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Therapy for Narcissism

Updated: 5 days ago

girl viewing herself in mirror

Alright, imagine there's a person who really, really loves themselves. They think they're the best at everything and they want everyone else to think the same. They might not care much about how others feel, and they could even get upset if someone doesn't admire them as much as they think they should. It's like they have a big mirror in their mind, and all they see is themselves, no matter what's happening around them. They might not be very good at being a good friend because they're so focused on themselves. It's important to remember that underneath all that boasting and self-centeredness, they might actually feel pretty insecure deep down.

Recognizing narcissistic personality disorder (NPD) in oneself can be challenging because

individuals with NPD may lack insight into their own behaviors and may be resistant to

acknowledging any flaws or shortcomings. However, if you're concerned that you may have

NPD, it's important to seek guidance from a qualified mental health professional who can

provide a thorough assessment and diagnosis. In the meantime, here are some signs and

symptoms associated with NPD that you may recognize in yourself:

1. Grandiosity: A pervasive pattern of grandiosity, where you consistently exaggerate your achievements or talents, expect to be recognized as superior without commensurate

achievements, and believe that you are special or unique.

2. Need for Admiration: A constant need for admiration and attention from others, with a

strong desire for praise, recognition, or validation of your superiority.

3. Lack of Empathy: Difficulty recognizing or understanding the feelings and needs of

others, and a tendency to disregard or minimize their experiences, emotions, or concerns.

4. Sense of Entitlement: A sense of entitlement, where you believe that you deserve special treatment, privileges, or recognition without regard for the feelings or rights of others.

5. Exploitative Behavior: A tendency to exploit or take advantage of others to achieve

your own goals or desires, without empathy or remorse for the harm caused.

6. Envy and Jealousy: Feelings of envy or jealousy toward others who you perceive as

having more success, admiration, or attention than yourself, leading to resentment or


7. Arrogance and Haughtiness: An attitude of arrogance, haughtiness, or superiority,

where you may look down on others or belittle their accomplishments or experiences.

8. Interpersonal Problems: Difficulties in maintaining healthy relationships due to a lack

of empathy, a need for constant admiration, and a tendency to manipulate or control


It's important to remember that having some narcissistic traits does not necessarily mean you have NPD. NPD is diagnosed based on a pattern of persistent and pervasive behaviors and attitudes that cause significant distress or impairment in functioning. Research on narcissistic personality disorder (NPD) has explored various aspects of this condition. Scientists have studied its causes, symptoms, and effects on individuals and their relationships. Research has also shown that NPD can lead to difficulties in maintaining healthy relationships and can be associated with other mental health issues, such as depression and anxiety. Therapies like psychodynamic psychotherapy and cognitive-behavioral therapy help treat NPD, although it can be challenging because individuals with NPD may struggle with acknowledging their flaws and seeking help. Ongoing research aims to deepen our understanding of NPD and improve treatment strategies.

Narcissistic personality disorder (NPD) can manifest in various ways, and researchers have

identified different subtypes or presentations of NPD based on observed patterns of behavior and traits. These subtypes include:

1. Grandiose Narcissism (“Thick Skin”): Individuals with this subtype exhibit an

exaggerated sense of self-importance, a constant need for admiration, and a tendency to

exploit others to achieve their own goals. They often display charisma and charm but

may lack genuine empathy for others.

Characteristics: Thick skin narcissists typically display a robust and resilient demeanor. They are often confident, assertive, and unbothered by criticism or negative feedback. They have a strong sense of self-importance and may exude charm and charisma.

Response to Criticism: Thick skin narcissists are less affected by criticism and rejection compared to thin skin narcissists. They may dismiss criticism easily, rationalize their behavior, or even retaliate against perceived threats to their ego.

Interpersonal Relationships: They may have an easier time maintaining relationships because they are less sensitive to criticism and rejection. However, their lack of empathy and tendency to prioritize their own needs can still strain relationships over time.

2. Vulnerable Narcissism (“Thin Skin”): This subtype involves individuals who harbor

deep-seated feelings of insecurity and inadequacy beneath a façade of self-importance.

They may be hypersensitive to criticism, prone to envy, and easily hurt by rejection or

perceived slights. Despite their outward bravado, they may struggle with low self-esteem

and fragile egos.

Characteristics: Thin skin narcissists tend to be more sensitive and emotionally reactive. Despite their outward confidence, they are deeply insecure and easily wounded by criticism or perceived slights. They may oscillate between grandiosity and defensiveness.

Response to Criticism: Thin skin narcissists are highly reactive to criticism, often experiencing intense emotional distress or anger. They may become defensive, engage in blame-shifting, or withdraw from situations to protect their fragile self-esteem.

Interpersonal Relationships: Thin skin narcissists may struggle more in relationships due to their hypersensitivity and difficulty handling conflict. Their emotional volatility and need for constant validation can lead to instability and conflict within interpersonal dynamics.

In summary, while both thick skin and thin skin narcissists share core traits of narcissistic

personality disorder, they differ in their emotional resilience, response to criticism, and

interpersonal dynamics. Thick skin narcissists exhibit a more robust and confident demeanor, whereas thin skin narcissists are characterized by heightened emotional sensitivity and reactivity.

Therapy can bring about various changes in individuals with narcissistic personality disorder

(NPD), although progress can be challenging due to the nature of the disorder. Some potential changes that therapy can facilitate include:

1. Increased Self-awareness: Therapy can help individuals with NPD gain insight into

their thoughts, emotions, and behaviors. Through self-reflection and exploration, they

may develop a deeper understanding of the underlying causes of their narcissistic


2. Empathy Development: Building empathy is a key goal of therapy for individuals with

NPD. Therapists may use techniques such as perspective-taking exercises and role-

playing to help clients understand the impact of their behavior on others and cultivate

empathy towards their feelings and experiences.

3. Improved Interpersonal Relationships: Therapy can provide a safe space for

individuals with NPD to explore and address relational challenges. By learning healthier

communication skills, boundary-setting, and conflict resolution strategies, they can

enhance their ability to form and maintain fulfilling relationships.

4. Reduction in Grandiosity and Entitlement: Through therapy, individuals with NPD

may gradually learn to recognize and challenge their grandiose beliefs and entitled

attitudes. By examining the unrealistic expectations they hold for themselves and others,

they can work towards developing a more realistic and balanced sense of self.

5. Coping Skills Development: Therapy can equip individuals with NPD with coping skills to manage stress, regulate emotions, and tolerate discomfort. Techniques such as

mindfulness, relaxation exercises, and cognitive restructuring can help them cope more

effectively with challenging situations and triggers.

6. Treatment of Co-occurring Issues: Many individuals with NPD may also struggle with

co-occurring mental health issues such as depression, anxiety, or substance abuse.

Therapy can address these issues concurrently, improving overall well-being and


Therapy can help individuals with NPD develop more adaptive ways of thinking, relating to

others, and coping with life stressors. It's important to note that treatment outcomes may vary depending on factors such as the individual's level of insight, motivation, and commitment to therapy, as well as the severity of their symptoms and any co-occurring mental health conditions. Additionally, not all individuals with NPD may be receptive to or benefit from therapy, particularly if they are unwilling to acknowledge or address their narcissistic traits. Nonetheless, for those who are motivated and engaged, therapy can offer valuable support and facilitate meaningful growth and change over time so individuals can learn to manage their symptoms more effectively and experience improvements in their relationships and overall quality of life. If you feel ready to take the leap, click here to schedule a session Houston Therapy.

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