Are Narcissists Sick?

It’s Narcissist Friday!

 In many ways it would be easier if we could think of the narcissist as sick.  If we could point to a mental illness or a chemical imbalance, we would have something to blame the behavior on. We could excuse the cruelty by saying, “Oh, he can’t help himself because he is sick.”  Then our desire for compassion would be justified and we could feel better about ourselves as we help a sick person and endure his or her abuse.

Unfortunately, narcissism doesn’t fit the concept of an illness.  For whatever reasons, narcissists have chosen and continue to choose their behavior.

(Now, I have to post a disclaimer here.  I am not a psychologist or a psychiatrist or a mental health therapist or counselor.  I am a theologian who has done a great deal of counseling over the years as a pastor.  So what I tell you is based on my experience and on what I have picked up from others.  You are encouraged to do your own research on anything I teach.)

Professional therapists use words like dysfunction, illness, disorder, and disability to refer to different causes of behavior or sensations.  These words are often used interchangeably, which makes it all the more confusing for the rest of us.  In general, illness or mental illness refers to a condition caused by some biological agent.  The agent could be a genetic anomaly, an injury, a chemical imbalance, or some other outside influence.  While many forms of mental illness may lead to narcissistic behavior, the behavior itself doesn’t prove the illness. 

Narcissism has been classified as a personality disorder.  All that says is that it is out of sync with what is considered to be normal behavior and perspective.  But it also suggests that narcissism is a choice.  That choice may be based on disturbing childhood experiences, but it is still a choice.  I believe that fear is the primary cause of narcissistic behavior, but the fear does not need to be current.  In other words, acting in a narcissistic way is how the narcissist learned to deal with fear throughout his life.

Addictions are particularly difficult to overcome because they are often the intersection of several types of problems.  What begins as a need to fit into a group or feel better can become a physical dependency through drugs or alcohol.  Those who deal with drug rehabilitation must work through both the biologically-caused illness and the psychologically-caused disorder.  To further complicate things, we now understand that repeated actions can create something very similar to physical addiction.  When we talk about people addicted to eating, shopping, gambling, hoarding, or pornography, we refer to behaviors that have become so ingrained that stopping them takes serious desire and effort.

It is my opinion that narcissism is a type of addiction.  The narcissist has chosen and continues to choose his behavior because he believes it works for him.  Over the years he has gained enough from this behavior that he continues to use it even in the face of negative consequences.  It is his default conduct and he has learned to apply various techniques in different circumstances.  It may be that he has done it so often and has convinced himself so strongly of its value that he simply no longer thinks of it as a choice.  In other words, it just comes naturally to him.

A simple observation from the Bible has become a well-known saying in our culture:

“As he thinks in his heart, so is he.”  (Proverbs 23:7)

Because the man thinks his narcissistic behavior works, and because he has invested so much into making it work, he has become a narcissist.  Whether the clinical definition fits him or not, he acts out of his perspective.  That perspective includes such concepts as the usefulness of others and the promotion of a certain self-image.  He acts this way because he thinks this way.

This is a very brief overview of my perspective on narcissistic behavior, but it reveals some important thoughts. 

  1. Narcissists are accountable for their actions because they are free to choose otherwise.
  2. Narcissists can change by “unlearning” certain ideas about themselves and others.
  3. Carefully applied negative consequences for narcissistic behavior may be helpful.
  4. Those in relationship with narcissists are victims or objects, rather than caregivers.


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Filed under Narcissism

19 responses to “Are Narcissists Sick?

  1. K

    I am a newcomer to your blog, Dave, and have been steeping myself for days in your words on narcissism and God’s grace. You manage to both dash all my hopes and offer them renewed. I just ended a short but damaging relationship with a man I might have married had his mask not slipped. I can’t tell you how refreshing your perspective is. It really helps to ease the incredible pain. Thank you from my heart for sharing the word.

    • Welcome K! These people can be downright frightening. Although I am sure that you are hurting these days, I am glad that you could see the truth in time. Now you have to un-believe the lies he told you about yourself. Most of them were twisted words to tie you to him, I would guess. So many stay with the narcissists because they have been made to believe they would be unacceptable to anyone else. Narcissists are very good at complimenting with criticism (or is that criticizing with compliments?) Always a little twist that keeps you off balance and dependent on them.

      Keep going! I care and you are welcome to write to me directly anytime.

  2. Penny

    Thank you for another insightful post; I think it is actually much easier to view the N as sick, b/c it requires less from those around them. So now I am really going to stir the pot: for those N’s who claim to be “Christians”, can we then say that not only are they not “sick”, but that they are, in fact, sinning? “Whoever knows the right thing to do and does not do it, to him it is sin”? I am so weary of Ns in the church and the church’s tolerance of the exploitation, divisiveness & damage they bring. It is as tho the Ns actually say “I will be like the Most High”, in words and deeds, but nobody gets it, no one calls them on it, nor are they called into repentance. What to do, when Matthew 18 tells us the process: “if he/she refuses to listen to you, tell it to the church”, but the church drops the ball and views the whistleblower as the problem? Is our obligation to “tell it to the church” also our relief [so-to-speak] from pursuing the N in their rebellion? This is a gut-wrenching place for many of us, who feel abandoned even by the church and can no longer tolerate the abuse.

    • Yes, narcissistic abuse is sin and it is abuse. The narcissist makes choices. As you know, he isn’t always this way and he isn’t this way to everyone. Some only see his “good” side, so he knows the difference between right and wrong. Narcissists often know exactly how much they can get by with.

      And, yes, I agree with your frustrations about the church. But we also need to remember that managing what others think about them is the narcissist’s super-power. Churches are great places for n’s to shine. Churches are not very good at really getting to know people, nor are pastors very good at listening to the concerns of wives. Yet, it was the words of an abused wife that got my attention. Her n had snowed everyone. He was cruel and manipulative, but people thought he was so spiritual. Eventually, the truth was exposed. It wasn’t accepted by all the people and that contributed greatly to a church split, but his power in the church went away. So sometimes pastors listen and believe.

      The only problem is that pastors who try to deal with narcissists almost always lose. You can’t be nice and gracious toward the narcissist. They will use any opening they are given. I know of pastors who lost their jobs because they tried to take on a narcissist. So, telling it to the church may not be much help. Many won’t believe you and others simply won’t take the risk.

      The answer is probably to find a few friends, outside his influence, who will care about you as a person. Find an exercise group or a Bible study or a reading group and be willing to go out to coffee with a couple of the ladies. You will be surprised at how encouraging it is to have someone who cares, even a little, just about you.

      Of course, this is advice for anyone reading this, not just you. Narcissists need to separate and control their victims. If the narcissist is not a spouse, you have some other options.

  3. CAL

    I just left a relationship with a N.At first I was a gift from God,an answer to prayer.When he ‘got’ me to himself it was” Satan is in your head trying to destroy our relationship” if I had any thoughts of my own.Only his interpretation of scripture was correct.Nothing I ever did was right.Caught him lying about internet activity with ex girlfriends-he asked forgiveness-then became very secretive about computer and texts.He put me on his restricted list,he had total access to my computer. He would call/text numerous times if I went anywhere.We met with his pastor and told I was “snake hunting” and man is to be the leader according to scripture. Emotionally abusive(nothing I said was right)compliments(?) were you have a nice smile but a bit of an overbite etc. and physically(never hit)grabbed my wrists left bruises,bit me until I yelled. He has 3 ex-wives who tell the same kind of stories. We broke up 5 times. His family /friends totally blame me.My friends/family/church have abandoned me because I told/showed them the truth yet took him back .Thought if I just loved him enough I could fix it-blamed myself.he is so meek, mild,caring, respectful,always praying and praising God for his being such a wonderful person.Privately he brags constantly and talks about how others are just not as good/smart/talented as he.Tells me who WILL and WILL NOT be in heaven.”It’s in scripture honey.”Why did I write this? I feel condemned by him,his friends,family AND pastor and rejected by mine because I still love him,cry and miss our public times together. HELP!

    • UnForsaken

      Dear CAL, you’ve started the New Year right! Please keep coming back and reading the articles here. We have all known some horrible people, and this site is here to help us deal with it and talk about it. I believe Every Word you say about your N and will be praying for you as you look for answers. Just wanted you to know your looking in the right place…Pastor Dave listens and so do we.


  4. CAL

    Thank you! Finding this site has already been such a blessing. Keeping me strong during this lonely “withdrawl” period.It is comforting to know I am not alone and unfortunately my experience is not unique.Praying for you

    • i want to be an angel

      Hi Cal,
      You are absolutely NOT “alone”. One thing I keep trying to make myself remember , and for you too, is that WE are the ones that tried to do what’s right, and not the ones in the wrong.! We can look ourselves in the mirror and know with a clean conscience this is true. Many might say that we are better off just because of that! We have to remind ourselves that the “withdrawal” is almost like a withdrawal from drugs, we’re withdrawing from a type of addiction: an addiction to a particular person. “How to Break Your Addiction to a Person:…” a book on Amazon. I wonder what this book is like? oh well. Just wanted to say, I feel so much for your anguish/pain and totally understand. My prayers are going out to you……..

  5. I am starting to think there must be a genetic component to narcissism, which perhaps is triggered by environment/trauma/neglect or something. I don’t know. It’s just turning up–narc abusers–in family lines now.
    In the last week alone, two separate women have come to me to share or ask for help. Both are married to narc abusers. In both cases, you can point to a close relative who also has narcissistic or abusive (or both) qualities that are very evident.
    I’m just heavy hearted with grief and concern for both right now. In one case, the woman does not feel safe, but is still in her home. In the other, she’s out of the home but everything is insecure, and it appears that her N set her up with extraordinary attention to detail, building her trust, then ripping the rug out from under her. I am afraid for her.
    Would appreciate prayers from the group. So much pain, all around me. God, have mercy!

  6. i want to be an angel

    I am SOO glad I found this site. I am also grateful for these other poor women who have also been victimized by narcissists that they have “seen the truth” and now know, & glad they are here. My prayers go out to you all and to you too Pastor, and many thanks for your wanting to help the suffering. I’ve been stuck in a relationship for 14 yrs (m.13) w/what has to be one of the most severe narcissists out there. I have NEVER in all my life known anyone so unbelievably cunning, sneaky and deceptive and determined to do whatever the heck he wants. He’s scr____ around on me since literally DAY ONE! He ALREADY had a 14 yr old “hook-up”/girlfriend that he has molested and de-virginized 2 yrs earlier at only 12! He refused to drop her for me, and in fact only stopped seeing her because we moved too far away for it to be convenient anymore! He has fervently denied this, although he admitted that he DID still see her in ’04 after he already denied anything to do with her other than “just one” instance at first. After our move, he simply picked up where he left off and continued to sexually predate anyone he was attracted to by nothing more than mere appearance sake.
    He refuses to stop. My problem now is that he has launched a smear campaign the likes of the universe to get back at me for finding out stuff and confronting him on it. He’s furious about it, and has hacked my pc, & my phone , recorded things and send the recordings and texts to other peoples phones in an attempt to make me out to be “the bad guy” because they have no idea what he ‘s like and why I would say and/or ask the things I have. Those people don’t know him (or me) from Adam! They haven’t lived my life with this guy for the past 14 yrs. He has slandered the bloody heck out of me to my neighbors, his family, all his work associates and now even his army unit people making them on his side and making me some sort of “Cruella deVille” ! I want a divorce, and I fully believe he will use it to his advantage having so many people come out of the “woodwork” to assist him in destroying me and taking my home and putting me on the streets. I am disabled, and he already signed several papers stating he knows this is my property, I bought it, he had no hand in it, and its my sons also. But I dont trust him one bit. He will say one thing and then turn around the do the opposite. He acts like a 2-faced backstabbing snake and several people at his last job said the exact same thing about him!! They told me to RUN!
    Any advice about all the destructive slander and defamation of character I would greatly appreciate. Thank you.

    • iwtbaa, I just happened to be on as your comment came through and I wanted to respond quickly. What you have described is criminal. This guy should be behind bars. Statutory rape is a felony in almost all states and there are good reasons. For a grown man to prey on a girl, as you describe a 12 year-old girl, is sick and will happen again and again. In most states the statute of limitations for reporting abuse of a child is very long. If the victim would testify against him, he could still go to jail after all this time. Some of these guys think they can do anything. That’s why we have laws to protect those who are vulnerable.

      It sounds like he is cruel and ruthless. Perhaps you will have to be the same. Get out, get out fast, and get out hard. Get the help of your son or whoever and protect yourself. If you are afraid, get a restraining order. If you have something you can report of his criminal behavior, report it. Now is the time for the strong action.

      In recent months I have heard of several victims who have lost almost everything to the narcissist, mostly because they just couldn’t believe how cruel and deceptive the N can be. Until it is too late. Then they see the truth and by the time they understand what has happened, it’s all over. So, if there is still time, be proactive and get yourself free. Be careful, though. Surround yourself with support as much as you can.

      We will be praying for you.

      • i want to be an angel

        Hello Pastor Dave,
        Thank you so so so very much for your reply. Actually makes me feel a lot better. Yes, you’re right . What he did by predating her and “de-virginizing” her IS criminal, but I’m afraid its been too long. When I met him he was 22 but lied about his age, making himself waaaaay older, because I myself was waaaaay older! He doesn’t even care about age limits, he just wants what he wants. He was still “doing” her at 22 when she was 14, so he was 20 when he got her at her age of 12. I don’t know where she is now, but I have her name somewhere. Of course, after she turned 18, they were still “hooking up” but he just lied about it. She’s moved out long ago from her fathers house and last I heard was somewhere in southern Oregon. He lived in Portland, Or when we met at work. He never told her about me,and I KNOW he never even told her he GOT MARRIED to me, and never told me about her, only said it was a “one time mistake” at MY property IN MY HOME when I was working nights. I didn’t believe it , but he has a way of arguing so fervently and aggressively, after a while you just sort of give up. He should have been an attorney! haha.I should have dumped him like a hot potato right then, but I was already sort of convinced that he “didn’t know” her age and that it was “only1 time”, but I told him if he felt free to do it once, he will do it again. You can imagine the answer. I was very weak emotionally from being raised and severely abused by a N. parent and had no one to help back me up in my life decisions. There was absolutely no one there for me.
        And yes my “husband” IS cruel and ruthless, the best darn pathological liar/con-artist you’ll ever know! He’s got everyone fooled. I am now “the bad guy” and “crazy” “paranoid delusional”, etc,etc, you name it, its all there. But of course, he’s perfect. I am taking your advice and getting out as fast as I can and HARD!. I am RUNNING like those girls said to do. I am running for my life and sanity. He’s already damaged me so severely I am now psychologically disabled and cant think or speak very well some time, but better at writing because I can take time to think to remember the words. ( I need school again) There is only one person I know (maybe 2, Im not sure) that might be able to help me in this transition. But if my husband finds out I’m talking with that person, he will get to him also and ruin it for me by getting him on my husbands side and against me. He still has recordings and texts that I believe are edited, because he found out how to do that from another person who had been doing it to us in the past.
        Pretty sad. So I will keep that secret helper in my mind for now. I have to finish up the paperwork, but I fully believe when I do and go to file, and he gets his copy, thats when poo will hit the fan because he will go directly to his homo-partner that he’s been cheating on me with (since 3/2011) that has mucho money and will help him with an attorney to get over on me. They BOTH want revenge for what my opinion of their
        “relationship”. I don’t even think his homopal knows that my husband is BI-sexual. He thinks my husband is being “faithful” to him too!!
        He doesn’t even know my husband has already sexually predated an extremely young private in his army reserve supply unit in Marysville, Wa.! He makes everyone think that he’s perfect and “not seeing anyone else” , just like he did to me way back and for the entire 14 yrs.
        Please pray for me and my protection from this snake of all snakes,
        I am going to need all of Gods protection and maybe He can throw in
        few angels too!!! That would be nice : ))

  7. i want to be an angel

    Pastor Dave,
    Wow, such a great article and insight. I want to include this link, something else I found……really great too….

    It shows the exact scriptures that talk about narcissism along with probably several other mental insanity disorders/symptoms. Kind of scary stuff, but
    “we shall know the truth and the truth shall set us free” !! I have to keep reminding myself of this, but believe me, this is not easy. It is way too easy to just feel what I’ve been made to feel. I have a literal mountain of evil up against me, and feel as if I have nowhere to run! Very easy to feel this way,
    and hard to divert those feelings.
    I know there are several if not numerous names for all of those symptoms, but regardless of what name someone wants to label it, isn’t it just plain old
    evil? They’re just evil people, people who actually make the conscious
    choice to do evil to others. That’s how I see it. It doesn’t really matter to me what label or “disorder” or whatever they’re supposed to be, it seems
    just plain downright evil behavior and Gods Word is very point blank about it.
    But as much as I can show it to my “husband” or read it to him, none of it
    matters to him because he DOESN’T CARE! So maybe all we can do for
    “the lost” is pray for them? Because they really are lost until they realize
    Gods Truth and accept it and Him and His Son and what He did for all of us.
    I wish I could change my situation and ward off the evil that’s been launched against me.

  8. Cecilia K

    I like your perspective, Pastor Dave. Since learning about Narcissism, I haven’t wanted to think of it in terms of a disorder or illness, for the very reason you talk about in your article – I don’t want to let the Narcs off the hook so they can blame their behavior on an “illness,” and say they can’t help it. If a disorder still allows for accountability, I can accept that, but even calling it a disorder makes me a little squeamish – it still sounds like something a person can’t help – although, there is no denying they have a very warped, twisted, demented way of thinking.

    I remember always thinking my ex often seemed to have a distorted perspective on things. There were a few times when he would observe a person’s behavior/body language and make a judgment about their intentions or the situation, and I would totally disagree (inwardly)…later it would turn out he was wrong. I always got satisfaction out of that but kept it to myself.

    You have mentioned several times how narcs characteristically blame others for their mistakes, wrong actions, anything that goes wrong, etc., and I was wondering, do you think they really know deep down that they are to blame and deliberately deny responsibility and cast blame on others, or do you think they are genuinely ignorant of their wrong doing and of how cruel their actions/words/attitudes are to the ones they hurt? I guess from your article, when you say they make a choice, that implies that they do know the things they do are wrong but do them anyway. Do you think, though, that they know that the inevitable consequences are a direct result of their choices, or do they genuinely miss the connection? Does my question make sense?

    • Fellow Survivor

      I once made this comment to my x narc wife:
      “either you know what you are doing is wrong, which make you evil, or you don’t know what you are doing is wrong, which makes you clueless” Does this comment ring a bell?

      I think they are so set on getting what they want that they just don’t care whether or not their actions are harmful to others.

      • UnForsaken

        Ditto, Fellow Survivor. However, there are all kinds of Ns. I wonder if like the variety of healthy people, that there must be a variety of N types….personality, upbringing, atmosphere all taken into account. They tend to play up to whatever seems to win at that moment, which might be very different from person to person. Yes, individual, but more like a chameleon/con than just an absorbant learner.

        I really agree with your saying they have distorted perspectives. Narcissism is after all a type of Thinking. Psychiatry was invented to try to help any human’s thinking – although we know it often fails – so it’s not uncommon to see a lot of distorted perspectives in people who aren’t Ns too.

        I have been helped reading about personality disorders, recognizing so many people I know, and even traits I want to watch in myself. But, totally agree with the people who find it hard to take the lable Personality Disorder as a good lable. I hate lables of any kind including the ones we give ourselves because they strip us of security, or puff us up, or define only a Small part of reality. Isn’t it great that we can find our identity in Christ, rather than from some silly or cruel statement that boxes people up! Whole truths are harder to define, deeper than a lable, but so worth it. But lables serve us in one way : so we know what we are talking about. 🙂

        To answer your question, at least my N doesn’t seem to see consequences as a result of his actions…but he is subtle and “smart”. I think it goes something like this: See truth, lie to self, lie to others ( or at least tell each person a different version/variation for confusion), a reaction causes suprise/hurt because it’s like they never knew the truth. I wonder, maybe they first convince themselves so they don’t feel they are betraying themselves, or anyone else. But the choice happened with the betrayal of truth when they first saw it, recognized it, and turned away, distorting it for their own purposes. By the end of the transaction, they have wiped it from their minds. Promises made are so well forgotten, they really may not know ” What I’ve done to deserve this?”!

        But , this is the way Mine works. He loves to play victim. I call him “smart” only because I can see he does have a small inkling at the back of his mind. It looks a lot like an internal con, but to milk it for all it’s worth, they have to stay a little aware of it and not be entirely taken in by their own machinations. That’s why I’m not sure all Ns function the same. Some are highly self destructive, others ride the waves. Don’t get me wrong. All of their actions are destructive ultimately, I’m just saying that some end up stabbing themselves by accident, when they meant to only be hurting others. :/

        So , your right . It is a denial of responsibility ,and it can be ignorance. But not a genueine one……I’m not sure that word could be used often for Ns except for surprise!

        Still praying for you on your journey of healing! So happy to hear you have loving family and friends who listen. One of my experiences with a full blown N was so bad because descibing this weird behavior can confusing in itself…..there is no support from people who have N traits and think you are panicking for nothing! What got me through was good reading, a Great sister, time, a journal, music, and eventually finding this site to discover what had really hit me. It was the first safe place I found to expess the reality of devaluation, and the need to Be. So you guys are the listeners in my life, and I Really Appeciate it!!!!!

  9. Cecilia K

    What you say about narcissistic behavior being so ingrained that they continue it even in the face of negative consequences echoes part of what has puzzled me about this kind of behavior. I have often wondered why my ex continues to be a jerk when it obviously doesn’t produce the results I would think he wants – primarily, a lasting relationship. But as you explain, even if they know it’s not getting them what they want, maybe they just don’t know how to change, or maybe they’re so convinced that it’s the other person’s fault, that they keep thinking, maybe the next one will work.

  10. J

    ACON here, as well as some adult experiences. I appreciate your perspective and agree almost completely. I have long believed that NPD is ultimately a series of choices that become ingrained. In other words, an addiction. I do, however, believe that each N passes a “point of no return” in life. A final moment of choice, beyond which he is a complete slave to his disorder. I believe I saw this happen both in my father and later in a close friend. While I COMPLETELY believe it is the result of choices, I would caution against hope for change. Part of the disorder is the inability to see any need for change.

  11. SSM

    If you could point to instances of “cured” or “sober” narcs, who no longer practice their bad behaviors, your argument would be stronger. But the psychology/psychiatry community cannot point to successful treatment w counseling or medication, and there are no 12-Step programs for Narcissists Anonymous. Narcs thrive as long as there are co-dependent flying monkeys around to do their bidding. I have forgiven my NMIL but I cannot be around her. She will die lonely in her assisted living facility without family near because she has driven them all away through her verbal abuse. I have difficulty believing she would not change this if she could.

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