The effects of narcissistic personality disorder include feelings of grandiosity and self-importance. Most clinicians agree that long-term therapy is the best option for treating narcissistic personality disorder.

People diagnosed with narcissistic personality disorder (NPD) might be resistant to treatment. Most people who have NPD do not wish to seek treatment for the disorder as they do not feel there is a problem. The effects of narcissistic personality disorder include feelings of grandiosity and self-importance. Clinicians have been able to develop a basic NPD treatment plan. Most clinicians agree that long-term therapy is the best option for treating NPD. Medication might be helpful when co-occurring disorders, including addiction, are present.

Medications Used for Treating Narcissistic Personality Disorder

Currently, there are no medications for narcissistic personality disorder. When a clinician prescribes medication to a person with NPD, it may be to treat a co-occurring mood disorder such as depression or anxiety. When these mood disorders co-occur with narcissistic personality disorder, the person affected usually has their feelings of self-importance challenged or threatened. Possible challenges and threats may result in physical illness, injury or failure on a large scale.

Therapy Options for Narcissistic Personality Disorder

Therapy for narcissistic personality disorder needs to be a long-term commitment to make progress. In many cases, even long-term therapy results in only minimal progress. This issue can be because people with narcissistic personality disorder may not want to make changes. Few therapeutic approaches have shown significant improvements in symptoms. These approaches include mentalization-based therapy, transference-focused psychotherapy and schema therapy.

Mentalization-Based Therapy

Mentalization-based therapy is used to treat borderline personality disorder. Some success has been found in populations with narcissistic personality disorder. Goals of mentalization-based therapy include:

  • Increasing the ability to see how one’s actions affect other people
  • Increasing empathy for other people

Transference-focused Psychotherapy

Another approach created for use with borderline personality disorder is transference-focused psychotherapy, which aims to change the underlying psychological structures that cause the specific symptoms of narcissistic personality disorder.

Schema-Focused Psychotherapy

Schema therapy, which is used to treat several personality disorders, is focused on identifying false beliefs about the world, ones that were often developed in early childhood. Once identified, these schemas are challenged and corrected. This process encourages reinforcement and development of healthy coping mechanisms. Applying schema therapy to narcissistic personality disorder focuses on schemas that cause an inflated sense of self-importance and excessive need for approval.

Related Topic: Narcissistic personality disorder treatment success rate

Treatment for Narcissistic Personality Disorder and Co-Occurring Substance Abuse

Narcissistic personality disorder and addiction frequently co-occur. People with narcissistic personality disorder may turn to substance use to cope with their negative emotions instead of relying on other people. Both distrust of other people and an inability to admit personal struggles may lead to substance use. When both disorders are present, treating substance use in addition to narcissistic personality disorder is essential.

While treating co-occurring narcissistic personality disorder and substance use disorders simultaneously are best, this may be challenging due to the symptoms of narcissistic personality disorder. A person with narcissistic personality disorder might be willing to address their substance use but may not be willing to change their false personality traits. The Recovery Village can treat both struggles at one time with an individualized treatment plan for each disorder. If you or someone you know struggles with NPD and substance abuse, call to learn more about rehab.

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Editor – Devin Golden
Devin Golden has worked for various print and digital news organizations. Devin's family has been affected by addiction and mental health disorders, which is a large part of why he wants to help others who have either directly or indirectly been affected by these diseases. Read more
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Medically Reviewed By – Denise-Marie Griswold, LCAS
Denise-Marie Griswold is a Licensed Clinical Addictions Specialist. She earned her Master's Degree in Substance Abuse and Clinical Counseling from East Carolina University in 2014. Read more
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.