People with narcissistic personality disorder (NPD) often crave admiration and struggle with a lack of empathy. This can make it difficult for them to relate to others. Although there’s no cure for NPD, there are many forms of therapy that can help people. Each type of therapy takes a different approach to treating narcissistic personality disorder and has its own, individual benefits. True NPD is actually not all that common, according to research. Only a qualified, medical or mental health professional can diagnose it. 

Read on to learn more about the narcissistic personality disorder treatment options.

Can Narcissism Be Treated with Therapy?

Experts consider therapy to be the most effective form of narcissistic personality disorder treatment. NPD therapy can help people become more aware of their narcissistic tendencies and how they impact others. It can also help them begin to understand and regulate their emotions.

Low empathy is common among narcissistic personality disorder symptoms, but studies show that empathy can be learned. Through therapy, people with NPD can learn to take responsibility for their actions, which can ultimately help them develop healthier relationships. Therapy is essential in that it can do more than just treat narcissistic personality disorder symptoms. It can focus on addressing the comorbid mental health symptoms and conditions — like bipolar disorder and other personality disorders — that commonly occur with NPD, too.

Therapy won’t be able to transform someone who presents themselves as a “narcissist” overnight. For many people, it can take years to see any significant progress. However, if they’re willing to work on their narcissistic tendencies and commit to therapy, even though NPD can’t be cured, treatment can offer very positive results.

“Therapy can absolutely help with traits, but narcissism cannot be cured per se. The conscious space of therapy is a great place and opportunity for reflection about insecurities or issues of self-esteem that may lie beneath. A professional clinician can offer just the right support to create more realistic expectations and address how one’s behavior can impact their relationships.”

Talkspace therapist Elizabeth Keohan, LCSW-C, MSW

Types of Therapy for Narcissistic Personality Disorder

Narcissistic personality disorder can be a difficult condition to treat, and it can take time to see progress. This makes it all the more important to find the best type of NPD therapy for someone’s individual needs. Understanding the different types of therapy is the first step. 

1. Psychotherapy

Psychotherapy is also known as talk therapy, and it involves regular one-on-one interactions between patient and clinician. During individual therapy sessions, people have the opportunity to discuss their emotions and actions with a care provider. Over time, they can learn to understand their behaviors and regulate their behaviors and thought processes.

2. Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy helps people begin to identify unhealthy or unhelpful thought patterns. Once someone is aware of these patterns, they can work to change them. In addition to practicing skills with a care provider, people in CBT treatment are generally given assignments to work on between sessions.

3. Gestalt therapy

This is a type of psychotherapy that’s more focused on the present than the past. Therapy sessions typically focus on the challenges someone is currently facing in life. During gestalt therapy, people are often asked to role-play social interactions so they can improve conflict resolution skills.

4. Schema therapy

Schema therapy utilizes elements of psychotherapy and CBT to help people identify and modify their internal schemas (which are patterns of thoughts and behavior that were learned). Many people with NPD have unhealthy schemas that they developed early in life. Once people become aware of these patterns, they can work to change them.

5. Transference-focused psychotherapy (TFP)

TFP is a highly structured type of psychotherapy that asks people to transfer their feelings about another person, experience, or situation to their care provider. This gives them the opportunity to work through those feelings in a safe, structured, guided environment. It can help people start to change the ways they see themselves and others.

6. Mentalization-based therapy (MBT)

Mentalization therapy asks people to think about their actual thought processes, that is, how they think. It’s designed to help someone see the connections between their thoughts and their behaviors. MBT can also help people better understand those around them, something that can be very challenging for anyone with NPD.

7. Dialectical behavior therapy (DBT)

Dialectical behavior therapy is a subset of CBT that works with people to help them improve emotional regulation, relationship skills, and distress tolerance. Although DBT was initially created to treat borderline personality disorder, we’ve found it can also be an effective therapy for narcissistic personality disorder. It typically involves both group and individual therapy sessions.

8. Eye movement desensitization and reprocessing (EMDR) therapy

Research suggests that there may be a link between NPD and early childhood trauma. EMDR therapy helps people process and compartmentalize trauma, which is likely why it can be beneficial in treating NPD. EMDR therapy asks people to engage in guided eye movements as they actively discuss traumatic or negative events with a therapist. Over time, this can make these traumatic events less distressing.

9. Metacognitive interpersonal therapy (MIT)

MIT works to deconstruct maladaptive behaviors and thought patterns. As people with NPD become more aware of these behaviors, they can learn effective coping strategies aimed at changing them. Therapists will also work to find and address obstacles to successful treatment.

What Type of Therapy is Best for NPD?

While people with NPD may share certain traits and behaviors, this condition doesn’t impact everyone in the same way. Experts believe that there are several narcissistic personality disorder types. These subtypes can change the ways NPD affects someone in their day-to-day life.

For example, the grandiose subtype may cause people to show more outward anger and hostility. A person with the vulnerable subtype, however, is more likely to be fragile to criticism and may struggle with low self-esteem.

When choosing the best type of NPD therapy, it’s important to consider both symptoms and goals. For example, EMDR can be a highly effective form of therapy for the person who struggles with early trauma, whereas someone who doesn’t have a traumatic past might benefit more from a therapy that’s focused on the present, like gestalt therapy.

Learning more about narcissistic personality disorder therapy gives you the opportunity to choose the type of therapy that’s best suited for addressing your specific symptoms, needs, and goals. You can think about what you want to work towards, and then find the therapy modality that’s most likely to help.

“Psychotherapy and dialectical behavioral therapy (DBT) can offer good results for narcissism. Both can provide space to learn, practice, and understand your relational impact on others. While both require some level of respectful collaboration, these therapies are a safe place to acquire skills for regulating emotion and increased coping.”

Talkspace therapist Elizabeth Keohan, LCSW-C, MSW

Finding a Therapist for Narcissistic Personality Disorder

Narcissistic personality disorder is a highly complex condition that shapes the way someone perceives themselves and others. It can be a difficult mental health condition to treat, which is why it’s essential that you only seek therapy from a professional who has experience.

As you can see, there are many forms of therapy for narcissistic personality disorder.  Although people with NPD are often reluctant to seek treatment, therapy can help them work on harmful behaviors and address the symptoms that impact them in their day-to-day lives.

If you or a loved one has shown symptoms of NPD, don’t hesitate to seek treatment. A mental health professional can provide a narcissistic personality disorder diagnosis and suggest treatments that will improve both quality of life as well as relationships.

Are you or someone you care about wanting to better learn how to deal with narcissistic personality disorder? Are you considering therapy but not sure where to start? Have you thought about Talkspace? We’re an online therapy platform that’s changing how people feel about getting the mental health help they need. With Talkspace, therapy is affordable, convenient, and easy to access. 

Now you can get the help you need in dealing with NPD, in the convenience and comfort of your own space, during the time that works best for you. You don’t have to live with the negatives of NPD. You can learn how to manage it.