Antagonistic narcissism is linked to cold feelings toward psychologists

People with certain narcissistic traits tend to hold negative views about seeking mental health treatment, often because they harbor cold feelings toward psychologists and psychiatrists. A recent survey analysis reveals that a specific antagonistic form of narcissism acts as a psychological barrier to pursuing therapy, while a more self-promotional form of narcissism does not. These findings were published in the journal Personality and Individual Differences.

Many people who experience severe mental health issues never seek professional treatment. Psychologists refer to this discrepancy between the prevalence of psychological distress and the use of services as the treatment gap. While some people readily seek assistance, others avoid clinics entirely even when their daily functioning is severely compromised. Finding ways to bridge this treatment gap requires untangling the specific beliefs and emotional reactions that keep people away from mental health care.

To understand why some individuals avoid therapy, researchers examine the psychological traits and social attitudes that shape decisions about care. Narcissism is one personality dimension that influences how people navigate interpersonal situations and personal vulnerabilities. Psychologists divide grandiose narcissism into two distinct dimensions. Narcissistic admiration involves a self-promotional strategy where individuals seek social approval, project confidence, and focus on personal success. Narcissistic rivalry is a defensive and antagonistic strategy where individuals protect an inflated self-image by devaluing other people and acting with hostility.

To measure these dimensions, psychologists typically ask people to rate how much they agree with specific statements. Statements like being a very special person gives me a lot of strength capture the essence of narcissistic admiration. Statements such as I want my rivals to fail capture the hostility of narcissistic rivalry.

Engaging in psychotherapy typically requires personal disclosure, accepting a vulnerable position, and opening up to an expert’s evaluation. For someone high in narcissistic rivalry, this uneven power dynamic can feel highly threatening. Marta Rogoza, a researcher at the Polish Academy of Sciences, led a team to investigate how these two facets of narcissism relate to views on mental health services. The researchers wanted to know if a person’s specific type of narcissism alters how they perceive mental health professionals.

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By testing their hypotheses in both the United States and Poland, the researchers aimed to see if the emotional mechanisms underlying these attitudes persist across distinct social environments. Mental health services are widely utilized and somewhat normalized in the United States. In Poland, seeking psychological help remains heavily constrained by stigma and structural barriers.

The research team conducted three separate survey analyses to test their ideas. In the first analysis, the researchers surveyed 1,622 adults in Poland using an online questionnaire. The participants answered questions designed to measure their levels of narcissistic admiration and narcissistic rivalry. They also rated their attitudes toward seeking professional psychological help, evaluating how useful or acceptable they found mental health services.

The results of the first analysis revealed a divergence between the two facets of narcissism. Narcissistic rivalry was associated with less positive attitudes toward seeking psychological help. Conversely, narcissistic admiration was linked to more favorable views of mental health treatment.

For the second analysis, the researchers recruited 556 adults in the United States to see if the pattern held across different cultures. In addition to measuring narcissistic traits and general attitudes toward therapy, the team asked participants to rate their emotional reactions using a feeling thermometer. This tool required participants to rate how cold or warm they felt toward mental health professionals and toward individuals diagnosed with mental disorders.

The American sample yielded results consistent with the Polish sample, while offering new insights into emotional reactions. Narcissistic rivalry was linked to cold feelings toward both mental health professionals and people with mental health conditions. Narcissistic admiration was associated with warmer feelings toward mental health professionals.

When the researchers ran statistical models, they found that cold feelings toward mental health professionals accounted for the association between narcissistic rivalry and negative attitudes toward seeking help. In the context of psychological help, professionals occupy positions of expertise and evaluative authority. Seeking their help requires stepping into an asymmetrical power dynamic.

The statistical models suggest that negative emotional reactions toward these specific authority figures are directly tied to decisions about whether therapy feels acceptable. Cold feelings toward people diagnosed with mental disorders did not have this same statistical relationship with help-seeking attitudes. Perceptions of other patients might reflect abstract social categorizations, making those feelings less relevant to a person’s own decisions about seeking care.

In the third analysis, the team surveyed 647 adults in Poland to look closer at specific types of mental health professionals. Instead of asking about a general group, the researchers asked participants to rate their feelings toward psychologists, psychotherapists, and psychiatrists separately.

Once again, narcissistic rivalry was associated with colder feelings toward all three groups of professionals, as well as toward people with mental disorders. These cold feelings toward the professionals statistically explained the link between narcissistic rivalry and negative attitudes toward seeking therapy. On the other hand, narcissistic admiration was linked to warmer feelings specifically toward psychotherapists, which in turn predicted slightly more positive attitudes toward seeking psychological help.

The survey analyses rely on self-reported data collected at a single point in time. Because the research is observational, it cannot prove that narcissistic traits directly alter a person’s attitudes or feelings. The statistical models show relationships between variables, but experimental studies would be needed to establish causality.

The research focused entirely on people’s reported attitudes rather than their actual behavior. Expressing negative views about therapy on a survey does not guarantee that a person will refuse help in a real crisis. The findings also highlight that grandiose narcissism is not a uniform trait. People with high levels of narcissistic admiration might actually view therapy positively, perhaps seeing it as an opportunity for self-improvement or personal development.

Future research could track individuals over time to see if changes in how they view mental health professionals precede changes in their willingness to seek therapy. Investigators might also explore qualitative interviews to understand exactly why individuals high in narcissistic admiration evaluate psychotherapy favorably. Learning whether this openness represents a genuine desire for growth or a superficial pursuit of status could guide efforts to make mental health care more accessible.

The study, “Only the weak need help? The role of narcissistic rivalry in attitudes toward psychological help,” was authored by Marta Rogoza, Marta Marchlewska, Zuzanna Molenda, and Dominika Adamczyk.