Is narcissism treatable?Is narcissism treatable? was the question I asked myself as I was thinking about a persistently self-centered person I encountered in the online forum I help moderate.
It occurred to me that I'd been seeing quite a few articles on dealing with difficult people recently. Many of these difficult types exhibit unhealthy narcissistic traits. (There is such a thing as healthy narcissism, but what I'm talking about here is an exaggerated self-love that is definitely not healthy.)
I turned to Google to see what might be available on the Web concerning the prospects for successful treatment of narcissism.
One of the first sites I came upon, wiki.answers.com, is populated almost entirely by amateurs, but that was still helpful. Reading laypeople's responses to the question, What is the treatment for narcissists? gave me a practical sense of how this personality disorder affects people who have to cope with narcissists (a fresh illustration of the value of Web-enabled conversation). There were even a couple of self-confessed narcissists who weighed in, one of whom said
... I'm not happy with being a narcissist, and have been working to be kind to people without receiving recognition, and I don't want my future wife to divorce me. So please be understanding and encourage narcissists to seek help instead of just crucifying them, even when they really deserve it.Which brings us back to the question, what sort of help is possible?
Narcissism is hard to treat. As reported by Daniel Goleman back in 1988, when diagnoses of narcissism were rising markedly,
[Narcissists] find it difficult to form the warm bond with a therapist that naturally evolves with most other patients. Instead, they often become cold or even enraged when a therapist fails to play along with their inflated sense of themselves.Given the difficulty of treating narcissists, people in the business world often are best advised to adopt protective countermeasures, such as speaking as a group to the offending party's boss and laying out the case for insisting on behavior change (not personality change, since the latter is highly unlikely). It is also important to maintain one's focus on accomplishing the organization's mission and to recognize that the only person you can really control is yourself. Maintaining your own professional standards is in your long-run best interest.
... at some point the therapist will have to deflate the narcissist's grandiosity, if only to help him or her find a firmer reality. It is at that point that the therapist risks becoming the target of the narcissist's rage.