Insight into Treatments for Narcissistic Personality Disorder

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Why Do Narcissists Need Treatment?

People with narcissistic personality disorder (NPD) have a great and constant need to be indulged, admired and respected but have no empathy for others in their life. Aside from their own benefit, they do not care about others’ feelings, and can take advantage or even abuse others. Because of these their relationships suffer, and they may even experience repercussions in their jobs.

NPD people are usually involved in failed marriages, broken families, and cannot hold jobs that require submission to authority. Their friends and families may ask them to seek professional help to save their marriage, their family and their job. However, because of their condition they do not accept that there is something wrong with them and they may often put the blame on others. Sometimes it will take a tragedy or a serious event in their life to push them to finally seek help.

Treatments for Narcissistic Personality Disorder

Pharmacologic Treatment

There is no definitive pharmacologic treatment for narcissistic personality disorder. However, symptoms of depression or anxiety may be treated with antidepressants like selective serotonin reuptake inhibitors, or SSRIs. Other symptoms like insomnia may be treated with anxiolytics and sedatives. Those who suffer from mood swings, irritability and agitation may be given mood stabilizers by their physicians.

Even if NPD is a life-long disorder, pharmacologic treatments may not be given as they can result in increased aggression, impulsive behavior and grandiosity when the symptoms of depression subside.


Psychoanalysis and psychotherapy are the usual modes of treatment for narcissistic personality disorder. Psychotherapy, talk therapy or counseling are helpful but do not aim to cure the patient with the personality disorder. The goals of treatment are modest, in that they are geared towards better self understanding and acceptance rather than a radical change in one’s personality.

Psychotherapy for NPD may be used alone or in combination with the use of medications to relieve symptoms of anxiety, depression and mood swings. It is usually conducted in a clinic, office or hospital, and takes about 45-60 minutes per session.

With the help of a psychotherapist, a psychiatrist or other mental health practitioner a patient can be guided to:

  • Understand the condition and the external factors that may have brought it about, such as family history, childhood experiences, etc
  • Talk about internal conflicts and explore painful feelings and experiences
  • Relieve anxiety and stress by learning stress management techniques
  • Resolve conflicts, especially with family members and coworkers
  • Cope with major problems like divorce or job-related situations
  • Learn to manage reactions, control impulses and empathize with others

The NPD person with a feeling of grandiosity may look upon the therapist as inadequate, so that a barrier of distrust may be present. The therapist in turn has the burden of showing empathy to the patient until he or she can break through these barriers and allow the vulnerable patient to finally open up.

Psychotherapy for NPD: Techniques

There are different forms of psychotherapy depending on the need and preferences of the patient and counselor:

Cognitive behavioral therapy – explores the patient’s unhealthy feelings, attitudes and behaviors and helps replace them with more positive and acceptable forms.

Family therapy – involves the patient’s family members who are brought together during sessions to foster better communication, discuss feelings and resolve conflicts.

Group therapy – the individual joins a group of people with similar conflicts and shares life experiences. This helps to person with NPD to empathize and relate to others who can in turn support them.

The techniques used in the treatment of narcissistic personality disorder help the afflicted individual to learn more about their own self and to accept the realities of their weaknesses and limitations. They are also taught to listen to others while learning to trust them. However, the process may take a long time and may not be completely successful because of deep-seated feelings of inadequacy relieved only by expressions of self-importance.


Encyclopedia of Mental Disorders,“Narcissistic Personality Disorder” accessed 1/5/11

Mayo Clinic, “Narcissistic Personality Disorder” accessed 1/5/11