Before we start… Keep in mind that Narcissistic Personality Disorder (NPD) is a diagnosable condition. We often throw the word “narcissist” around the same way we throw around terms like OCD. “I’m kinda OCD about keeping my car clean.” But Obsessive-Compulsive Disorder is also a legit diagnosable disorder even though it often gets used in a non-clinical way to describe someone who is really into cleanliness or organization.

So, first, we need to determine if you are potentially married to a narcissist with clinical NPD or have a spouse who is arrogant & self-centered or is not responsive to your needs. Don’t worry, you’re gonna find help no matter what. Let’s get flowing…

Doctors and mental health professionals often use the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose mental disorders, such as NPD. The DSM-5 diagnostic criteria for NPD include the following traits:

• having an inflated sense of self-importance and entitlement
• needing constant admiration and praise
• expecting special treatment due to perceived superiority
• exaggerating achievements and talents
• reacting negatively to criticism
• being preoccupied with fantasies about power, success, and beauty
• taking advantage of others
• having an inability or unwillingness to recognize the needs and feelings of other people
• behaving in an arrogant manner

Remember, these are Narcissistic Personality Disorder traits or characteristics. These are also traits or characteristics that anyone can display from time to time and not have NPD. To understand whether or not you are potentially married to a narcissist, we need to go deeper than this…

• The exact cause of NPD is unknown. The cause of narcissistic personality disorder is not fully understood and complicated. NPD may be linked to: genetics, a childhood of being over-praised or over-criticized, abused or neglected, and then there’s neurobiology, the brain/behavior/thinking connection. Yeah, complicated.
• Who does NPD affect? When does it “show up?” Usually, men slightly more than women and it usually begins in young adulthood. But it’s kinda rare – less than 200,000 US cases a year.
• NPD Complications? Clinical narcissistic personality disorder usually comes with a lot of significant baggage: professional difficulties, problems with relationships, other disorders like depression and anxiety, abuse of drugs or alcohol, even suicidal thoughts or actions. Serious stuff!

Okay, so you think you are married to a narcissist and your spouse might be clinically diagnosable with NPD. This is a serious situation and we need to proceed very carefully.

First, unless you’re on the internet looking for qualified, professional support in your area, I want to encourage you to avoid clicking around and trying to diagnose your spouse online. Wanting to be informed and educated is absolutely important and understandable, but NPD is complicated and often misunderstood. There is no shortage of conflicting and outdated misinformation online related to NPD. What you need right now is clarity.

Second, let’s press PAUSE and make three important distinctions. Just to be absolutely clear. There are three distinctions we need to keep in mind. Ready?

1. “Narcissism” being used as a casual synonym for selfish behavior or self-centeredness. (“OMG! He’s such a narcissist sometimes!”)
2. Narcissistic Personality Disorder traits or characteristics that anyone can have but not actually have NPD. (“Wow. He can’t handle criticism and always needs my affirmation.”)
3. Narcissistic Personality Disorder clinically diagnosed by a qualified professional. (“Umm. I’m in over my head with this. This is serious and I need serious professional support.”) 

It’s not just important that you make these three distinctions, but it’s just as important to know if other people are making these three distinctions. (Friends giving advice, online resources, even a counselor or therapist.) Don’t be afraid to ask someone to unpack what they mean.

You don’t have to tolerate any of the above, but they warrant different responses. Especially that third one. If you think you might be dealing with that, get to a professional.

Finding the “right fit” when you’re seeking professional help involves several factors and is usually a process, especially if you are potentially married to a narcissist. This is what you need to know to streamline this process. Let’s begin with a very practical first step that many people often overlook:

1. What do you want to get out of this? Take some time to think through your needs. Where do you hurt? What are your personal and relationship goals? (A professional will speak into this, but start thinking about it now. It’s. Time. To. Grow.)
2. What are you able to put into this? This will involve time, money, and effort – but you are absolutely worth investing in! Do you have health insurance coverage? What will it cover? Do you have other forms of insurance? 
3. Your mental health and physical health are connected. When was the last time you saw a medical doctor for a physical evaluation or check-up? 
4. As you search the internet, pay attention to credentials. Not sure what some letters behind a name mean? Google. When you make phone calls, ask about a counselor or therapist’s approach. Take notes. Look up anything you don’t quite understand. Ask about what insurance they take, or if they have a “sliding scale.”
5. One of the most important factors is purely subjective. Do you feel comfortable with this professional? Or do you feel like they listen to truly hear you? Do you feel like they ask questions that help you understand yourself, your spouse, and your situation?

So maybe you’re not married to a narcissist. (This is a good thing!) But, your spouse might be selfish, self-absorbed, self-centered, and be destroying your self-image. (This is NOT a good thing!) 

Let’s talk about selfishness in marriage, because, let’s face it, we all struggle with selfishness to some degree sometimes. What kind of selfishness is to be expected as two individuals learn how to build a life together? What kind of selfishness is out of line, over the line, time to draw the line?

TWO WORDS: ME & WE

• Does your spouse have an attitude of, “It’s all about me”?
• Communication: Do they cut you off, talk over you, insult you?
• Conflict: Do they have to win and get their way?
• Emotions: Is it all about their feelings being understood?
• Sex: Is the only thing that matters is that they have sex when they want it? Selfish lover?
• Decision-Making: They make all the decisions and have to get what they want?
• Self-Image: Does your spouse have to put you down to try to elevate themself?

This is all “Me” stuff. Marriage is about forming a team, building a “We.” There should be healthy give and take along with mutually beneficial solutions, and both people should feel heard, understood, respected, and validated. 

In a healthy marriage, the marriage wins, not just one spouse. We win. They say there is no “I” in “Team,” but there is an “I” in “Win.” Marriage is all about growing into a winning team. That’s a “We” thing. 

Don’t forget – not all “self” stuff is selfish. Right now, you need a healthy view of your “self.” You definitely have to remember that you have self-worth. Period. Full stop. You need to cultivate self-awareness and constructive self-care. Your self-talk is what you ultimately believe. It needs to be reality-based and brave, not self-sabotaging or a projection from your spouse.

Please use the resources below to address your specific needs:

• What to Do When You Disagree With Your Spouse
• Working Through Resentment With Your Spouse
• Should You Apologize to Your Spouse for Something You Didn’t Do?
• 8 Things You Should Never Do During an Argument With Your Spouse
• 5 Tips for Understanding Your Strong-Willed Spouse
• What To Do When Your Spouse Gives You The Silent Treatment
• What to Do When Your Spouse Doesn’t Meet Your Expectations
• How to Communicate Better With Your Spouse
• 6 Ways To Agree To Disagree With My Spouse
• How to Deal with a Spouse Who Can’t Handle Conflict
• My Spouse Is Putting Me Down. (How Do I Get Them to Stop?)
• What to Do When Your Spouse Is Toxic

You may not be married to a narcissist, but remember: Nobody can make you feel anything without your consent. Recognize what is in your control and what is not in your control. Focus on what you can control. You aren’t responsible for things that are out of your control. Have a support system around you of trusted people that are for your marriage. If you aren’t seeing growth and change – it’s time for the professionals.