What Is A Narcissistic Personality Disorder Therapist?

The term “narcissist” may be a buzzword these days, but experiencing the mental health condition known as narcissistic personality disorder (NPD) is often complicated and goes beyond high levels of self-absorption. People with NPD may struggle to form intimate and satisfying relationships with others and may experience consistent conflicts in their professional and social lives that impact their overall well-being.

Narcissistic personality disorder may be caused by various factors, including exposure to narcissistic traits while young or having experienced childhood trauma. Regardless of what has contributed to the development of NPD, a narcissistic personality disorder therapist may be able to deploy several therapeutic techniques that have been shown to possibly reduce the prevalence of NPD symptoms. 

What is narcissistic personality disorder (NPD)?

Narcissistic personality disorder is a mental health condition with diagnostic criteria that must be met to receive an official diagnosis. It is more than occasionally displaying narcissistic tendencies such as self-centeredness or being dismissive of others’ feelings. Narcissistic personality disorder can cause high levels of conflict in families and other close relationships, marriages, social settings, and workplaces.  

People with NPD may demonstrate a variety of symptoms that heighten the possibility of unhealthy narcissistic relationships in their lives and, in significant cases, perpetrate narcissistic abuse. 

Common NPD symptoms

• Self-enhancement and self-centeredness
• Arrogance
• Fantasizing about or, in extreme cases, believing they are destined to experience success, perfect romantic love, beauty, power, brilliance, etc. 
• Low self-esteem (this symptom may appear to be in contrast with the symptoms listed above, but a paradox of NPD is often that the person with the disorder outwardly appears to think highly of themselves but inwardly experiences deep insecurity)
• Hypersensitivity, particularly to criticisms, failures, perceived humiliations, or “defeats,” and a tendency to avoid situations that may result in those outcomes
• Craving attention and admiration from others
• Lack of ability to regulate emotions, particularly frustration
• Higher likelihood of developing other personality disorders, such as borderline personality disorder
• Higher likelihood of developing mood disorders, such as depression or bipolar disorder
• Lack of sensitivity to other people’s needs
• Decreased ability to collaborate
• Problems with commitment or forming close relationships with other people
• Constant desire for competition or acting competitive in inappropriate ways 
• Frequently criticizing other people or comparing them unfavorably to oneself
• Tendency to take advantage of others to achieve their own goals, a belief that “the ends justify the means”
• Acting patronizing, condescending, or “snobby” to those they believe are beneath them
• Frequently lying or misrepresenting the truth
• Antagonistic or provocative behavior
• Manipulating or exploiting others

How a narcissistic personality disorder therapist may help

NPD cannot necessarily be cured, but several treatment methods may help mitigate the symptoms. One of the most successful forms of narcissistic personality disorder treatment can be talk therapy with a mental health professional.

People with NPD may be unlikely to seek therapy of their own volition, as one of the hallmarks of the disorder is a lack of self-awareness or a belief that one can do no wrong. As a result, people with NPD may have their first exposure to counseling via a family therapist because of persistent challenging family dynamics. If they do seek individual therapy, it may be because their family members have requested they do so. Regardless of what has led a person with NPD to therapy, they may use several therapeutic treatments that have shown to be effective in many cases.

Psychodynamic psychotherapy

Psychodynamic psychotherapy is considered to be one of the most effective treatment methods for most personality disorders, including narcissistic personality disorder. Its primary focus is usually to help the client understand patterns in their interpersonal relationships and overall functioning. 

A narcissistic personality disorder therapist employing psychodynamic psychotherapy may work with their client to address any avoidance of emotions or past and present experiences that may be contributing to unhelpful behavior patterns. 

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy is one of the most common treatments for various mental health conditions. It often explores the link between a person’s thoughts and behaviors, based on the belief that changing unhealthy thought patterns can lead to behavioral change and an overall improvement in a person’s well-being. 

Cognitive behavioral therapy may not be helpful for everyone with NPD. Still, it might make a difference for those who may find greater control of their thoughts and behaviors to be beneficial. Core tenets of cognitive behavioral therapy that may make a difference for someone with NPD include validation, psychoeducation, and identifying and addressing target behaviors to potentially modify.

Transference-focused psychotherapy (TFP)

Transference-focused psychotherapy typically emphasizes reflection and increasing a client’s understanding of their internal states and the ways these states may impact how they interact with others. 

With TFP, a therapist may help clients develop perspective-taking and emotional regulation skills, which can address NPD symptoms such as shame, inferiority, envy, humiliation, entitlement, defensiveness, grandiosity, and aggression.

Schema-focused therapy

Like cognitive behavioral therapy, schema-focused therapy is often used to treat various mental health conditions. It focuses on schemas, defined as thoughts and behavior patterns learned at a young age. Because schemas are often ingrained, people can be unaware of such patterns and how they may affect their lives.

Schema-focused therapy may benefit people with narcissistic personality disorder, as current research understands the disorder to potentially develop based on early childhood experiences. Schema-focused therapy for NPD often focuses on several cognitive distortions associated with narcissistic thinking, such as perfectionism; the idea that one is devalued by others; and a rigid, unchanging, “black and white” sense of the world. 

Finding support for narcissistic personality disorder

If you believe you may be experiencing narcissistic personality disorder, finding a therapist skilled in treatments that specifically address your symptoms may be beneficial. Because the therapist-client relationship is often particularly integral in treating NPD, you may consider online therapy options, which might give you a wider range of therapist options to select from and a relatively convenient transfer process if your initial therapist ends up not being the best fit for you.

Research demonstrates that online therapy may be just as effective as traditional in-person therapy for treating a range of mental health conditions, including personality disorders. One study found that online delivery of cognitive behavioral therapy, one of the most common treatments for NPD, resulted in “high patient satisfaction.”