Can A Narcissist Change With Therapy Sessions?

What is Narcissist Personality Disorder?

NPD is a personality disorder that affects a person’s sense of self and how they treat others. It is more than being self-centered, manipulative, egotistical, arrogant, or selfish. Those are traits anyone can have and do not define a personality disorder. Narcissist Personality Disorder runs deeper and affects all aspects of self. Often, people with NPD don’t see anything wrong with their behavior, making it a very difficult disorder to treat. 

Externally, a person with NPD will present very confidently, often using others to elevate their status. Symptoms of NPD include:

• Grandiose sense of self-importance
• Believing they deserve success, power, love, beauty, and other highly valued qualities.
• Thinking they are unique or superior 
• Preoccupation with what others think
• Sense of entitlement
• Consciously or unconsciously using others
• Lack of empathy
• Seeing the desires and needs of others as a weakness
• Belittling others’ achievements
• Envious of others’ success
• Arrogance, often resulting in snobbiness or talking down to others 

However, internally a person with narcissism might be struggling with: 

• Need for admiration and compliments
• Fragile self-esteem
• Self-doubt or emptiness, but they rarely show this to others
• Fear of vulnerability
• Perfectionistic tendencies, or a fear of failure
• Hypersensitive to failure or critique
• Experiencing depression or anger when faced with failure or rejection 

The core issue with narcissists is often an incredibly low sense of self concept. This means low self-esteem, self-worth, and self-image. To compensate, they seek out validation from others through manipulation or put others down in an effort to push them up. These narcissistic actions are a reflection of an internal wound, one that therapy can help address. 

Narcissism is not only caused by internal issues with self. Brain chemistry and genetics likely play a part. That’s why behavioral therapy is also an important part of efficient treatment for narcissism. They must be willing to face their behavior and make changes even if they don’t feel like it yet.

Types of Narcissism

Although not officially recognized in the DSM-5, the book of diagnostic criteria for mental health disorders such as NPD, many mental health professionals recognize different types of narcissism. These can include: 

• Covert narcissist: A shy, introverted narcissist who may more openly display their struggles with self-esteem and vulnerability. Often their actions are more subtle and passive-aggressive. 
• Communal narcissist: Someone who focuses on having a prominent role in society. They may believe they have a prominent mission or value that the world needs. 
• Malignant Narcissists: Also known as narcissistic sociopaths, these people are least likely to change their behaviors, as they get a thrill out of harming others to meet their own needs. Note that not every Narcissist enjoys hurting others in this way, instead most “typical” narcissists feel like they need to use and manipulate others for their own gain. They may not experience much remorse without therapy, but they don’t enjoy it in the way Malignant Narcissists will. 

Knowing the type of narcissist you are in a relationship with, or the type of narcissist you are, is important because it will inform your therapeutic plan. A covert, communal, or typical narcissist will have an easier time changing their behavior than a malignant narcissist.

Narcissistic Traits vs NPD

Another important distinction to make is the difference between narcissistic traits and Narcissistic Personality disorder. Anyone can experience narcissistic traits and become selfish, arrogant, or believe they are better than others. This does not mean they have NPD. NPD is usually a lifelong affliction that carries a heavy social stigma, so it’s best not to accuse someone of being a Narcissist without getting a professional diagnosis. People with narcissistic traits will find it much easier to change than those with NPD.

Narcissistic Abuse

You may have heard of “Narc Abuse” to describe abusive narcissists. On one hand, yes—a narcissist’s grandiose sense of self, envy, and sense of entitlement can lead to manipulation and abuse in interpersonal relationships. Many people who fall in love with or are in a relationship— familial, romantic, or otherwise—with a narcissist may experience narcissistic abuse. Anyone can suffer from narcissistic abuse, but it’s more common in people who have past trauma or an empath. 

However, it’s important to note that abuse is always a choice. A mental health disorder does not make anyone become an abuser, and not all abusers are narcissists. 

If your relationship is unhealthy, abusive, or manipulative, try to distance yourself from them. Therapy for abuse can also help you recover and heal. Reach out to a mental health professional to receive therapy for narcissistic abuse today.

Can a narcissist change?

If they are willing to, yes. However, it is difficult. A person with NPD must recognize they need help and authentically participate in therapy. Signs a narcissist is willing to change include: 

• They take responsibility for their actions 
• They listen to your concerns 
• They consistently attend therapy and follow through with their work 
• They pay attention to the needs of you and others without exploiting those needs
• They show efforts at emotional regulation 
• They apologize unprompted when they slip back into old patterns

It won’t always be easy for them, but a person with Narcissistic Personality Disorder can change.

Therapy treatments for NPD

Therapy is vital for a narcissist to change their behavior. The most effective types of therapy for people with narcissism include:

• Schema therapy: This type of therapy targets “schemas”, which are maladaptive thinking patterns that can result in unhealthy behavior. Schema therapy empathetically approaches a client’s maladaptive schemas and helps them identify them, understand their causes, and eventually replace them with healthier behaviors. 
• Transference-focused therapy: In their search for validation, many people with NPD will act towards their therapist how they feel about themselves. Using a psychotherapy technique known as transference, narcissists can learn to understand their deeply held beliefs about themselves. Transference-focused therapy has been proven to be effective in treating NPD as it gets to the root of the issues of self many people with NPD struggle with. 
• Gestalt therapy: This type of therapy helps clients focus on what is happening to them in the present without getting it tangled with what happened in the past. Most personality disorders originate in childhood and are strongly influenced by one’s experiences during their youth. Gestalt therapy helps a person with NPD understand how their behaviors and choices are influencing them now and how they react based on past traumas and experiences. 

These are just a few examples, each person with NPD will need a unique approach depending on their needs, goals, and symptoms.

Will NPD go away on its own?

In general, no. Some studies have shown that NPD decreases with age. Although these people will likely score high on narcissist trait scales for the rest of their lives, they can go into remission from NPD. In fact, one study found that 53% of people with NPD were in remission two years later. However, this is not spontaneous and typically takes place over at least 2 years, and is not guaranteed to happen to all narcissists. Also, they did show high narcissist traits, just not enough to maintain the NPD diagnosis.

Can love change a narcissist?

No, love will not change a narcissistic person, and there is no proof that they will pursue therapy to save an important relationship. Do not stay in an abusive relationship with a narcissist just because you love them. 

If you’re currently in an unsafe, abusive relationship, call the National Domestic Violence Hotline: 800-799-7233 or text START to 88788

How to support a narcissist through their change

If a narcissist shows signs of authentically wanting to change, they must take that first step and go to therapy. Often, therapy for personality disorders occurs at least once or twice a week. As someone who loves them, here are some things you can do to help their journey: 

1. Get therapy for yourself: It is crucial you understand your loved one’s personality disorder and what it means for you. You’ll need to have strong emotional regulation, communication, and coping skills in place, as well as address any past traumas or mental health issues that you may be dealing with. 
2. Don’t enable or put up with abusive behavior: If they are serious about receiving help, they will appreciate your strict boundaries. For example, if you were helping a spouse through alcoholism, you wouldn’t let them drink whenever they like. In the same way, don’t enable someone with NPD to get away with the toxic behaviors they are working to stop.  
3. Acknowledge their difficulty and fears: Receiving a personality disorder diagnosis and starting therapy is a heavy thing. There is a lot of stigma surrounding personality disorders that they may be struggling with. Listen to their fears and concerns, and encourage them however you can. 
4. Ask them how you can best help: Like with any mental health disorder, everyone’s needs will be different. Ask how you can help and be receptive to their answers.  
5. Set boundaries: Make sure you’re taking care of your own mental health while they are receiving therapy (and after, too) by setting strong boundaries. What do you want out of this relationship? What does a healthy relationship look like to you? Practice talking about and respecting these boundaries together. 
6. Know when to leave: If the relationship becomes toxic or abusive, it’s okay to leave. You are not abandoning them. If a narcissist is serious about changing, they will continue their treatment, but you have to remember that you cannot save them. Only they can save themselves. Know when to walk away. 

Can I have a healthy relationship with a narcissist?

Yes, similar to other chronic health conditions, your partner will likely always struggle with aspects of NPD. Consider your own expectations: are you waiting for them to be miraculously healed? Or are you willing to accept them for who they are? With proper treatment and effort, people with NPD and narcissistic traits can sustain beautiful, healthy relationships, but that relationship, like all relationships, will take mutual effort. It will mean a lot of good boundaries and communication, but that too is like most other relationships. 

Remember to take care of yourself first. You can’t pour everything you are into someone else.

I’m a narcissist and I want to change, what do I do?

If you can recognize narcissism in yourself and desire change then you are well on your way to it. A lot of people think that therapy for NPD is just changing toxic behavior, but a large chunk of it is addressing the internally painful parts of NPD: a diminished sense of self, sensitivity to rejection, and fear of vulnerability. Therapy for NPD will also be about addressing any comorbid conditions, such as depression or anxiety that often arise as a result of NPD.

The next step is to find a therapist who you trust and want to work with. The best therapy for NPD is consistent, and you will ideally be seeing this therapist at least once a week for a long time. To get matched with a therapist, consider what’s important to you. Do you care about gender, race, sexual orientation, religious background, or methodology? Be specific about who you will be most comfortable with. 

Finally, reach out to a therapist to begin your treatment. Lifebulb employs many therapists versed in treatment for NPD and would be happy to match you with one who meets your needs today.

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