Therapy For Narcissistic Personality Disorder
- For those experiencing suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline at 988
- For those experiencing abuse, please contact the Domestic Violence Hotline at 1-800-799-SAFE (7233)
- For those experiencing substance use, please contact SAMHSA National Helpline at 1-800-662-4357
Understanding Narcissistic Personality Disorder
You may have heard the term “narcissist” used to describe someone who is excessively vain or arrogant, but clinical narcissism goes beyond just being self-centered. Narcissistic personality disorder (NPD) is a mental health condition that can have serious impacts, both on those who are living with it and their loved ones. In this article, we will explore the key narcissistic personality disorder symptoms, different types of therapy that can be used for treating NPD, and how therapy can serve as a treatment and help those with NPD improve their relationships and develop a healthy sense of self-esteem.
DSM-V definition of narcissistic personality disorder
Symptoms of narcissistic personality disorder
It is important to note that not everyone who exhibits narcissistic tendencies has narcissistic personality disorder. Almost everyone experiences difficult feelings such as jealousy and frustration when things don’t turn out as planned, and many people’s outward expressions of self-centered behaviors may stem from strong self-criticism. That being said, it is important to learn to recognize and treat NPD to improve these people’s quality of life and their relationships with others.
NPD may present as a sense of excessive superiority, often accompanied by problems interacting with others. Those with NPD may see other people more as a means of getting what they want, which can lead to conflict—especially with friends and family members.
Some of the symptoms of narcissistic personality disorder include the following narcissistic traits:
- An inflated sense of self-importance (also called a grandiose sense of self) is one symptom of narcissistic personality disorder
- Frequent thoughts of being perceived as “better” than others can be a characteristic of narcissistic personality disorder
- A sense of entitlement to favorable treatment or special favors
- Taking advantage of others to increase personal gain
- Envy of others
- Someone with narcissistic personality disorder has a lack of understanding of the needs and feelings of others
NPD and feelings of insecurity and low self-esteem
Conversely, NPD may also be associated with secret feelings of insecurity or low self-esteem (about both physical appearance and personality traits) as well as trouble with personal relationships. It is not uncommon for people with NPD to have coexisting mental health conditions such as depression, bipolar disorder, or substance use disorders.
According to the American Journal of Psychiatry, These conflicting symptoms can make it hard to get narcissistic personality disorder diagnosed, as other mood and personality disorders can present similar symptoms. It’s usually best to contact a mental health professional for an official diagnosis if you are looking to seek treatment.
The best therapy for narcissistic personality disorder
Like other personality disorders, NPD is a mental health condition that can cause significant distress to both those who have it and the people in their lives. That being said, it is possible to treat NPD with the help of psychotherapy.
Currently, there are no medications specifically designed to treat NPD, that said, there are a variety of options available for treating NPD, including therapy for narcissistic personality disorder. In cases where NPD is accompanied by another mental health condition, like depression or anxiety, medication may be useful in treating the symptoms of those conditions. However, psychotherapy and counseling (particularly individual therapy) remain the primary treatment to address the symptoms of narcissistic personality disorder.
Several types of treatment exist that may help those with NPD improve their self-esteem and learn to connect with others in a healthier, more constructive way. This is because, as with other medical conditions, not every person with NPD is going to respond well to the same treatment. It is better to consult a licensed therapist to know the right psychotherapy that is suited for the condition.
Different types of therapy for NPD
Therapy may be given in an individual or group therapy format. The types of therapy for narcissistic personality disorder include:
Schema therapy
The goal of schema therapy is to identify and change “schemas,” or negative feelings around traumatic events and thoughts, that may be causing a person distress. Schema therapy is a modality that has similarities with cognitive behavioral therapy, or CBT.
Transference-focused psychotherapy (TFP) for narcissistic personality disorder
Transference-focused psychotherapy concentrates on the therapeutic relationship between an individual and their therapist, with the goal of improving behavior and communication. During this therapy a person may direct their own feelings and emotional distress towards a therapist. Doing this type of psychotherapy enables a person with NPD to practice emotional control and may improve relationship skills.
Gestalt counseling
Mentalization-based counseling
Also known as MBT, this is a form of counseling focused on understanding one’s mental state and how it can influence behavior and perception. It may focus on relaxation techniques and distress tolerance.
Metacognitive interpersonal therapy
Metacognitive interpersonal therapy focuses on helping an individual better understand how they view their thoughts and ways of thinking and interpersonal effectiveness skills. Metacognitive interpersonal therapy (MIT) works by dismantling narcissistic thought patterns at their base by improving a patient’s access to their “inner states” or the emotional and mental states that lead to these patterns. It generally works toward being able to recognize, pause, and restructure these patterns for a healthier worldview. Undertaking metacognitive interpersonal therapy requires regular supervision by a mental health professional.
Eye movement desensitization and reprocessing therapy
Eye Movement Desensitization and Reprocessing therapy, also called EMDR, is a psychotherapeutic approach primarily designed to alleviate distress associated with traumatic memories. EMDR therapy is commonly used for individuals who have experienced trauma, such as post-traumatic stress disorder (PTSD). While EMDR is not a primary treatment for personality disorders like Narcissistic Personality Disorder (NPD), it may be used by a mental health provider to indirectly impact certain symptoms or issues related to trauma.
Dialectical behavior therapy for narcissism
Dialectical-behavioral therapy, also known as DBT, this modality concentrates on helping individuals manage their emotions and improve their behaviors while learning to accept challenging situations with realistic expectations for their outcomes. DBT is based on cognitive behavioral therapy, CBT, and it’s also a common option for borderline personality disorder. Sessions for dialectical behavior therapy (DBT) may focus on changing certain traits and maladaptive patterns using healthy coping mechanisms to build better interpersonal relationships and increase healthy thought patterns.
Like other personality and mental conditions, the best NPD treatment will vary from person to person. If you are seeking treatment to help with NPD, your mental health professional may recommend a range of approaches depending on your individual needs, background, and situation.
How therapy for narcissistic personality disorder can help loved ones
Narcissistic personality disorder doesn’t just affect those who experience it; it can also immensely impact that person’s friends and family. Loved ones may feel isolated or taken advantage of by those with NPD. They may experience narcissistic abuse, frustration, anger, and distress at the person’s perceived lack of empathy or compassion. In fact, a 2021 study found a 69% rate of depression and an 82% rate of anxiety among those who were living with someone with NPD.
Counseling may also be beneficial in helping the loved ones of individuals who develop NPD to cope with these and other mental health and emotional impacts. For situations in which a loved one’s NPD has led to symptoms of anxiety and depression, which can make leaving the house difficult, it may be beneficial to seek treatment online. In general, the cost of traditional in-person talk therapy can range anywhere from $100 to $200 per session without insurance, whereas online therapy may cost about $20 to $90, depending on the platform that you pick. Through a platform like BetterHelp, individuals who seek therapy can attend sessions from the comfort of their own homes. Online therapy prices with BetterHelp can range from $65 to $100 per week and $260-$400 for monthly billing.
Efficacy of online counseling
Online counseling has been found to be an effective alternative to in-person counseling when it comes to treating symptoms of depression, anxiety, and various other mental health conditions. A study from 2013 found that an internet-based intervention for depression was “equally beneficial to regular face-to-face therapy.”
Whether you seek help in person or online, counseling can be an invaluable tool for helping the friends and family of those with NPD navigate their loved one’s condition, gaining support, and developing constructive coping skills.
Takeaway
Treating narcissistic personality disorder: Can counseling help a person with narcissistic personality disorder change?
Yes, while it’s not successful in all instances, therapy can help a person with NPD gain insight and cultivate healthier relationships. Individuals with NPD will be able to learn more about themselves and others with the help of psychotherapy.
Understanding narcissistic personality disorder: What is the root cause of narcissism?
Narcissistic personality disorder is recognized by the American Psychiatric Association's Diagnostic and Statistical Manual as a mental health disorder. Researchers do not know the exact cause of NPD, but key factors likely include a combination of early life experiences and genetic factors. Narcissists care immensely about people seeing them positively, which is different from antisocial personality disorder, in which people don’t care how others see them. In order to be diagnosed with NPD, a person must meet nine criteria. These include lack of empathy, grandiosity, difficulty with attachment in relationships, and excessive need for admiration, among others.
Therapy for narcissism: Can someone with narcissistic personality disorder be treated with therapy?
Yes, a treatment plan that includes psychotherapy can help a person with NPD learn emotional regulation and increase self-awareness. However, even with psychotherapy, certain symptoms can make people with NPD difficult to treat. Haughty behaviors can hinder the therapeutic relationship, and unwillingness or inability to engage in self-reflection can hinder the therapeutic process. Also, because people with NPD have fragile ego structures, questions the therapist might ask might challenge a person's sense of self-worth and either make them defensive or try to please the therapist. Severe NPD, sometimes called malignant narcissism or sociopathy, is very difficult to treat.
What type of treatment is most effective for narcissistic personality disorder?
Once a person has received a formal diagnosis, talk therapy is often used to treat narcissistic personality disorder. The therapist may choose to use a specific therapy modality such as cognitive behavioral therapy or dialectical behavioral therapy during therapy sessions. They may discuss interpersonal relationships or early childhood experiences in psychotherapy sessions. In some cases, medication such as mood stabilizers or antipsychotic medications can be helpful too.
What is the most effective way to help someone with narcissistic personality disorder?
The best way to help someone with NPD is to encourage them to see a therapist. They may resist, since they may not believe they need therapy and may have a deep fear of being vulnerable. However, only a qualified mental health professional can help them with therapeutic interventions and diagnosing narcissistic personality disorder. Be kind and clear, but be sure to set boundaries for yourself when talking to them.
What happens to a person with narcissistic personality disorder in counseling?
During narcissistic personality disorder treatment mental health professionals will engage a person with NPD with techniques designed to help them become more self-aware and modify their behaviors. However, a person with NPD may not be totally responsive to the therapist’s interventions, sometimes becoming angry, not taking responsibility, or dropping out of counseling altogether. Here are some of the things that happen during treatment for NPD:
- During psychotherapy and treatment, the therapist identifies narcissistic behaviors. Treatment helps individuals recognize behaviors that are causing problems and distress in their lives.
- Treatment for narcissistic personality disorder can help individuals understand their emotions. Through therapy and treatment, people with narcissistic personality disorder can learn the causes of their emotions and what triggers and drives their actions.
- Individuals with narcissistic personality disorder must seek treatment to help them gain emotional intelligence, learn how to empathize with others, and develop behaviors that are positive through therapy.
Understanding narcissistic personality disorder: What are coping mechanisms of a narcissist?
Narcissists use a number of coping mechanisms to protect their sense of self-worth. These coping mechanisms may include putting others down to elevate themselves, playing the victim and blaming others for their mistakes and shortcomings, and distorting facts to suit their positive view of themselves, as well as lying, gaslighting, and manipulating others to gain control. With the help of psychotherapy, the therapist will be able to identify these coping mechanisms, helping the individual to adapt to healthy ones.
Can a person with NPD love someone else?
A person with NPD can have feelings of love for another person, but their love is often superficial and conditional.
Does a narcissist know they are a narcissist?
Some narcissists know that they are narcissistic, while others remain unaware or deny the fact if they are made aware of it.
Narcissistic personality disorder impact: Can a narcissist ever live a normal life?
While change can be challenging for a narcissist, it is possible, with therapeutic help, for a narcissist to change and lead a more normal life. A trained therapist can help individuals live a normal life with the right psychotherapy.
How do narcissists affect the mental health of the people around them?
Being involved with a narcissist can negatively affect one's mental health. Narcissistic behaviors affect others by making them feel disrespected and diminished, and often by making them lose confidence in their own abilities, feelings, and ideas. If you have a narcissist in your life, it is important to maintain healthy boundaries. You may also seek psychotherapy if you feel like your mental health has been affected by dealing with a narcissist.
How to help a narcissist heal?
If you know someone who is a narcissist, and you want to help them heal or manage their narcissistic tendencies, there are a few things that you can consider doing:
- Learn more about narcissistic personality disorder. Know the signs, symptoms, causes, and treatment of narcissistic personality disorder. Also, learn the subtypes of narcissistic personality disorder, and whether the individual involved is willing to change or not.
- After understanding the signs of narcissistic personality disorder, it’s time to build healthy boundaries and limits with a narcissist.
- Understand that people with narcissistic personality disorder must be held accountable for their actions, especially if it already affects other people.
- Empathize with people with narcissistic personality disorder, and try to put yourself in their shoes. There must be an underlying reason why these individuals formed narcissistic personality disorder. Understand that NPD is a mental health condition that needs treatment. Generally, treatment for NPD involves psychotherapy, or talking with a therapist.
- Support people with narcissistic personality disorder as they seek the proper treatment and therapy. Encourage them to seek treatment for NPD and other mental health conditions associated with it.
Is narcissism a mental illness?
Yes, narcissistic personality disorder is a mental health condition that affects one’s identity and the way they treat themselves and other people. The treatment for NPD usually involves psychotherapy or talking to a therapist. There are many types of therapy available for the treatment of NPD.
How long does a narcissist need therapy?
Therapy for narcissistic personality disorder is usually long-term and might take years since therapy is a complex process and the individual must attend sessions consistently for their treatment.
Can a narcissist heal without therapy?
Narcissistic personality disorder is a lifelong condition that has no cure, but it can be treated with the use of therapy. However, individuals with NPD will have a hard time changing their behaviors without the help of therapy. Psychotherapy is the primary treatment for NPD.
- Previous Article
- Next Article