Can A Narcissist Really Love You?

Narcissistic personality disorder (narcissism) is a psychiatric disorder characterized by a pattern of self-importance (grandiosity), a constant need for admiration and attention, and a lack of empathy for others. Because of this lack of empathy, a narcissist cannot really love you. Narcissists do not experience and show love in the sense that most people do.

Narcissistic personality disorder (narcissism) is a psychiatric disorder characterized by a pattern of: 

• Self-importance (grandiosity)
• A constant need for admiration and attention
• A lack of empathy for others

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines narcissistic personality disorder as one that has:

• A pervasive pattern of grandiosity (in fantasy or behavior)
• A constant need for admiration
• A lack of empathy

The above personality traits begin by early adulthood and are manifested by at least 5 of the following 9 criteria:

• An extreme sense of self-importance
• Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
• A belief that he or she is special and unique and can only be understood by, or should associate with, other special or high-status people or institutions
• A lack of empathy
  • This lack of empathy means a narcissist cannot really love you
  • Narcissists do not experience and show love in the sense that most people do
  • They do not care about the happiness of others except as it relates to them
  • They are really only concerned about their own happiness and needs
  • Some seem to find “love” but are really only seeking a practical arrangement for their own needs or are chasing perfection and once they see flaws, they will end the relationship
• A need for excessive admiration
• A sense of entitlement
• Exploitive behavior of others
• Envy of others or a belief that others are envious of him or her
• Arrogance and haughty behaviors or attitudes

The cause of narcissistic personality disorder is unknown but it may be the result of a combination of biological, social, environmental, and psychological factors.  

It is believed an unhealthy early parent-child relationship may be a significant factor in the development of the disorder. 

There does not seem to be a genetic link to narcissistic personality disorder. 

Narcissistic personality disorder is diagnosed with a psychological evaluation. 

Before arriving at a diagnosis of narcissistic personality disorder, other personality disorders with similar characteristics must first be ruled out, such as: 

• Antisocial personality disorder
• Borderline personality disorder
• Histrionic personality disorder

There are no specific lab tests used to diagnose narcissistic personality disorder, but a toxicology screen may be used to rule out use/abuse of drugs and alcohol as the cause of the behaviors. 

Personality tests may also be use to help make the diagnosis of narcissistic personality disorder, such as:

• Personality Diagnostic Questionnaire–4 (PDQ-4)
• Millon Clinical Multiaxial Inventory III (MCMI-III)
• International Personality Disorder Examination (IPDE)

Treatment for narcissistic personality disorder often involves a combination of psychotherapy and medication.

There are no specific medications used to treat narcissistic personality disorder, but medicines may help relieve some symptoms or treat other co-existing mental illnesses.  

Medications that may be used to treat symptoms of other mental illnesses include: 

• Serotonin reuptake inhibitor (SSRI) antidepressants
• Antipsychotics 
• Mood stabilizers