Narcissistic personality disorder treatment involves various types of psychotherapy rather than medications. However, doctors may use medications to treat a co-occurring mood disorder.

Narcissistic personality disorder (NPD) presents as a continued need for admiration and feelings of grandiose self-importance.

Although psychotherapy can entail different approaches, the goal of them all is to aid in adaptive emotion regulation. This ability may foster an increase in empathy for others and stronger relationships.

This article discusses treating NPD, including when to contact a doctor and types of therapy. It also examines the diagnosis and causes of the condition and names support groups that may help family members.

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The Food and Drug Administration (FDA) has not approved medications for the treatment of NPD, notes a research review. That said, doctors may use medications to treat ongoing symptoms of a cooccurring mood condition, such as anxiety or depression.

While there are no established specific psychological treatments, in most cases, some type of psychotherapy is the main intervention. This involves:

  • working with a therapist to learn to take responsibility for a person’s actions
  • building healthier relationships
  • building a greater understanding of the effects of a person’s actions on others

It also includes acquiring emotional intelligence, the ability to understand and manage emotions in positive ways. This entails developing empathy for others, strong relationships, and effective communication.

What is NPD?

Health experts define NPD as a condition with the following characteristics:

  • a long pattern of grandiose self-importance and an excessively elevated view of achievements and talents
  • an elevated need for admiration and attention
  • lack of empathy
  • fantasies of unlimited power, beauty, sex, or brilliance
  • either cool indifference or feelings of humiliation or rage in response to defeat, criticism, or indifference

Estimates of the prevalence of NPD in the United States range from 1 to 15%.

Learn more about NPD.

Most people with NPD are reluctant to admit they may have the condition and seek treatment. However, if a person or a family member recognizes the symptoms and believes they may have NPD, they need to make an appointment with a doctor.

Additionally, they should do this if they have ongoing symptoms of a co-occurring mental health condition, such as depression.

Types of therapy include:

Psychodynamic psychotherapy

In general, psychodynamic therapy explores how past experiences may influence present behavior. It focuses on defense mechanisms that present during therapy sessions. These mechanisms are unconscious ways of preventing disturbing thoughts from becoming conscious.

Transference-focused therapy

This involves structured twice-weekly sessions that emphasize an individual’s emotional expressions toward a therapist. A 2020 study states it helps people identify and change negative ways of thinking about themselves and others that underlie their atypical behavior.

Schema therapy

This is an alternate form of cognitive behavioral therapy (CBT), which is talk therapy that helps people identify and change inaccurate thinking. It entails activating emotions.


CBT can help people change existing negative thought patterns and find new positive ways to behave.


When it comes to NPD, doctors may use medications to treat co-occurring mood disorders such as anxiety or depression.

These may include:

A diagnosis starts with a history, which frequently involves a standard psychiatric interview. However, because the presentation of symptoms of people with the condition varies broadly, getting an accurate picture can be challenging.

A consistent pattern of at least five symptoms suggests the diagnosis. One symptom that indicates a person has a severe case is aggression. The others include:

  • an overly grand sense of self-importance
  • a preoccupation with fantasies of success, power, brilliance, beauty, or perfect love
  • a belief they are “special”
  • requiring excessive admiration
  • having a sense of entitlement
  • exploitative behavior
  • a lack of empathy
  • envious thoughts or a belief that others are envious of them
  • arrogant behaviors and attitudes

Most support groups for NPD appear to focus more on the family members and loved ones of those with the condition rather than the people themselves. Below are some options:

  • Narcissistic Peer Support Group: This group provides support for individuals with NPD and their families.
  • Out of the Fog: This is for family members of people with NPD and other personality disorders. The resource includes general information, what to do and what to avoid, and a forum.
  • Stop Walking on Eggshells: This also gears itself toward family members and offers workshops and coaching.

An array of factors may lead to the development of NPD. These include:

  • a genetic predisposition
  • reduced tolerance to stress
  • aggression
  • an issue with controlling emotions

Additionally, certain childhood experiences may play a role, such as:

  • rejection
  • excessive praise
  • fragile ego

The main narcissistic personality disorder treatment is psychotherapy, but a doctor may use medications to treat co-occurring mental health conditions, such as depression or anxiety.

Types of psychotherapy for NPD may include CBT, psychodynamic therapy, transference-focused therapy, and schema therapy. Doctors base a diagnosis on a standard psychiatric interview that reveals someone has at least five symptoms.

People who have NPD may feel reluctant to admit they have a mental health condition and seek treatment. However, a family member can encourage them to get medical attention.