Narcissistic personality disorder (NPD) is a complex mental disorder that, among other symptoms, is characterized by a grandiose or inflated sense of self and an extreme need for admiration and attention.

Sometimes, individuals with NPD or narcissistic tendencies exhibit a pattern of manipulative, controlling behavior that includes both verbal abuse and emotional manipulation.

Common types of narcissistic manipulation include:

Triangulation. A person employing this approach will attempt to involve a third party in your conflict, typically to back up their own opinion or position.

Gaslighting. Someone attempting to gaslight you attempts to make you doubt your perspective and reality, typically by distorting facts or insisting on the falsity of memories.

Hoovering. This strategy entails reconnecting or luring you back into a toxic or abusive relationship.

Silent treatment. This behavior becomes manipulative when someone ignores you on purpose to exert control or make you feel alone.

Scapegoating. Parents who employ narcissistic manipulation may designate one child as the scapegoat and place all the responsibility on him or her.

Passive aggression. Indirect shifting of responsibility, sabotage, and sarcasm are all indicators of covert narcissistic manipulation.

DIAGNOSIS

No tests from laboratories are required for the diagnosis of NPD. The diagnosis of NPD is made by a mental health professional, such as a psychiatrist, with the aid of APA-approved diagnostic guidelines. The psychiatrist uses the patient's familial history and personal history of any other psychiatric illness, along with a series of questions, to determine whether or not the patient is addicted to alcohol or drugs. They may distribute a questionnaire to the individual who must respond truthfully. Typically, a family member or close friend is involved in the entire procedure.

12 Signs of Recognizing Narcissistic Behavior

1. SUPERIORITY AND ENTITLEMENT

Narcissists see right and wrong, good and evil, and superior and inferior. The hierarchy is the only secure haven for the narcissist. Narcissists must be perfect, correct, capable, and in command. Additionally, narcissists can feel superior by being the worst, most flawed, or most damaged.  

2. EXAGGERATED NEED FOR ATTENTION AND VALIDATION

Narcissists require frequent external validation. Since narcissists do not believe that anyone can adore them, no amount of praise is sufficient. Despite their grandiose boasts, narcissists are insecure and fearful of failure. To bolster their fragile egos, they are exceedingly in search of others' praise and adulation.

3. LACK OF RESPONSIBILITY—BLAMING AND DEFLECTING

When things do not go according to plan or when they feel criticized or less-than-perfect, narcissists assign all culpability and responsibility to others. There must be someone else to blame. Occasionally, this blame is generalized, but the narcissist most frequently faults their spouse, who is the most emotionally close, attached, loyal, and loving person in their life.

4. LACK OF BOUNDARIES

Narcissists cannot distinguish between themselves and you. They appear immature and believe that everything belongs to them, everyone shares their thoughts and emotions, and everyone desires the same things.

5. LACK OF EMPATHY

Narcissists are not capable of empathizing with others. They have a tendency to be self-centered and egocentric and are frequently unable to comprehend how others truly feel.  

6. EMOTIONAL REASONING

Your explanations, however, are incomprehensible to the narcissist, who appears only capable of understanding his own thoughts and emotions. Although narcissists may claim to comprehend, they do not.

7. SPLITTING

The narcissist's personality is divided into positive and bad aspects, and they divide everything in their relationships along the same lines. They attribute any negative thoughts or actions to you or others, whereas they claim credit for everything positive and good. They deny their negative words and actions and accuse you of disapproval repeatedly.  

8. FEAR

The narcissist's entire existence is driven and fueled by dread. Most narcissists have buried and repressed anxieties. They perpetually fear being ridiculed, rejected, or proven wrong - discovered.

9. ANXIETY

Fear drives and fuels the narcissist's entire existence. Most narcissists have repressed and suppressed their fears. They constantly dread being ridiculed, rejected, or shown to be mistaken - discovered.

10. SHAME

Narcissists feel little remorse because they believe they are always right and they do not believe their actions have a significant impact on others. However, they harbor considerable remorse. Shame is the conviction that there is something profoundly and irrevocably bad about oneself.

11. AN INABILITY TO BE TRULY VULNERABLE

Due to their inability to comprehend feelings, lack of empathy, and constant need for self-protection, narcissists are unable to genuinely love or emotionally connect with others. They cannot view the universe from the perspective of others. They are largely emotionally oblivious and isolated. Thus, they become emotionally dependent.

12. AN INABILITY TO COMMUNICATE OR WORK AS PART OF A TEAM

It is useless to expect the narcissist to understand your emotions, concede, or give up anything he desires for your benefit.  Any acts of kindness or benevolence are strategic and have an ulterior motive – they give in order to receive.

How do you deal with a narcissist?

Dealing with a narcissist, who may be a family member, a close acquaintance, or a superior, is extremely difficult, but not impossible. Here are some strategies for dealing with them when they are nearby:

· To avoid dissatisfaction, do not exert effort to change them.

· Confront the narcissist in person, not in the presence of others.

· Establish a strong support network in order to let go of the negativity generated by the narcissist.

TREATMENT

A person with narcissistic personality disorder requires long-term therapy with regular follow-ups with a mental health professional. The treatment consists of a combination of psychotherapy and medication administration.

Options for psychotherapy include the following

· Psychotherapy on an individual basis

· Group therapy

· Family therapy

· Couples therapy

· Cognitive-behavioral therapy (CBT)

The individual's violent behavior may necessitate hospitalization to avoid hazardous situations.

There are no psychiatric medications designed specifically for the treatment of NPD. Generally, the medications used to treat other psychiatric disorders are useful for managing the symptoms of NPD. These medicines include

· Antidepressants

· Antipsychotics

· Mood stabilizers

REFERENCES:

www.healthline.com/health/narcissistic-victim-syndrome#reaching-out

www.medicinenet.com/what_are_12_signs_of_a_narcissist/article.htm

www.fulhamconsulting.com.au/mental-notes/narcissism/personality/relationships