Can narcissists be cured

Answer 1

Disciplinary intervention, for the illegal activities of a person suffering from NPD, including but not limited to the domestic abuse symptoms of this disorder, handled by a trained domestic violence officer, limiting the sufferers illegal behaviour, with co operation from the narcissists intimate family (zero tolerance), without disrupting the integrity of the sufferers family unit, is regarded by 'front line' experts in domestic violence to be the most responsible and effective course of action.

This type of early intervention is the necessary first step in any treatment protocol, to protect everyone involved, before any other treatment options are considered.

Experts disagree on whether Pathological Narcissism - or, more precisely, NPD - can be "cured". But most of the behaviors associated with NPD can be modified so that the narcissist can live a happy and productive life.

Group Therapies

Narcissists are notoriously unsuitable for collaborative efforts of any kind, let alone group therapy. They immediately size up others as potential Sources of Narcissistic Supply � or potential competitors. They idealise the first (suppliers) and devalue the latter (competitors). This, obviously, is not very conducive to group therapy.

Moreover, the dynamic of the group is bound to reflect the interactions of its members. Narcissists are individualists. They regard coalitions with disdain and contempt. The need to resort to team work, to adhere to group rules, to succumb to a moderator, and to honour and respect the other members as equals - is perceived by them to be humiliating and degrading (a contemptible weakness). Thus, a group containing one or more narcissists is likely to fluctuate between short-term, very small size, coalitions (based on "superiority" and contempt) and outbreaks (acting outs) of rage and coercion.

Some think that adult narcissists can rarely be "cured", where some scholars think otherwise. Still, the earlier the therapeutic intervention, the better the prognosis. A correct diagnosis and a proper mix of treatment modalities in early adolescence guarantees success without relapse in anywhere between one third and one half the cases. Additionally, ageing ameliorates or even vanquishes some antisocial behaviors.

In their seminal tome, "Personality Disorders in Modern Life" (New York, John Wiley & Sons, 2000), Theodore Millon and Roger Davis write (p. 308):

"Most narcissists strongly resist psychotherapy. For those who choose to remain in therapy, there are several pitfalls that are difficult to avoid ... Interpretation and even general assessment are often difficult to accomplish..."

The third edition of the "Oxford Textbook of Psychiatry" (Oxford, Oxford University Press, reprinted 2000), cautions (p. 128):

"... (P)eople cannot change their natures, but can only change their situations. There has been some progress in finding ways of effecting small changes in disorders of personality, but management still consists largely of helping the person to find a way of life that conflicts less with his character ... Whatever treatment is used, aims should be modest and considerable time should be allowed to achieve them."

The fourth edition of the authoritative "Review of General Psychiatry" (London, Prentice-Hall International, 1995), says (p. 309):

"(People with personality disorders) ... cause resentment and possibly even alienation and burnout in the healthcare professionals who treat them ... (p. 318) Long-term psychoanalytic psychotherapy and psychoanalysis have been attempted with (narcissists), although their use has been controversial."

The reason narcissism is under-reported and healing over-stated is that therapists are being fooled by smart narcissists. Most narcissists are expert manipulators and they learn how to deceive their therapists.

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Here are some hard facts:

There are gradations and shades of narcissism. The difference between two narcissists can be great. The existence of grandiosity and empathy or lack thereof are not minor variations. They are serious predictors of future dynamics. The prognosis is much better if they do exist. There are cases of spontaneous healing and of "short-term NPD" [see Gunderson's and Roningstam work, 1996].

The prognosis for a classical NPD case (grandiosity, lack of empathy and all) is decidedly not good as far as long-term, lasting, and complete healing. Moreover, narcissists are intensely disliked by therapists.

BUT�

Side effects, co-morbid disorders (such as Obsessive-Compulsive behaviors) and some aspects of NPD (the dysphorias, the paranoiac dimensions, the outcomes of the sense of entitlement, the pathological lying) can be modified (using talk therapy and, depending on the problem, medication). these are not short-term or complete solutions � but some of them do have long-term effects.

The DSM is a billing and administration oriented diagnostic tool. It is intended to "tidy" up the psychiatrist's desk. The Personality Disorders are ill demarcated. The differential diagnoses are vaguely defined. There are some cultural biases and judgments [see the diagnostic criteria of the Schizotypal PD]. The result is sizeable confusion and multiple diagnoses ("co-morbidity"). NPD was introduced to the DSM in 1980 [DSM-III].

There isn't enough research to substantiate any view or hypothesis about NPD. Future DSM editions may abolish it altogether within the framework of a cluster or a single "personality disorder" category. As it is, the difference between HPD, BPD, AsPD, and NPD is, to my mind, rather blurred. When we ask: "Can NPD be healed?" we need to realise that we don't know for sure what is NPD and what constitutes long-term healing in the case of an NPD. There are those who seriously claim that NPD is a cultural disease with a societal determinant.

Narcissists in Therapy

In therapy, the general idea is to create the conditions for the True Self to resume its growth: safety, predictability, justice, love and acceptance - a mirroring and holding environment. Therapy is supposed to provide these conditions of nurturance and the guidance necessary to achieve these goals (through transference, cognitive re-labelling or other methods). The narcissist must learn that his past experiences are not laws of nature, that not all adults are abusive, that relationships can be nurturing and supportive.

Most therapists try to co-opt the narcissist's inflated ego (False Self) and defenses. They compliment the narcissist, challenging him to prove his omnipotence by overcoming his disorder. They appeal to his quest for perfection, brilliance, and eternal love - and his paranoid tendencies - in an attempt to get rid of counterproductive, self-defeating, and dysfunctional behaviour patterns.

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By stroking the narcissist's grandiosity, they hope to modify or counter cognitive deficits, thinking errors, and the narcissist's victim-stance. They contract with the narcissist to alter his conduct. Some even go to the extent of medicalizing the disorder, attributing it to a hereditary or biochemical origin and thus "absolving" the narcissist from guilt and responsibility and freeing his mental resources to concentrate on the therapy.

Confronting the narcissist head on and engaging in power politics ("I am cleverer", "My will should prevail", and so on) is decidedly unhelpful and could lead to rage attacks and a deepening of the narcissist's persecutory delusions, bred by his humiliation in the therapeutic setting.

Successes have been reported by applying 12-step techniques (as modified for patients suffering from the Antisocial Personality Disorder), and with treatment modalities as diverse as NLP (Neurolinguistic Programming), Schema Therapy, and EMDR (Eye Movement Desensitization).

But, whatever the type of talk therapy, the narcissist devalues the therapist. His internal dialogue is: "I know best, I know it all, the therapist is less intelligent than I, I can't afford the top level therapists who are the only ones qualified to treat me (as my equals, needless to say), I am actually a therapist myself�"

A litany of self-delusion and fantastic grandiosity (really, defenses and resistances): "He (my therapist) should be my colleague, in certain respects it is he who should accept my professional authority, why won't he be my friend, after all I can use the lingo (psycho-babble) even better than he does? It's us (him and me) against a hostile and ignorant world (follies-a-deux)�"

Then there is: "Just who does he think he is, asking me all these questions? What are his professional credentials? I am a success and he is a nobody therapist in a dingy office, he is trying to negate my uniqueness, he is an authority figure, I hate him, I will show him, I will humiliate him, prove him ignorant, have his licence revoked (transference). Actually, he is pitiable, a zero, a failure�"

And this is only in the first three sessions of the therapy. This abusive internal dialogue becomes more vituperative and pejorative as therapy progresses.

Narcissists generally are averse to receiving medication. Resorting to medicines is an implied admission that something is wrong. Narcissists are control freaks. Additionally, many of them believe that medication is the "great equaliser" � it will make them lose their uniqueness, superiority and so on. That is unless they can convincingly present the act of taking their medicines as "heroism", a part of a daring enterprise of self-exploration, a distinguishing feature and so on.

They often claim that the medicine affects them differently than it does other people, or that they have discovered a new, exciting way of using it, or that they are part of someone's (usually themselves) learning curve ("part of a new approach to dosage", "part of a new cocktail which holds great promise"). Narcissists must dramatise their lives to feel worthy and special. Aut nihil aut unique � either be special or don't be at all. Narcissists are drama queens.

Very much like in the physical world, change is brought about only through incredible powers of torsion and breakage. Only when the narcissist's elasticity gives way, only when he is wounded by his own intransigence � only then is there hope.

It takes nothing less than a real crisis. Ennui is not enough.

Narcissists can change just like anyone else. Psychoanalysts who say narcissists can�t change don�t live in the real world. (I love it when psychoanalysts spend their entire life pretending to study people�s inner workings when all they really do is read Freud. Freud was a real creep. Psychoanalysts declare that narcissists are screwed up, and that there�s no hope of them ever changing because they fell in love with themselves in infancy and did not inappropriately fall in love sexually with their mothers. Huh? Gee, that�s one good way to make a narcissist feel great about his �true self� and to change his ways.)

Even though I don�t have a doctorate in Freud�s frightening material, I�ve formulated my own theory on how a narcissist can improve himself.

To formulate any therapy, one has to understand how the brain thinks.

In general, people form initial impressions or assumptions about the world. Whatever information people receive after forming an assumption either reinforces that assumption or forces them to completely revise that initial assumption. Assumptions are formed from primary social networks and wishful thinking.

Narcissists grew up in an environment where they were ignored unless they performed. Most of the time, they were ignored. But when they performed, their parents gave them intense attention. They clapped and exclaimed �great job�. Narcissists didn�t get love and attention for just �hanging out� and acting normal in their family.

For instance, I was completely ignored until I played the piano. When I played the piano, my mom would clap her hands and say �Wow, that was terrific!� When I went to my friend�s house though, my friend�s parents would constantly talk to her in regular conversations, and they would just hang out and watch TV together. My friend didn�t have to jump through hoops to get the attention she needed. She didn�t have to be super funny or super amazing at the piano.

Thus, I, and other narcissists, formed assumptions early in life that (1) you have to be great to be loved; you have to perform to be loved; (2) you can�t just be normal and be loved; acting normal is boring; boring people are ignored (3) love is intense attention and awe; love occurs when people are jumping up and down shouting �Hooray! Good job Johnny!� (4) You are loved because one time, people clapped their hands after you performed (5) since you are loved, you must be great and are entitled to many things; (6) Other people act normal. Since normal people don�t get attention, they must be unloved, and hence, inferior.

Many of these assumptions need to be revised for a narcissist to heal. These are some skills a narcissist can work on to be better adapted to the world: 1. Become aware of behavior: The first step to healing is to just be aware of the faulty assumptions you made early in life and the pattern of behaviors that developed based on those faulty assumptions. These behaviors might not �work for you� later in life. I believe every narcissist should list specific examples in his life where his behavior was based on faulty assumptions and become aware of his current behavior. He should list different situations where he feels entitled. He should list different things he does to impress people. He should list different examples where he dissed someone or devalued someone. Being aware of behavior is the first painful step, and is half the battle. 2. Start loving the true self: A narcissist needs to start loving his true self. A narcissist isn�t a bad and stupid person. A narcissist simply formed logical assumptions like everyone else based on an environment that wasn�t completely normal. A narcissist just needs to realize that the outside world operates on different assumptions, and that different behavior is rewarded in the real world. A narcissist can relax a little bit. Love is not about being the best circus performer. Love is more about not being such a jack ass. A narcissist can be loved just by being normal. Plus, it may be easier for the narcissist to get love because he probably picked up some cool skills by aiming high early in life. 3. Learn social skills: A narcissist would benefit from picking up a few social skills to make friends. His social skills are underdeveloped because his parents did not interact with him in a normal social manner. His parents rarely sat down to carry on a conversation with him. There are different sets of social skills � seduction skills, skills in keeping a spouse or girlfriend, job interviewing skills, skills in making friends, skills in keeping friends, public speaking skills, assertiveness skills, etc. Usually, a narcissist has no problem seducing the opposite sex initially with their intense attention-getting stares and boasting. And sometimes he has no problem getting his first job because of his performance and boasting skills. But a narcissist has problems making friends and keeping friends. That includes initializing a conversation (not trying to �get noticed�, but to notice someone else). It also includes being interested in whatever small talk another person utters. Friendships require time and investment. Social skills can be developed just like any other types of skills. Someone isn�t a bad person because his social skills aren�t honed. 4. Give and accept love: A narcissist should accept love from a normal person. Not attention and awe. A narcissist should also painfully start giving love to a normal person. A narcissist should initialize a friendship with a new person or initialize sex with his spouse out of the blue. 5. Stop feeling entitled: A narcissist feels entitled to a $200,000 a year job simply because he made good grades in third grade. A narcissist feels entitled to a wife centering her life around him because he paid attention to her for a few seconds at the beginning of the relationship and because he is better looking than her (he picked her out because she was homely). A narcissist doesn�t realize that having a good job is a �verb� and having a good relationship is a �verb�. One has to give something to get something. 6. Surround yourself with healthy people: This assumption applies especially to the inverse narcissist. Healthy people don�t have pissing contests all the time. Healthy people have fun and like each other no matter what their class rank was. 7. Realize the appropriate time to boast: Boasting is OK in a job interview. Boasting is OK when slipped in during a time of courtship. Boasting does not work in making friends. 8. Examine goals: One bonus to a narcissist is that he�s a natural goal-setter. But the narcissist could benefit if he sets his goal to �serve as a good spouse� or �serve as a good lawyer�. Not to �impress the socks off those people�. 9. Become interested in the outside world: Narcissists sometimes lack experience in the outside world. They grew up in this closed, isolated, insane small world. They sometimes have these real bizarre amazing skills that let them get attention, but lack normal skills and habits � like reading the paper, talking to people, people watching, etc. They spend their free time sometimes on becoming even more amazing at a bizarre skill instead of learning about the outside world and becoming normal.

A narcissist can improve his behavior just like anyone else with a little knowledge and a lot of work. The people who are in most need of complex therapy are the psychoanalysts who believe that narcissists should have desired sex with their mothers.

Maybe, following a big narcissitic injury, the narcissict will become aggressive and hurt those who he loves the most. When the dust settles, the narcissist will look at the outcome and realise that hes not the victim anymore, since he has hurt the ones around him who were the most vulnerable to him, just like he was hurt earlier. This can be freeing, but it comes at the expense of inflicting narcissism to others...

Also, it helps to be less hard on yourself, be gentle with yourself. okay :) ?

Answer 2

NO.