This content was created by Lewis Howes. This content was uploaded by Lewis Howes. This is a YouTube video titled "NEVER diagnose a narcissist! Here's why." created on September 28, 2025. It features a discussion between two speakers about the complexities of diagnosing narcissistic personality disorder, emphasizing the need for a thorough clinical evaluation and the distinction between traits and the disorder itself.
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A lot of people use the word narcissistic or the term narcissistic personality disorder. I actually think it's phenomenal that you haven't been using it, because it's a mistake to use that languaging. And I'll tell you why.
Narcissistic personality disorder, okay?
Npd. So lots of people out there will say, oh, I'm in this relationship, or I've got this boss, and they have narcissistic personality disorder. I'm always like, slow down, sister. Okay? Because narcissistic personality disorder, like all diagnoses, require a full workup, a lengthy clinical interview. It even takes me. I'll be honest with you. I have a client in my office, usually takes me four to six sessions to be confident that that's what I'm dealing with, a disorder.
Because you could have narcissistic personality traits different than a disorder.
And it gets into the weeds in terms of diagnostic stuff you don't want to.
It could be more like when I'm triggered, I have narcissistic traits, as opposed to.
It's more complex than that because it's that in order to give someone a diagnosis, and the Diagnostic and Statistical Manual of Mental Disorders, the dsm, in order to give someone a diagnosis, that person who is showing the symptoms has to either be uncomfortable themselves, like what we call it subjective distress. So depressed people, they're like, I'm miserable, I'm miserable. I'm sad all the time. I can't get out of bed. That's subjective distress. Or they have to have something called social and occupational impairment, meaning that the symptoms are getting in the way of their lives in a way that they're aware of. Right. It's causing problems for them. Where this gets dicey with narcissistic personality is that, first of all, a lot of narcissists are on top of the world. They think their lives are great. They walk around with them. I'm the one. I'm the guy.
It's working for me.
I'm the one.
I've got money, I've got success, I've got the girl. Whatever it is, it's working for them.
So everything's working for them. So that's no subjective distress. Nothing's wrong with you. Social and occupational impairment. Now, in some cases, they may be having trouble at work, and then, yeah, sure, they'll meet that criterion. But for a lot of folks just walking around on the street, they're making. They're making bank at work. They got. They got a partner and a side piece, like everything's working out for them, so they don't even think they're having that impairment. But what they're doing is they're blowing up other people's lives.
Oh, yeah.
We as therapists cannot issue a diagnosis of social. We can't say that they have social and occupational impairment because someone else is bothered by them. Make sense?
Yeah.
It has to be in the. It has to be that the person is saying, I'm not going to work on time, or I got a dui. Those are examples of social and occupational impairment or behavioral impairment. I personally think they need to get rid of the diagnosis. I think it's worth nothing. It's a diagnosis with no treatment. So why would you have a disease that you can't treat? There's no point to that.
