Narcissism in Relationships: What It Actually Means and How It Shows Up in Bed

Narcissist has become one of the most overused words in our cultural vocabulary. It gets thrown around in text message breakdowns, shared in memes, whispered between girlfriends over wine. It has become a way to name something real that hurt us, without necessarily knowing what that thing actually is.

On a recent episode of Sex Ritual Radio on KXFM, I sat down with Dr. Edward Margines, a clinical psychologist based in Newport Beach and the host of the mental health show Moody on the same station, to have an honest conversation about what narcissism actually means, where the clinical definition ends and the casual label begins, and how all of this plays out in our most intimate moments.

I also shared some things on air I had never shared publicly before. This episode got real.

What Narcissism Actually Is

Clinically, narcissistic personality disorder involves a grandiose sense of self-importance, fantasies of unlimited success or ideal love, a belief in being uniquely special, a deep need for admiration and validation, and a lack of empathy for others. Only one to two percent of the population meets the full clinical criteria.

But here is the nuance Dr. Margines was careful to bring forward: we all have a healthy level of narcissism. Having a sense of self, believing you have something valuable to offer, taking pride in your accomplishments, those are not pathological. They are human. The clinical disorder lives at the extreme end of a long spectrum, and most people who are called narcissists in daily conversation do not actually meet the diagnostic threshold.

That said, people absolutely can have narcissistic traits and behaviors that cause real harm in relationships without ever receiving a formal diagnosis. The traits matter even when the label does not fully apply.

Why Narcissists and Codependents Find Each Other

This pairing is not random. It is almost magnetic, and there are specific reasons why.

The person with narcissistic tendencies is often very skilled at inducing feelings in others. They know how to show up in a way that feels intensely validating, attentive, and passionate in the early stages of a relationship. And the person who is codependent, who has a blurry sense of where they end and another person begins, who is hungry for that kind of reflected love, is going to be particularly susceptible to it.

Dr. Margines described the dynamic this way: once the narcissist has the other person hooked, the relationship becomes about maintaining control. The tool for that control is the alternating cycle of reward and withdrawal. Enormous warmth and attention, followed by criticism or coldness, followed by warmth again. The codependent person keeps working harder to get back to the warmth. The narcissist gets the validation of being the one who controls the temperature.

This is what love bombing sets up. It is not necessarily a consciously calculated scheme from the beginning. Sometimes it is genuine enthusiasm that the narcissist simply cannot sustain once they feel secure. But over time, the pattern reveals itself, and by then the codependent partner is often already in deep.

What I Shared on Air

I am going to be honest with you about something I had not spoken about publicly before this episode.

Several years ago, during a period when I was physically unwell and financially depleted, a man came into my life who felt like rescue. He was from Egypt. We moved in together almost immediately. And looking back, I can see clearly what I could not see then: I had grown up with a bipolar mother whose instability I had unconsciously translated into my nervous system as love. Chaos felt familiar. Intensity felt like connection.

He was not able to hold space for anything that was not about him. I had a panic attack on the freeway coming home from school one night, pulled over, called him hysterical, and asked him to come get me. When he arrived, he was angry. Not worried. Angry. Because my emergency had not been created by him, had not centered him, and required something from him that interrupted his plans.

When I tried to get him to take me to the hospital and he refused, I escalated. I poked. I threatened to be so loud he could not focus until he helped me. And in that moment, I was being codependent rather than resourceful. I was demanding love from someone who had shown me repeatedly that he could not offer it, instead of calling a friend or calling an ambulance.

Dr. Margines offered me something in that conversation that I genuinely needed to hear: the narcissist cannot hold emotional space for something they did not create. When something happens that is outside of them, outside of their control or authorship, it does not compute. The response is to make it about them anyway, often through anger or blame, to drag the focus back to the dynamic between you.

I had not understood that before. And understanding it changed something.

The relationship ended not because I left, but because he left for international travel once he received his citizenship. And in that window, through a combination of plant medicine, a ceremony in Joshua Tree, and a single moment of choosing differently, everything shifted. Within days I had my first coaching client, a new community, a new roommate, and more financial flow than I had seen in months.

Transformation can happen in an instant. What builds up behind it is everything.

How Narcissism Shows Up in the Bedroom

This is the part that most people do not talk about, and where I have the most direct experience from my work with clients.

The narcissistic lover often starts out feeling extraordinary. They are attentive, passionate, seemingly focused entirely on you. Early sex with someone who has strong narcissistic traits can feel like being truly seen. The issue is that over time, you begin to sense that all of it was performance. The pleasure they gave you was not about your experience. It was about their image of themselves as a great lover.

Dr. Margines put it this way: the narcissist is using sex for self-validation and self-aggrandizement. What looks like generosity in the bedroom is actually the narcissist watching themselves be generous. And once that distinction becomes visible, it is hard to unfeel.

The extractive lover, which is a term I use often in my coaching, is someone who approaches sex as a taking. What can this experience give me? How do I feel? Did I perform well? Their pleasure is the center, even when they appear to be focused on yours.

This can also manifest as men who consistently finish before their partner and simply do not seem troubled by it. I want to be careful here not to shame anyone around premature ejaculation, which is often physiological, anxiety-related, or tied to overconsumption of pornography and self-stimulation patterns. But there is a subset of men for whom the pattern is about self-centeredness rather than anxiety, and that distinction is worth naming.

On the other side, I have seen women use vibrators in a way that becomes its own form of withdrawal from genuine intimacy. Again, toys are wonderful and have a real place in healthy sexuality. The question is always about intention. Are you bringing this into a shared experience, or are you effectively checking out of one?

Before You Call Someone a Narcissist

Point your finger at someone and notice what is pointing back at you.

I rarely use the word narcissist with clients, and when people use it around me it creates a visceral discomfort in my nervous system. Not because the behavior it describes is not real, but because the label so often becomes a way to avoid looking at our own role in a dynamic.

If you grew up in a chaotic home, you may have been wired to seek intensity and mistake it for love. If you were taught that your needs were a burden, you may have learned to stay in relationships where they are consistently unmet. If you have never been shown what it looks like to have someone receive your pain without making it about themselves, you may not recognize the absence of that until you are deep inside a relationship with someone who cannot offer it.

None of this means you deserved poor treatment. It means that healing requires looking at both sides of the pattern, not just diagnosing the person who hurt you.

The Difference Between a Coach and a Therapist in This Work

Dr. Margines and I are genuinely different in our approaches, and that difference matters.

Therapists help you process what happened in the past. They hold a clinical, boundaried space for you to understand how old wounds are showing up in current patterns. Coaches help you get clear on what you want going forward and hold you accountable to creating it.

In my work, I help clients understand what they actually desire, how to communicate it, and how to stop abandoning themselves in order to keep someone else comfortable. That often includes looking at patterns around codependency, extractive dynamics, and the difference between intensity and real intimacy.

Both approaches have enormous value. For many people, the most powerful work happens when both are happening simultaneously.

For the full conversation, including our discussion of dissociative identity disorder, why taking orgasm off the table can be a powerful tool for couples, and what happened when Dr. Margines and I continued this conversation on his show Moody, find Sex Ritual Radio on KXFM and wherever you stream podcasts.

If you are ready to stop pointing fingers and start doing the work that actually changes things, private coaching with me begins at roseheartsong.com.

Rose Heartsong is a certified intimacy coach and the host of Sex Ritual Radio. She works with couples, men, and women who are ready to understand their patterns, communicate their needs, and build the kind of intimacy that actually lasts. Your heartsong is waiting.