How to treat narcissism in therapy – Online Psychologists

Narcissism can be seductive at first, but its true nature can do a lot of harm to those around it. If you feel trapped in a toxic relationship with a narcissistic person, or if you've realized you have narcissistic traits that you want to change, online therapy can be a very useful tool. But how do you address narcissism in therapy effectively? In this article, we'll explore the goals of therapy for narcissistic personality disorder, the most effective approaches, and the special challenges and considerations to keep in mind during the treatment process.

What is narcissism and how can it affect a person's life?

The first thing we need to be clear about is what narcissism is. It is a term used to describe a person who has excessively high self-esteem and a constant need for attention and praise. Narcissism can manifest itself in different ways, from simple excessive vanity to a severe narcissistic personality disorder, called NPD.

NPD is a mental disorder. People with NPD have a disproportionately high self-esteem and a constant need to be admired and praised. They may also have a lack of empathy towards others and a need for control and dominance in their emotional relationships.

Narcissism can affect a person's life in many ways. It can hinder a person's ability to have healthy relationships, as it can make them feel superior to others and have a hard time empathizing with others' feelings.

It can also negatively affect work or academic performance, as the constant need for praise can distract the person and hinder their ability to focus on important tasks. Additionally, narcissism can lead to arrogant and manipulative behaviors that can push people away and create interpersonal conflicts.

How is narcissistic personality disorder diagnosed?

Diagnosing narcissistic personality disorder (NPD) requires an evaluation by a mental health professional, such as a psychiatrist or clinical psychologist. During the evaluation, the professional may use a variety of tools, such as interviews, psychological tests, and symptom assessments.

To be diagnosed with NPD, a person must meet at least five of the following criteria:

  • Have a disproportionately high self-esteem and an insatiable need for recognition.
  • Lack of empathy towards others and a tendency not to consider the feelings or needs of other people
  • Constant need for control and mastery over their relationships.
  • Expectation of special treatment and privilege.
  • Be arrogant and feel superior.
  • Have difficult interpersonal relationships. They can be manipulative or deceptive to get what they want.

It is important to note that NPD is a serious and complex disorder, and assessment and treatment should be conducted by trained mental health professionals.

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Narcissistic personality disorder: how it works in therapy

The goals of therapy for the narcissistic personality disorder may vary depending on each person's specific needs and circumstances. However, some common goals of therapy might include:

  • Help the person understand and accept the reality of their narcissistic thoughts, feelings, and behaviors.
  • Develop empathy and the ability to consider the feelings and needs of others.
  • Improve communication and conflict resolution skills.
  • Learning to manage emotions in a healthier and more adaptive way.
  • Strengthen self-esteem in a healthier and more realistic way.
  • Learning to have healthier and more satisfying relationships.

It is important to note that treating NPD can be a long and challenging process, and may require a long-term commitment to therapy and other medical treatments. However, with time and effort, therapy can help people with narcissism significantly improve their quality of life and relationships.

Effective therapy approaches for narcissism

There are several therapy approaches that may be effective in treating narcissistic personality disorder. Some common approaches include:

  • Cognitive-behavioral therapy: This therapy focuses on how we think and act, and seeks to change negative or ineffective patterns of thinking and behavior. In the treatment of NPD, cognitive behavioral therapy can help people develop skills to manage their emotions in healthier ways and have more satisfying relationships.
  • Interpersonal therapy: focuses on how we interact with others and how our relationships affect our well-being. Interpersonal therapy can help people develop more effective communication skills and have healthier relationships.
  • Self-Centered Therapy: focuses on a person's subjective experience and how their thoughts, emotions and behaviors are interrelated. It can help people develop greater self-awareness and take their self-esteem into account in a healthier way.

It is important to note that treatment may involve a combination of different types of therapy and may require adjustments and adaptations over time. The most important thing is to find an approach that works for each person and that they feel comfortable and safe with.

Challenges and special considerations when treating narcissism in therapy

Working through severe narcissism disorder in therapy can encounter some significant challenges and require special considerations. Some of these challenges may include:

  • Resistance to change: People with pathological narcissism may become comfortable with their narcissistic thought and behavior patterns and may resist change. This can make it difficult for them to accept the reality of their narcissistic thoughts and behaviors and may delay progress in therapy.
  • Lack of empathy: Difficulty putting themselves in other people's shoes can result from their lack of awareness of how their actions affect others. This can make it difficult for them to understand a therapist's perspective and can hinder progress in therapy.
  • The desire for admiration: Narcissistic people may have a need to be constantly admired and praised, which can be exhausting for the therapist and may distract from the goals of therapy.

To address these special challenges and considerations, it may be helpful to establish a safe and respectful therapy environment, set clear boundaries, and set realistic and achievable therapy goals. It may also be helpful to work with a therapist who has experience treating narcissism.

The role of family and friends during treatment

The environment plays a very important role in the process of improvement of a person with narcissistic personality disorder. Therefore, having the support of family and friends is very important during treatment. Here are some ways in which loved ones and friends can support someone with pathological narcissism during treatment:

  • Offer emotional support and listen actively and comprehensively.
  • Respect the person's limits and needs.
  • Help the person maintain a healthy routine and follow the treatment plan established by the therapist.
  • Promote self-control and responsibility.
  • Encourage the person to participate in healthy, positive activities and relationships.
  • Educate yourself about NPD and how it can affect you and your relationship with them.

It is important to note that support from loved ones and friends should not replace professional treatment, but rather complement and reinforce it. Also, it is important to remember that treatment can be a long and challenging process, and it is normal to have ups and downs and difficult moments. Offering love and understanding throughout the process can be very valuable.

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