Various forms of narcissism have differing implications for therapy.
It is not unusual today for individuals to be labeled as narcissistic by family members, friends, or co-workers. It has become a popular concept and, according to some experts, a more common problem among today’s Generation Y than among prior generations (Twenge, 2006). Other experts disagree about the change in prevalence. Most notably, Dr. Craig Malkin has written comprehensively on the subject of narcissism (Malkin, 2015) and has concluded that the prevalence of Narcissistic Personality Disorder (a specific diagnosable form) remains unchanged at 1% of the population. The contradictions are head-spinning, especially when you take into account all of the various forms of this personality style and all of the labels given to these forms.
It is somewhat helpful to know that most of the experts at least agree that there are different forms of narcissism. The most basic difference is that between what most have called “grandiose narcissism” versus “vulnerable narcissism” (Wink, 1991; Dickinson and Pincus, 2003). The grandiose narcissist is described as arrogant, entitled, exploitative, and envious. He maintains his own self-esteem by self-enhancement, denial of weaknesses and demands of entitlement. He may become angry and aggressive (at least verbally) when his needs are not met. In contrast, the vulnerable narcissist is overly self-inhibited and appears modest, but actually has grandiose expectations for himself and others. The failure to meet his own high expectations as well as the failure of others to meet his expectations often leads to anger, disappointment, shame, and social withdrawal. Both types feel entitled, lack empathy, and exploit others to meet their own needs.