Why People Talk About Themselves. Conversational Narcissism, ADHD and Autism Can Look Alike.
Answering someone's worry with a story about yourself is what sociologist Charles Derber called a shift-response. It can come from a bid for attention, ADHD impulsivity or an autistic way of connecting, and one exchange cannot tell you which.
Idea in Brief
The Pattern
Turning someone's concern into a story about yourself is a shift-response, a term from sociologist Charles Derber's work on conversational narcissism.
The Lookalikes
The same move can reflect a habit of seeking attention, ADHD-related impulsivity or an autistic way of showing understanding through a parallel experience.
The Caution
Traits vary widely between individuals. A conversational habit is not narcissistic personality disorder, and no single behavior supports a diagnosis.
When a conversation turns into a monologue, the usual verdict is quick: this person is self-centered. Clinicians make that call all day, about patients, families and colleagues, often under time pressure.
Talking about oneself is not one behavior, though. The same move, answering someone's concern with a story about yourself, can come from a bid for attention, from impulsivity of the kind seen in ADHD or from a way of connecting that many autistic people describe. Those traits vary widely from person to person, and none of them can be identified from a single exchange. Below, one conversation is played three ways.
A note on the examples: the speakers below are illustrative composites written for this article, not real people or patients, and the dialogue is invented.
The baseline
Illustrative. Maya says: “I've been so stressed lately. My team at work is restructuring, and I'm genuinely worried about whether my role is safe.” Here is how three different people might answer.
Scenario 1: the shift-response
Illustrative. Derek: “Oh, tell me about it. Honestly, you're lucky. At my company I'm the one restructuring the whole department. Upper management relies on me so much that I barely have time to breathe. Did I tell you about my board presentation on Tuesday?”
Sociologist Charles Derber described this pattern as “conversational narcissism” in his book The Pursuit of Attention. He distinguished the support-response, which keeps attention on the speaker and the topic they raised, from the shift-response, which moves attention to the responder. Derek uses Maya's worry as a springboard to talk about his own status.
Two cautions apply. Derber described a conversational habit, common and often unconscious, not narcissistic personality disorder, a clinical diagnosis no one can make from small talk. And Derek's motive is not visible. A shift-response can come from wanting status, but also from anxiety or habit. What is visible is the effect: Maya's concern drops out of the conversation.
Clinical Pearls
- Derber's support-response keeps attention on the speaker's topic; a shift-response moves it to the responder.
- Conversational narcissism describes a common habit, not narcissistic personality disorder.
- DSM-5 lists talking excessively, blurting out answers and interrupting or intruding among ADHD hyperactivity-impulsivity symptoms.
- The double empathy problem frames autistic communication difficulty as two-way rather than a one-sided deficit.
- A 2020 study found mixed autistic and non-autistic chains lost detail faster; a 2025 replication with 311 participants did not find that gap.
- How someone responds to clear redirection is a useful clue, not a diagnosis.
Scenario 2: the rush of associations
Illustrative. Sam: “Restructuring is the worst! Wait, that reminds me, did you read about that company that laid off 500 people on a video call? And my cousin went through a restructure last year and got a big severance package. You should negotiate yours if it comes to that. Sorry, I just blurted all of that out. How are you actually feeling about your team?”
Talking excessively, interrupting and blurting are part of how ADHD is defined. The National Institute of Mental Health lists talking excessively among signs of hyperactivity and interrupting or intruding on others among signs of impulsivity, and notes that symptoms usually continue into adulthood. The DSM-5 criteria, as reproduced by Nora Volkow and James Swanson in the New England Journal of Medicine, include “often blurts out an answer before a question has been completed,” with examples such as finishing other people's sentences and being unable to wait for a turn in conversation.
In this composite, Sam means to help, then notices the takeover and hands the conversation back. That arc is not guaranteed. Some people with ADHD catch themselves, many do not in the moment, and plenty of people without ADHD talk this way when excited or tired. The self-correction is a feature of this example, not a diagnostic sign.
The same sentence can come from a bid for attention, a rush of associations or an attempt to show understanding. One exchange cannot tell you which, and it cannot tell you anyone's diagnosis.
Scenario 3: sharing a parallel experience
Illustrative. Alex: “In 2022 my department went through a restructure. I spent four weeks not knowing if my job existed, and my resting heart rate was ten beats higher than normal every day. I saved three months of living expenses and made a spreadsheet of my daily tasks to show HR. It was very uncomfortable.”
Many autistic adults describe answering someone's difficulty with a closely matching experience of their own as a way of saying “I understand.” That is a common self-description, not a universal rule, and peer-reviewed research testing it directly is limited. Related research is consistent with it. Damian Milton's “double empathy problem” reframes autistic social difficulty as a two-way problem of reciprocity between autistic and non-autistic people rather than a one-sided deficit. In a 2019 study in Autism, Brett Heasman and Alex Gillespie recorded 30 autistic adults playing collaborative video games and found that a “generous assumption of common ground” could build rapport quickly when the partner shared it but could appear egocentric to an outside observer when it did not.
The experimental evidence is mixed. Catherine Crompton and colleagues tested information passed along chains of eight people (n = 72) in 2020 and found that autistic chains retained detail as well as non-autistic chains, while mixed chains lost detail faster and reported lower rapport. A larger registered replication in Nature Human Behaviour (N = 311) in 2025 again found autistic chains communicated as effectively as non-autistic ones, but found no extra loss in mixed chains; non-autistic chains reported higher rapport, and disclosing diagnosis improved rapport. The fair summary: autistic people share information effectively with each other, and how mixed conversations go is still being worked out.
If Maya says she just needs to vent, Alex may well adjust. Some autistic people find an explicit request easier to act on than a hint, but individuals differ.
Comparing the three patterns
In these examples the motives differ: attention or standing for Derek, excitement and thinking out loud for Sam, connection and useful information for Alex. So does the flow. Derek steers back to himself and asks no real question; Sam hops between topics; Alex offers a detailed, concrete parallel with some problem-solving.
The response to redirection is the most useful clue, and still only a clue. Derek brushes the concern aside, Sam apologizes and asks about Maya, and Alex responds to a clear statement of what she needs. Real people do not sort this neatly, and how much someone cares cannot be read reliably from one exchange.
What it means in clinic
These patterns show up across the desk. A patient who answers a symptom question with a long story about a relative's illness may be anxious, may have ADHD, may be autistic and offering what feels like relevant context, or may simply need to be heard. A colleague who turns every case discussion to their own experience may be showing insecurity, habit or a different style. None of this is grounds to label or diagnose. It is a reason to ask one more question before deciding someone is not listening.
Respond to the pattern, not a presumed diagnosis. When someone keeps shifting the spotlight, short answers and a firm return to the agenda beat competing for airtime. When someone is racing through associations, a warm interruption (“Hold that thought, let me finish this so I don't lose it”) keeps the exchange balanced without shaming them. When someone answers with a parallel story, saying plainly what you need (“I just need to vent, not advice right now”) tends to help. The same tools carry over to clinical communication; see our pieces on communicating risk in ways patients understand and giving hard feedback to a physician peer.
Reported, fact-checked and edited by The Script Pad's editorial staff.
This article is for professional education and does not replace clinical judgment. Treatment decisions should be based on the individual patient and current guidelines.
