Narcissistic Personality Disorder (NPD) Treatment, Counseling and Therapy Programs
Narcissistic personality disorder, or NPD, can be a paradox. To others, you might seem to radiate confidence that often borders on entitlement. Internally, however, your self-worth entirely depends on the validation of others and maintaining an inflated self-image.
NPD is one of the most controversial and misunderstood mental health issues. People affected by someone’s narcissistic behavior can suffer tremendously, yet the person with NPD rarely seeks help on their own. In fact, someone with this condition may think that their problems stem from other people, so why would they need treatment?
People with NPD do suffer, though. Chronic emptiness, fragile self-esteem, and an inability to form meaningful connections can hamper them every day. If you recognize these patterns in yourself or someone you love, then treatment can help. A mental health professional can provide valuable support and guidance.
This page can help you better understand narcissistic personality disorder in adults, as it discusses:
- The symptoms of narcissistic personality disorder adults may display
- The potential causes of NPD
- The unique traits of Cluster B personality disorders
- Mental health interventions for NPD, including specialized therapy and residential treatment
- Answers to frequently asked questions about narcissistic behavior problems
The Signs and Symptoms of Narcissistic Personality Disorder
The disorder entails much more than feeling confident in yourself or having healthy self-esteem – it represents a fundamental distortion in how someone both perceives themselves and relates to others.
Narcissistic behavior problems include an exaggerated sense of self-importance, driving a belief that someone is special and deserving of unlimited power or success.1 This sense of entitlement is often paired with a lack of empathy toward others, along with a willingness to exploit those around you to get what you want.
However, underneath these feelings of self-importance, people with NPD often struggle with fragile self-esteem that requires constant praise from others.1 This need for constant admiration helps protect them against underlying and pervasive feelings of inadequacy.
When reality contradicts a grandiose self-image, someone may experience what’s known as a “narcissistic injury” – rage, shame, or depression that’s triggered by perceived slights or failures.2
Further, people with NPD often view others as extensions of themselves, existing to serve their needs and purposes, rather than being unique individuals with their own needs and values.1 In other words, relationships tend to serve as conduits to enhance their status, rather than being partnerships filled with genuine and mutual care.
DSM Diagnostic Criteria For NPD
For an official diagnosis of NPD, the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV, requires a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.An assessment will be conducted by a mental health professional, and at least five of the following nine criteria need to be met:3
An exaggerated, grandiose sense of self-importance: Someone frequently exaggerating their achievements and talents, or overestimating their abilities and importance, expecting to be recognized as superior.- A preoccupation with fantasy: Ongoing preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love that lack any basis in reality.
- A belief in being special and above others: People with NPD typically think that they’re unique and can only be understood by others who are “special” or have achieved a high status in their field.
- The need for excessive admiration: Need frequent and lavish admiration from others, seeking out constant praise and validation in order to maintain their self-esteem.
- A sense of entitlement: Having unreasonable expectations of being treated differently from everyone else, or that others should automatically carry out your wishes.
- Exploitation of relationships: Taking advantage of others to achieve their own goals, or frequently using people without regard for their feelings and needs.
- A lack of empathy: An unwillingness (or inability) to recognize and identify with the feelings of other people, showing little concern for their experiences.
- Frequent envy or having the belief that others are envious of you: People with NPD often view relationships through a competitive lens, either being envious of others or believing that they must be jealous of them.
- Displaying arrogant behaviors and attitudes: Showing arrogant and haughty behaviors across life domains, displaying contempt toward others they view as inferior.
Narcissism and Mental Health
Reactions to being criticized can reveal NPD’s core vulnerability. In fact, even minor feedback from others can trigger disproportionate rage and defensiveness.
Constructive criticism can feel devastating, as it threatens the self-image someone has created to guard against shame and negative thoughts. They might attack those around them or even cut them off entirely for having an opinion.
Many people with NPD can also develop depression when life circumstances rise up to challenge their grandiose beliefs. For example, aging might threaten fantasies of special beauty, or career setbacks could contradict beliefs about unmatched success.4
Furthermore, people with narcissistic tendencies may struggle with anxiety over the thought of being exposed as less than special. Essentially, they may fear that others will see through their facade and glimpse the inadequacy they’ve been desperately trying to hide.
We accept most major insurance providers and can check your coverage levels for you.
If we are not an appropriate provider for care, we will assist in finding a care provider that can help.
What Causes Narcissistic Personality Disorder?
While there’s no singular cause for narcissistic personality disorder, several studies have identified a few key contributing factors. We discuss these factors in the following sections.
Childhood and Parenting Patterns
On the other hand, severe neglect or cold, critical parenting can also create narcissistic patterns.5 Grandiosity can develop as a compensation for profound feelings of worthlessness to protect someone against the shame of feeling as if they don’t matter or are somehow defective.
Biological Factors
Social Factors
American culture and other Western societies tend to encourage self-promotion and standing out as “unique” – values that can feed narcissistic patterns. Social media has intensified these pressures, creating platforms for constant self-display and validation-seeking that reinforce narcissistic behaviors.
Having said that, NPD existed long before social media, which means that while cultural factors can influence its expression, they don’t fully explain the disorder’s development.
NPD and Cluster B Personality Disorders
Antisocial Personality Disorder (APD)
APD involves the blatant disregard for others’ rights, as people with it often act out with aggression and deceit while lacking remorse. People with APD may also show a callous indifference to others’ feelings and needs.6
Unlike narcissistic personality disorder and its need for admiration, APD’s exploitation works to serve the person’s immediate gratification without any concern for the consequences.
Borderline Personality Disorder (BPD)
BPD is characterized by frequent instability in relationships and self-image, along with impulsivity. Those diagnosed with BPD experience intense fears of abandonment and chronic emptiness.6
While those with NPD typically maintain an overly inflated self-image, people with BPD experience an unstable self-image that shifts dramatically. Both can create chaos in relationships, albeit through different mechanisms.
Histrionic Personality Disorder (HPD)
Histrionic personality disorder involves excessive emotionality and attention-seeking, including shallow emotions and the use of physical appearance and sexuality to draw attention.6 Both NPD and HPD involve patterns of seeking attention, but people with histrionic disorder usually want any attention they can get, whereas narcissists specifically need admiration and recognition of their supposed superiority.
Free and Confidential Narcissistic Personality Disorder (NPD) Assessment, Evaluation and Testing Near Me
Before you can begin looking for a behavioral health center offering NPD treatment, it is important to know which level of care you should be focusing on in your search. A Mission For Michael is here to support you and offers confidential and free assessments. This can be helpful for those experiencing a range of mental health concerns, including narcissism.
At the end of your assessment, our clinicians will provide you with some insight into the symptoms you’re experiencing and their severity. They will go through available treatment options, honing in on the one they feel best aligns with your personal needs. Our assessments are completed by trained and experienced professionals and provide detailed recommendations. Call us today to get started.
Mental Health Interventions for NPD
Personality disorder therapy for adults with NPD usually requires a specialized, tailored approach. This approach involves balancing confronting problematic behaviors with avoiding narcissistic injury, as this injury can trigger rage or the premature end of treatment
Rather than recognizing that their personality and behavioral patterns require addressing, people with NPD often enter treatment due to external pressures. These pressures may include relationship ultimatums, potential legal consequences, or depression.
Psychodynamic therapy can help people explore how narcissistic patterns developed and what they’re working to protect them against. The work examines their early experiences that taught them their worth depends on being special. This can help them understand that narcissism serves to defend against shame and allows them to create new motivations for change.
Group therapy can also be a powerful treatment tool for those coping with NPD. Groups led by a trained clinician provide direct feedback as to how someone’s behavior affects others – information they might otherwise dismiss in other settings. Seeing others struggle with similar patterns helps to reduce shame, with skilled group leaders using reactions therapeutically.
Find Mental Health Treatment For Narcissistic Personality Disorder
Recognizing that narcissistic patterns are damaging your life and relationships takes real courage. If you’re ready to explore your options, A Mission For Michael offers residential and outpatient treatment programs designed for complex personality disorders and other dual diagnosis concerns.
AMFM clinicians get that confronting grandiosity takes practice and skill, which is why we offer the best in evidence-based and holistic interventions for total-person wellness.
Admitting you need help can be scary, but it’s also a sign that you’re ready to change. Contact us today to get started.
Find Narcissistic Personality Disorder Treatment Programs
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Personality Disorder support is a phone call away – call 866-478-4383 to learn about our current treatment options.
See our residences in Southern California’s Orange County & San Diego County.
Take a look at our homes on the east side of the Metro area in Washington County.
View our facilities in Fairfax County, VA within the DC metro area.
Frequently Asked Questions About Narcissistic Personality Disorder
Narcissistic personality disorder can impact the lives of those with it and their loved ones. While the goal of this page was to help you better understand the condition, it’s both normal and expected to have some continuing concerns. For this reason, we’ve provided some responses to FAQs about NPD. If you still have questions to ask, feel free to reach out to AMFM’s team.
How Do I Know What Level of Care I Need For NPD?
AMFM can help you decide on the best course of action and treatment plan for your circumstances. Some people might do well in outpatient therapy (such as IOP or PHP), participating in treatment while still returning home several times per week.
However, residential treatment for NPD might be necessary when co-occurring conditions are complicating your recovery or when there are safety concerns.
Can Narcissistic Personality Disorder Actually Be Treated Successfully?
Historically, NPD was once considered one of the most difficult mental health conditions to treat. However, recent decades have shown that specialized, long-term therapy can produce meaningful results.
It’s important to remember that success doesn’t mean eliminating all NPD-based traits. However, treatment can reduce harmful behaviors and build awareness that these actions destroy relationships and hamper self-worth.
What’s the Difference Between NPD and Just Being Arrogant?
Everyone is selfish or arrogant from time to time, especially in stressful or competitive situations.
Adults with narcissistic personality disorder, however, often consistently experience these patterns throughout their relationships and across environments. In contrast, people without NPD can usually recognize when they’re being selfish, feel remorseful, and adjust their behavior as needed. People with NPD typically lack the flexibility to do so, as these patterns are rigid and feel like natural expressions of who they are.
References
- American Psychiatric Association. (2024, January 30). What Is Narcissistic Personality Disorder? Www.psychiatry.org. https://www.psychiatry.org/news-room/apa-blogs/what-is-narcissistic-personality-disorder
- Green, A., & Charles, K. (2019). Voicing the Victims of Narcissistic Partners: A Qualitative Analysis of Responses to Narcissistic Injury and Self-Esteem Regulation. SAGE Open, 9(2), 215824401984669. https://doi.org/10.1177/2158244019846693
- Mitra, P., Fluyau, D., & Torrico, T. J. (2024, March 1). Narcissistic Personality Disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK556001/
- Fang, Y., Niu, Y., & Dong, Y. (2021). Exploring the relationship between narcissism and depression: The mediating roles of perceived social support and life satisfaction. Personality and Individual Differences, 173, 110604. https://doi.org/10.1016/j.paid.2020.110604
- Ross, A. G., Giri, S., Anyasodor, A. E., Mahmood, S., Astawesegn, F. H., Huda, M. M., Ahmed, K. Y., Mondal, U. K., & Thapa, S. (2024). Adverse childhood experiences leading to narcissistic personality disorder: a case report. BMC Psychiatry, 24(1). https://doi.org/10.1186/s12888-024-06307-9
- Cleveland Clinic. (2025, November 4). Cluster B Personality Disorders: What They Are & Traits. https://my.clevelandclinic.org/health/diseases/cluster-b-personality-disorders
