Whether it’s applied in popular culture to a politician, a difficult spouse, or an annoying friend, the label of narcissist has become ubiquitous lately. Narcissism alarms have been sounded more generally about predatory, powerful men, and about a selfie-obsessed, social-media-driven society. As the question of what constitutes clinical narcissism has begun reverberating through our society, clients have started paying attention to the diagnosis in new ways.

Most therapists understand that true narcissistic personality disorder affects only a tiny percentage of the population. But as narcissistic behavior becomes increasingly recognizable, and clients take a second look at the power-hungry manipulations of partners and family members, therapists are having to ask: Are we talking about a true clinical issue here? How can we help with clients who think they have a narcissist in their lives?

Ramani Durvasula, a clinician and professor of psychology at California State University, Los Angeles, gave a popular TEDx talk on this topic last year. The author of Don’t You Know Who I Am? How to Stay Sane in an Era of Narcissism, Entitlement, and Incivility and Should I Stay or Should I Go? Surviving a Relationship with a Narcissist, Durvasula treats both narcissists and clients struggling with the…