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Narcissistic Personality Disorder: Is There Hope?

Written by Christina Jackson, LPC-MHSP(Temp.)

Note: The following article is for informational purposes. Narcissistic Personality Disorder (NPD) is a clinical diagnosis. Please be careful not to label loved ones or coworkers/employers. Instead, if this information resonates with you, use it as a launch pad to seek further assistance. This article includes effective treatments and resources for those suffering from NPD and for those who suffer from the effects of someone with NPD.

Before we begin, here are some important definitions to understand.

  1. Narcissism – is a personality trait, not a clinical diagnosis. Narcissism is the human tendency to be ego-centric (i.e., self-centered, see the world from their own perspective). Typically, people begin to consider other people’s perspectives as they grow and develop. It is common for people to be selfish sometimes and in some areas of life. That does not qualify them for NPD. People will generally gain empathy and mend relationships.
  2. Narcissist – is a person who displays self-centered (narcissistic) tendencies.
  3. Narcissistic Personality Disorder (NPD) – a clinical term found in the DSM-5 (Diagnostic Statistical Manual, 5th ed.), which is used to make a diagnosis of a mental health disorder. “Narcissistic personality disorder involves a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy. Those with narcissistic personality disorder may have a grandiose sense of self-importance (i.e., exaggerates achievements and talents), be preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love, believe that they are ‘special’ and can only be understood by other special or high-status people, require excessive admiration, have a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment), take advantage of others to achieve his or her own ends, lack empathy, or is unwilling to recognize or identify with the feelings and needs of others, is often envious of others or believes that others are envious of them, or show arrogant, haughty behaviors or attitudes.” A narcissist does not gain empathy to see other people’s perspectives, and the narcissistic tendencies are prevalent at all times and in all areas of their life. (Psychiatry.org)
  4. Empathy – viewing an event from another person’s perspective and understanding the other person’s feelings and point of view.  (Merriam-Webster)
  5. Gaslighting – psychological manipulation of a person usually over an extended period of time that causes the victim to question the validity of their own thoughts, perception of reality, or memories and typically leads to confusion, loss of confidence and self-esteem, uncertainty of one’s emotional or mental stability, and a dependency on the perpetrator. (Merriam-Webster)
  6. Grandiose (overt) narcissism – a personality trait that is dominant, attention-seeking, and openly entitled. Their presence may “take up the room” when they enter and consume attention.
  7. Vulnerable (covert) narcissism – a personality trait that is sensitive, defensive, and shame-prone, meaning they commonly shame others to get their way in situations.
  8. Schema Therapy – a form of therapy that looks at early childhood attachments and maladaptive schema (a belief or narrative based on experience that continues to inform how a person responds to a situation) that formed. Schema Therapy gets past the deflective tendencies associated with NPD and deals with the underlying shame and insecurity that drives the disorder. (Dieckmann, E., & Behary, W.)
  9. CBT (Cognitive Behavioral Therapy) – a form of therapy that examines maladaptive thoughts and behaviors and seeks to modify them to be more adaptive or effective.
  10. Psychotherapy – talk therapy. (Merriam-Webster)
  11. Psychodynamic Therapy – a form of therapy that focuses on examining past (i.e., early childhood) experiences and unconscious processes that influence current behaviors. (Merriam-Webster)

What Narcissistic Personality Disorder Is Not

Narcissistic Personality Disorder (NPD) doesn’t merely mean a person who is prideful and boasts a lot. Nor does it mean a person who can be selfish in a relationship. It is not something you can simply watch a TikTok, Clip, or Reel about then begin diagnosing your friends or family members. It is not just an employer that annoys you on the job, or the coworker that dances on your last good nerve. Neither is it your partner who ate the last treat in the cupboard that you were looking forward to. NPD is much more than the occasional or typical relational conflict. Also, traits that are common to NPD overlap with other personality disorders, which is why it is important to seek clinical assistance rather than diagnosing loved ones and work associates based on material viewed from the internet that is only suited to be informative.

What Narcissistic Personality Disorder Is

Narcissistic Personality Disorder is an ongoing personality pattern that will show up in every area of life rather than a situational behavior, and it begins showing up in early adulthood. A true narcissist that fits the diagnosis criteria does not develop empathy the way people typically do. Instead, they will continue to only see the world through their own perspective and manipulate others into accepting their version of reality by means of gaslighting. For example, narcissists with NPD tend to have an inflated view of themselves that does not match reality, and they will seek to make others believe the exaggerated version of reality. The tactics they use go far beyond a playful ‘fish tale’ or children playing fantasy games. A person with NPD causes significant mental and emotional damage to those under their influence. These behaviors can be particularly devastating for children who look to their caregiver for stability but find someone who is twisting reality to benefit their own needs with no regard for the child’s needs and proper development.

Overt Narcissism

An overt narcissist displays traits that go big. Their chosen reality is that they are the best. They tend to dominate other people. It is the arrogant form that people typically associate with narcissistic tendencies. They can degrade people in order to gain control. It is important to them that others do not question them, and they may get upset when challenged.

Covert Narcissism

On the other hand, a covert narcissist displays traits that try to minimize themself in order to be the victim in every situation. This type of narcissistic tendency thrives on guilt trips and ‘being the martyr’. Arrogance is still at the root, but it is shown as “poor me, I do all this for you so you should do this for me.” Yet the demands never end and typically cross emotional boundaries that deprive the needs of others.

There Is Hope for Narcissists

Unfortunately, due to the nature of NPD (i.e., the denial of reality), it is difficult for a narcissist to seek help because they often do not believe they need to change. However, if you have been diagnosed with NPD or you have realized that you have narcissistic tendencies that are damaging your relationships, there is hope! Individual therapy will include treatments that develop empathy, cultivate interpersonal skills, and practice emotion regulation. Psychotherapy is the primary intervention. Particularly, Schema Therapy is commonly used to get past the typical NPD traits and begin reorganizing their perception of themselves and others. Therapists frequently incorporate CBT to help the person develop more effective behaviors that do not harm their relationships, and Psychodynamic Therapy is effective for discovering root causes of the maladaptive thoughts and behaviors that need to be modified.

Moreover, group therapy will help the narcissist receive feedback in a safe environment and family therapy is effective for improving relationships and working through systemic issues. In every situation, though, the narcissist should want to seek help rather than have someone try to persuade them to attend. If the narcissist is unwilling or does not see a need to change their behaviors, the time invested in treatment will have poorer outcomes due to deflection and manipulation.

There Is Hope for You

Furthermore, there is hope if you have come to realize that you have been adversely affected by a narcissist. You too can begin healing! Individual therapy can validate your experience after being gaslit and help you learn how to begin implementing healthy boundaries. For example, when a person interacts with a narcissist for a prolonged period, it is common for boundaries to be disregarded, blurred, or never developed. Because narcissistic tendencies can be insidious, a person’s ability to self-advocate may diminish over time as they are repeatedly manipulated into accepting a false reality. Therefore, working with a therapist can help you discover healthy limitations in your relationship with the narcissist and cultivate the strength to enforce the boundaries.

Self-care also declines because the narcissist consumes the energy of other people. The closer the relationship, the more energy is consumed. People often find themselves catering to the narcissist and ‘walking on eggshells’ to not upset them, which results in insufficient energy to care for their own mental, emotional, and sometimes physical needs. Therapy can help establish self-care routines that allow you to flourish.

Resources for Support

Support groups, either online or in-person, provide education and peer support as you rebuild your life. You will also receive the much-needed empathy and validation that has been lacking in your life. Likewise, group therapy can reduce feelings of isolation.

If you are suffering, you do not have to do this alone. We encourage you to begin your journey of healing today.

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