Some might find it curious, but I really enjoy working with some of the narcissists who come into my office. They are mostly charming and engaging at the start; however, many do not last long past the “beginning-to-see-the-light” phase. It is then that the dark side of this particular personality will emerge — and it is most usually painful.

You see, when an individual with a narcissistic personality becomes threatened in some way, he will become insulting and hurtful. Therapists call this a de-valuing defense mechanism, in which the threat to the inflated ego is minimized by insulting remarks that, in effect, de-value the source of the threat. Even for a therapist, this is painful and we know what’s happening. When you’re a poor, unsuspecting spouse, partner, friend or co-worker, the sharp stab seems to come from nowhere. “What just happened?” you wonder.

Narcissists are really rather delicate souls who try to keep themselves together by a combination of grandiosity, ego inflation and sucking from an environment designed to provide enough narcissistic supplies to keep them happily ensconced in their self-absorbed existence. Mostly, they operate out of complete unawareness of their modus operandi and are often genuinely surprised when another relationship or friendship ends. Their understanding is impeded by their desperate need to be right, wonderful and faultless.

There are numerous theories as to how any personality disorder develops and what the cardinal features of those disorders entail. Google will help you if you’re interested in the origins of the syndrome, but I’m going to tell you how to survive in your relationship and encourage you to escape if you cannot. Survival is only possible if both commit to therapy and stick to it until the relationship offers more than mere survival.

A personality disorder is different from the simple, everyday neurotic issues most of us have. Some of us are generally late to appointments, or too early; many of us don’t read our mail or pay our bills on time. Some of us fear flying, the dark, snakes. Others won’t eat slimy food. We are all what would be considered normal neurotics, and we somehow plod through life earning a living and keeping ourselves clean and useful.

Those with personality disorders generally have persistent, maladaptive ways of dealing with people and the challenges of life, and they become resistant to change. Generally they don’t come to therapy under their own motivation or because they are in emotional pain like garden-variety neurotics. They come because people around them are in pain. They usually are clueless as to why they would need any help at all but are coming in to humor others valuable to their lifestyles.

An individual with true Narcissistic Personality Disorder (NPD) will likely make few emotionally internal connections that lead to changes affecting his behavior. Someone who simply has strong narcissistic traits, on the other hand, can make changes if he’s willing to do the work. And some are amenable to doing so. They learn cognitively that always focusing on their own needs and living to keep themselves feeling special is not going to work for others in their lives. They can be taught to ask, “How was your day?” and “What would you like to do this weekend?” Often they may enjoy what another wants or needs, but this interest is typically difficult for them and, therefore, short-lived. They will try, nonetheless.

The NPD? Not happening. Remember: They are egocentric and do not walk well in another’s moccasins. It is impossible for them to truly care about others’ feelings if they conflict with their own pressing needs. If you are in a relationship with someone having NPD, recognize that he believes, down to his core, that “It is all about me.” I’m not joking.

I advise that you get out of the relationship when: 1) You are regularly being verbally abused through criticism, insults and character assassination; 2) You feel you’re in a no-win spot most of the time – damned if you do and damned if you don’t; 3) Your own self-esteem has plummeted; and/or 4) You are confused about why you are always supposedly wrong.

And, most importantly, you have tried valiantly to please this person, even at times feeling ashamed at the efforts you have made to do so. You may sense that you are losing yourself, and you often feel exhausted. You begin to doubt your own perceptions about what is really happening within the relationship. For your emotional well-being, you must get away to regain your own sense of self and to analyze the relationship under no duress. After all, you have been told – likely repeatedly – that you are responsible for the problems and if only you could do what you need to do to keep the NPD feeling wonderful, all would be great.

The reality, though, is that you are not responsible, you cannot make the other better, and things would generally not be great. You will fail, again and again, because you alone can’t make another person happy. Neither can I. Each of us is in charge of our own happiness and must take responsibility for the choices we make in our lives and be willing to live with the consequences. A narcissist cannot do that.

So run like the wind.