There are several forms of therapy that can treat narcissistic personality disorder, though much depends on the person’s ability to stick with treatment. However, change is possible.

Narcissistic personality disorder (NPD) is a personality disorder included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the “personality disorders” category.

NPD is characterized by the following:

  • a lack of empathy
  • a strong need for admiration
  • a pervasive pattern of grandiosity

Living with NPD can be hard. The condition can negatively affect your relationships and your career. You can also come across as selfish and self-absorbed when in reality, you may experience feelings of intense insecurity.

That said, a 2018 research review showed that true NPD is not common. It requires a diagnosis by a mental health professional, such as a psychiatrist or psychologist.

Let’s take a look at the common therapies and treatments, as well as tips on where you can find help.

Your mental health provider will begin by assessing your psychological functioning. They’ll also consider differential diagnoses and coexisting conditions before recommending a plan for treatment.

Therapy for NDP will likely involve:

  • helping you overcome resistance to therapy
  • identifying narcissistic behaviors that are causing problems in your life
  • examining past experiences and assumptions that led to narcissistic behaviors
  • acknowledging how these behaviors affect others
  • replacing grandiose thoughts with more realistic ones
  • exploring new patterns of behavior and practicing them
  • seeing the benefits of newly learned behaviors


Psychoanalysis is a form of talk therapy. Through one-on-one sessions, you’ll explore the reasons behind your feelings and behaviors.

As you begin to understand your past, current emotions and behaviors come into focus. This can help you better manage your thoughts and feelings. Then, you can start changing the way you react to them.

Cognitive behavioral therapy (CBT)

The focus of CBT is to identify unhealthy patterns of thought and behavior and replace them with healthier ones.

You’ll practice new skills with your therapist. You’ll also have homework assignments to put these skills into action between sessions.

Schema therapy

Schema therapy is an integrative approach to therapy. It combines elements of psychotherapy and CBT.

The aim is to help you identify and understand unhelpful patterns and coping mechanisms that formed from early childhood experiences. Once you uncover these maladaptive schemas, you can learn to modify them.

Gestalt therapy

Gestalt therapy is a form of psychotherapy. You’ll focus more on the present than the past or the future. Earlier life experiences are considered in the context of how they affect you today.

You’ll be encouraged to reflect on what’s happening in your life now. You’ll work on improving self-awareness and self-responsibility.

Mentalization-based therapy (MBT)

MBT works on improving your ability to reflect on yourself, as well as the thoughts and emotions of others. Then, you’ll learn to connect emotions to behavior patterns.

You’ll explore the intent behind other people’s behavior and work on thinking things through before reacting.

Transference-focused psychotherapy (TFP)

In TFP, you take your emotions about someone else and direct them toward the therapist. This may make it easier to talk things through. The therapist can help you gain insight into your thoughts and feelings.

Dialectical behavior therapy (DBT)

DBT is a form of CBT with a focus on the following:

  • mindfulness
  • emotion regulation
  • distress tolerance
  • interpersonal effectiveness (relationship skills)


Applying a modified version of DBT, psychoeducation can help you better understand your emotional and internal experiences.

This can give you a feeling of greater control and authority over your feelings and mental state. It can also help reduce fear related to losing control of unfamiliar emotions.

Lastly, it can also help you increase your motivation for treatment by giving you a better understanding of its purpose and what things in your mind may stand in the way of your success.

Metacognitive interpersonal therapy (MIT)

MIT is a step-by-step treatment designed to:

  • dismantle narcissistic processes by looking at problems as they pertain to your own life
  • recognize maladaptive patterns and interpersonal functioning
  • promote change by distancing from old behaviors and building new adaptive patterns

The therapist will also look for barriers to effective therapy and work to help improve them.

Eye movement desensitization and reprocessing (EMDR) therapy

In EMDR therapy, the assumption is that narcissism is based on difficult early life experiences or traumas.

EMDR therapy is a step-by-step process divided into eight distinct phases. As you progress, you’ll be encouraged to address the following:

  • negative memories
  • traumatic events
  • emotional triggers

As you do, the therapist will direct eye movements to divert your attention. The goal is to lessen the impact of traumatic memories.

Group therapy

Combining group therapy with individual therapy can help you challenge and confront feelings of shame, dependency, difficulty relating to others, and narcissistic fantasies.

This happens through the interaction with others in your group.


The Food and Drug Administration (FDA) hasn’t approved any medications specifically to treat NPD.

That said, a doctor may choose to treat certain symptoms, especially if you are also diagnosed with another mental health condition like anxiety or depression.

For instance, your doctor may prescribe selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Lifestyle changes

Different things may work for different people. It’s a good idea to try to lead a healthy lifestyle by eating a balanced diet, exercising, and avoiding alcohol or other substances that can increase problematic behaviors.

Practicing relaxation through mindfulness and meditation can also help. While you’re doing this, try your best to attend all your therapy sessions. Focus on making progress one step at a time.

If you’re concerned that you exhibit narcissistic behaviors, consider contacting a medical or mental health professional for evaluation.

Even if you only have a few tendencies toward narcissistic behavior, therapy can help you look at things differently.

According to a small 2017 review of case studies, people who have NPD experience significant social problems and multiple medical conditions, so it’s worth seeking help.

Also, what appears to be narcissistic behavior could very well be due to another condition.

NPD doesn’t always present the same way. A broad spectrum may exist that includes covert narcissism and malignant narcissism. A qualified doctor or therapist can help determine the best approach.

You can start with your primary care doctor. They can refer you to a qualified psychiatrist or psychologist experienced in the treatment of NPD.

You can learn more about finding a provider at these sites:

What therapy is best for narcissism?

There’s no one therapy modality that is considered best for treating NPD. What works for one person may not work for another. Only a qualified mental health professional can help you find the right approach for you.

Can narcissism be treated or cured?

It’s not so easy to stop having NPD. That said, with the right therapy, you can learn to recognize your triggers and learn coping mechanisms or behavioral changes that can make a lasting, positive impact on your life.

How to tell if someone is narcissistic?

There are certain traits commonly associated with narcissism, such as a lack of empathy, a big ego, underlying low self-esteem, or a need for attention. However, people can exhibit these traits and not have NPD. Only a mental health professional can give you a diagnosis.

NPD is a mental health condition typified by grandiose ideas, lack of empathy, and need for admiration.

Despite the frequent use of the word “narcissism,” the actual disorder is not common. It takes a mental health professional to make the diagnosis.

Narcissistic behaviors can affect your relationships and your quality of life. But a variety of therapies can help you learn to change these behaviors for the better. These are usually long-term treatments that depend on a willingness to continue over the long haul.