“They did a personality test, and through a process of elimination, it came out that it was Narcissistic Personality Disorder. So from that moment on, I started therapy, because I didn’t want to have this disorder.”

These are the words of a narcissist interviewed by SBS in 2019.

After six and a half years of therapy, he was released and now runs counselling sessions to help other narcissists change and help victims of narcissistic abuse deal with what they’re going through.

Is this really a case of successful treatment? And if so, is this a common outcome? Can a narcissist change with the right therapy or motivation?

CanANarcissistChangeWithoutTreatment?

There are a number of ways to look at this, and we need to define the question a little better.

If we’re asking “Can a narcissist change?”, the answer is yes.

As we saw in the example above, there are cases of narcissists changing their ways through therapy – although it’s a notoriously difficult condition to treat.

But what about without treatment? Do narcissists change on their own?

Well, a number of studies have shown that narcissism tends to decline over the course of a lifetime.

One study followed nearly 500 people over 23 years and found that narcissistic traits declined as people reached their 40s.

Narcissistic traits don’t disappear, but they do seem to fade a bit as people get older.

Interestingly, the study also found that narcissism declined more in people who had stable family lives (including having children), and in people who didn’t work in leadership or supervisory roles.

Now, given how the study was conducted, we can’t be sure of cause and effect here.

It could be that people who are higher in narcissism tend not to have families, and also tend to seek roles where they are responsible for other people.

But it’s also possible that a stable family life, and avoiding leadership roles, could prevent narcissism from flourishing as much as it otherwise would.

But one problem with these types of studies is that they measure narcissistic traits in healthy people.

What about full-blown narcissists, people with narcissistic personality disorder (NPD)?

Can Narcissists Change

Changing any part of our personality is difficult, but when we enter the world of Narcissistic Personality Disorder, change becomes less likely.

This is due to the nature of Narcissistic Personality Disorder itself.

If you have a mental health issue, and you want to fix it, you have to go through several stages:

1) Self-awareness: Understanding what you are going through

2) Acceptance: Realizing that you need help

3) Action: Seeking help and following a treatment plan

Narcissistic Personality Disorder blocks this process at every step. Let’s take them one by one.

1) Self-awareness: Do narcissists know they are narcissists?

Narcissists have an inflated image of themselves, and they do everything they can to get compliments and praise from others so that they can maintain this image.

This is why narcissists often brag, boast, and act in arrogant ways.

In this regard, they are actually self-aware. They may not have heard the term “narcissist” before, but they are aware of the ways they act.

What’s more, they are proud of it! In their minds, you would act this way too, if you were as successful, talented, and handsome as they are!

While they may have some self-awareness about the way they act, narcissists have a hard time seeing this as a problem. In their eyes, their way of thinking and acting is completely justified.

You can learn more about this in my main article: Do Narcissists Know They Are Narcissists?

2) Acceptance: Can Narcissists Realize They Need Help

However, while narcissists know how they act, they lack awareness of why they act the way they do.

All this bragging is masking a deep-seated vulnerability. It is extremely painful for a narcissist to face this vulnerability, and in many ways, their entire life revolves around hiding it.

Anything that makes him see his true, insecure self could lead to narcissistic injury – and that includes accepting that he has a personality disorder.

Let’s say a narcissist learns about Narcissistic Personality Disorder one day.

Maybe they read a blog like this, or maybe someone told them they’re a narcissist.

Even if they reach the point of self-awareness (“Huh, that sounds like me…”), the step from there to realizing they have a problem is a huge one.

That means confronting the narcissistic injury and moving forward anyway. That’s a big hurdle.

3) Action: Can narcissists seek help?

There’s a stigma attached to mental health conditions, and sometimes people who need help don’t seek help because they’re worried about what others will think.

Since narcissists spend most (some claim almost all) of their effort portraying themselves as powerful and superior—both to others and to themselves—this is harder for them to do.

But there’s another hurdle—control. Seeking help for a mental illness puts you in a vulnerable position.

You’re going to have to really open up to someone else and put yourself in their hands, which narcissists generally don’t tend to do.

Related : How to Make a Narcissist Fear You? 12 Greatest Fears of the Narcissist

Narcissists seek control—that’s how they can manipulate how people around them behave so they can push them to act in ways that give them their narcissistic supply.

They’re not going to get that from being honest with a therapist—in fact, it’s almost the opposite.

They’re going to be in a position where they’re confronting their inner demons, and they won’t have much control over where that path leads them.

That’s hard for anyone, and even harder for a narcissist.

Can a Narcissist Change with Therapy?

While the success rate for treating Narcissistic Personality Disorder isn’t great, I don’t want to paint an overly negative picture.

For some narcissists, certainly not all, change is possible. But how much change, exactly? Can narcissism be cured?

Okay, let’s get back to the guy we talked about at the beginning of the article.

This man, after six years of hard work, was released by his therapists, and now spends some of his time helping others deal with Narcissistic Personality Disorder.

By his own account, he might seem like a typical example, right? A success story.

However, even he admits, “Because I realize I’m a narcissist… I have to rethink all my decisions. It will be like this until the end of time.”

It seems that even in positive cases, the word “therapy” can be too strong.

Let’s explore how therapy works for narcissism, and the changes we might hope for.

ChangeThoughts

Treating narcissism involves examining thought patterns.

This is often done through cognitive behavioural therapy (CBT) or dialectical behavioural therapy (DBT), but another popular approach is called schema therapy.

Schema therapy is sometimes called ‘reparenting’. The idea is that narcissistic personality disorder is more likely to develop in people who had certain needs not met as children (such as warmth and affection from their parents).

This leaves a gap in the narcissist, which they try to cover with their abusive behaviour and actions.

The therapist works with the narcissist to uncover these unmet needs, and find ways to meet them in healthier ways.

It also involves increasing their self-awareness – so that the narcissist becomes more aware of their actions, and realises that they are attacking, bragging and lying just to protect their vulnerable inner self.

If they realise that they are doing this, they can try to change their behaviour.

This all sounds great on paper, but there isn’t a lot of research behind schema therapy yet, so we can’t be sure how effective it is.

EmpathyChange

People with Narcissistic Personality Disorder are often said to lack empathy, but that’s not entirely true.

While some narcissists may be incapable of empathy (which we classify as malignant narcissists), most simply have very low levels of it. This may be something we can work with.

In one interesting study, a group of people high in narcissism were compared to a group of non-narcissists.

They were asked to watch a video of a domestic abuse victim talking about her experiences.

While watching the video, the participants were hooked up to a heart rate monitor.

The non-narcissists experienced an increase in their heart rates—because of their empathy, they were able to put themselves in the victim’s shoes and feel what she felt.

This triggers a stress response, which increases their heart rates. The narcissists’ heart rates, on the other hand, were flat. A complete lack of empathy.

However, in a follow-up study, researchers trained narcissists to empathize.

They taught them how to take perspective—how to pretend to be the other person, and imagine how they would feel in that situation.

This time, the narcissists’ heart rates increased when they watched the video.

This is a similar approach that has been taken in many rehabilitation programs for people who commit serial violent crimes.

Again, the success rate here is not high, but it does at least show a chink in the armor of Narcissistic Personality Disorder, and it may be helpful for some people.

What does a narcissist have to do to change?

You may have heard the expression that for any treatment to work, the patient must want to change.

That’s true, but for narcissism, it takes more than that. According to psychologist Elinor Greenberg, for narcissists to succeed in therapy, they need to:

1) Be motivated – they must want to change

2) Be high-functioning – they must be able to succeed in life despite their narcissistic personality disorder

3) Be psychologically minded – they are interested in mind and behavior

4) Be able to self-reflect – the ability to be self-aware is key, as we’ve already seen

5) Be intelligent – ​​they are able to see the bigger picture of their actions and their impact

6) Be emotionally stable – narcissists are known for their outbursts of anger. The better they can control this, the better

7) Be self-improving – narcissists who are willing to put in the time for things like learning new skills or languages ​​are more likely to put in the hard work in therapy

Of these, motivation is perhaps the most important. Let’s take a look at a specific motivation you may be wondering about…

CanANarcissistChangForLove?

If you are in a relationship with a narcissist or in love, you may hold out hope that he will change in order to save the relationship. However, this all depends on whether he is in love in the first place.

Working with your own therapist: It’s going to be a tough road for both of you. If you’re sure this is what you want to do, you should definitely work with a therapist yourself. This will help you deal with potential emotional turmoil in the future.

Maintaining boundaries: It’s very important to set and maintain boundaries with narcissists, even if they seem to be making progress. One boundary might be, for example, that if they talk to you in a degrading way, you’ll leave the house and stay overnight. If after a while they start saying mean things to you, you should follow through. They’ll try to turn you around: “Sorry, it was just a slip-up, I’ve been doing great so far, it won’t happen again.” But you should follow through. Otherwise, you’re rewarding the behaviors you’re trying to discourage.

Be prepared to walk away: Beyond boundaries, you should also know what behaviors have serious consequences. While you may love the narcissist, and you may understand that they’re behaving this way because of a mental health condition, there are some behaviors that you shouldn’t accept. If he engages in any kind of abuse (physical, sexual, or emotional), take steps to leave him. You are under no obligation to put up with the abuse under any circumstances.

Have you ever known a narcissist to change? Have you ever tried to help a narcissist change? If so, let me know your experiences below!