“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?
1. Can a narcissist ever change?
There are a few ways of looking at this, and we need to define the question a little 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, a number of 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.
Now, because of how the study was conducted, we can’t be sure about the cause and effect here. 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 a stable family life, and avoiding leadership roles, can prevent narcissism 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)?
2. Can a person with narcissistic personality disorder 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 extremely painful 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.
3. Can a narcissist be cured 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.
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 realises that they are only lashing out, bragging, and lying to protect their vulnerable inner self. And if they realise 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.
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.
4. When is therapy for narcissism successful?
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…
5. 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.
In the early phases, however, they are too busy turning the charm dial up to 11 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.
6. 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 to not be a narcissist? As we’ve seen in our discussion up to now, 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 that 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 in an insulting way, 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 are rewarding the very behaviors that you’re trying to discourage.
- Be prepared to bail out: Beyond boundaries, you should also know what behaviours 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 behaviours you should not accept. If they engage in abuse of any kind (physical, sexual, or emotional), take steps towards 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!