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Tommy Recovery Coaching


The Relationship Between Alcohol & Narcissism

Substance abuse isn’t a monolithic condition. It’s often accompanied by mental health issues that guide risky or negative behaviors. In the field of addiction research, the interactions between substance use disorders and mental health conditions are called comorbidities. Alcoholism and narcissism are comorbidities that researchers from the University of South Dakota found to be present in 23 percent of patients who participated in a 2018 survey conducted among recovering alcoholics. Narcissistic drinking can be described as a negative life situation for patients whose alcohol use disorder is motivated by problematic grandiose or vulnerable feelings.

Narcissism as a Personality Trait

Everyone practices narcissism to some extent. The appeal or need to be admired is a normal personality trait. As such, it can be more pronounced in some people. A pathological desperation to be admired is one dimension of narcissistic personality disorder (NPD). While there are various types of narcissism, most alcoholics with NPD usually exhibit vulnerable or grandiose ideations. Grandiose NPD is centered on overly irrational self-esteem while vulnerable NPD results in hypersensitive behavior and caustically defensive reactions.

Grandiose & Vulnerable Narcissistic Drinking

People who live with grandiose NPD won’t be affected by alcohol use disorder (AUD) unless they’re in environments where drinking is either encouraged or the norm. The problem is that they’ll likely engage in competitive drinking just so they can thrive in front of others, and this is a one-way ticket to AUD. People who live with vulnerable NPD will keep it hidden as much as possible, so their approach to AUD is more likely to be a coping mechanism or a misguided way to feel better about themselves.

Diagnosis & Treatment of Alcoholics with NPD

It’s important to point out that AUD isn’t the only substance abuse condition that’s comorbid with NPD. For example, recalcitrant smokers show higher rates of NPD than alcoholics. In the 1980s, American popular culture incorrectly associated NPD with cocaine use and debauchery. Mental health professionals strive to diagnose all conditions that either interact with or stimulate addiction. This is vital because it will determine the treatment strategy. In some cases, depression or emotional trauma is a component of a dual NPD and AUD diagnosis. For the most part, alcoholics who live with NPD don’t require clinical interventions unless they’ve fallen into severely pathological AUD. However, the majority will need behavior modification through talk therapy and lifestyle coaching. If left untreated, NPD can become an obstacle to recovery. In Carlsbad, CA, compassionate sober companion services are available from Sober Lifestyle Coaching as a part of a comprehensive treatment plan.

Recovering & Getting Better with Sober Living

Patients affected by AUD and NPD are often good candidates for sober lifestyle coaching. Decades of addiction recovery research show that sobriety is the most powerful booster of behavioral therapy. After a dual AUD-NPD diagnosis has been established, the initial priority is placing the patient on the right track to sobriety. The next step is to arrange the therapy on a dual-treatment track so both conditions are addressed simultaneously, and this is when sober lifestyle coaching is recommended because patients learn to develop coping mechanisms conducive to long-term sobriety and mental health.


If you’re concerned about a loved one’s level of drinking but don’t know where to turn, a good place to start is with an interventionist. Carlsbad residents can trust the expertise and experience of the compassionate team at Sober Lifestyle Coaching. Our interventions are guided by love and compassion for the addict to ensure he or she doesn’t feel attacked or judged. In addition, our interventions are well structured and appropriate for coaxing a willingness to change in your loved one who may resist accepting help such as treatment, detox, or rehab. As part of our comprehensive intervention services, we also offer the support of a dedicated Sober Companion to accompany your loved one on the journey to recovery, providing the care and guidance he or she needs in daily life. To learn more about how we can help you or someone you love, call us today.

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