If you’ve researched to determine whether someone you know has narcissistic personality disorder, you’ve probably come across a lot of articles claiming that narcissists are inherently evil and incapable of change.

But these assumptions don’t do justice to the complexity of narcissism. The truth is that everyone is capable of change. However many people with narcissistic personality disorder lack the desire or face other barriers (including harmful stereotypes).

People with narcissistic tendencies may exhibit:

Grandiose delusions and behaviors
Vanity and entitlement
Lack of empathy
Need for admiration and attention

These traits, while often deeply ingrained, aren’t always permanent. A 2019 study suggests that narcissistic tendencies naturally tend to decline with age.

That doesn’t mean you should wait for nature to take its course. If someone is ready to change, treatment offers a faster, more effective path.

How to Tell If Someone Is Ready to Change

Again, some people with narcissistic tendencies may not have an interest in changing. But others do.

How to Identify

The following signs indicate that someone is open to examining their behavior and exploring ways to make a change.

Acknowledge Others’ Feelings

Many people think that “narcissism” equates to “lack of empathy.” While people with narcissistic tendencies often have difficulty considering the feelings and perspectives of others, research from 2014 suggests that empathy, while often low, is not always absent.

Related : Cluster B Personality Disorders and Suicide Awareness

People with narcissism can develop greater empathy when they are prompted to do so, especially when taking the perspective of someone they see as similar to them or when considering the experiences of their children or others they idealize or admire.

A person who shows affection or concern for certain people may be ready to explore further change in therapy.

Concern about their behavior

A person who is wondering why they behave the way they do may be open to exploring their behavior in therapy. This interest may come after reading articles or books about narcissism, or when someone points out their narcissistic tendencies.

People with narcissistic traits can function fairly well in everyday life. Intelligence and a desire to succeed can fuel interest not only in their behavior but also in the behavior of others. This can lead to progress toward viewing other people as equals rather than inferiors.

Preparation for Self-Reflection

Self-reflection can be challenging for people dealing with narcissism because it damages their protective shell of perfectionism.

One of the key features of narcissism is an inability to see the mix of positive and negative characteristics that all people possess (known as whole object relationships).

Instead, most people with narcissistic traits tend to see people, including themselves, as either completely good (perfect) or completely bad (worthless). If their assumption of self-perfection is challenged, they may lash out or fall into a spiral of shame and self-loathing.

Those who can examine and reflect on negative behaviors—without responding by devaluing the person offering the criticism or themselves—may be ready for a more comprehensive exploration.

Dual Diagnosis

It’s not uncommon for people with narcissistic tendencies to have other mental health issues, including depression, anxiety, anorexia nervosa, and substance abuse.

These other issues, rather than narcissistic traits, often prompt people to seek treatment. The desire to relieve current emotional pain and prevent future distress can be a powerful motivator for working toward change.

What Therapy Looks Like

While therapy can help address issues related to narcissism, it works best when provided by a therapist with specialized training in narcissism and narcissistic personality disorder (NPD).

There are several ways to deal with narcissism, but treatment typically involves these basic steps:

Identifying existing defense mechanisms
Exploring the reasons behind these coping styles
Learning and practicing new patterns of behavior
Exploring how the behaviors affect others
Examining the links between their inner voice and their treatment of others

The key to lasting progress often lies in:

Helping someone see how positive change can benefit them
Helping them explore the causes of narcissistic defenses without criticism or judgment
Providing validation
Encouraging self-forgiveness and self-compassion to manage shame and vulnerability

Finding the right type of therapy

Some types of therapy are particularly helpful for dealing with narcissism.

Schemata therapy, a newer approach to therapy that is helpful for narcissism, helps people process trauma from early experiences that may have contributed to narcissistic defenses.

Other helpful therapies include:

Gestalt therapy

Imagination-based therapy

Transfer-focused psychotherapy

Psychoanalysis

Dr. Wheeler also emphasizes the importance of group therapy for people with personality issues. Group therapy provides an opportunity for people to see how others view them. It also allows people to notice how parts of their personality affect others.

How to Support Someone in Treatment

The causes of personality disorders are not fully understood, but narcissistic tendencies often emerge as a form of self-protection.

Related : 14 Signs to Test if YOU are a Narcissist

In other words, many people with narcissism had a narcissistic parent or experienced some form of abuse or neglect early in life. The negative messages and criticism they absorb become their inner voice.

To defend against this negative voice, they develop maladaptive coping strategies or narcissistic defenses. Their treatment of others often reflects how they feel about themselves.

If someone you love chooses to get help for narcissism, here are some ways you can support them.

Provide encouragement and validation

People with narcissism typically respond well to praise. They may want to improve to prove that they are capable, especially as they begin treatment. Your acknowledgment of the effort they are putting in can motivate them to continue and increase the likelihood of successful treatment.

Understanding when they are making progress

Narcissism treatment can take a long time, and progress can come slowly. You may notice some changes early on, such as trying to control your outbursts or avoiding lying or manipulation. But other behaviors, such as anger in response to perceived criticism, may persist.

Working with your therapist can help you learn to recognize improvements and determine what behavioral changes you need to make to continue the relationship.

Learn What Apology Behaviors Look Like

Part of therapy may involve identifying problematic behaviors and learning how to fix mistakes. However the person may still have difficulty admitting a mistake or sincerely apologizing.

Instead of discussing the situation or saying “I’m sorry,” he or she may choose to make an apologetic gesture, such as inviting you out to a fancy dinner or doing something nice for you.

Pitfalls to Avoid

When maintaining a relationship with someone who has narcissistic traits, remember that mental health conditions do not justify abuse and other bad behaviors. Your health should remain your top priority.

Beware of Abuse

Narcissistic behaviors aren’t always abusive, but watch out for:

Insulting, manipulating, and the silent treatment

Lying

Getting extremely angry when they don’t get what they feel they deserve

Attacking when they feel insecure or humiliated

It’s never wrong to be compassionate, but don’t let that stop you from noticing abuse or manipulation. You may care about your partner, but you also need to care about yourself.

Don’t treat therapy as a miracle cure

Therapy can have many benefits, but it may not be enough to help you and your partner maintain a mutually satisfying relationship.

Also, keep in mind that small positive changes don’t indicate complete improvement. Try to accept and encourage these instances of growth without expecting more of the same right away.

Pushing someone too hard can lead to resistance to further change, so it’s often helpful to pick your battles.

You may choose to call out attempts at manipulation, for example, but let self-admiring comments go unaddressed. Balancing this with encouraging their efforts can also have positive outcomes.

Don’t Let Boundaries Slip

You may have said, “If you use bad language, I’m leaving tonight.” After a few months of your partner offering you kind words without any insults, he or she put you down on one occasion during an argument.

You’re tempted to let it go because he or she was being so good. But this can only reinforce the behavior, which hurts both of you. Instead, stick to your boundaries while encouraging him or her to continue making progress.

Conclusion

Narcissistic tendencies can improve with the support of a compassionate, trained therapist. If you choose to stay in a relationship with someone who struggles with these issues, it is essential to work with your therapist to set healthy boundaries and develop resilience.

Treatment requires a great deal of commitment and effort. Even during and after treatment, your partner may never respond in the way you hope. He or she may experience vulnerability throughout life and continue to find empathy difficult.

However, if he or she is interested in and committed to the process, small improvements in his or her behavior and emotional outlook can lead to larger, lasting change.