The Narcissist’s Playbook: Treatment of Narcissistic Personality Disorder (Part 7)

The term ‘Narcissist’ is heavily overused in the world these days.  However, they do exist, and they can be extremely toxic people in marital relationships. Understanding how to spot one and how to deal with one when they are being difficult is really important. And even more important, is how to recover from Narcissistic Abuse. This article series is going to be broken up into different segments: Identifying a Narcissist; Possible Causation of Narcissistic Personality Disorder; Spotting Narcissist Tactics and Habits;  Dealing with a Narcissist; Overcoming Narcissistic Abuse and Defusing the Narcissist; Treatment of Narcissistic Personality Disorder, as well ‘de-bunking’ theories of Narcissism.  Society has gotten far too comfortable calling people narcissists without being properly informed. Therefore, to better explain who a narcissist is, how they operate, and how you can handle a narcissist, follow along this series of articles for a 101 on Narcissistic Personality Disorder.

Part 7: Treatment of Narcissistic Personality Disorder

There is a lot of talk on whether Narcissistic Personality Disorder is treatable. Fortunately, there have been a lot of studies done that show the possibility for improvement for people suffering from NPD.  However, the path to treatment can be long and very emotionally draining for not only the person suffering from NPD, but for a partner as well.

Challenges with Treating NPD

  1. It can be very hard for a person to recognize that they have NPD, and therefore they often end up not picking the right type of therapist to diagnose and treat the disorder.
  2. There are many people who will not admit that they have NPD and therefore will not seek help.
  3. Even if they agree to treatment, there is still this underlying sense of “there is nothing wrong with me” that can prevent them from taking treatment seriously, or even being willing to complete treatment.
  4. Treatment is time consuming and very expensive.
  5. There are a limited number of psychotherapists that have the training and qualifications to successfully treat persons with NPD.
  6. It can be very difficult for people suffering from NPD to open and be authentic, due to an underlying sense of shame. People can only get out of psychotherapy what they are willing to put into it.

Diagnosing NPD in People

As stated in earlier articles, NPD is extremely challenging to diagnose. This is because of two main things (1) it is difficult to get a person with NPD to admit they may have something ‘off’ with them; and (2) It is very difficult to find a narcissist willing to see a professional about it.

There are a couple ways in which NPD is diagnosed. First is the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Both manuals lay out specific characteristics related to people with NPD and it becomes the job of the mental health counselor to diagnose a person.

Another way to assist in diagnosis is to have a brain scan done. Brain scans are a great way to help break through denial for people who have a hard time believing or trusting the diagnosis of a psychotherapist. There are many professionals who doubt whether it is possible to be certain that a person suffers from a personality disorder based on a brain scan, but they can be a great way to supplement the more traditional methods of diagnosis.

What Does Treatment Look Like?

Treatment for NPD can look very different depending on a number of circumstances.  Because NPD is a personality disorder, and personality is controlled by the brain, the first thing that should be done is to look at one’s brain health.  This does not mean that anyone questioning if they have NPD should immediately go and get a brain scan, but perhaps people should be looking at their diet, getting updated blood work done, making sure their body is healthy, looking at what their exercise routine looks like, and taking any other measures necessary from a holistic perspective to ensure that their brain is able to function as well as it can.

A lot of therapy is going to be based on psychotherapy and talk therapy.  In talk therapy, mental health professionals are going to go through a number of exercises with patients to help break through some of the denial, and focus on the cause of the underlying feelings of shame, abandonment, and the feeling of not being wanted.  Psychotherapy will also help focus on how people with NPD can better relate to others and help clients begin to strengthen the empathy “muscle” per se.  And remember, treatment for NPD is not for the vein heart. Treatment typically can take 5-10 years, and it can be a lot of work.

So There Isn’t Just a Pill For This?

No, unfortunately there is not a pill for this.  As stated above, the most important thing a person with NPD can do is get their body and brain healthy. Before seeking treatment, it is important to make sure that their vitamin levels are where they should be, their hormone levels are where they should be. They should start with the premise, “Help your body help you.”

That is not to say that there isn’t medication out there that can help with some of the symptoms or co-existing mental health issues associated with NPD.  There are a lot of patients that have co-existing issues with mood regulation, anxiety and depression that will require medication to treat.  In either case, it is important to understand that underneath the symptoms there is still a bigger issue at hand. Although medication is not going to treat or cure NPD, it can definitely become a great supplement to psychotherapy.

Goals of Treatment and Psychotherapy

The goal of psychotherapy is going to be reverse some of the negative habits that are formed due to NPD. Some of these include:

  • Allowing real relationships to form, and learn how to maintain those relationships
  • Learn how to handle issues that arise from self-esteem and insecurity issues, including accepting defeat and responding to criticism better
  • Learn ways to better regulate your emotions
  • Learn to set more realistic goals and become more realistic about personal achievements

Success with NPD Treatment

It is important to first acknowledge that treatment for NPD is likely going to be a life-long process. This does not mean that a person will consistently need to seek treatment, but there is a high likelihood that a person is going to need to go in for ‘tune-ups’ over the years.  The good news is, however, it is treatable. There are many people who have been able to successful be treated for NPD and continue to live happy and fulfilling lives.  The statistics surrounding success are not easy to find, which is likely due to the difficulty of obtaining a diagnosis and finding a person with NPD who is willing to stick it out through the treatment.  However, if a person has recognized that there is a problem and is willing to seek treatment and stick to it, treatment is possible.