“You are nothing but a narcissist and I can’t take it anymore. The constant focus on self, the lack of empathy for my feelings, your need to be admired, thinking you are special…this relationship is making me feel like I am crazy. You belittle me, manipulate to get your way, and you are always right!”

The person above is dealing with a narcissist. Narcissists are not easy people to live with, especially if they refuse treatment. Narcissists are those people who exhibit grandiosity and lack of empathy, along with several of the characteristics mentioned above.

First, keep in mind that we all tend to be self-centered and prideful. And most of us are not fond of criticism either. Narcissism is best thought of on a continuum or spectrum. Some people have more traits than others, and some have crossed over to a clinical definition of narcissism.

Second, the brains of narcissists look different when scanned compared to people without the disorder. Narcissists tend to have less gray volume in a part of the brain called the left anterior insula. This structure regulates empathy, emotions and cognitive functioning. The less volume, the more problems with empathy and compassion. Furthermore, the white matter shows less connectivity in parts of the brain that deal with how we think about ourselves. Less connectivity means lower self-esteem. Theses differences are not an excuse for behavior, but they do help us understand that this is a type of brain disorder.

Treatment is possible, but change is slow. It is like moving a glacier! But slow and steady change can happen once a person recognizes that his or her behavior is causing relationship problems.

In order to respond to someone with narcissism, keep these pointers in mind:

1. As hard as this is, you can’t take criticism from a narcissist personally. This means you have to have a good sense of self to know who you are. Be confident in your own identity.
2. Set boundaries. Don’t allow the person to push you around. And don’t absorb everything they say about you as truth.
3. Do not try to please the person. This is like trying to fill a bottomless pit.
4. Don’t use direct confrontation as it only makes the person escalate. Instead, take a time out or try to calm the situation. Focus on the problem, not the person.
5. Adjust your expectations based on what you learn about the disorder. If you expect empathy, you will be disappointed unless the person is working on learning to be more empathetic.
6. Find supportive people in your life who will listen to you and show empathy.
7. Practice grace as you will not win most battles. Thus, you have to pick your battles.
8. Stop exhausting yourself to be good enough. This is less about you and more about the perfectionism of the other person.
9. Discuss biblical principles and what they mean such as the first shall be last, or having the fruit of the Spirit.
10. Understand that the person has a vulnerability aversion. Allowing you to see the real them is frightening.

Therapy can help in many areas. It can help the person understand brain differences, and work on the renewing of the mind. A person can learn to tolerate criticism and failures, understand and regulate feelings and develop behavior that brings success in relationships.

Most of all, the narcissist can learn that underneath the sense of superiority is really someone who is anxious and hyper-vigilant to not allow vulnerability to show. Weakness is not about allowing others to have power over you. And a person doesn’t have to overcompensate by acting stronger. The key to success in the therapy room is the same as in any relationship–letting down your guard, becoming vulnerable, and recognizing our weaknesses. The hope is that no matter how difficult, we can do all things through Christ.