Healthy narcissism is a term that emerged with the introduction of a set of psychotherapeutic theories and techniques referred to as psychoanalysis. The term became widespread during the late twentieth century and describes individuals who have a realistic self-esteem that does not lead to them being emotionally isolated from others, as can happen in the case of unhealthy narcissism.

Sigmund Freud believed that narcissism is a natural component of human nature that only causes dysfunctional relationships and behavior when taken to an extreme. Although Freud acknowledged how alluring narcissistic individuals could be to those around them, he did not develop the concept of healthy narcissism. In the 1930s, Paul Federn introduced the notion that the term narcissism could simply be applied to those with an adequate level of self love and in the 1970s, the concept of healthy narcissism came to the fore. Work by American psychoanalyst Heinz Kohut introduced the idea of “normal narcissism” in children and theorized that a normal degree of narcissistic entitlement in a child could lead to the development of mature and positive self-esteem, if the individual’s narcissistic needs were met during childhood.

This theory was challenged by Neville Symington, a member of the Middle Group of British Psychoanalysts. Symington argued that positive narcissism is always associated with self hatred and that it was meaningless to discuss the concept of a healthy type of self-centredness, which is at the core of narcissism.

However, the concept of healthy narcissism as a tool for achieving self assertion and success has been taken up by popular culture and it has been suggested that narcissism should be considered as a continuum, where healthy narcissism can provide an aid to achieving success at one end of the scale and pathological narcissism can lead to dysfunctional relationships and isolation.