Can Narcissism Be Successfully Treated in Counseling?

 By: Brian Murray, LMHC 

 

Is it possible to treat narcissism? It really depends on the counselor you ask. Some say yes while many are likely to say no. There are a lot of counselors out there who feel this condition is next to impossible to treat. Treating narcissism is a very difficult and time-consuming effort on behalf of the therapist, even for the most qualified. Treatment can be equally frustrating for the client. Most narcissistic clients end up feeling defeated through lack of change and quit prematurely usually within the first 1-6 months. This is partly due to high expectation due to the general condition of narcissism and perhaps a therapist who is not used to treating narcissism.

Treating narcissism requires a therapist who is experienced and has equipped themselves to take on these personality types. Self-reflection and forming internal resolutions with the client are very common in counseling, however, these same processes have led to the narcissist building a library of internal bias that is conflicting to the world around them. In other words, this internal reflection with a narcissist has led to a disorder of their personality.

A well-trained counselor who specializes in narcissism can easily spot and create interventions that help the narcissist change their internal perspective of who they are and how they interact with others. So, can narcissists be treated? Absolutely! However, it is a marathon of counseling that can easily take 1-2 years on a consistent basis. Changing a narcissist is the equivalent of changing someone’s personality and it can be a grueling process, but it is possible. To put this into perspective, think about what it would take for you to change your personality.

So how does a narcissist change? Like any change in counseling, the client must want to change. When examining a call for change it is important to identify the “change agent.” This agent is the one, or both in couples counseling, who owns the problem and needs things to be different. This involves a motivation check at the beginning of the counseling process, setting goals and the client articulating the change they desire.

The same goes for narcissistic clients, however there is one caveat that must take place first. They may not know what needs to be changed because they don’t see themselves as having a problem. They are too special to have problems. Typically, narcissists seek counseling as a result of some kind of difficult relationship, marriage problems, addictions, affairs and difficult uncontrollable feelings and play victim as to why they struggle. At times they may be forced into counseling due to threats or coercion from others.

Discovery in counseling reveals a diagnosis of Narcissistic Personality Disorder as observed by the clinician. Counselors are usually now faced with a choice of how to address the diagnosis. One way is to describe the diagnosis to the client and hope they are accepting of the condition, and if so, then discuss treatment options. Some therapists do not discuss a diagnosis and just treat the symptoms. Just treating symptoms with a narcissist will not work as it’s a core root developmental issue that stems back to childhood. For example, coping strategies for unwanted behavior will not work because the root cause is due to much deeper issues.

So, first things first with treating narcissism which is to build awareness. This can be very tricky with a narcissist. Telling someone they are a narcissist too early in the counseling process is likely to run them off or create tension in the counseling session. There is a saying, If you poke a dragon they will breathe fire. The narcissist’s ego is the fire breathing dragon. Slowly building awareness of how their behaviors are working against them is key, emphasis on slowly. Telling them several sessions that they suffer from narcissism is much easier for them to accept. At this point the diagnosis serves more like a compass giving direction as opposed to name calling. Narcissists are often very sensitive at their core and so it may take a while for them to handle their reality. This is why they are so arrogant and boastful externally as they are trying to compensate for their internal lack of self-esteem.

At this point after building self-awareness and the client accepting of the diagnosis the real work can begin. Both counselor and client know exactly what is going on and what direction they are both headed. Skill building in various forms comes next such as understanding empathy and developing bilateral communication skills. The narcissist can begin to conceptualize how their words and behaviors are affecting others and negative feelings can manifest because of how they are engaging with others. As with any change in life, these changes form new habits for the narcissist to constantly practice until they become better.

A narcissist with their newfound skills set and putting them into daily practice will see results with changes in their social lives whether it’s their jobs, marriage and family. It is typically a lifelong effort that will have to be managed. It’s a lot like recovering from an addiction, just because you are not who you were, you still have to be vigilant so that old ways don’t creep back into their lives. Ongoing supportive therapy can be helpful at this point with most recovered narcissists visiting typically every 1-3 months. 

 

To schedule an appointment with Brian Murray,
Please call our office at 407-647-7005.
www.lifeworksgroup.org