Narcissistic personality disorder can be treated but no cure exists for this lifelong condition. As a trait, narcissism may respond well to professional support but treatment isn’t needed.
Narcissism can be a natural expression of self-appreciation. It might be the extra moment of admiration in the mirror, or the sense of pride you have knowing you’re top in your field.
In fact, narcissistic traits that manifest on occasion don’t necessarily mean you’re living with a personality disorder or need professional treatment.
But when these traits become persistent across situations and over time, they may negatively impact the way you see yourself and the world around you. If this is the case, a diagnosis of narcissistic personality disorder (NPD) is likely and mental health treatment may help. However, there’s no known cure for NPD.
It’s not always easy to distinguish between narcissism and NPD.
“Narcissism just means self-love which we all should have,” says Dr. Laurie Hollman, a psychoanalyst and licensed clinical social worker from Cold Spring Harbor, New York.
Many experts place narcissism on a spectrum, with the low end resulting in poor self-esteem and the high end resulting in symptoms of narcissistic personality disorder.
Healthy narcissism is found somewhere in the middle, says Lena Derhally, a licensed psychotherapist from Washington, D.C. She indicates that on a scale of 1-10, healthy narcissism may fall at a 5 or 6.
“Healthy narcissism would be defined as someone who has confidence in themselves and believes they can do what they set out to do, while not being self-centered and lacking in empathy,” says Derhally.
Pathological narcissism
Narcissistic trait vs. disorder
Narcissism can be a personality trait. It can exist in mild, discreet ways that don’t significantly impact your everyday life or relationships.
Being convinced you have the most beautiful hair, for example, can be an isolated manifestation of narcissism.
NPD, on the other hand, is more than a passing behavior of self-admiration. The disorder involves multiple, enduring patterns of grandiosity, low empathy, and persistent attention-seeking behaviors.
Narcissistic personality is recognized as a mental health diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). It can severely impact important areas of function, particularly interpersonal relationships.
Low empathy
Even if you have a few narcissistic traits, you may still be able to relate to and understand the feelings of those around you.
When you live with NPD, however, you’re more likely to lack empathy and disregard the impact your behavior may have on other people.
Preoccupying fantasies
Derhally explains narcissism can be seen as confidence and a stalwart belief in your own capabilities.
When you live with a narcissistic personality, though, you may constantly find yourself engaged in fantasies of unlimited power, beauty, and success. You may also need constant praise and admiration, and get frustrated if you don’t get them.
Narcissism as a personality trait doesn’t require a cure or treatment. As with any other trait, change is possible and psychotherapy may help.
A narcissistic person who may not meet the diagnostic requirements for NPD may still be capable of empathy. They might be more likely to have insight and self-awareness about how their behaviors impact others. This may make change more likely.
According to Hollman, narcissism in general can be managed with purposeful intervention.
She explains many people seek guidance because they’re at a loss for why relationships keep failing or why they can’t keep friends.
“When it is kindly identified to them […] how they actually push people away by their overriding conceit and disregard of others’ needs, they become capable of considering their behavior and then hopefully why it’s occurring,” says Hollman.
Over time, working on developing this self-awareness and empathy may help someone modify some of their narcissistic behaviors by increasing awareness and recognition of the needs of others.
No. Narcissistic personality disorder is a lifelong mental health disorder. However, treatment might help you manage symptoms and reduce the impact the condition may have on self-esteem, work, and relationships.
However, someone with NPD isn’t likely to reach out for professional support. Derhally and Hollman point out people with narcissistic personality typically can’t recognize the disorder in themselves.
This lack of insight is often a defining feature of NPD and may be the reason people with the disorder don’t feel the need to see a therapist.
When someone with the disorder does reach out for help, progress may be limited.
Emotion-focused therapeutic approaches such as cognitive behavioral therapy (CBT) and transference-focused therapy may help someone with NPD manage some of their symptoms.
Change is possible if and when the person becomes aware of the need for it and takes the necessary steps to begin the process. This awareness and intention may not be likely in someone with NPD, though.
Even with treatment, some NPD symptoms may continue to impair function and cause interpersonal friction.
How much change you notice may depend on where the person lands on the narcissism spectrum.
“People who have some narcissistic traits will do much better with treatment than someone who has clinically diagnosed NPD,” says Derhally.
There’s no cure for narcissistic personality disorder, although treatment can help you manage some of the symptoms.
Those people who may rank lower on the narcissism scale are more likely to benefit from mental health therapy compared to those who have a clinical NPD diagnosis.