Healthy Narcissism?

Healthy Narcissism?

By James R. Agapoff IV, M.D., M.S.


When you hear the word narcissist, what do you think? Arrogant. Power driven. Haughty. If you have been in a relationship with a narcissist, your reaction might be visceral. That’s because pathological narcissists are exploitive and tend to act in their own self-interest, especially in relationships. Being able to distinguish healthy versus unhealthy narcissism is an important skill because both may appear similar at first glance. 

Pathological narcissists are attractive to others because they are charming. This quality draws generous people to them like butterflies to a spider’s web. Once captured, the entitled nature of the narcissist is revealed. They tend to form relationships with people who they consciously or unconsciously believe can enhance their self-importance or advance their goals in some way. This lack of empathy leads to exploitation and a pattern of interpersonal abuse.

In psychology, not all narcissism is considered negative. Self-Interest and self-love are necessary parts of being human. The degree to whether someone’s self-regard is healthy versus pathological is not always clear, especially in our culture which values highly successful, goal-driven people. The validating comments and attention we receive from our loved ones helps us develop a stable sense of self. A lack of validation and love, especially in childhood, leads to pathological patterns of narcissism later in life.

So what traits distinguish healthy from unhealthy narcissism?


Traits of unhealthy narcissism.

    1. Apathetic. Unhealthy narcissists lack empathy. They often cannot see the world from another’s perspective. This makes them oblivious or uncaring to the suffering of others.
    2. Self-Centered. Unhealthy narcissists are self-centered. They are focused only on achieving their own goals.
    3. Grandiose. Unhealthy narcissists tend to be grandiose and preoccupied by unrealistic ideals of perfection, power, and beauty. They regard themselves as special and often overestimate their abilities and/or embellish their accomplishments. 
    4. Entitled. Unhealthy narcissists are entitled. They believe they should receive special treatment or status, and become angry when this is not recognized by others. 
    5. Envious. Unhealthy narcissists are envious. They often devalue the accomplishments of others to protect their fragile egos.


  • Exploitative. Unhealthy narcissists are exploitive. They take advantage of others for personal gain. In relationships they expect compliance.



Traits of healthy narcissism.

  1. Empathetic. Healthy narcissists are compassionate. They can see the world through another’s eyes and change their behavior accordingly.
  2. Humble. Healthy narcissists are humble. They do not flout their abilities or accomplishments.
  3. Realistic. Healthy narcissists have a realistic view of their achievements and abilities. They do not regard themselves as special or more deserving than others.
  4. Confident. Healthy narcissists are confident. They have a stable ego and sense of self and are not intimidated by the successes of others. 
  5. Generous. Healthy narcissists are generous. They do not believe in the concept of limited good and believe in the value of service.
  6. Leaders. Healthy narcissists are leaders. They lift up others and never exploit them. They see the successes of others as essential to their own. Healthy narcissists have the heart of a teacher.


About the Author: James is a writer, professor, and psychiatrist practicing in Honolulu, Hawaii. He likes all things related to dragons. To follow Dr. Agapoff’s blog, follow him on social media, or view his other writings, visit his website

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