Treating Narcissistic Personality Disorder with CBT

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Personality disorders are mental illnesses that involve chronic patterns of unhealthy attitudes and behaviors, inflexible thoughts, and false beliefs. Narcissistic Personality Disorder (NPD) is a personality disorder that’s characterized by an inflated sense of self-importance, a deeply-ingrained need for admiration, and a lack of empathy for others. Beneath the excessive show of confidence, people with NPD usually have an extremely fragile self-esteem and are unable to cope with even slight criticism, according to the Cleveland Clinic.

People with Narcissistic Personality Disorder often use drugs or alcohol as a way of dealing with with the inevitable relationship problems and other interpersonal issues that result from this disorder, which also commonly co-occurs with other mental illnesses like depression, eating disorders, and bipolar disorder.

Due to the complexity of Narcissistic Personality Disorder, one of the most effective treatments for this condition is cognitive behavioral therapy, which can be modified to treat a wide range of conditions, including depression, anxiety, and substance abuse and addiction, which often co-occur with NPD.

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy (CBT) is a combination of cognitive therapy, which focuses on how thoughts and beliefs influence someone’s actions and mood, and behavioral therapy, which focuses on changing unhealthy patterns of behavior.

According to the National Institute of Mental Health, a cognitive behavioral therapist helps patients focus on their current problems and develop relevant and meaningful ways to solve them. The therapist helps the patient identify his or her own distorted beliefs, self-destructive attitudes and thought patterns. Then they help the patient replace them with healthier and more accurate ways of thinking. The patient then learns to modify behaviors accordingly.

How Does CBT Benefit People With Narcissistic Personality Disorder?

In addition to being characterized by inaccurate and self-destructive beliefs about oneself and others, NPD is often marked by deficiencies in certain skills that prevent patients from adapting to change, and other environmental and contextual factors serve to reinforce destructive behaviors.

According to the National Institutes of Health, cognitive behavioral therapy addresses all of these components of a personality disorder through a range of techniques that produce meaningful shifts in thought and behavior. These techniques include:

    • Cognitive restructuring, which is the process of learning to identify irrational thoughts, known as cognitive distortions, and replace them with rational thoughts. Cognitive distortions most commonly associated with Narcissistic Personality Disorder include black-and-white thinking, magical thinking, and magnification.
  • Behavior modification, or learning to replace harmful behaviors with those that are healthy.
  • Exposure therapy, during which patients are gradually exposed to a situation they fear so that they become less sensitive to it over time.
  • Psychoeducation, which involves educating patients about their mental condition to better understand how it affects their thought processes.
  • Skills training, during which patients develop tools and learn techniques and strategies for coping with certain aspects of the condition.

Cognitive behavioral therapy is practical and technique-based, with “homework” assignments that help patients immediately put to use the skills they’ve learned in therapy. If you have a loved one who suffers from Narcissistic Personality Disorder, either alone or in addition to a substance abuse problem or other mental illness, finding a qualified cognitive behavioral therapist or a recovery program that utilizes this highly effective therapy can help restore your loved one’s mental health and improve his or her overall quality of life.

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