Science Answers: Can Narcissism Be Cured?

Maybe you know someone who always blames you. The one who smirks when his lie is exposed, twists your words so much that you have to apologize for his mistakes. As time passes, you may wonder if such a person can really change. However, this person may be a narcissist. When such people feel disrespected or criticized, this threatens their poor or arrogant self-esteem, and they are forced to react aggressively to protect their self-image. When people encounter these types of people, they often ask them to change their personality.

But sometimes, this type of behavior affects the narcissist as well as others. These people may feel rejected; This feeling probably originates from the same behavior that makes people stay away from them. So, can narcissists change with psychological interventions? Understanding narcissism from a work psychology perspective is helpful. In general, there are two types of narcissism: proud narcissism and vulnerable narcissism. People with the former tend to see themselves as superior to others, while vulnerable narcissists are highly sensitive to criticism.

In both cases, narcissists can be arrogant and selfish. If these traits become severe, a person may develop something like narcissistic personality disorder (NPD) or be known as a pathological narcissist. Narcissists can indirectly try to undermine you with covert aggressive behavior. For example, these people may exclude others from their social circle or withhold affection from you as a form of punishment. Sometimes these behaviors may not be so subtle. Research has shown that people with narcissism may be prone to violence, even when there is no stimulus in front of them.

Pathological narcissism

While a person with NPD has a persistent mental disorder, this does not mean that there is no cure. Research shows that treatment can help manage the symptoms of this disorder. Treatment of narcissism usually begins with talk therapy. This method is considered a classic therapy in which the consultant sits and talks with his patient. The most common technique a counselor will use for narcissists is cognitive behavioral therapy, which may help them identify and challenge their incorrect or unhelpful thoughts so they can change their behavior.

However, when therapists were asked what they found to be the most effective approach, they said they preferred introspective and relational techniques, according to a 2015 study. This method involves examining the patients’ feelings and motivations, while the counselor sits with them non-judgmentally and with full understanding. This approach is especially important when working with narcissists because some patients assume that the counselor thinks they are vulnerable. Fear of vulnerability is often associated with difficulty in establishing rapport and mutual trust between patients and counselors. For example, instead of admitting any potential weaknesses, narcissists may feel the need to impress their counselor or present a self-image of high self-confidence.

Feelings of inadequacy, shame, guilt, aggression, and being a victim can all cause narcissists to become defensive. Counselors must identify these barriers and overcome them so that medical interventions are successful; Of course, this work requires skill. When narcissistic patients seek treatment, they are often in a state of vulnerability, not narcissism. Of course, the symptoms of these two conditions can be shown at the same time, that is, the characteristics of self-aggrandizement begin to appear during treatment. Then the counselor may recognize the symptoms of NPD in the patients and advance the counseling according to them. When these obstacles are not removed, the patient may end his treatment prematurely.

There are many other reasons why a patient may drop out of treatment. Of course, the rate of withdrawal from treatment is generally between 10-15%, and this number reaches 63-64% in narcissists. Additionally, it is rare for a person with narcissistic disorder to seek treatment in the first place because they often do not believe they have a problem. These people come to their doctor or therapist for other reasons, such as an external problem (such as job loss or divorce) or an emotional problem (perhaps depression caused by rejection).

What other methods are there to treat narcissism?

Most of the innovations in the treatment of personality disorders originate from borderline personality disorder, and some treatment methods of this type of disorder have also been adapted and tested for narcissistic people. These approaches are usually successful in the treatment of borderline personality disorder, examples of which are: conversation-based behavioral therapy, mind-reading therapy, and schema therapy. The first focuses on challenging negative thoughts and bad feelings, while also embracing self-identity. The treatment based on mind reading also helps the patient to understand his thoughts and beliefs and relate them to his behavior.

Schema therapy helps challenge the unhelpful and negative mental schemas a person has about how the world works. For example, if you were neglected as a child, you may have created a schema in your mind that tells you that your needs will never be met by others. However, there is limited evidence that these approaches are effective for narcissistic personality disorder. These approaches have the same obstacles as introspective and relational techniques, such as long treatment times and challenges in building rapport and trust.

In response to these issues, psychiatric researchers Alexa Albert and Anthony Beck said in April 2025 that long-term use of psychoactive drugs may create an opportunity in which narcissistic clients are more ready and receptive to feelings and emotional responses. MDMA, commonly known as euphoria, can increase empathy, prosocial behaviors, and feelings of closeness to others. Although MDMA treatment has been successful for some conditions, such as post-traumatic stress disorder (PTSD), it may lead to worsening of psychological problems.

Additionally, relationship building is very important in substance abuse treatment. In this method, it is necessary to build a relationship so that the patient can safely trust the therapist while under the influence of the drug. The treatment also faces legal hurdles, as ecstasy is Schedule 1 of the Misuse of Drugs Regulations, meaning it has no recognized medicinal use in the UK. Researchers, mental health charity founders, patients and some members of parliament have called for this substance to be included in List 2 to allow for clinical trials, but no legal changes have been made in this regard yet.

Of course, Albert and Beck’s suggestion is theoretical, as they have not completed any clinical trials yet. Currently, therapists must rely on their own skills to connect with patients and overcome barriers to treatment without the use of chemicals. Therefore, it can be concluded that narcissists can change, but this change requires a lot of care from the therapist and patience from both parties, that is, the patient and the counselor.