Narcissistic Personality Traits

Finding The Right Treatment

Treatment

Getting treatment and staying with it is half the battle. Individuals with narcissistic personality disorder may be unlikely to reach out for treatment, as they may believe themselves to be free of any problems. However, some do accept treatment for another mental health issue, such as depression, anxiety, alcohol or substance abuse, or relationship problems, that may accompany NPD behavioral patterns. Frequently, low self esteem and fear of being vulnerable and criticized in therapy can keep people from getting the help they need. However, if they are willing to take a risk and explore themselves and the ways they think, behavioral change and improved relationships is possible.

Talk therapy

Psychotherapy, (talk therapy) is the primary modality in the treatment of narcissistic personality disorder. Dialectical Behavior Therapy, DBT, is a treatment modality that is recommended for borderline personality disorder, but it can be helpful for other mental health conditions, including NPD. Cognitive Behavioral Therapy (CBT) is another recommended treatment modality for NPD and other mental health conditions, as well. CBT explores and challenges distorted belief systems as a means to achieve positive behavioral change.

Goals of psychotherapy for NPD

- Improve the ability to relate with others and to acquire effective communication tools

  • Be able to maintain personal family and work relationships
  • Improve the ability to regulate and manage strong emotions
  • Understand and appreciate the impact of one’s words and behaviors upon others
  • Work to take personal accountability for one’s actions
  • Improve self esteem and acquire the ability to tolerate criticism or the perception of criticism
  • Work on self acceptance and let go of perfectionistic expectations
  • Work toward accepting others, despite flaws and struggles
  • The acquisition of parenting and other relationship skills

Treatment of co-occurring conditions

It merits repeating that psychotherapy and medication management are effective treatments for the conditions that often accompany NPD, such as alcohol and substance abuse, depression, bipolar depression, anxiety, ADHD, insomnia, and others. Antidepressant medications are designed to improve not only the symptoms of depression, but also anxiety.

Mood stabilizing medications are available to help ward off mood swings and regulate mood. Antipsychotic medications, which augment the helpfulness of the antidepressant, are another tool in the mental health tool box. In addition, there are medications to reduce cravings for alcohol and substances and even manage food cravings. Sleep is widely regarded as a powerful determinant of daily functioning and mood, therefore, medication for insomnia is another treatment option. All these medications have passed rigorous clinical trials for effectiveness and safety.

Research studies recommend a combined program of psychotherapy and medication management as the gold standard of mental health care. Treating the co-occurring conditions, in tandem, can reduce the overall symptom burden on the individual, who struggles with NPD, and enhance their outcome.

Finding a therapist

Individuals who identify with the characteristics of NPD are encouraged to reach out to a qualified therapist or primary care physician in their insurance network. Look for a therapist who displays a compassionate, skillful, and judgment-free approach to helping. Therapy works best when the client feels a sense of emotional safety and connection.

There are different kinds of professionals who are trained in psychotherapy.

  • Clinical Psychologists (PhD)
  • Licensed Social Workers (LCSW)
  • Licensed Professional Counselors (LPC)
  • Licensed clinical professional counselors (LCPC)
  • Licensed Marriage and Family Therapists (LMFT)

The decision to start therapy

Many people try to cope with their distress on their own, and then feel disappointed when they find that this is very difficult to do. Deciding to start therapy can be hard; it takes courage.

For some people, it can take time to warm up to the idea of sharing one’s intimate thoughts or disclosing details of one’s life, especially for those who grew up in a culture where seeking psychological help was frowned upon.

Psychotherapy is increasingly accepted as not only a way to improve mental health symptoms, but also a means for self exploration and personal growth. No problem is too small for a trained therapist: an individual need not worry that others may have it worse. The willingness to reach out for help is increasing: in 2020, one out of every six Americans (men and women) reported seeing a therapist.

Seeing a therapist with whom one feels comfortable, and a sense of connection, and who also participates in their insurance network, is essential. It may take a couple tries to find a therapist who feels like the right fit. If therapy didn't help the first time around, it can be helpful to give another therapist a try because therapeutic styles vary so much from therapist to therapist.

Where to start

Asking one’s physician to make a referral is often a good place to start. Many health insurance cards have websites or 1-800 numbers to call for a list of in-network providers.

To find a therapist who takes your insurance, the National Institute of Mental Health offers a comprehensive list of resources.

Psychology Today also lists therapists by type, location and insurance.

By nature, an individual with NPD, may not acknowledge the role they play in their problems. They may feel that therapy is not necessary, and there is nothing about themselves that needs improving. It is important to remember that meaningful shifts in a person’s perceptions and changes in their behavior are possible, even as an adult.

The following suggestions are offered to assist with obtaining treatment:

  • Adopt an open, curious approach to self exploration.
  • Avoid the expectation of being perfect
  • Reframe mistakes as growth opportunities
  • Select a therapist who offers a comfortable, non judgmental approach
  • Obtain treatment for other co-occurring disorders.
  • Obtain treatment for alcohol and substance abuse.
  • Focus on the goals of improving important family and work relationships, improved functioning, and working toward a healthier, more satisfying quality of life.
  • Strive toward accurate feedback with treatment providers.
  • Avoid the urge to discontinue therapy. Stay with it!
Next: Management and Resources