Not everyone who struggles with their mental health is willing to step foot inside a therapist’s office. Researchers call this the treatment gap, a frustrating disconnect between the number of people suffering from psychological distress and those actually receiving professional care. To understand why some people remain stubbornly resistant to help, a new study published in the journal Personality and Individual Differences suggests that the answer may lie in specific shades of narcissism. Specifically, it isn’t just ego that keeps people away, but a particular brand of antagonism known as narcissistic rivalry.
Psychologists distinguish between two main types of grandiose narcissism. There is narcissistic admiration, which manifests as a drive for social approval, confidence, and personal success. Then there is narcissistic rivalry, a defensive strategy characterized by hostility and the tendency to protect one’s self-image by putting others down. According to the study led by Marta Rogoza at the Polish Academy of Sciences, these two traits lead to wildly different perspectives on mental healthcare. While those high in narcissistic admiration generally viewed therapy favorably, those driven by rivalry harbored deep seated negativity toward seeking help.
The reason for this avoidance appears to be rooted in emotion rather than logic. By surveying adults in both Poland and the United States, researchers discovered that people with high levels of narcissistic rivalry felt an inherent coldness toward psychologists, psychiatrists, and psychotherapists. Because therapy inherently requires vulnerability and places the patient in an asymmetrical power dynamic under an expert’s evaluation, those with antagonistic tendencies find this shift in authority threatening. Essentially, their dislike for the professional themselves becomes the primary barrier preventing them from accessing care.
Interestingly, this coldness wasn’t limited only to doctors; these individuals also expressed negative feelings toward other people diagnosed with mental disorders. However, the data showed that it was specifically their frosty relationship with providers—not their view of other patients—that drove them away from clinics. Whether in a culture where therapy is normalized like the U.S., or one where stigma remains prevalent like Poland, the internal mechanism remained the same: antagonistic narcissism creates an emotional wall that makes professional intervention feel unacceptable.
