If you’ve ever researched narcissism to understand someone in your life, you’ve likely encountered the common belief that narcissists are irredeemable. However, this viewpoint oversimplifies the complexity of narcissistic personality disorder (NPD). While many narcissists lack the desire to change, it’s not impossible for them to do so with the right motivation and support. 

Narcissists often display grandiose behavior, low empathy, and an incessant need for admiration. These traits are deeply ingrained but not necessarily permanent. In fact, some studies suggest that narcissistic tendencies can naturally diminish with age. But if you’re not willing to wait for time to take its course, understanding the potential for change and how to facilitate it is crucial. 

Narcissism Defined 

In today’s culture, “narcissist” is often thrown around to describe anyone who is vain or self-centered. In psychological terms, however, narcissism goes beyond mere self-love. Narcissists are enamored with an idealized version of themselves, which helps them avoid confronting deep-seated insecurities. Maintaining this grandiose self-image requires considerable effort, often resulting in dysfunctional behaviors and attitudes. 

Narcissists are characterized by patterns of arrogant, self-centered thinking and behavior, a lack of empathy for others, and an intense need for admiration. They are often manipulative, patronizing, demanding, and selfish. Their behavior impacts all areas of their life, from friendships to work and family to romantic relationships. Despite these traits, change is possible if the narcissist is willing to engage in self-reflection and therapy. 

Recognizing a Narcissist 

Here are key signs that someone in your life may be a narcissist and some scenarios of the behavior in action: 

Grandiosity: Narcissists believe they are superior and can only be understood by other special people. They exaggerate their achievements and talents and expect to be recognized as exceptional, regardless of their actual accomplishments. 

Scenario: Imagine your teen boasts incessantly about their minor achievements, expecting constant praise. Instead of criticizing them, try gently bringing them back to reality: “I’m proud of what you’ve done, but let’s remember that everyone contributes in their own way.” 

Fantasy World: To support their inflated self-image, narcissists create a world of fantasy filled with self-deception and magical thinking. They react defensively to any facts or opinions that threaten their delusions. 

Scenario: If your young adult child dismisses constructive feedback, validate their feelings while gently challenging their distortions: “I understand you see it that way, but could there be another perspective to consider?” 

Need for Admiration: Narcissists require constant admiration to maintain their sense of superiority. Relationships with them are often one-sided, focusing on how others can serve their needs. 

Scenario: Your partner constantly seeks validation and becomes upset when they don’t receive it. Encourage open communication: “I see you’re feeling unappreciated. Let’s talk about how we can better support each other.” 

Sense of Entitlement: Narcissists expect special treatment and compliance with their wishes. They react with outrage if others fail to meet their demands or ask for anything in return. 

Scenario: Your sibling demands preferential treatment and reacts angrily when it’s not given. Establish boundaries respectfully: “I care about you, but it’s important we all respect each other’s needs and boundaries.” 

Exploitation: Narcissists often exploit others without shame or guilt, viewing people as tools to serve their own needs. 

Scenario: If your friend frequently takes advantage of you, assert your boundaries: “I’m happy to help sometimes, but I also need your support when I’m in need.” 

Bullying and Intimidation: Feeling threatened by others’ success or confidence, narcissists may demean or bully to prop up their own ego. 

Scenario: Your colleague belittles others’ achievements to feel superior. Promote a positive environment by praising colleagues openly and encouraging collaborative success. 

Can Narcissists Change? 

Change is possible, but it requires the narcissist’s willingness to work on themselves. Here are indicators that a narcissist might be open to change: 

Acknowledging Others’ Feelings: Some narcissists can develop empathy if motivated by the experiences of valued individuals. 

Scenario: Your partner shows genuine concern for your feelings after you’ve expressed how their behavior affects you. Encourage this empathy: “I appreciate you listening and understanding how I feel.” 

Interest in Their Own Behavior: A narcissist might start questioning their actions after reading about NPD or receiving feedback. 

Scenario: Your friend starts asking why they behave in certain ways. Support their curiosity: “It’s great you’re reflecting on this. Maybe talking to a therapist could help you understand it better.” 

Self-Reflection: Narcissists struggle with self-reflection, but if they can examine their behavior without lashing out, they might be ready for therapy. 

Scenario: Your sibling recognizes their defensive reactions and is open to discussing them. Validate their efforts: “It’s brave of you to look at this. Let’s find ways to work through it together.” 

Co-existing Disorders: Narcissists often seek therapy for other issues like anxiety or depression, which can open the door to addressing narcissism. 

Scenario: Your partner seeks help for anxiety and starts recognizing narcissistic traits. Encourage comprehensive treatment: “Addressing all aspects of your well-being can lead to greater improvements.” 

Treatment for Narcissistic Personality Disorder (NPD) 

Effective treatment for NPD typically involves psychotherapy with a specialist, preferably in a residential setting. Key therapeutic approaches include: 

Identifying Defense Mechanisms: Understanding and challenging the behaviors that protect their grandiose self-image. 

Learning New Behaviors: Practicing healthier ways of relating to others. 

Exploring Behavioral Impacts: Recognizing how their actions affect others and developing empathy. 

Connecting Internal Voices: Linking their self-critical inner voice to their outward behavior and learning to manage it. 

However, evidence-based therapies have shown promise in managing and treating NPD. The primary therapeutic approaches include: 

1. Cognitive Behavioral Therapy (CBT) 

CBT is a widely used therapy for various mental health disorders, including NPD. This approach focuses on identifying and challenging distorted thinking patterns and behaviors. CBT helps individuals with NPD: 

• Recognize and alter dysfunctional beliefs and attitudes. 
• Develop healthier thinking patterns. 
• Improve emotional regulation. 
• Enhance empathy and interpersonal skills. 

2. Schema Therapy 

Schema therapy combines elements of CBT, psychoanalysis, and attachment theory. It is particularly effective for personality disorders. Schema therapy aims to: 

• Identify and address maladaptive schemas (deeply ingrained patterns of thought and behavior). 
• Develop healthier coping mechanisms. 
• Foster emotional healing by addressing unmet needs from childhood. 

3. Dialectical Behavior Therapy (DBT) 

Originally developed for Borderline Personality Disorder, DBT has been adapted for NPD. DBT focuses on: 

• Mindfulness: Encouraging present-moment awareness and acceptance. 
• Distress Tolerance: Building resilience to stress. 
• Emotional Regulation: Managing intense emotions effectively. 
• Interpersonal Effectiveness: Improving relationship skills and empathy. 

4. Psychodynamic Therapy 

Psychodynamic therapy explores the unconscious processes and how past experiences shape current behavior. For NPD, this therapy aims to: 

• Understand the root causes of narcissistic behavior. 
• Explore unresolved conflicts and traumas. 
• Foster insight into how past experiences influence present behavior. 
• Develop healthier self-perceptions and relationships. 

5. Transference-Focused Psychotherapy (TFP) 

TFP is a type of psychodynamic therapy specifically designed for personality disorders. It focuses on the relationship between the therapist and the patient to understand and change problematic interpersonal patterns. Key aspects include: 

• Addressing issues that arise in the therapist-patient relationship. 
• Using these dynamics as a microcosm for understanding the patient’s relationships outside therapy. 
• Enhancing self-awareness and emotional understanding. 

6. Mentalization-Based Therapy (MBT) 

MBT helps individuals with NPD improve their ability to understand their own and others’ mental states. This therapy focuses on: 

• Enhancing the capacity to mentalize (understand the thoughts, feelings, and intentions behind behavior). 
• Improving emotional regulation. 
• Strengthening interpersonal relationships. 

7. Group Therapy 

Group therapy can be beneficial for individuals with NPD as it provides opportunities to practice interpersonal skills and receive feedback in a supportive environment. Benefits include: 

• Learning from the experiences of others. 
• Developing empathy and social skills. 
• Gaining insights from group interactions. 
• Combination of Approaches 

Given the complexity of NPD, a combination of therapeutic approaches is often recommended. This integrated approach can address the diverse aspects of the disorder more effectively. 

Supporting a Narcissist in Therapy 

Supporting a narcissist through therapy is important to their health development and involves: 

Validation and Encouragement: Praise their efforts to change to motivate them further. 

Recognizing Progress: Acknowledge small steps towards improvement, even if some problematic behaviors persist. 

Understanding Apologies: Accept that their way of making amends might not involve direct apologies but actions that show they care. 

Taking the Next Step 

If someone in your life shows signs of narcissism, encouraging them to seek help is crucial. While most narcissists resist admitting they have a problem, those willing to get help can benefit from psychotherapy and, in some cases, medication. Residential treatment programs, like those offered by The Meadowglade, provide comprehensive support to help narcissists develop healthier relationships and greater emotional intelligence. Success depends on the individual’s willingness to engage in therapy and the skill of the therapist in addressing the unique challenges of NPD. 

Change is challenging and requires effort and commitment, but with the right support, even deeply ingrained narcissistic behaviors can improve. If you or someone you love needs help, reach out to The Meadowglade for more information on how we can assist. 

By understanding and addressing narcissistic behaviors compassionately and constructively, we can foster healthier interactions and support positive change.