Therapy with a Narcissist: Myths and Realities

Is Therapy with a Narcissist Ever Effective? Or Is It Just More Dangerous?

The idea of seeking therapy with a narcissist is often met with hesitation and skepticism. Some believe that it is a futile endeavor, while others fear it could escalate into a more dangerous situation. This article explores the reality of therapy with a narcissist and the complex dynamics at play.

Personal Experience: A Marriage Shattered by Narcissism

My marriage came to an end when I sought therapy with my last partner, and it ended in a bitter and emotionally draining manner. Despite my efforts, the therapy seemed to exacerbate the situation. My therapist advised me to calm down while my partner, a closeted coke addict, remained calm and distant. The experience left me feeling more hurt and disillusioned. Even my therapist seemed to hint that I should consider divorce without him, much to my chagrin.

Reflecting on this experience, it is clear that unless the narcissist acknowledges and is willing to address their disorder, therapy can become a form of continued manipulation and gaslighting.

The Realities of Narcissist Personality Disorder

Narcissist personality disorder is a specific condition characterized by a profound lack of empathy and an inflated sense of self-importance. Unlike other disorders, where the patient is treated and everyone else is left alone, with a narcissist, the reverse is often true. Therapy can be a complex and challenging endeavor, especially when the narcissist is unwilling or incapable of addressing their issues.

Case Study: A Hostage Situation

During one particularly harrowing incident, my ex-partner held me hostage in a hotel room 2500 miles from home under the guise of needing a little "work" on the relationship. Despite my demands that he seek help for his issues, it took weeks of persistence to convince him to go to therapy.

The therapy turned out to be a double-edged sword. While I encouraged him to go, he used it to his advantage by telling his entire family that I was the problem, driving him to madness with my "infidelity" and "lying." Realizing the potential for further manipulation, I stopped encouraging him to seek therapy.

However, the experience led me to the realization that therapy could be a tool for my own healing. I began attending therapy sessions to navigate the emotional aftermath and seek support for my own well-being.

Understanding Narcissistic Personality Disorder

As a neuropsychologist and forensic psychologist, I have observed the overuse of the narcissist label, often applied by those who dislike others or fail to accomplish their goals. True narcissism, as a neuroanatomically encoded deficit, is characterized by a lack of empathy and the inability to see things from others' perspectives due to under-activation of the right frontal cortex.

It is crucial to differentiate between biologically based narcissism, which is lifelong, and situational or substance abuse-induced narcissism, which can be addressed with the right interventions. In cases where the narcissist is willing to acknowledge and accept their deficit, therapy can be beneficial, but it must be carefully managed to avoid further manipulation and harm.

Conclusion: The Role of the Therapist

Therapists play a crucial role in addressing the complexities of narcissistic personality disorder. They must be skilled in recognizing the signs of narcissism and approach the therapy with a clear understanding of the patient's needs. A therapist must also be vigilant in maintaining ethical standards and avoiding the perpetuation of harmful behaviors.

While therapy with a narcissist may not always be effective or safe, a competent and ethical therapist can help the narcissist become a less harmful person, focusing on practical ways to improve their life situation. The key is recognizing the disorder and creating a safe and supportive environment for the patient to address their issues.