, physical violence, or other forms of narcissistic abuse, focus on your own safety rather than trying to manage the person’s reactions. This may mean seeking support from trusted family members, friends, an abuse-support service, or emergency services.
Narcissist Meaning in a Relationship
In difficult relationships, people often describe a cycle that begins with intense attention or “love bombing,” followed by criticism, emotional distance, or devaluation. A sudden breakup or withdrawal is sometimes called a discard, while later attempts to draw someone back into the relationship are known as hoovering. However, these are only descriptive terms, not diagnoses. No single pattern proves that a partner has NPD.
What matters is if there is a recurring pattern of controlling or manipulative behaviours. Oftentimes, these can include gaslighting, a form of psychological manipulation or emotional abuse that leaves the other partner doubting their own memories. This dynamic can often involve shifting standards that the partner is never quite able to meet, triangulation involving an ex or friend, or apologies such as, “I’m sorry you feel that way.”
Over time, these patterns can leave the partner walking on eggshells, questioning their own perceptions and oftentimes, withdrawing from friends. If any of the above resonates with you, support is available. If you decide therapy might be something you want to pursue, our free Therapist Matcher can assist you in finding the path that feels right for you.
Growing Up With a Narcissistic Parent
Parents who meet the diagnostic criteria for narcissistic personality disorder (NPD) exist, though they make up a small percentage of the population. It is entirely possible to have a narcissistic parent who does not meet the diagnostic criteria for NPD.
In these cases, the parent may engage in recurring patterns of self-centeredness, entitlement, emotional unavailability, or a lack of empathy—all of which can significantly affect a child. Conversely, a genuinely narcissistic parent differs from parents who happen to be strict, stressed, or overwhelmed, yet maintain a baseline level of empathy, accountability, and responsiveness to their child’s needs.
What is a Narcissistic Mother?
A narcissistic mother may have narcissistic personality disorder, or she may display narcissistic behaviours. In both cases, her patterns can affect her child’s emotional and psychological development. One study indicates that vulnerable presentations of narcissism in mothers can be especially impactful (Estlein et al., 2024).
Family Systems Language
Clinicians and researchers sometimes use family-systems language to understand how recurring stress, conflict, and emotional invalidation can shape relationships and roles within a household. While no two families are alike, this framework can help describe patterns and roles that may occur more frequently where at least one parent has NPD or engages in routine, narcissistic behaviour.
While this is not a comprehensive list, these roles can include:
The Golden Child
Parents may praise this child excessively and, if siblings are present, disproportionately direct positive attention towards one child but not the others.
The Scapegoat
This role is typically held by a child and involves absorbing blame and conflict. This family member is often held responsible when problems arise.
The Identified Patient
Sometimes known as “The Truth-Teller,” this role points out the issue(s) the family is invested in minimizing. In a family system organized around denial, this member may be recast as the source of the conflict.
The Lost Child
This member of the family typically learns to stay quiet in an attempt to avoid conflict and is often hesitant to express their needs.
The Caretaker
This child takes on adult-like practical or emotional responsibilities, such as regulating parents or caring for siblings, to help keep the household functioning.
The Enabler
This role is typically held by the other parent, rather than a child. The enabler will shield the narcissistic individual from consequences through rationalization or by covering up the issue(s) entirely.
Aftereffects: Adult Children of Narcissistic Parents
While the long-term effects of parental narcissism are still being researched, some adults who grew up with at least one narcissistic parent report struggling with persistent self-doubt, guilt about their own needs, difficulty trusting their perceptions, and a tendency towards conflict avoidance and putting other people first.
What’s clearer is a potential link between narcissistic parents and depressive and anxious tendencies in adult children. A 2015 study of 409 young adults and both of their biological parents found that, among the participants, higher parental narcissism was associated with higher levels of anxiety and depressive symptoms in the young adults (Dentale et al., 2015). Research has also linked childhood emotional invalidation with emotional inhibition and psychological distress in adulthood (Krause et al., 2003).
Still, having a narcissistic parent does not necessarily lead to these experiences—or to any particular outcome, for that matter. Similar emotional and interpersonal difficulties can result from many forms of childhood stress, including in adults who did not grow up with a narcissistic parent.
As adults, some people raised by narcissistic parents find that distance or estrangement provides a sense of safety or stability; others decide that limited contact, with clear boundaries and appropriate support, works better.
How to Deal With a Narcissist
When a narcissistic individual regularly denies, redirects, or escalates conflict, it may be more effective to focus on what remains within your control. Setting a boundary is not a demand you make of the other person; it’s a decision about what you will do. For example, ending a conversation in response to yelling, or keeping co-parenting communications limited to email.
Engaging in arguments about what “really” happened often becomes circular. Rather than repeatedly defending your version of events, keep your responses brief, neutral, and consistent. This approach, sometimes called grey rocking, means limiting emotional engagement and responding only to practical matters instead.
When co-parenting, workplace conflict, or legal matters are involved, save relevant messages and make dated notes after significant interactions. It can also be important to maintain connections with trusted friends, family members, or even a counsellor. Writing things down and seeking an uninvolved person’s perspective can be especially helpful if you’ve begun to question your own memory or judgement.
Can Narcissism Be Treated?
Narcissistic personality traits can change with sustained therapy. That said, the patterns treatment focuses on, such as defensiveness, sensitivity to criticism, difficulty acknowledging vulnerability, and problems trusting or collaborating with others, can be the very things that interfere with treatment itself.
It’s possible that an individual with patterns of narcissistic behaviour may be more receptive to therapy than someone with NPD. While they can exhibit periods of self-absorption, entitlement, emotional unavailability, and even a lack of empathy, these responses tend to surface in response to periods of stress, fear, or grief. By contrast, an individual with NPD will, by definition, show enduring, inflexible patterns of narcissistic behaviours that remain in place regardless of circumstantial changes.
NPD is also associated with a heightened sensitivity to actual or perceived criticism. Individuals with NPD may be less receptive to constructive feedback during the course of NPD treatment, perceiving it as criticism instead. At the same time, a pervasive sense of grandiosity can also make it difficult to recognize there’s an issue to begin with.
Support for People Around a Narcissist
When this person does pursue counselling, it’s often due to depression, a relationship breakdown, a career setback, or another situation that has made their usual ways of coping impossible to sustain. This kind of crisis is sometimes called a narcissistic collapse: an informal term for the distress that can follow when a person’s self-image is seriously threatened or can no longer be maintained. While these situations can create an opening to seek real help, they don’t automatically lead to earnest self-reflection or lasting change.
Schema therapy, transference-focused psychotherapy (TFP), and mentalization-based treatment (MBT) are among the approaches used in personality-disorder treatment. (Choi, 2022) They aim to help people recognize their own entrenched patterns and develop a greater tolerance for shame and other difficult emotions. Treatment can also help people understand their own states of mind more clearly, as well as the perspectives of those around them.
In short, change is possible, but it is usually gradual and non-linear. Ultimately, progress will rely upon the individual showing sustained willingness to remain in treatment. A partner, friend, or family member cannot make this happen.
If you have been experiencing anxiety, low mood, or other difficulties associated with a challenging relationship, counselling can provide support for those concerns as well. Reaching out for help is not a failure, and you do not need a diagnosis or a decision to leave the relationship before beginning therapy.
VCC’s free Therapist Matcher can help you find a counsellor who is a good fit. Depending on your unique situation, support may include individual counselling or the trauma program, which can help address the effects of long-standing, unhealthy relationship dynamics. Couples counselling may also be appropriate when both partners can participate safely and freely. However, it can also carry clinical risks when abuse is present. In these cases, individual counselling is often a safer option.
Some counseling services may also be covered, depending on your insurance or extended health benefits plan.
If you have been experiencing anxiety, low mood, or other difficulties associated with a challenging relationship, counselling can provide support for those concerns as well. Reaching out for help is not a failure, and you do not need a diagnosis or a decision to leave the relationship before beginning therapy.
Counselling Options
VCC’s free Therapist Matcher can help you find a counsellor who is a good fit. For some, individual counselling can provide the best type of support; others may find that our trauma program is especially helpful in addressing long-standing, unhealthy relationship dynamics.
Couples counselling may also be appropriate when both partners can participate in therapy safely and freely. However, it can also carry clinical risks when abuse is present. In these cases, individual counselling is often a safer option.
If cost is a concern, some counseling services may also be covered, depending on your insurance or extended health benefits plan. You can also learn more about our sliding scale plans here.
A Closing Note
There are many reasons people might want to know what narcissist means. Understanding both definitions may help provide some clarity about your relationships with family members, friends, colleagues, or a partner. That said, when something in life stops making sense, a label alone doesn’t necessarily fix the issue.
In these instances, a brief phone conversation with a registered clinical counsellor or registered clinical social worker may help you sort through your thoughts and figure out where you stand. If you decide additional support might be right, a consultation can also help you identify which type of therapy might be the most useful. While counselling cannot diagnose another person, it can help you better understand your own experience and perspectives.
Common Questions About Narcissism
What is the simplest definition of a narcissist?
A narcissist is an individual with narcissistic personality disorder (NPD), a mental health condition characterized by pervasive grandiosity, a strong need for admiration, and impaired empathy. Narcissistic traits can exist without NPD, but the disorder involves a persistent, inflexible pattern that causes significant problems in functioning or relationships, rather than isolated selfishness, vanity, or attention-seeking.
What does narcissistic mean?
“Narcissistic” describes traits or behaviours associated with narcissism, such as grandiosity, entitlement, a strong need for admiration, or reduced empathy. To an extent, most people are capable of engaging in narcissistic traits. Their severity level determines a diagnosis of NPD, not just their presence.
What’s the difference between a narcissist and someone who’s just selfish?
One selfish act or a single difficult relationship does not make someone a narcissist. Selfishness can be occasional, situational, and changeable, whereas NPD involves a persistent, pervasive pattern that affects self-image and relationships across many contexts.
What is a covert narcissist?
A covert narcissist is an informal term for someone with a vulnerable, less outwardly grandiose presentation of narcissism. The person may avoid seeming obviously arrogant; rather, they can come across as insecure, withdrawn, self-effacing, resentful, or highly sensitive to criticism.
Are narcissist tests online accurate?
No online test can diagnose narcissistic personality disorder or reliably determine whether another person has the condition. Most quizzes assess selected narcissistic traits. However, even formal self-report measures are only one part of a clinical evaluation. A qualified mental health professional such as a psychiatrist or registered psychologist will assess long-term behaviour patterns, functioning, impairment, and other possible explanations before diagnosing NPD (American Psychiatric Association, 2022).
Can a narcissist love someone?
A diagnosis of narcissistic personality disorder cannot, on its own, determine whether a particular person experiences love. NPD can involve difficulties with emotional empathy and close relationships, but these capacities can vary among individuals and across situations (Baskin-Sommers et al., 2014).
Should I confront a narcissist about their behaviour?
Directly confronting someone about suspected narcissistic traits is unlikely, on its own, to resolve a harmful pattern and may increase defensiveness or conflict. It may be better to focus instead on communicating clear boundaries. If the relationship involves intimidation, threats, coercion, or fear, prioritize your safety and seek support from trusted people or appropriate local services.
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