Narcissists can intentionally or unintentionally trick therapists, as they are used to masking their emotions and putting on a facade to impress others.
They can present as a victim to gain empathy from therapists. They might also downplay or lie about how they treat others.
In family or couples therapy, people often note that the narcissist acts entirely differently when talking to a therapist than they are at home.
And even when narcissists have insight into their behavioral issues and want help, they profoundly struggle with vulnerability and accepting feedback.
Both these barriers can make therapy tremendously challenging.
In this article, I will explore whether narcissists can trick therapists, the behaviors they commonly exhibit in therapy,
the challenges of therapy for narcissists, why they may deceive therapists, and the effectiveness of therapy in treating narcissism.
How Do Narcissists Act in Therapy?
It’s a misconception that narcissists don’t attend therapy. Many of them have received mental health support throughout their lives.
In addition, I see many narcissists pursue treatment on their own accord. That said, therapy may not always address narcissism directly.
Here’s what narcissists often do in therapy sessions:
#1 Focus on Other Issues
Narcissism is comorbid with many other conditions, including depression, anxiety, substance use disorders, and eating disorders.
Narcissists may enter treatment because they recognize needing support for those other issues.
They may also make significant progress treating those symptoms even if they don’t touch their narcissistic behavior.
However, narcissistic traits tend to affect all areas of functioning. Therefore, relapse rates tend to be high.
And even if the narcissist achieves sustainable recovery with one issue, they might “cross over” into other conditions. I have seen this occur many times and in many settings.
#2 Blame Others
Narcissists may spend much time in therapy projecting and blaming people for their behavior.
Because the therapist only hears one side of the story, they might not fully understand what’s going on.
This can cause the therapist to unknowingly believe the narcissist’s version of the story as the absolute truth.
Because many narcissists have complex histories of trauma, it can be easy to assume that the narcissist is solely a victim of their past.
Narcissists may spend many years in therapy talking about their past hurts, but the progress will feel stunted or nonexistent.
#3 Seduce/Impress the Therapist
Many narcissists selectively filter what they disclose in therapy. They might, for example, only highlight their successes or talk about what they’re doing well with respect to working on a specific issue.
But the opposite may also be true. Sometimes, narcissists present as having a tough time gaining more sympathy and validation from the therapist.
When this is the case, they might use their therapist as a narcissistic supply.
It’s no secret that most narcissists are experienced storytellers. To receive validation, they often tell stories to elicit certain emotions, whether excitement, fear, disgust, anger, or sadness.
Narcissistic clients may have transference (transferring feelings and reactions about another person onto their therapist), causing them to recreate specific patterns with their therapists.
For example, if a therapist reminds a narcissist of their uninvolved father, they might often brag about themselves, hoping it wins their therapist’s approval.
Why Do Narcissists Trick Therapists?
Narcissists may not intentionally trick therapists, but personality disorders are inherently chronic and persistent. When a narcissist enters therapy,
Here are some explanations about why narcissists might trick therapists:
#1 They Want to Be Perceived Favorably
At their core, narcissists deeply fear rejection. They try to impress or manipulate others to meet their needs to avoid rejection.
This can happen even in therapy, particularly because we therapists are trained to be nonjudgmental and see the good in the clients they treat.
#2 They Have Malignant Tendencies
Malignant narcissists consciously and actively hurt others, often through severe emotional manipulation or even violence.
These clients may present as highly hostile or combative within their therapy sessions.
If a malignant narcissist is mandated to treatment (or given an ultimatum by someone), they might trick their therapist because they don’t have any real incentive to work on themselves.
They want to get other people off their backs.
#3 They Don’t Even Realize They’re Lying
Narcissists often lie so frequently that they don’t even recognize their behavior when it’s happening.
Lying is a way they cope with stress and connect with others. This pattern naturally presents itself within therapy.
Narcissistic clients will tell exaggerated stories or make up complete lies to deceive their therapists.
#4 They Want to Outsmart and Manipulate Their Therapist
Some narcissistic clients trick or manipulate their therapists because they get a thrill out of being smarter than others, especially when that other is deemed an expert.
This may be more common among cerebral narcissists, who are often deeply analytic and intellectual. They often present in therapy as actively trying to prove a therapist wrong.
A good therapist can sense this pattern when it’s happening. But some therapists may feel threatened by the behavior, causing them to withdraw emotionally from the work and relationship.
Is Therapy Effective for Narcissism?
Yes, but it depends.
Narcissistic personality disorder is complex, and therapists aren’t always aware of its presence.
If a narcissistic client comes into therapy with many other presenting issues, those may take precedence over narcissism.
This is especially true if the problems are crisis-oriented, such as suicidal ideation, substance use, or domestic violence.
That said, trauma-informed therapists tend to recognize the role of narcissism as a survival mechanism. They may be better equipped for detecting narcissism and working through it with their clients.
Long-term treatment tends to be more effective than short-term work when it comes to personality disorders.
Building safety and trust with a therapist can take a long time. Narcissists often spend most of their lives “masking” themselves and removing that true mask can take several months (or even years) in therapy.
How Can You Tell If A Narcissist Is Tricking or Manipulating Their Therapist?
You can’t always tell if a therapist has been “fooled.” The reality is that therapy is a complex profession, and all therapists are different when it comes to understanding and treating people.
Some therapists, for example, might recognize narcissism, but they don’t call it out right away because they want to build rapport with their clients.
They know that directly confronting the issue might turn someone away. Instead, they wait until it feels safe to highlight the problematic patterns they have observed gently.
Other therapists might suspect narcissism exists, but narcissistic traits overlap with many different conditions, including other personality disorders, bipolar disorder, anxiety disorders, and even depression.
Likewise, having narcissistic traits does not inherently indicate that someone has a narcissistic personality disorder.
Finally, premature treatment dropout is also a real problem among narcissists.
Many narcissists will stop therapy once they feel the therapist is “against” them.
This can happen after a single comment or nonverbal gesture. It can also occur if the narcissist deems the therapist as “unintelligent” or “unhelpful.”
When this is the case, the narcissist doesn’t even have a chance to trick their therapist because they’ve given up on the process.
How Do Psychologists Deal With Narcissists in Therapy?
Psychologists use different strategies to help narcissistic clients. Here are some common ones they use:
- Building trust: Psychologists create a safe and welcoming space for therapy. This helps narcissistic clients feel comfortable and willing to participate.
- Setting boundaries: Psychologists set clear rules for therapy sessions. This helps narcissistic individuals understand their limits and behave appropriately.
- Challenging distorted thinking: Narcissists often have skewed ideas about themselves and others. Psychologists work to correct these distorted thoughts and encourage more realistic thinking.
- Empathy and self-reflection: Psychologists encourage narcissistic clients to consider the feelings of others and think about their own actions. This helps them grow and understand how their behavior affects those around them.
- Addressing underlying issues: Narcissism can stem from past hurts or insecurities. Psychologists help clients explore these underlying issues and past traumas.
- Coping skills: Psychologists teach narcissistic individuals healthy ways to handle their emotions and communicate. This includes techniques for managing anger, improving empathy, and regulating emotions.
- Collaboration with other professionals: Psychologists may work with psychiatrists or family therapists to provide a well-rounded approach to treating narcissism.
Therapy outcomes can vary based on how willing the person is to participate and their understanding of their own behavior.
What Should I Do if I Know the Narcissist in My Life Is Tricking Their Therapist?
Knowing exactly what’s happening is impossible unless you are in therapy with them.
Therapists are legally required to maintain confidentiality, which means they won’t disclose session material content.
I recommend that you try to accept that you can’t control the outcome of what ultimately happens with a narcissist in therapy.
Will a Therapist Tell you if You are a Narcissist?
A therapist typically provides a diagnosis based on their professional assessment and evaluation of a person’s symptoms and behavior.
If a therapist determines that an individual meets the criteria for Narcissistic Personality Disorder (NPD) or displays narcissistic traits, they may share this diagnosis with the person during the course of therapy.
However, this can vary depending on the therapist’s approach and the individual’s situation.
Keep in mind that professional ethics and confidentiality bind therapists, so they will provide feedback and diagnosis in an appropriate and supportive manner.
Can Couples Therapy Actually Help Treat Narcissism?
Skilled therapists can treat couples where one or both partners have narcissistic traits. The work often focuses on setting clear boundaries about what is and isn’t tolerable.
However, if the therapist takes sides or can’t detect the presence of narcissism, therapy may hit an impasse.
In all cases, the narcissist must take accountability for their behaviors and commit to changing how they relate and connect with their partner.
Is Therapy With a Narcissist Ever Productive?
It can be, but the therapist has to be aware of the narcissistic patterns, and the narcissist has to be willing to continue engaging in therapy even if they get “called out.”
Working through past trauma can also help narcissists recognize the origin of the behavior they want to change.
Research on treating people with NPD is limited. However, some studies indicate that schema therapy, mentalization-based therapy, transference-focused therapy, and DBT may help change narcissistic behavior.
I recommend you consider these options if you’re seeking therapy for yourself.
I Think I Am Narcissistic Myself. How Do I Get the Most Out of Therapy?
If you want to stop being a narcissist, honesty and personal accountability are everything.
You must be willing to confront your behaviors, even if they are uncomfortable. Change can be slow, but it’s possible.
Narcissism is often a product of complex trauma- from that framework, you’ve been a victim yourself, and you deserve support and recovery.
I encourage you to try to find someone who has experience treating trauma. You may also find it beneficial if they specialize in treating borderline personality disorder, as traits of BPD and NPD exhibit many similarities.
You may notice yourself disagreeing with your therapist or wanting to quit treatment, but those reactions often result from narcissism.
Sticking it out can help you change your ways even when you feel frustrated.