Narcissistic Personality Disorder - Treatment

Treatment

Prominent clinical strategies are outlined by Heinz Kohut, Stephen M. Johnson and James F. Masterson, while Johns discusses a continuum of severity and the kinds of therapy most effective in different cases. Schema Therapy, a form of therapy developed by Jeffrey Young that integrates several therapeutic approaches (psychodynamic, cognitive, behavioral etc.), also offers an approach for the treatment of NPD. It is unusual for people to seek therapy for NPD. Unconscious fears of exposure or inadequacy often cause defensive disdain of therapeutic processes. Pattern change strategies, over a long period of time, are for the narcissist to work on increasing their ability to become more empathetic in everyday relationships. To help modify their sense of entitlement and self-centeredness schema is to help them identify how to utilize their unique talents and to help others rather than for their own personal gain. This is not going to change their self-perception of their "entitlement" feeling but more so help them empathize with others. Another type of treatment would be temperament change.

Anger, rage, impulsivity and impatience can be worked on with skill training. Medication can also be an effective addition if needed. Anxiety disorders and somatoma dysfunctions are prevalent but the most common would be depression. Medication can be extremely beneficial when treating the disorder with regular therapy. Medications to help reduce impulsivity, depression, and anger (along with skilled training) will help the person create interpersonal relationships, be less impulsive, be less angry, and treat the depression/anxiety.

Group treatment has its benefits as the effectiveness of receiving peer feedback rather than the clinician’s may be more accepted, but group therapy can also contradict itself as the patient may show "demandingness, egocentrism, social isolation and withdrawal, and socially deviant behavior." Relationship therapy stresses the importance of learning and applying four basic interpersonal skills: "effective expression, empathy, discussion and problem solving/conflict resolution." Marital/relationship therapy is most beneficial when both partners participate.