From what I understand people with NPD themselves suffer significantly. It is difficult to feel sorry for them, but I believe they do suffer. Emptyness, deep rooted trauma. It’s why they act the way that they do. The rage is driven by injury and pain.

Finch, E. F., & Mellen, E. J. (2025). “Labeled, Criticized, Looked Down On”: Characterizing the Stigma of Narcissistic Personality Disorder. Personality and Mental Health, 19(2), e70015-n/a. https://doi.org/10.1002/pmh.70015

The term “narcissist” has become a widely used pejorative in the common lexicon […] Yet many of these cultural characterizations of “narcissists” are, at best, reductionist and, at worst, harmfully inaccurate. In reality, narcissistic personality disorder (NPD) is a highly heterogeneous and complex psychiatric illness, and people who are diagnosed with NPD struggle with a plethora of challenging symptoms

Participants (N = 9) were mental health clinicians who have experience treating patients with NPD

General consensus among participants was that people with NPD internalize stigma, conceal their diagnosis, and anticipate future stigma. Participants reported that at the individual level stigma can intersect with and exacerbate existing vulnerabilities related to NPD, such as a tendency toward shame and low self-esteem.

Honestly, given the misgivings around narcissism, I’m also not recommending that [my patients] talk about it much.

I think that [disclosing one’s NPD diagnosis] is perceived as a path of being basically invalidated, not being taken seriously, not being heard, people wanting to get away from them because it’s a way to easily pre-reject someone…who would want to be close to a narcissist?

Participants agreed that patients often internalize negative stereotypes about NPD, such as the belief that people with NPD are “bad” or “dangerous,” leading them to experience shame and hopelessness in relation to their NPD diagnosis. Notably, participants highlighted that shame is a feature of NPD independent from stigma; however, internalized stigma about having NPD often compounds that shame.

In terms of labeling, participants repeatedly reported that the word “narcissist” has become synonymous with an insult. This reality can make it difficult for patients to accept their diagnosis. One participant reported that a patient told them: “I’m not saying I do not have these traits but I just cannot get past the label. It just does not feel like me.”

Multiple providers noted that the degree to which clinicians hold stigmatizing attitudes against patients with NPD varies substantially by treatment setting. In general, stigma is lower among providers who have received education about NPD and are supported in its diagnosis and treatment, such as providers who work in specialized personality disorder treatment centers. In contrast, there may be more stigma among generalist providers who are not trained or resourced to treat NPD.

Although our participants acknowledged that there are potential risks to treating patients with NPD—as is the case with any serious mental illness—there was also a typical consensus that many clinicians believe working with a patient with NPD will be more risky than it is in reality, often assuming that all NPD patients will be highly aggressive and/or motivated to victimize others.

Participants identified more research on NPD as a critical step toward reducing stigma

Increasing psychoeducation among clinicians was also identified as an important tool for stigma reduction. This includes both adding information about NPD into clinician curricula and facilitating psychoeducation of clinicians later on in their careers. Participants noted that a critical aspect of this psychoeducation may be increasing awareness of NPD complexity and heterogeneity, particularly pertaining to the presence of narcissistic vulnerability. This would combat some of the harmful stereotypes about NPD rooted in grandiosity. Multiple participants mentioned the NPD Basic (Ronningstam 2016), a booklet that reviews identifying, diagnosing, and treating NPD, as a valuable resource for the psychoeducation of clinicians.

Another potential avenue for stigma reduction, according to our interviews, may be transitioning to a dimensional conceptualization of NPD, which places narcissistic traits on a spectrum instead of applying categorical labels. This finding aligns with recent empirical work, which observes that stronger “continuum” beliefs about mental illness (e.g., that mental illness exists on the continuum of life experience and is not categorically distinct) are associated with lower stigma toward mental illness stigma (Peter et al. 2021). Similar findings have been established for personality disorders

You are a fool or a troll. My money is on fool.