Narcissism is a term that has been widely used to describe a host of undesirable traits. However, most of us exhibit some aspect of it to a greater or lesser degree. Self-esteem, confidence, and feeling a bit special are all healthy; yet, always feeling superior to others becomes problematic. In other words, narcissism is on a continuum from healthy self-regard to a pathological personality disorder. Most of us are somewhere on that scale.
According to Rebecca Webber, (“The Real Narcissists,” Psychology Today, September 2016) narcissism is a highly heritable trait, and it manifests itself early in life. An overly attention-seeking preschooler might end up more on the hazardous end of the scale, whereas the cautious child may become a healthier adult. Parenting styles also have an impact. Warm, caring parents help children internalize the belief they are worthy individuals, the core of self-esteem. By contrast, parents who praise unrealistically and place their children on a pedestal are more likely to promote narcissistic traits.
Personally, I do not always know whether telling a friend about some accomplishment is sharing my pleasure or boasting. I think the difference is intent. If the intent is to be admired, it is narcissistic; if it is to share some newly acquired knowledge, it is collegial. There is a fine line between the two, and they can overlap. Barack Obama once said that the issue for a lot of people is the fear of insignificance. We all want to be loved, and most wish for recognition. We want to be a valued member of society. Yet, there are also those who prefer anonymity, to be invisible in a crowd, to fade into the woodwork.
The people who are upfront and visible, who have a cause they pursue, who are vocal regarding issues they care about, who monopolize conversations, may be seen erroneously as narcissistic. Feeling good about oneself and wanting others to recognize one’s accomplishments while still being confident enough to welcome helpful criticism is the kind of self-esteem we encourage in children.
People with a narcissistic personality have some common traits, such as needing to be the center of attention or feeling entitled to special treatment. This may arise from trying to compensate for feelings of insecurity or vulnerability, which can be manifestations of a fear of being found to be not as important as one professes to be. While these traits exist in some form in many people, narcissism becomes a personality disorder that needs treatment when one:
Is unable to handle even the slightest criticism to the point of seeking revenge;
Exaggerates one’s achievements or talents; Feels unjustifiably superior to others or expects to be recognized as more knowledgeable without achievements that warrant it;
Surrounds him or herself with people who are in agreement and dismisses those with a contrary opinion;
Needs constant admiration;
Expects special favors and, if they’re not forthcoming, becomes enraged;
Refuses to take into account the needs or feelings of others;
Belittles others or calls them names; Lies to convince oneself and others about one’s superiority to the point of constant, obsessive self-aggrandizement;
Denies any reality that threatens one’s image to the point of inventing, and often believing wholly fictional scenarios. All of these traits are pathological because they are not connected to reality.
Treating people with narcissistic personality disorder is thorny because of their assumption that if their superiority is not recognized, it is the fault of others for not seeing and acknowledging it. The defenses are so strong that it is difficult to deal with until the whole edifice cracks under the pressure of a more reality-based belief system. The ensuing depression can be a positive outcome because it exposes the underlying feelings of worthlessness which can then be dealt with to arrive at a new reality.
The opposite of narcissism is humility. A leader who is humble would be self-aware, could acknowledge his or her limitations, faults and mistakes, would be open to feedback even if critical,  appreciate followers’ strengths and contributions,  have low self-focus with an orientation toward others more than towards self. Leaders who are humble would consider mistakes as normal, even beneficial, to learning and failure as necessary to continued success. 
 Jean Wang et al “Understanding How Leader Humility Enhances Employee Creativity”  The Journal of Applied Behavioral Science, March 2017.
Natasha Josefowitz is the author of more than 20 books. She currently resides at White Sands Retirement Community in La Jolla. Copyright © 2017. Natasha Josefowitz. All rights reserved.