The Real Challenges of Therapy for Narcissists
Published by Dr. S. PON SHYLAJA, Ph.D. | PSYCHOLOGIST
When it comes to therapy for narcissistic individuals, many people wonder if change is possible. But as a therapist, I often find myself telling them that it’s not just a matter of whether change can happen. It’s much more about understanding the challenges involved. When someone asks if they can treat their narcissistic partner, I usually guide them to reflect on why it’s such a tough road.
One reason is the inflated sense of identity many narcissists have. They often see themselves as superior or above needing help, which makes it hard for them to acknowledge that there might be a problem. This inflated self-image leads them to dismiss therapy as unnecessary, thinking they have all the answers already. Additionally, then there’s the tendency to manipulate situations. In therapy, narcissists might try to steer the conversation to paint themselves as victims or to keep the focus away from their behaviors. This strategic approach can derail the therapeutic process, making it difficult for any real progress to occur. They may also perceive therapy as a competition. Instead of engaging in genuine self-reflection, they might focus on impressing the therapist or coming out on top in the discussion.
Fear plays a big role too. Many narcissists worry about being exposed for who they really are. They might be afraid that if they let their guard down, their insecurities and flaws will come to light. This fear often leads to defensive behavior, making it tough for them to open up. Adding to this is an underlying paranoia about how others perceive them. They might feel that the therapist is judging them, which creates distrust in the therapeutic relationship. Narcissists can also have a tendency to idealize authority figures, expecting therapists to fulfill unrealistic roles. If a therapist doesn’t meet these expectations, it can lead to feelings of disappointment and resistance to therapy. They often struggle to process criticism, too. Instead of viewing feedback as an opportunity for growth, they might react defensively or lash out, which stifles meaningful conversations.
Additionally, there’s a constant need for reassurance. Some narcissists look to their therapists for validation, focusing more on receiving affirmation than on engaging in meaningful work. This dynamic can make it feel like the therapy is more about pleasing them than addressing the underlying issues. They also have a fear of dependency, which leads them to reject therapy altogether. Many narcissists pride themselves on being self-sufficient and see needing support as a weakness. Their limited emotional range makes it hard for them to articulate deeper feelings, which further complicates therapy. They might struggle to express sadness or vulnerability, often coming off as shallow or self-serving.
On top of that, narcissists often focus heavily on external success. They equate their worth with achievements, which can make it difficult for them to engage in the internal emotional work that therapy often requires. They may have a history of avoidance, shying away from discomfort and difficult conversations. This defensive posturing can show up as sarcasm or hostility, making it hard to foster a productive therapeutic alliance. Moreover, many narcissists have a pattern of transient relationships, entering and exiting quickly. This transient nature can affect their commitment to therapy. They may not see the value in long-term engagement, which is often necessary for any real progress.
Expecting a narcissist to change is like waiting for a miracle that never happens, risking your own happiness for someone who might not even see that they need to improve. Instead of hoping they will change, it’s important to take care of your own mental health. This means setting clear boundaries, taking time for self-care, and realizing that you can’t control how another person acts or what they choose to do. Your well-being should come first. It’s not just about whether change can happen, it’s about recognizing the deep-rooted difficulties that make it feel like a long shot.
