The term narcissist is often used casually to label people who seem excessively in love with themselves or intensely interested in their own lives.

However, it’s crucial to understand that there’s a significant difference between a person having occasional narcissistic tendencies or traits and the clinical condition known as narcissistic personality disorder (NPD).

According to the Diagnostic and Statistical Manual of Mental Disorders 5, Text Revisions (DSM-5-TR), NPD is a personality disorder that manifests as an inflated sense of self-importance and an excessive need for attention and admiration from others.1

A person with NPD also has a striking lack of empathy for others. While they might come across as overly confident, they typically have a fragile self-esteem that can come apart when criticized.

It’s not entirely understood why NPD occurs. A combination of neurobiological, environmental, and genetic factors is thought to be at play. Some research shows that traumatic childhood experiences or even being excessively spoiled can play a significant role in the development of this condition.

Symptoms of NPD include:

  • Fantasies about success and power
  • A sense of entitlement
  • Exploiting others without guilt or shame
  • Exhibiting arrogant behaviors
  • Feeling they can only be understood by or associate with special or high-status people or institutions
  • Feelings of envy or that others are envious of you

These symptoms can be pretty challenging for the loved ones of people living with this disorder.

If you or someone you love is living with NPD, you might question if a narcissist can change. The answer to this question isn’t a simple yes or no. For a person with NPD to change, they require some self-awareness, therapy, and a genuine desire to change and transform their behaviors.

Narcissistic personality disorder (NPD) is a complex and nuanced condition, and like most personality disorders, it can be difficult to treat. However, this does not mean it is impossible for individuals with NPD to change. They can, with appropriate therapy and a genuine desire to improve their relationships and lives, make meaningful changes.

The Potential for Change

In many cases, a person with NPD is blind to their own hurtful behaviors. This can make it challenging to truly change. For a person to change, they need to recognize that they have a problem that needs to be fixed.

In many cases, people with NPD simply don’t believe anything is wrong with them. They are content with how they behave, and often, they attribute problems in their life or relationships not to their behavior but to the actions or attitudes of friends and loved ones.

Psychodynamic therapists maintain that change is possible when a person gains insight into their unconscious patterns, which can be a significant challenge for people with NPD due to their defensive self-structure.

Acknowledging the disorder and a willingness to change are requirements for any therapeutic process. Sometimes people with NPD arrive at this point when they lose someone they care about or when their behavior becomes less effective in gaining attention or love.

Beyond self-awareness, change for a person with NPD is complicated because it also requires a commitment to follow through. It involves learning new patterns of behavior and ways of thinking that go against years, often decades, of established behaviors.

It involves learning to let go of the need for constant admiration and validation from others and instead finding a sense of self-worth from within. It also means learning to navigate relationships in a healthier, more balanced way—developing empathy, learning to listen, and finding ways to meet the needs of others without infringing on their rights and boundaries.

So, can a narcissist change? In theory, the answer is yes. With the right mindset, tools, and support, a person with NPD can reach a place of better understanding, healthier relationships, and a more balanced sense of self.

“Theoretically, change is possible. It hinges on whether the individual can recognize their problematic behaviors, an introspection that is often elusive to those with NPD. However, the will to change must be self-driven, and this is often where the real challenge lies.

Can NPD Be Cured?

There’s no “cure” for NPD. It’s important to remember that NPD isn’t an illness in the conventional sense; it’s a personality disorder. With an illness, a cure usually means eliminating the disease entirely, like using antibiotics to treat bacterial infections.

But when it comes to NPD, the patterns of thought and behavior associated with the condition are deeply ingrained and form a significant part of a person’s identity. These patterns can’t be gotten rid of easily.

This doesn’t mean there’s no hope for change or significant improvement or growth. A narcissist who sincerely wants to change and is willing to put in the work can learn healthier ways of interacting with others, develop a more realistic and stable sense of self-esteem, and begin to value and respect the needs and boundaries of those around them.

Therapeutic Strategies for Narcissists

As mentioned, NPD is a complex condition deeply ingrained in a person’s sense of self. For people with NPD who don’t see a problem with their behavior, it can be challenging to understand how therapy can help.

However, therapists have developed various strategies tailored to address the unique challenges of NPD. These strategies aim to manage symptoms and help people with NPD rebuild their self-perception and learn healthier ways to interact with the world.

Cognitive Behavioral Therapy (CBT)

One of the most well-known and widely used therapeutic strategies is cognitive behavioral therapy (CBT). CBT is beneficial for people with NPD because it directly addresses distorted thinking patterns. The aim is to help you recognize and question distorted, habitual reactions and beliefs, such as a sense of superiority or entitlement, and replace them with healthier and more adaptive thoughts and behaviors.

Schema Therapy

Another therapeutic approach is schema therapy. It involves identifying and changing maladaptive schemas—deeply held beliefs about self, others, and how the world operates—which can drive self-defeating behavior patterns. Schema therapy is like getting to the roots of a weed. It’s about uncovering the deeper, often subconscious beliefs that drive narcissistic behavior and finding healthier ways to meet one’s emotional needs.2

Dialectical Behavior Therapy (DBT)

Therapists may also use a technique known as dialectical behavior therapy (DBT). This is particularly useful for people struggling with emotional regulation. DBT provides you with new skills to manage painful emotions and decrease relationship conflict. These skills are often underdeveloped in those with NPD.

It’s also important to note the role of group therapy. Narcissists often feel isolated and misunderstood, and being part of a therapy group can provide valuable insights and feedback from peers dealing with similar issues.

Through therapy, people with NPD can explore their early life history and understand the roots of their narcissistic defenses. Therapy can help in revealing and processing unconscious patterns and can make it safer for a narcissist to feel and process the wounds of their early childhood. Over time, this can lead to a shift in their internal world, promoting healthier interpersonal relationships and a more integrated sense of self.

Psychodanimic Psychotherapy

There are several established psychodynamic psychotherapy approaches that focus on unconscious processes that contribute to NPD and often use the exploration of the transference, or the psychotherapeutic relationship, to help understand and modify underlying narcissistic dynamics. These include Transference Focused Psychotherapy (TFP) and Mentalization Based Treatment (MBT).

Practical Tips for Dealing With Narcissists

Living or working with a narcissist can often feel like walking on eggshells. Their unpredictability, lack of empathy, and constant need for admiration can make relationships with narcissists incredibly challenging. However, there are practical strategies that can help you navigate these complex dynamics.

Maintain Firm Boundaries

Narcissists often have a sense of entitlement and expect special treatment from others. They may also disregard your feelings, opinions, or needs. To protect yourself from being exploited or abused, you need to set clear and firm boundaries. For example, you can limit the time you spend with them, say no to unreasonable requests, or refuse to engage in arguments or drama.

Let’s say you have a narcissistic friend who constantly belittles your accomplishments. You can assert your boundaries by saying, “I understand your perspective, but I’m proud of my achievements and would appreciate it if you respect that.” Remember, it’s okay to protect your emotional space.

Practice Emotional Detachment

When dealing with a narcissist, it can be beneficial to practice emotional detachment. This means not allowing a narcissist’s behavior to affect your emotional state or dictate your self-worth. Don’t let their words or actions affect your self-esteem or self-worth. Remember that their behavior is not about you, but about their issues and needs.

Be Realistic About Expectations

When dealing with a narcissist, it’s essential to be realistic about your expectations. If you expect empathy, understanding, or validation that they are unlikely to provide, you set yourself up for disappointment. Acknowledge that they may not be capable of fulfilling these needs and look for ways to fulfill them elsewhere.

Seek Support

Having a solid support system can be invaluable when dealing with a narcissist. This can be a trusted friend, family member, or mental health professional. Sharing your experiences, frustrations, and feelings with someone understanding can provide emotional relief.

Avoid Power Struggles

Narcissists love winning and can draw you into unnecessary power struggles. Try to avoid these by not engaging in arguments that you know are unproductive.

Next Steps

For people diagnosed with NPD, change can seem impossible. However, if you’re able to recognize and acknowledge the need for change, you’ve taken a crucial and significant first step toward getting help. You must also confront deep-seated patterns of thought and behavior you have held for years. As daunting as it may seem, seeking help for NPD can lead to greater self-awareness, healthier relationships, and a more resilient sense of self.