How to speak to a narcissistic entrepreneur

Imagine you are at a cocktail party and, inevitably, at least in the US, one of the first questions will be, “So, what do you do?” 

NB: Do not ask this as the first question when in Europe or Asia.

The answer: “I’m a physician entrepreneur”. Now what?

Consider it an exercise in cultural competence with a dose of psychology thrown in too. Here are some things you should know about narcissistic personality disorder.

Do you know or work with someone like this?

The “key negative traits” of a narcissist in a work setting

  • They demonstrate a clear lack of empathy for how others feel or what they need.
  • They often have an overly excessive focus on getting others to consistently validate them (even small accomplishments).
  • They tend toward impulsivity and making decisions “from the hip.”
  • They may rage, pout, gossip, devalue and otherwise act out when they don’t get their way.
  • They are not great team players. They tend to get into power struggles and “I’m right, you’re wrong” discussions. They need to be right.
  • They tend to see people as being either on their side or against them, with few gray areas.
  • They will use gossip, manipulation, charm and even seduction to get their way.
  • They will use other people and their thoughts and ideas to get ahead.
  • They are not (consciously) malicious, and they will feel ashamed (even self-hating) for their bad behavior when it’s pointed out, but then they will turn around and do the same thing without a second thought.
  • They are often highly demanding of themselves and others, which can lead to them being perfectionists and controlling, holding unreasonable expectations for others and their performance.
  • They struggle with close relationships and lack trust.
  • They are easily frustrated (and can rage) if their projects, goals and needs aren’t getting equal or more focus than the projects, goals and needs of others.
  • They have limited leadership skills due to their excessive self-focus.

The narcissist does have a variety of positive attributes, which can make working alongside them inspiring and rewarding, assuming you are aware of how to handle the negative aspects:

  • They tend to speak out about a problem, whereas others will be more polite and say nothing.
  • They tend to be creative and passionate about any projects they take on as “theirs.”
  • They tend to think and work outside the box, often offering unexpected new and fresh ideas and concepts.
  • Their perfectionism and control (when tempered) can produce profoundly positive results within their organizations.
  • Their need for attention and validation can shine on their workplace, bringing more attention and useful notice to an organization.
  • They can be great leaders, provided that they have people around them to provide the interpersonal functions they don’t have (essentially, they need someone in power to contain and confront them, and they also need someone to provide a buffer between them and those who might react negatively to them).
  • They work extremely well on their own, tending to be highly self-motivated.
  • If they embrace an organization as their own, they will work tirelessly to help it succeed (as it has become a reflection of them).
  • They are often good at working with the media in PR, outreach, social media, etc.
  • Their charm, extroversion and seduction makes them great sales and marketing people.
  • They are great at creating superficial relationships (see sales/marketing above), though not so great at personal follow-through.
  • They can use their powerful persona to shape and mold a company or work environment.

It turns out there are a lot of narcissistic entrepreneurs.

You might want to start off with the assumption that you are talking to a narcissist and all that comes with it, both the light and the dark sides.

Here are the five myths of everyday narcissism. You might be talking to someone who suffered from childhood emotional neglect or who had parents who made that person feel that, since their feelings didn’t matter, neither did they.

Research indicates that:

 Student entrepreneurs score higher on the Narcissistic Personality Inventory than other vocational groups.

Narcissism is positively correlated with general self-efficacy.

Narcissism is positively correlated with locus of control.

Narcissism is positively correlated with risk propensity.

Narcissism plays a significant role in explaining entrepreneurial intentions..

Past research shows that narcissism is often tempered by adversity and failure 

It may be possible to contain and control the downsides of narcissism. For example, what if those grandiose self-views could be redirected to become focused on others, such as being the best helper, advice giver, or team member? The narcissists who do this naturally are called communal narcissists. They are self-appointed saints who have unrealistic views of their contributions to others. While, like all narcissists, they are driven to maintain unrealistic, inflated self-views and crave positive feedback, their narcissism can be channeled toward productive ends because their self-image is tied to helping others. Whereas traditional research has examined agentic narcissists, those who think their abilities are far grander than others’ and are focused on achieving things in the world for themselves, communal narcissists are more likely to share credit and resources in group settings in order to support their self-perceptions as heroic helpers — and they could just be the narcissists your organization needs.

Then, there is a category of humble narcissists. There are three kinds of humility that matter: ideas, performance and cultural.

That is not the only entrepreneurial psychopathology they exhibit. Then, throw in the doctor part, like a high producing surgeon, and things start to get sticky.

Here are some tips on how to spot and speak to a narcissistic entrepreneur:

1. Forget about changing the stripes on a tiger. Narcissist entrepreneurs think they got as far as they did because of who they are and you are not about to convince them otherwise. They have been told most of their lives how exceptional they are. They prey at the altar of the meritocracy and think luck has absolutely nothing to do with their success and they have little empathy for those who simply put, just don’t work hard enough.

2. Plan to spend no more than 5 minutes talking to them, because they will only talk about themselves and the more you encourage them, the worse the conversation will get.

3. Beware of the narcissist in sheep’s clothing. They know it’s all about them and so they try to compensate and only ask questions about you without sharing anything about themselves. You can tell they are faking interest because they are looking over your right shoulder during the conversation.

4. They are the only ones in the room overdressed

5. They answer very short questions with very long answers, particularly if they are men and deliver a manologue.

6. They incessantly post on Linkedin Pulse and other social media. Beware of anyone with over 500 posts.

7. They have mostly superficial relationships and expect you to pay your part of the bill since most of their money is going for alimony and child support.

8. They like the limelight and make good leaders

9. They value validation

10. They like to use lingo, jargon and bizspeak

Here are some more tips on how to deal with people who have big egos.

One thing you can count on , though, as Uber stockholders are discovering, is that therapy for CEOs displaying toxic behavior will have to wait until there is a substantial impact on profits.

The next time you run into a narcissist entrepreneur, just smile and say, “Wow, did you do that all by yourself?” Then take a sip of your Chardonnay, listen for the next 5 minutes and then politely excuse yourself. Millenials self promote because they have to. Maybe in the new economy we all do. Or , if you are a narcissist yourself, just hang out together for a while and ride the career ladder together.

I’ll bet you think this post is about you.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs and Co-editor of Digital Health Entrepreneurship