Is Healthy Narcissism a Contradiction in Terms?

Narcissism. It’s a word that is showing up a lot lately in the popular press. My in box at Ask the Therapist contains multiple letters with questions about it. “Is he a narcissist?” “How can I get a narcissist to let me go?” “Am I really a narcissist?” And so on. News analysts ponder the possibility that certain politicians suffer from it. (Actually, the narcissistic politicians don’t suffer. The rest of us do.) It’s a wonder to me that “narcissism” wasn’t identified by Merriam Webster as the word of the year.

Any word that gets so much use can become misunderstood and misused. The latest is the spate of articles that support an idea of “healthy narcissism.” To me that is a contradiction in terms. It’s like suggesting that there is healthy heart disease. Although there are things to be learned from any illness, the illness is just that – an illness.

The narcissism that gives people so much trouble is narcissism that has risen to the level of a disorder.

A person with a Narcissistic Personality Disorder (NPD) is obsessed with him or herself. In order to shore up a deep-seated feeling of inferiority and insecurity, they need others to actively support their feelings of superiority. Although they have little to no empathy for others’ pain, they respond to even imagined slights with hostility and exaggerated and self-serving rebuttals and lies.

They have highly developed skills for charming people into a relationship with them. But if someone questions them or expresses needs of their own, people with NPD scramble to reassert their central specialness. They become controlling, manipulative, contemptuous and increasingly self-important.

Those who thought they were in their charmed circle (especially those who fell in love with them) become confused, hurt, and mystified. Where did that charming person go?

The notion that there is “healthy narcissism” seems to be grounded in the fact that behaviors and attitudes that look narcissistic do occur on a spectrum. We all know and maybe even admire people with such traits. Charming, extroverted, and self-assured, they seem to become the center of any gathering. They are exceptionally self-confident and willing to talk about themselves and their enjoyment of their many achievements.

But, bottom line, these people are generally agreeable and can even laugh at themselves. They don’t need to constantly demonstrate their superiority to everyone else. They don’t need you to always agree with them. Most importantly, they have empathy for others who are in pain.

What may at first seem like narcissistic traits are really quirks of personality, not the symptoms of mental illness. A quirk only becomes a disease when it interferes with daily social, occupational, and psychological functioning, as it does in NPD.

Stages of Developmental Narcissism are Adaptive

So – Is there ever such a thing as healthy narcissism? Well maybe – but only at certain and limited developmental stages. The demanding self-centeredness of a two-year-old  is a study in narcissistic behavior. Normal adolescents often spend a great deal of time worrying about whether they are special enough and looking in the mirror. Their relationships are often unstable and their over-estimation and under-estimation of themselves can be extreme.

But even in these life stages, we usually see evidence of empathy that belies the narcissism. A two-year-old who senses that his mother or another kid in their daycare setting is sad, will show concern and perhaps even offer a hug. The sullen and seemingly self-centered teen often shows generosity toward others, empathy for their friends’ troubles and gratitude for help as they develop a moral compass as well as a more certain identity.

Theorists like Donald Winnicott (1960s) and Heinz Kohut (1970s) suggest that the stages of developmental narcissism are adaptive. It is what supports creativity, experimentation and psychological growth. In fact, narcissism at these times is essential for determining an individual’s strengths and positive qualities, for developing social skills, and for finding the motivation and courage to try new things.

But childhood and adolescence end – and so should the self-centeredness of childhood and adolescence. When the outcome of these periods of self-centeredness is resolved in healthy ways, the young person can identify many reasons to feel good about him or herself without a driving need to feel fundamentally superior to others. This is the unfolding of a positive self-esteem.

We are at risk of leaving adolescent narcissism unresolved if we buy into the idea that developing that  positive self-esteem requires constantly affirming our worth, as some pop psychology books suggest. Posting positive affirmations on the wall or telling ourselves we are loveable without doing what is required to deserve it supports self-aggrandizement.

Over-valuing minimal contributions may make us feel better but we do know, maybe not so deep inside, that it’s a sham. Seeking, even demanding, reassurance that we matter may temporarily shore up a sense of negative worth but doesn’t resolve the insecurity of adolescence. I think holding on to adolescent narcissistic traits is not “healthy narcissism.” It is unhealthy arrested development.

Adolescent Narcissism to Adult Self-Esteem Depends on Definition

The successful resolution of adolescent narcissism to positive self esteem as an adult depends on accepting a complex definition of self-esteem. Feeling good about ourselves simply isn’t enough unless it is coupled with doing good for others. Although it is not talked about nearly enough in the popular press, the necessity for engaging with the doing part of self-esteem has been well researched since the 1970s and most recently by the leaders in Positive Psychology.

To have a high self-esteem as an adult, they argue, one has to do more than feel self-worth or talk oneself into believing it. One has to earn it by doing worthy things. Those who successfully resolve adolescent narcissism come to understand that a positive self esteem isn’t the cause of doing well, it is the result.

How then, do we avoid narcissistic self-congratulation and instead build a healthy adult sense of self? It comes down to being the friend, partner, parent, boss or relative we wish we had. It is the outcome of actively and generously providing emotional support and practical help to others in ways that are empathic, ethical, and beneficial. Feeling good when unselfishly doing good is the opposite of being narcissistic. It is an indication of a positive self-esteem and positive engagement with life.


Is Healthy Narcissism a Contradiction in Terms?

Marie Hartwell-Walker, EdD

Marie Hartwell-Walker, Ed.D. is an author, licensed psychologist, and a marriage and family therapist who has been in practice for more than 35 years. She is a regular contributor to Psych Central and one of the therapists who answer questions at Ask the Therapist.


APA Reference
Hartwell-Walker, M. (2018). Is Healthy Narcissism a Contradiction in Terms?. Psych Central. Retrieved on October 22, 2020, from


Scientifically Reviewed
Last updated: 5 Dec 2018
Last reviewed: By John M. Grohol, Psy.D. on 5 Dec 2018
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