What Is The General Approach to Treating Narcissistic Personality Disorder (NPD)?
MoodRx Clinical Staff - 2024-02-29

What Is The General Approach to Treating Narcissistic Personality Disorder (NPD)?

What Is The General Approach to Treating Narcissistic Personality Disorder (NPD)?

It's important to note that treating narcissistic personality disorder (NPD) can be challenging due to the nature of the disorder, which involves significant ego-syntonic features and a lack of insight into one's own behaviors. However, there are some approaches that may be beneficial in working with individuals with NPD:

  1. Engage in Psychotherapy: While individuals with NPD may be resistant to seeking therapy, engaging in psychotherapy can be helpful in addressing underlying issues and improving interpersonal functioning. Cognitive-behavioral therapy (CBT), psychodynamic therapy, and schema-focused therapy are among the approaches that may be considered. Therapy can focus on exploring underlying vulnerabilities, developing empathy and self-awareness, and improving coping skills.
  2. Set Boundaries: Establish clear and consistent boundaries in the therapeutic relationship to prevent manipulation or exploitation. It's important to maintain professional boundaries and not tolerate abusive or inappropriate behavior.
  3. Focus on Concrete Goals: In therapy, focus on concrete goals and outcomes that are relevant to the individual's functioning and well-being. This may include improving interpersonal relationships, managing anger or impulsivity, and developing healthier coping strategies.
  4. Address Core Beliefs and Insecurities: Explore the underlying beliefs and insecurities that contribute to narcissistic behaviors. Help individuals recognize and challenge distorted perceptions of themselves and others, and work on building self-esteem and self-worth based on more realistic and adaptive foundations.
  5. Develop Empathy and Perspective-Taking: Encourage individuals with NPD to develop empathy and perspective-taking skills by considering the thoughts and feelings of others. This may involve exploring the impact of their behavior on others and practicing perspective-taking exercises.
  6. Encourage Self-Reflection: Facilitate self-reflection and introspection by encouraging individuals to explore their thoughts, emotions, and behaviors in therapy. Help them identify patterns of behavior that contribute to relationship difficulties or personal distress.
  7. Promote Emotional Regulation: Teach individuals with NPD techniques for managing intense emotions, such as mindfulness, relaxation exercises, and emotion regulation skills. Helping them develop healthier ways of coping with emotional distress can reduce impulsive or destructive behaviors.
  8. Address Co-occurring Conditions: Address any co-occurring mental health conditions, such as depression or anxiety, that may contribute to or exacerbate narcissistic traits. Medication may be considered for managing symptoms of co-occurring conditions, but it's important to recognize that there are no specific medications for treating NPD itself.
  9. Involve Family Members: In some cases, involving family members or loved ones in therapy can be beneficial for improving communication and addressing relationship dynamics. However, it's important to ensure that family involvement is appropriate and does not contribute to enabling or reinforcing maladaptive behaviors.
  10. Manage Expectations: Manage expectations for therapy and recognize that change may be slow and incremental. Individuals with NPD may be resistant to acknowledging or addressing their symptoms, and progress may require patience, persistence, and ongoing support.


It's important to approach treatment for narcissistic personality disorder with empathy, compassion, and a focus on collaboration. While change may be challenging, with the right support and therapeutic interventions, individuals with NPD can work toward improving their relationships, gaining insight into their behaviors, and leading more fulfilling lives.