How Healthy Self-Esteem and Clinical Narcissism Differ

Araya Baker, M.Phil.Ed., Ed.M.
7 min readJul 4, 2022


Confusing healthy self-esteem with narcissism can trivialize narcissistic abuse.


  • Individuals with healthy self-image can balance high self-esteem with prosocial behaviors that nurture reciprocal relational dynamics.
  • Clinical narcissism is characterized by authoritarianism, envy, grandiosity, shallowness, and sociopathic deficit of empathy and remorse.
  • Clinical narcissism can arise from insecure parent-child attachment during early childhood and a subsequently underdeveloped prefrontal cortex.

Psychology Today published the original version of this essay.

Source: Syarafina Yusof/Unsplash

There’s a vast gulf between healthy self-esteem and narcissism, and conflating strong confidence with narcissism can do more harm than good. This post aims to unpack specific sociopathic features of narcissistic personality disorder (NPD), with the overarching goal of illustrating how failure to distinguish between wholesome levels of self-acceptance and clinical narcissism can inadvertently invisibilize or trivialize narcissistic emotional abuse.

Narcissistic personality disorder (NPD) is a sociopathic personality disorder characterized by antisocial attitudes and behaviors (not to be confused with introversion). Clinically, the term “antisocial” refers to a void of empathy and remorse, in addition to an overall disposition that is antagonistic and unfeeling.

Other characteristics of NPD include authoritarian personality traits, chronic emotional emptiness, distrust and cynicism, entitlement to respect, envy, exploitation, grandiosity mixed with worthlessness, and an obsession with interpersonal control and social dominance. Those with NPD can also exhibit extremely fragile egos, even despite notable outward arrogance, so much so that they often easily misconstrue constructive criticism.

Source: Spin Cycle Coaching, used with permission.

Unlike individuals with NPD, however, those with healthy self-image are more likely to successfully balance high self-esteem with ethical and prosocial behaviors. Their high, yet healthy, confidence level can produce a more authentic and direct disposition, as well as a less cynical view of people. Moreover, success in cultivating prosocial dynamics can elicit a snowball effect, attracting like-minded people and presenting more opportunities to learn the benefits of reciprocity.

This generative relational style is markedly different from the power imbalance characteristic of narcissistic abuse, which is often enacted by socially astute people with moderate to low levels of NPD. These individuals usually have the ability — and shrewdness — to temporarily mask their traits for the sake of disarming others they can use socially, romantically, professionally, or otherwise. Similar to the antisocial antipathy characteristic of those with higher levels of NPD, they can also devalue people, but primarily in an opportunistic way.

Source: Iulia Mihailov/Unsplash

The mask drops, however, once people’s novelty wears off or their usefulness expires. The narcissist then swiftly discards their “supply,” and masks their callousness. Failed attempts to dominate and control close relations can also prompt them to abruptly abandon or dispose of others.

Awareness of narcissistic abuse is critical for myriad reasons, but perhaps most notably, because there is no “cure.” Personality disorders like NPD are often rooted in insecure parent-child attachment during early childhood, when love (or lack thereof) shapes one’s ability to love others. Treatment is therefore viewed primarily through a developmental lens, and unfortunately, the very symptomatology can prove to be a high barrier to treatment. Research also suggests that an underdeveloped prefrontal cortex may be a characteristic of this developmental personality disorder.

Below are five red flags that illustrate clinical narcissism’s sharp departure from healthy self-esteem:

1. They’re the self-appointed authority of your reality

Narcissism overlaps with authoritarianism, as both narcissists and authoritarians tend to believe that they are the one and only authority on reality (and morality). Both groups can be overconfident about the objectivity of their perceptions, and therefore deputize themselves as the omniscient narrators of others’ stories.

Narcissists can presume, for example, that the suspicious motives they project onto you are driven by an exclusive level of intuition, or that how their resentment has re-written you retrospectively is true. This can make reasoning with them impossible, since they are likely “seeing” only what they expect or believe — not reality — yet cannot be convinced otherwise.

2. They kiss up, punch down

Narcissists tend to filter their first impressions of people through shallow criteria used to screen for the most accomplished, attractive, or popular romantic partners. The same checklist can sometimes apply to their children and friendships. Moreover, they tend to see others as either above them, below them, or on their level. This is never more evident than when they extend double standards and favoritism to those perceived as “above” them, while exhibiting contempt toward those “beneath” them — sometimes for the exact same mistakes or harm.

They can engage in this type of hypocritical favoritism without the slightest cognitive dissonance. Losing or maintaining access to social capital is usually the only primary concern. This makes sense, considering research proves many narcissists believe that only a select few possess the capacity to understand them — usually, that means wealthy socialites, famous celebrities, or those with public visibility. This upper echelon is almost always afforded the benefit of the doubt and spared from ridiculing accountability or irrational grudges.

Source: Cottonbro/Pexels

3. They rip survivors’ self-esteem to shreds

Despite the superficial tendency to collect an impressive entourage of high-rollers, narcissists can prefer lovers who are inwardly naive or needy. The helplessness and insecurity of these paramours can offer an immediate ego boost, but perhaps more importantly, they make for partners who will look up to the narcissist, feel lost without them, and relinquish control.

Even so, there’s a thin line between being a narcissist’s “prize” — their arm-candy or golden child — and making them feel upstaged or overlooked. Veering into the latter territory can result in them aggressively humbling the same “prize” they’ve objectified as a source of self-worth. This can manifest as unsolicited hypercriticism, ruthless put-downs, backhanded compliments in public, or constantly moving the goalpost, so survivors learn to live with narcissists never being satisfied. Subsequent feelings of inadequacy cause many survivors to shrink and play small.

4. They magnify survivors’ reactions, but minimize their provocation

This tactic typically coincides with a turning point: when a survivor begins publicly challenging the narcissist’s one-sided, self-serving stories. For this reason, many specialists encourage survivors to forgo any and all attempts at whistleblowing or setting the record straight. Exposing a narcissist’s embellishments or half-truths, they argue, can result in narcissistic injury or severe and lifelong retaliation.

Source: Yan Krukov/Pexels

This stage of narcissistic abuse often plays out with the narcissist goading a survivor to a breaking point, then using their pent-up reaction to incriminate them as emotionally unstable, or, in cases of fundamentalist religious abuse by narcissistic spiritual leaders, rebellious or in dire need of repentance. The narcissist then may incriminate the survivor as too dishonest and out of control to ever be believed, while appearing cool, calm, and collected themself.

Reputation management is core to narcissistic abuse, which is why it can seem as if narcissists can rebound from relationships so easily. “Upgrading” to a partner who supposedly is so much less of a hassle only corroborates their victim-playing.

5. They mask with false humility and perpetual victimhood

Narcissists’ top priority is protecting their own fragile yet overblown ego from facts and reality. Accordingly, the faults they share on first dates, or even just in chitchat, will usually be self-flattering. Think of the quintessential “I overwork myself” job interview response to, “What’s your greatest weakness?” When asked about their growth areas romantically, narcissists will likely claim to be a martyr who sacrifices too much and is too hard on themself, masking their deflection with virtue.

This false humility is a form of gaslighting that can prompt survivors to cry out with their own story, which, ironically, is the very thing narcissists try to suppress through intimidation and manipulation.

Survivors often feel unfairly silenced and disbelieved because of the persistent silent treatment and stonewalling characteristic of narcissistic abuse. But from the typical narcissist’s point of view, dialoguing through an equitable and fair examination of conflict requires too much confrontation with reality and self-delusion.

Just as NPD traits can thwart help-seeking, a narcissist’s denial of their true self can end up obstructing healthy and straightforward conflict resolution with others. They allow passive aggression and unspoken tension to fester instead, sometimes indefinitely. And, of course, it’s still the survivor’s fault for not perusing the channels of communication the narcissist shut down.