How to Treat Narcissistic Personality Disorder

Written by:Bisma Anwar, MA, MSc, LMHC

Published On: July 27, 2022

Medically reviewed by: Elizabeth Keohan, LCSW-C, MSW

Reviewed On: July 27, 2022

Updated On: May 3, 2024

Overview

Although it might be challenging to persuade someone to seek help, treating narcissistic personality disorder (NPD) is possible. Many people with NPD see significant improvement in symptoms and interpersonal relationships after receiving professional care.

If you or a loved one has exhibited symptoms of or has a narcissistic personality disorder diagnosis, you should learn about potential treatments that may help. Here, we’re discussing each of the suggested narcissistic personality disorder treatment options in detail, so you can learn as much as possible as you begin the process of understanding how to deal with narcissistic personality disorder. We will discuss the following treatments for NPD as follows:

  • Dialectical behavior therapy (DBT)
  • Schema therapy
  • Gestalt therapy
  • Mentalization-based therapy (MBT)
  • Transference-focused psychotherapy (TFP)
  • Metacognitive interpersonal therapy
  • Supportive psychotherapy
  • Medication
  • Holistic treatment

Therapy for Narcissistic Personality Disorder

While there’s currently limited research on how to treat NPD, most experts agree that some form of therapy is going to be most effective. NPD can be very complex, which is why it’s always best to work with a mental health professional who has experience treating personality disorders.

How does therapy treat narcissistic personality disorder?

It’s true that narcissistic personality disorder causes are unknown, but we do know that many people with this condition have a history of trauma. During therapy sessions, people have a safe place to discuss and explore their early life experiences. Ultimately, therapy can offer an opportunity to identify experiences that may have contributed to someone developing the types of defense mechanisms that are common in NPD.

In treating NPD, therapists also work with people to help them become more aware of how their (often negative) narcissistic traits and behaviors impact others in their life. NPD can distort the way that someone perceives themselves and those around them. With the help of a therapist, someone with NPD can develop more realistic, healthier viewpoints.

Common goals of NPD therapy might include:

  • Improving empathy
  • Developing healthy coping mechanisms
  • Working on interpersonal skills

Over time, people can begin to correct negative behaviors and improve the way they treat others.

Types of therapy for narcissistic personality disorder

Many types of therapy have been found effective when treating narcissistic personality disorder types.

“Dialectical behavioral therapy is one the best modalities to help individuals with narcissistic personality disorder. It focuses on regulating emotions and interpersonal effectiveness, which can be challenging for such individuals.”

Licensed Mental Health Counselor (LMHC), MA, MSc Bisma Anwar

Dialectical behavior therapy (DBT)

Although Dialectical behavior therapy (DBT) was originally designed to treat borderline personality disorder, it’s now used to treat other personality disorders and mental health conditions as well. It’s a treatment approach that teaches people mindfulness and helps them learn to regulate their emotions. Typically, people will receive both individual and group therapy when using the DBT method.

Schema therapy

In schema therapy, therapists work with people to identify schemas, which are patterns of thinking that influence how we interpret the world around us. People with NPD commonly develop unhealthy schemas during childhood if their emotional needs aren’t met. After identifying harmful schemas, therapists work with people to change these patterns and develop healthier interpersonal skills.

Gestalt therapy

Gestalt therapy for narcissistic personality disorder encourages people to explore their emotions and experiences and see them in a new light. It may include roleplay, guided imagery, and questioning sessions. Through exercises, people begin to become more aware of their behaviors and understand why they act in certain ways.

Mentalization-based therapy (MBT)

Mentalization-based therapy (MBT) is a psychodynamic form of therapy that teaches people to think about their own thoughts. During therapy sessions, people will reflect on experiences and learn to identify the differences between their feelings and the feelings of others. Over time, emotional insight will strengthen, which can help someone learn to regulate negative emotions and behaviors.

Transference-focused psychotherapy (TFP)

Many people with NPD practice a defense mechanism known as splitting, which causes them to see people and events as purely good or bad. During TFP, people learn to transfer their thoughts and feelings to their therapist, who helps them reinterpret events in more productive and useful ways. This practice can help someone start to recognize distorted thinking patterns like splitting and see the world in a more nuanced way.

Metacognitive interpersonal therapy

Metacognitive interpersonal therapy is a two-stage form of therapy that focuses on identifying and changing harmful patterns. During the first stage, people work with a therapist to identify defense mechanisms and negative thought and behavior patterns. In the second stage, they’ll work to strengthen skills like honesty and empathy, allowing them to become more aware of how other people think and feel.

Supportive psychotherapy

Many forms of narcissistic personality disorder treatment look at the causes of narcissistic behaviors, but supportive psychotherapy, also known as supportive talk therapy, primarily focuses on improving symptoms. Therapists work to teach people cognitive behavioral therapy techniques and build healthy coping mechanisms. Family or group therapy may be recommended as part of treatment.

Medications for Narcissistic Personality Disorder

Currently, there aren’t any specifically designated narcissistic personality disorder medications. However, medication may be recommended as part of an overall treatment plan. Medication can be used to treat specific narcissistic personality disorder symptoms such as paranoia, anxiety, or depression.

How does medication treat narcissistic personality disorder?

Researchers have found that people with NPD often have other mental health conditions as well. When someone’s struggling with other symptoms — like paranoia, anxiety, or depression — it can be incredibly difficult to focus on treatment.

In many cases, medication can be beneficial in helping manage symptoms that are getting in the way of successful therapy. The right medication might help to improve mental health and well-being, allowing someone with NPD to put more energy into self-improvement.

Types of medication for narcissistic personality disorder

Medications prescribed to treat NPD will vary based on the symptoms a person has been experiencing or any comorbid mental health conditions they’ve been diagnosed with. People can be prescribed antidepressants, anxiety medication, or other medication that might help ease adverse symptoms.

“Medications have limited effectiveness when it comes to treating NPD. Some medications such as antidepressants or anti-anxiety meds can be effective in minimizing some of the mood-related symptoms. Therapy is the most effective method to treat personality disorders.”

Licensed Mental Health Counselor (LMHC), MA, MSc Bisma Anwar

Holistic Treatment for Narcissistic Personality Disorder

When exploring how to treat NPD, many people are intrigued by holistic options. Research has uncovered that people with NPD often have unhealthy relationships with food or exercise. Building healthier habits can help decrease irritability, putting people in a better position to focus on treatment.

Substances like alcohol and caffeine are known to make the symptoms of most mental health conditions more severe. Limiting consumption of these beverages can make it easier for some people with NPD to control their behaviors.

Stress can be a trigger for emotional outbursts too, which is why natural stress management techniques can be a valuable tool for anyone trying to manage NPD. Breathing exercises, meditation, and healthy sleep hygiene can all be great ways to manage stress.

Find Treatment for NPD with Talkspace

Even though treating narcissistic personality disorder can be difficult, it’s far from impossible. Mental health experts have made great strides in learning how to treat narcissistic personality disorder successfully, and today there are many options widely available for treatment.

If you suspect that you or a loved one has NPD, don’t hesitate to seek care from a mental health professional. It can take time to see results, but most people who start treatment are often able to reduce or improve symptoms and effectively address negative behaviors.

Ready to get help but not sure where to start? Talkspace therapists are here for you, so you can learn to cope with and manage narcissistic personality disorder. Talkspace is an online therapy platform that’s changing how people access solid, proven, and — most importantly — necessary mental health help. Our online services mean you can get the therapy you need to effectively treat NPD or any other mental health condition, when and how you want it. Reach out to learn more about Talkspace today.

See References

Bisma Anwar, MA, MSc, LMHC

Bisma Anwar is the Team Lead for the Talkspace Council of Mental Health Experts. A major focus in her work has been anxiety management and helping her clients develop healthy coping skills, reduce stress and prevent burnout. She serves on the board of a non-profit organization based in NYC called The Heal Collective which promotes advocacy and awareness of mental health issues in BIPOC communities.

Effective and affordable mental health treatment

Get Started

Articles about Narcissistic Personality Disorder

View all articles
Featured Image
Narcissistic Personality Disorder March 26, 2024

How to Heal from Narcissistic Parents

Featured Image
Narcissistic Personality Disorder December 28, 2023

How to Live With a Narcissist

Featured Image
Narcissistic Personality Disorder December 28, 2023

What to Know About Dating After Narcissistic Abuse

Featured Image
Narcissistic Personality Disorder September 28, 2023

How to Respond to a Narcissist

Featured Image
Narcissistic Personality Disorder September 28, 2023

How to Leave & End a Relationship With a Narcissist

Featured Image
Narcissistic Personality Disorder September 27, 2023

How to Get a Narcissist to Respect You

Featured Image
Narcissistic Personality Disorder September 27, 2023

Narcissistic Rage: Identifying & Protecting Yourself From It

Featured Image
Narcissistic Personality Disorder February 21, 2023

How to Diagnose Narcissistic Personality Disorder

Featured Image
Narcissistic Personality Disorder September 29, 2022

Narcissistic Abuse: Examples, Signs, and Effects

Featured Image
Narcissistic Personality Disorder August 30, 2022

Sociopathy vs Narcissistic Personality Disorder: Similarities & Differences

Effective and affordable mental health treatment

Get Started