Today, we asked Dr. K what the difference is between narcissism and covert narcissism. Can either be helped with couples therapy?
There has been a lot of discussion about narcissism and covert (or vulnerable) narcissism on the web. And a lot of it is confusing, contradictory, and simply wrong.
There’s a lot of noise online about narcissism. Some of it’s flat-out wrong. Some of it’s deeply personal. And most of it confuses more than it clarifies. Today, I want to help you cut through the fog.
Let’s talk about narcissism, covert narcissism, and what these patterns look like inside a marriage. And yes—whether couples therapy can actually help when these traits are present.
What Is Healthy Narcissism?
Narcissism isn’t always a bad word. We all have narcissistic motives—and we need them. A healthy sense of self includes pride, ambition, and even a little flair. People with healthy narcissism pursue goals, acknowledge their strengths, and don’t crumble over weaknesses. They’re empathetic. They care about others.
What they don’t do? Exploit. Control. Stonewall. Lash out when they feel unseen.
Healthy narcissism fuels connection and growth. Pathological narcissism burns it all down.
Pathological Narcissism Isn’t Just “More” Narcissism
Some researchers treat narcissism like a dimmer switch: the higher it goes, the more problematic it becomes. But it’s not that simple.
Healthy narcissism supports self-esteem. Pathological narcissism reflects a fragile self that lashes out or withdraws when challenged. It can show up as:
- Narcissistic rage
- Deep insecurity masked by arrogance
- Grandiosity or deep shame
Periods of intense withdrawal or emotional coldness
These aren’t just personality quirks. They impact empathy, intimacy, and emotional regulation—core ingredients in a relationship.
Is healthy vs pathological narcissism a continuum?
Overt vs. covert narcissism
These aren’t separate diagnoses. They’re different modes of expressing the same underlying struggle: a wounded, rigid sense of self.
Overt narcissists often present as confident, self-important, and entitled. They may seem dominant, critical, or emotionally dismissive.
Covert narcissists present more quietly. They may seem sensitive, anxious, or even self-effacing—but they, too, crave admiration and validation. They often express entitlement through guilt, emotional manipulation, or martyrdom.
Overt narcissists might say: “You’re not like other people. They’re idiots.” Covert narcissists might say: “I finally found someone who understands me. I don’t know what I’d do if you left.”
Both may feel threatened by criticism. Both may struggle with empathy. Both can shift between grandiosity and vulnerability—sometimes in the same hour.
Self-Regulation: The Hidden Struggle
Whether overt or covert, pathological narcissism reflects a deeper problem: difficulty with emotional regulation. These individuals may fluctuate between:
- Idealizing and devaluing their partner
- Needing admiration, then withdrawing in shame
- Expressing affection, then exploding in rage
This pattern begins early and shows up across many areas of life. It’s not just a relationship problem. It’s a self-structure problem.
Can Couples Therapy Help?
Maybe.
But here’s what won’t help:
- Coming to therapy to diagnose your partner.
- Using “narcissist” as shorthand for “selfish.”
- Expecting change without ownership.
Couples therapy can help when both partners are willing to look inward. When there’s some capacity for empathy. When the person with narcissistic traits can tolerate discomfort without retreating into blame.
If one person insists: “There’s nothing wrong with me. I’m just here because my partner has a problem”—therapy goes nowhere.
But when there’s a shared desire to understand and shift relational patterns, even painful ones—therapy can be a turning point.
What If You’re Unsure?
Then start with an assessment.
At CTI, we don’t diagnose your spouse. We help you name what’s happening between you. If it’s emotionally unsafe, we’ll say that. If there’s room for change, we’ll work toward it. And if it’s already broken beyond repair, we won’t waste your time.
You don’t need a label to know when something hurts. And you don’t need a label to start healing.
