“They did the personality test, and by process of elimination, it was concluded that it was narcissistic personality disorder. So from that moment on, I started treatment, because I didn’t want to have that.”

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

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

Is this truly a case of successful treatment? And if it is, is this a common outcome? Can a Narcissist Change with proper treatment or motivation?

Can a narcissist ever change without therapy?

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

If we’re asking “is it possible for a narcissist to change?”, the answer is yes.

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

But what about without therapy? Do narcissists ever change by themselves?

Well, several studies have shown that narcissism tends to decrease over the course of life.

One study tracked nearly 500 people over 23 years and found a decrease in narcissistic traits as people reached their 40s.

The narcissistic traits don’t disappear, but they do seem to fade slightly as people age.

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

We can’t be sure about the cause and effect here because of how the study was conducted.

It could be that people higher in narcissism tend not to start families, and also tend to seek out roles where they are in charge of other people.

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

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

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

Article continues below this section.

---

---

Are Narcissists Able to Change?

Changing any part of our personality is difficult, but when we get into the realms of NPD, change becomes even less likely.

This boils down 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 a few stages:

1) Self-awareness: understanding what you’re going through

2) Acceptance: realising you need help

3) Action: seeking out help and following a treatment plan

NPD blocks this process at every step. Let’s go through them one-by-one.

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

Narcissists have a massively inflated image of themselves, and they do all they can to get flattery and praise from other people so that they can maintain that image.

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

And in this respect, they are indeed self-aware. They might not have heard the term “narcissist” before, but they are aware of the ways they behave.

What’s more, they are proud of it! In their minds, you’d act that way too, if you were as successful, talented, and good-looking as they are!

So while they may have some self-awareness about the way they behave, narcissists find it difficult to see this as a problem.

In their eyes, how they think and act is totally justified. 

You can learn more about this in my main article: do narcissists know they are narcissists?

2) Acceptance: Can narcissists realise they need help

However, while narcissists know how they act, they lack awareness of why they act in the ways that they do.

Underneath all the bravado hides a deep vulnerability. It’s excruciating for a narcissist to be confronted with this vulnerability, and in many ways, their whole lives revolves around covering it up.

Anything that makes them see their true, insecure self will trigger a narcissistic injury – and this includes accepting that they have a personality disorder.

So say a narcissist learns about Narcissistic Personality Disorder one day.

Maybe they read a blog like this one, or maybe someone tells them they are a narcissist.

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

It means facing a narcissistic injury and pushing through anyway. This is a huge hurdle.

3) Action: Can narcissists seek help?

There is a stigma around mental health conditions, and sometimes people who need help won’t seek it out because they are worried about what other people will think.

Since narcissists put most (some would argue almost all) of their efforts into portraying themselves as strong and superior – both to others and to themselves – this is even harder for them.

But there’s another roadblock – control. To seek help for a mental illness puts you in a position of vulnerability.

You’ll have to really open up to another person and put yourself in their hands, which narcissists generally aren’t inclined to do. 

Narcissists strive for control – it’s what enables them to manage how people act around them so that they can push them towards behaving in ways that give them their narcissistic supply. 

They are not going to get that by honestly engaging with therapist – in fact, almost the opposite.

They’ll be in a position where they face their inner demons, and they’ll have little control over where that path leads.

This is difficult for anyone, and for a narcissist, even more so.

Can a narcissist Change with therapy?

While the success rate for Narcissistic Personality Disorder treatment isn’t great, I don’t want to paint too negative a picture.

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

Well, let’s go back to the gentleman we talked about in the beginning of the article.

This man, after six years of hard work, was discharged by his therapists, and now spends some of his time helping others deal with NPD.

By his account, he would seem like a model example, right? A success story.

Yet, even he admits, “because I am aware that I’m a narcissist… I have to second-guess all my decisions. It will be that way until the end of time.”

It seems that, even in the positive cases, “cure” might be too strong a word.

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

Changing thoughts

Treatment for narcissism involves some examination of thought patterns.

This is often through cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT), but another common approach is called schema therapy.

Schema therapy is sometimes called “reparenting”. The idea is that Narcissistic Personality Disorder is more likely to spring up in people who didn’t get certain needs met as children (such as warmth and affection from their parents).

This leaves a hole in the narcissist, that they try to cover up with their posturing and abusive behavior.

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 realizes that they are only lashing out, bragging, and lying to protect their vulnerable inner self.

And if they realize they are doing this, they can try to change how they behave.

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

Changing empathy

It’s often said that people with NPD have a lack of empathy, but this isn’t quite correct.

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

In one interesting study, a group of people high in narcissism was 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 saw 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 causes a stress response, which increased their heart rate. The narcissists’ heart rates, on the other hand, were flat. A complete lack of empathy.

However, in a follow-up study, the researchers trained the narcissists in empathy.

They taught them about perspective-taking – how to pretend they were the other person, and imagine how they would feel in that situation.

This time, the narcissists’ heart rates did increase when watching the video.

This is a similar approach taken in many reform programs for people who commit serial violent offenses.

Again, the success rate here isn’t high, but it at least shows there is a chink in the armor of NPD, and for some people, it might help.

What Should a Narcissist Do To Change??

You’ve probably heard the expression that for any therapy to work, the patient has to want to change.

This is true, but for narcissism, it takes even more than that. According to psychologist Elinor Greenberg, for narcissists to do well in therapy, they need to be:

1) Motivated – they have to want to change

2) High-functioning – being able to get by in life despite their NPD

3) Psychologically-minded – being interested in the mind and behviour

4) Self-reflective – the capacity for self-awareness is key, as we’ve already seen

5) Intelligent – being able to see the larger picture of their actions and the effect of them

6) Emotional stability – narcissists are well-known for their angry outbursts. The better control they have over this, the better

7) Self-improvers – narcissists who are willing to put time into things like learning new skills or languages are more likely to put serious effort into therapy

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

Can a narcissist change for love?

If you are in a relationship with a narcissist or in love, you might hold out hope that they will change in order to save the relationship.

However, this all depends on whether they are in love in the first place.

Most people with NPD don’t experience love in the same way as other people.

They are not in love with you, exactly. They are in love with the way they feel when they are with you.

They love what a catch you are, as having someone so great makes them look good in the eyes of others. They love the narcissistic supply you give them.

This doesn’t mean they have no positive feelings towards you. It doesn’t mean they don’t want to be with you, and they won’t take steps to stay with you.

Indeed, some narcissists who went into therapy did so on the insistence of their romantic partners.

However, in all likelihood, the motivation wasn’t love. It’s most likely a practical matter.

They feel they have more to gain by staying with you and trying to change than they do by you leaving them.

Can a narcissist change in a new relationship?

For people with narcissistic tendencies when it comes to new relationships, the possibility of change is even lower.

In the initial phases of a relationship, narcissists really turn on the charm.

They know that first impressions count, and they will “love-bomb” you with attention and affection.

But, they can’t keep this up forever, and soon enough, their true, often abusive self, will rear its head.

This is where they start to leverage control over you, to put you in a weaker position so that they can manage your behaviour and keep you in-line.

At this point, they have something to gain by keeping you, as you’ve proven yourself a good source of narcissistic supply.

However, they are too busy turning the charm dial up to 11 in the early phases to worry about changing.

You haven’t yet proven yourself as a steady, controllable source of supply, so there’s no leverage. Changing is probably the last thing on their minds.

How to help a narcissist change?

If you have a narcissist in your life, you might want to help them change.

Can you teach a narcissist how not to be a narcissist? As we’ve seen in our discussion, the outlook sadly isn’t great.

But if you do decide to go down this route, here are a few things to keep in mind:

Be realistic

Refer back to Greenberg’s seven criteria for success in therapy above.

Does your narcissist meet all of these criteria? Any of them? The fewer of them he meets, the less optimistic you should be about your chances of success.

If the narcissist doesn’t look like a good candidate for success in therapy, don’t pretend that they are.

Work with your own therapist

It will be a difficult path for both of you. If you are sure that this is what you want to do, then you should certainly work with a therapist yourself.

This will help you deal with the likely emotional turmoil ahead.

Maintain boundaries

It’s very important to set and maintain boundaries with narcissists, even if they do appear to be making some progress.

One boundary might be, for example, if they speak to you insultingly, you will leave the house and stay somewhere else for the night.

If some time down the line, they do start saying nasty things to you, you must follow through on this.

They will try to turn you around: “Oh I’m sorry, it was just a slip-up, I’ve been doing great up to now, it won’t happen again.”

But you must follow through. Otherwise, you reward the behaviors you’re trying to discourage.

Be prepared to bail out

Beyond boundaries, you should also know what behaviors are full-on deal breakers.

Even though you may love the narcissist, and you may understand that they act the way they do because of a mental health condition, there are some behaviors you should not accept.

If they engage in abuse of any kind (physical, intimacy, or emotional), take steps toward leaving them. You’re not obliged to endure 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!

Do Narcissists Know What They Are Doing?

It’s tempting to give narcissists the benefit of the doubt, especially if you’re in love with one.

You might want to believe that they’re unaware of their destructive behavior and that their manipulative ways are completely subconscious.

Many people who’ve struggled to survive a narcissistic relationship have asked themselves, “Do narcissists know what they are doing?”

And you can understand why. It’s hard to believe that someone who claims to love you would intentionally treat you so badly. 

Narcissists may not be aware every time they manipulate, gaslight, or blame you for something they did, but they are aware of their general behavior, much of which is premeditated. 

Of course, it’s never that simple with narcissists, so we need to dig a little deeper.

In this article, I want to examine whether narcissists are truly oblivious to the pain they cause or if their actions are intentional.

Are Narcissists Self Aware?

Narcissists know when they’re love bombing you or gaslighting you. They invest time and thought into their manipulations, ensuring they’ll have their desired effect. 

There’s nothing wrong with a narcissist’s level of self-awareness – the problem stems from their lack of empathy.

Narcissists know that flying into a narcissistic rage will upset you or even drive you to tears, but they don’t really care. 

One of the easiest ways to understand a narcissist’s behavior is to compare them to a dog (not very flattering, I know, but bear with me). 

When a dog barks at you, it’s not doing it to upset you or even frighten you – it just wants you to go away. It doesn’t think about or even care how its behavior makes you feel as long as it has the desired outcome. 

The narcissist behaves in the same way. They can see that their behavior upsets you but can’t empathize with those emotions, so think no more about them. 

A degree of premeditation is essential. It would be impossible to consistently love-bomb and then devalue someone without a certain measure of self-awareness.

Sadly, the narcissists’ self-awareness is a little different from other people’s.

If we behave in a manner that upsets someone else or is perceived as antisocial, we strive to change and become better people in the eyes of others. 

Narcissists don’t have this desire. They’re ego-dystonic, meaning they see their behavior only in terms of their self-image and goals, so it doesn’t arouse the same self-recrimination in them as it does in others. 

Do all Narcissists Know What They are Doing is Wrong?

Narcissists may have some self-awareness, but that doesn’t shed much light on the question, “Do narcissists know what they are doing is wrong?”

We need insight into their complex thought patterns to answer that. 

While some narcissists may recognize their behavior as problematic, others might genuinely believe their actions are justified or even righteous because they achieve certain goals.

Think about it like this – a narcissist believes they’re perfect and superior to everyone around them.

In their formative years, no one ever told them what they were doing was wrong, so they never learned to be accountable for their behavior or learn from their mistakes. 

Researchers at Oregon State University found that because narcissists refuse to acknowledge they’ve made a mistake, they fail to learn from them.

They lack the self-reflection to recognize bad behavior and the motivation to change it. 

Even if they recognize that they’ve done something wrong, they’ll refuse to take responsibility for it, either by understating it or blaming someone else for provoking it. 

For instance, a narcissist might realize that cheating on their partner is wrong.

Still, instead of owning up to it, they might shift the blame onto their partner, claiming that the partner’s perceived coldness or inattentiveness pushed them into the situation.

In essence, the degree to which narcissists comprehend the wrongfulness of their actions can vary greatly.

It’s often intertwined with their deeply ingrained self-image, upbringing, and capacity for self-reflection.

In general, most narcissists are aware that their behavior might be considered wrong but don’t accept that the rules that apply to everyone else apply to them. 

Narcissists believe themselves so superior that they think they can break the rules and get away with doing things others would be admonished for. 

Do Narcissists Know They are Manipulating?

Not every manipulation will be premeditated, but the narcissist will be aware of their manipulative behavior. 

So, “do narcissists understand what they are doing?” – to a degree. In some instances, narcissists aren’t just aware of what they’re doing but also proud of it.

In other situations, a narcissist may react subconsciously, using well-worn patterns of behavior simply out of habit rather than conscious intent. 

I’ve got a couple of examples to help illustrate my point. 

Premeditated Manipulation

Imagine you’re in a committed relationship with a narcissist, but his need for attention and validation is such that he’s always looking out for other opportunities to boost his self-esteem.

After a few months, he feels his narcissistic supply is drying up and seeks the thrill of a new context.

He plans each moment of his deception, starting by strategically creating distance between himself and you.

He instigates subtle arguments, withdraws emotionally, and starts planting seeds of doubt about the stability of your relationship.

The narcissist then pinpoints a co-worker who’s shown a friendly interest in him and starts spending more time with her, telling her his relationship with you is on the rocks and hinting at his emotional vulnerability.

He slowly escalates the physical aspect of their relationship, love-bombing her into believing this relationship is all he’s ever wanted.

At the same time, he rationalizes the affair, telling himself he has every reason to look elsewhere because you’re not giving him the attention he deserves. 

When you finally find out about the affair, he blames you for his infidelity, saying you’ve been emotionally distant and neglectful.

This is a clear example of deliberate manipulation. Not only did your partner prepare the ground for his betrayal.

He also identified a target, pursued her, and justified the affair to himself while maintaining the role of the victim in his relationship with you. 

Subconscious Manipulation

Narcissists might behave unconsciously in a different scenario, but their manipulation will be just as effective. 

Imagine your narcissistic partner feels insecure in the relationship and employs passive-aggressive tactics to manipulate your emotions.

When you tell him you’ll spend the evening with friends, he responds, “Oh, you’re going out with them again? I guess you really enjoy their company more than mine.” 

This makes you feel guilty and conflicted, even though your partner is completely unaware of his passive-aggressiveness. 

His actions reflect his unconscious efforts to control your emotions to maintain security in their relationship.

Whether intentional or subconscious, narcissistic manipulation is confusing and hurtful.

It may be the product of planning or could be the result of their ingrained behavior patterns. 

In either case, the impact on those around them can be deeply damaging and emotionally distressing. 

Do They Know They Are Using You?

Narcissists may have some self-awareness but are not in tune with those around them.

Remember, narcissists see other people as extensions of themselves rather than autonomous beings, so they believe they have every right to control and use them to achieve their goals. 

This brings us back to the narcissist’s understanding of right and wrong.

They may know it’s wrong for someone to cheat on their partner, but they don’t believe it’s wrong for them because they’ve justified the behavior in their minds. 

From their perspective, they’re not hurting you; you were in the way and accidentally got caught in the crossfire. 

Imagine you’re a soldier on the frontline, and you have a choice between shooting one of the enemy or being shot yourself.

In this context, you won’t feel guilty about killing someone, as it was the only way to ensure your survival. 

Similarly, narcissists justify their manipulations by viewing them as necessary for survival, fulfillment, and validation.

This unique perspective allows narcissists to detach themselves from their actions’ consequences emotionally.

Instead of seeing their targets as individuals with feelings, they view them more like obstacles in their path to getting what they want. 

This lack of empathy and inability to see things from another person’s point of view contributes to their manipulative behaviors. 

In this light, the narcissist’s actions are not perceived as morally wrong in their own internal narrative, and they may not even consider the possibility that they’re causing harm or pain. 

Do They Know They Are Narcissists?

Most narcissists know they are narcissists, especially as they mature. Researchers at Washington University in St. Louis found that narcissists know they’re narcissists and are proud of the fact.

They also know other people think they’re narcissists but don’t care – they would rather be admired than liked. 

Researchers also believe that narcissists may downplay their behaviors to make them seem more acceptable.

For instance, if you tell a narcissist they’re being arrogant, they might perceive it as a compliment, thinking you mean deservedly confident. 

Do They Consider Themselves Evil?

Narcissists think their actions are completely justified. Even though some narcissists intentionally hurt other people, they don’t necessarily see that behavior as wrong or evil.

If you’ve ever wondered, “Do malignant narcissists know what they are doing?” The most accurate answer is both yes and no. 

From their perspective, they might acknowledge that their actions can cause harm, but they often justify their behavior based on their own needs, desires, and self-centered worldview. 

This lack of empathy and the conviction that their actions are warranted prevent them from considering themselves as doing something genuinely wrong or evil. 

Instead, they might rationalize their actions as necessary or even righteous within their distorted understanding of the world.

Can You Make Narcissists Understand What They Are Doing?

You might be able to get a narcissist to develop some level of self-reflection about their behavior if you approach the situation correctly. 

As we’ve already established, most narcissists know they are narcissists but don’t necessarily see this as bad.

They also know their behavior impacts you but can’t empathize with your emotions, so they don’t care. 

As a result, you might find it challenging to get a narcissist to understand what they’re doing.

Ask Pertinent Questions 

When you witness a narcissist making unreasonable demands, call them out. Ask them, “Do you think that request is reasonable?” Or “How would you feel if I asked you to do that?”

Hold a mirror in front of the narcissist and encourage them to look at their reflection and see themselves from your perspective. 

Don’t Blame the Person

Accusing a narcissist of being a narcissist sounds confrontational and may lead to them becoming defensive, so focus on specific examples of their behavior instead.

For example, instead of saying, “You’re such a narcissist,” you could say, “I noticed that during our conversation, you repeatedly interrupted and redirected the topic to yourself.

I find such behavior narcissistic, and it makes me feel like you don’t value my thoughts or feelings.

This approach highlights the behavior while also expressing your feelings, making it more likely for the narcissist to engage in a constructive dialogue.

Use Humor 

Using humor can indirectly help a narcissist understand their behavior without triggering their defensiveness.

Let’s say you have a friend who consistently dominates conversations with their own stories.

Instead of saying, “You’re always making conversations about you,” you could take a more humorous approach: ”You must be the world’s greatest storyteller; every conversation becomes a thrilling episode of ‘The Me Show’!”

This adds a playful twist to the situation and might make them pause to consider their behavior.

It also reduces the likelihood of them feeling attacked or becoming defensive, creating a more open space for self-reflection.