Jul 20th 2023
Narcissistic personality disorder (NPD) is a mental health condition associated with a lack of empathy and a pattern of grandiose behavior and a need for excessive admiration. Individuals with NPD are often referred to as narcissists.
Given the negative impact they can have on others, people often wonder if narcissists can change. While positive change is possible, it often requires professional intervention and a willingness to engage in treatment .
The term “narcissist” is often thrown around to refer to individuals who demonstrate narcissistic traits, such as arrogance, lack of empathy, and tendency to take advantage of others for their own gain. In a clinical sense, NPD is diagnosed when a person meets the diagnostic criteria for the disorder .
To be diagnosed with NPD, a person must meet five of the following nine diagnostic criteria :
People who interact with narcissists often wonder if people with NPD can change. This question is commonly asked by people who are in a romantic relationship with a narcissist, or who have a parent, sibling, or close friend with the personality disorder. In many cases, it is the narcissist’s lack of empathy that creates problems, such as antisocial behavior and exploitation of others. When considering whether narcissists can change, it’s helpful to evaluate whether people with NPD can become more empathetic .
One recent study attempted to answer this question by looking at empathy levels in people with narcissistic traits. Case studies showed that people who scored higher in narcissism generally demonstrated lower levels of empathy toward a person, unless a person was experiencing severe depression. On the other hand, individuals who demonstrated maladaptive levels of narcissism lacked empathy, regardless of whether the person in the case study had severe or mild depression .
In the second stage of the above study, participants were directly instructed to take the perspective of a person in a case vignette, who was described as being distressed. Individuals in the control group, who were not instructed to take the perspective of the person in distress, showed low empathy. However, perhaps quite surprisingly, those who were instructed to take the perspective of the person in distress were able to demonstrate empathy, even if they showed signs of maladaptive narcissism .
What can be gathered from these responses is that narcissists are lacking in empathy, but they have the ability to develop it. This would suggest that with proper support and guidance change is possible, but the person with NPD must be willing to accept treatment.
Some other factors impacting change in narcissists are described in more detail below.
Some researchers have theorized that narcissism may decline with age. One recent study found that narcissism generally does decline from young adulthood to middle age, but this depends upon a person’s profession and their family life. For instance, individuals who work in supervisory positions and those who are in unstable relationships show smaller declines in narcissism from young adulthood to middle age .
Another study, which explored narcissism levels in over 250,000 individuals found that levels of narcissism were highest in young adulthood, suggesting that narcissists can change with age .
It is common for people in a relationship with a narcissist to believe they can “love the narcissism out” of the person. The unfortunate truth is that loving a person with NPD will not magically change them.
Individuals with narcissism tend to lack empathy for their partners, which makes it difficult for them to engage in loving, healthy relationships. Because of this lack of empathy, narcissists in relationships are often unstable, manipulative, and detached from reality. This leads to problems in their romantic relationships, demonstrating that even the most loving of partners cannot change these narcissistic traits .
That being said, if a narcissist cares for their partner and wants to maintain the relationship, they may be more motivated to seek treatment in order to change their narcissistic behavior. While change is possible, it may be difficult to get a narcissist to engage in treatment.
Finally, people may ask if it is possible for a narcissist to change with treatment. There are treatments that show evidence of benefit for individuals with NPD. For treatment to be effective, a person with NPD must be willing to engage in treatment, and the therapist must be skilled and able to build a strong alliance with the individual .
Individuals with NPD present with several challenges that can make the treatment process more challenging. For instance, they are likely to drop out of treatment prematurely, demonstrate extreme sensitivity to any sort of criticism (including from the therapist), and show hesitation to accept the NPD diagnosis .
Nonetheless, those who have a willingness to improve their overall functioning can benefit from entering therapy for NPD. The two most-commonly recommended talk therapies for narcissism are psychodynamic therapy and cognitive-behavioral therapy, but many experts recommend an integrated approach that combines these and other modalities .
A psychodynamic approach to therapy includes transference-focused psychotherapy, which can help patients with NPD to explore the roots of their envy, aggressiveness, grandiosity, and defensiveness. Another psychodynamic approach, called mentalization-based therapy, allows individuals to reflect on their own and others’ thinking while linking thoughts to behaviors .
Two cognitive-behavioral approaches that can be effective in the treatment of NPD include schema-focused therapy and dialectical behavior therapy. Schema-focused therapy serves to challenge maladaptive “schemas” or mental models that people build in childhood, and dialectical behavior therapy (DBT) teaches skills including mindfulness, emotion regulation, and distress tolerance .
If you or someone you love demonstrates symptoms of NPD, there are ways to change the unhealthy and abusive behaviors associated with this disorder. The following strategies can be helpful for behavioral change:
Rather than turning to unhealthy coping mechanisms, such as excessive spending, substance misuse, or risky sex, find healthy coping skills that help you to feel better and manage uncomfortable emotions, such as anger, jealousy, and disappointment. Engaging in hobbies, getting physical exercise, and making time for rest and relaxation can be beneficial ways of coping.
As research has shown, individuals with NPD can learn to be more empathetic by considering the perspectives of other people . When you’re interacting with someone who is upset or distressed, try to consider what they are experiencing. How would you feel in the same situation? How might you act? Pausing to consider others’ perspectives can train you to become more empathetic.
In most cases, ongoing treatment is necessary for a narcissist to change in meaningful ways. This means that it’s essential for you to seek treatment and follow your treatment plan. Remain engaged in counseling, even when it makes you uncomfortable. If you’re having a hard time staying committed to treatment, think about your goals, as well as what you might have to give up if you don’t make changes.
The grandiosity and defensiveness that comes along with NPD can make it difficult for individuals with this disorder to change. However, change is possible, if a person with NPD is willing to seek help and alter their usual patterns of thinking and behaving. A person with NPD may be especially motivated to change if they know that it will benefit them in some way (ie: keeping their relationship or getting to see their children).
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