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Narcissistic Personality Disorder Treatment

What is Narcissistic Personality Disorder?

While narcissism is a classic negative personality trait, pathological narcissistic behavior classifies as a personality disorder, and can be treated professionally. True narcissism is more than vanity or moments of self-centered behavior.

People with narcissistic personality disorder (NPD) have a debilitating need to put themselves on a pedestal above others, suffer from grandiosity (a false perception of self-worth), and lack empathy. It is a complex personality disorder that can co-occur with other personality disorders and mental health issues and requires a dedicated treatment approach.

Narcissistic Personality Disorder vs. Other Personality Disorders

Narcissistic personality disorder is one of ten known personality disorders, and one of four personality disorders in a related cluster, alongside antisocial personality disorder, borderline personality disorder, and histrionic personality disorder.

However, while some of the signs and symptoms of narcissistic personality disorder overlap with related personality disorders, such as irrational behavior, dramatic action patterns, theatrics, and a need to be the center of attention, the core of any case of NPD is an extreme sense of inflated self-worth and lack of regard for others.

Is My Teen Really a Narcissist?

Narcissism as a character trait can be a sign of narcissistic personality disorder, but it doesn’t mean that every teen with an obsession with selfies or the bathroom mirror is struggling with a personality disorder.

Children and young teens alike may exhibit signs of narcissism or egoism, but this is usually normal and healthy behavior for their age. While children can display empathy, truly empathic behavior and an understanding and appreciation for people outside of oneself usually develops later in adolescence. It takes time for the brain to learn to put oneself in other people’s shoes.

Behaviorally, a narcissistic will struggle to think of anyone but themselves, and their actions will speak for it. In addition to being the center of their own world, they may impose themselves as the center of everyone else’s. In some cases, this can result in outright abusive behavior. As narcissistic teens get older and smarter, they learn to employ charisma, confidence, and manipulative behavior to further cultivate and engender the admiration of their peers, and put down anyone who won’t contribute to their ego.

If your teen continues to display egoism well into puberty, they may be a budding narcissist, but there may still be a difference between narcissism as a learned character trait (i.e., being spoiled) and a teen with a narcissistic personality disorder. Teens who grew up with an inflated ego can still learn to be kind and caring, cultivate empathic skills, and develop a healthier ego, especially if their parents and peers adjust to signs of detrimental narcissism.

However, teens with narcissistic personality disorder will fail to develop empathy without dedicated treatment, which they will not outright agree to without serious detrimental setbacks in their life. This form of clinical narcissism is an extreme psychological coping mechanism to a fragile ego and develops in part due to environmental factors (growing up with a weakened sense of self, or an inability to form a healthy self-esteem through a cycle of failures and successes) and genetic factors, such as related personality disorders in the family.

What Does Narcissistic Personality Disorder Look Like?

Ironically, people with narcissistic personality disorder have a secretly low self-worth, and a very weak self-esteem. They aggressively pursue and demand validation from people around them to cultivate a stronger image. As time goes on, however, this behavior is often far more dangerous than it is impressive.

Getting work can become more difficult as narcissists fail to acknowledge their employer, and consistently put down those who hired them (and fired them) in the past. While some narcissists use manipulative behavior to trap a mate in an abusive cycle, many end up alone due to their actions.

Their shallow behavior betrays obvious signs of envy and no respect for other people. Their acquaintances leave when things get difficult, or successes become rarer as they do not make true friends. Their lack of compromise in their grandiosity leaves them with no allies. They fail to take accountability for their mistakes, consistently denying wrongdoing. They cannot maintain a stable relationship.

Narcissistic personality disorder is formally characterized by:

  1. Limited insight into other people and the world around them.
  2. Poor empathy, if at all.
  3. Extreme arrogance, always coupled with scorn or envy.
  4. Inappropriate competitiveness, and total lack of trust.
  5. Often uses manipulation tactics to strongarm people into doing what the narcissist wants.
  6. Constant power fantasies.
  7. Inflated or unreal sense of self-importance.
  8. Displays and statements of entitlement.
  9. Needs to be the center of attention, and constantly receive praise.

Convincing a narcissist to get help can be incredibly difficult. Because they put themselves on a pedestal, it is hard for them to accept that they are not special and may in fact need treatment.

Some teens can be convinced to get help for their narcissistic tendencies as a result of the consequences that their actions may have had, such as ruining a relationship they enjoyed, losing them an important spot in a team, or cutting them out of an opportunity they wanted. While these are still entirely self-centered motivations, it is important to start somewhere.

Narcissists will not accept treatment under the guise that it might help others – it’s always going to start with them. However, treatment can help them understand the importance of empathy and compromise, even if only as tools for survival in a social world.

How is Narcissistic Personality Disorder Treated in Teens?

Treatment for teens with narcissistic personality disorder centers on individual talk therapy, particularly cognitive behavioral therapy. The goal of therapy is to help narcissists understand and identify the root of their thought patterns, and how they negatively affect their life, and begin to employ healthier thoughts and behaviors to re-engage with others.

Narcissists have a weak self-image – therapy can help them find ways to improve that self-image without the approval of others, giving them greater resilience in the face of criticism, and the ability to acknowledge their own failings over time. In addition to learning to be vulnerable, teens with narcissistic traits must learn to cultivate and build empathy.

These steps can take time to get to. We at the Arrow House can help your teen get started on the road to emotional recovery.