Almost all professionals who deal with narcissists and psychopaths insist they cannot be cured, but say that Cognitive-Behavioral therapy can help “train” them to act in more prosocial ways. Of course, this isn’t going to work unless there’s something to be gained for the narcissist in doing so. Most won’t even enter therapy. Cognitive-behavioral therapy isn’t a cure though and does nothing to address the underlying problem or access the “true self” which even the narcissist has obscured from their consciousness with their elaborate series of masks.
I was thinking about a much more intense form of therapy, that would be costly and difficult, and takes into account several different methods of treatment, that may actually be able to cure narcissism. This therapy would take place in several stages:
Stage One: The Narcissistic Crisis/Narcissistic Injury
I was skimming through Vaknin’s book and toward the end he has a chapter about curing a narcissist. He believes these incorrigible people can actually be cured (which of course begs the question, why isn’t he cured? Or is he?) However, in order to be open to being cured they must have undergone a “narcissistic crisis” or “narcissistic injury”–that is, his or her sources of narcissistic supply must have been removed (such as after a divorce or the death of their primary source of narcissistic supply, loss of a career, financial ruin, incarceration, what have you).
In a state like this, without anything to prop them up or continually affirm their “greatness,” a narcissist will usually sink into a deep depression, and will do ANYTHING to make themselves feel better, even voluntarily entering therapy.
The tricky part would be identifying the depressed patient as a narcissist, but there should be enough signs in the way they talk about the glory of their “former life” and they will still lack remorse and empathy and blame others for their sorry condition rather than themselves. So identifying a severely depressed narcissist shouldn’t be too difficult for a trained professional.
The therapist cannot, under any circumstances, give the narcissist any sources of narcissistic supply or affirm them in any way, or give them any sympathy, at least not at first. In other words, they cannot mirror them. That will just make the narcissist feel good enough that their masks will go back up and they may think they’re “cured” and leave.
Stage Two: “Cold Therapy:” Deny the narcissist any narcissistic supply!
In order to force the narcissist to face what’s inside, it’s important the therapist does not affirm or mirror the narcissist. Instead, the therapist should stay nearly silent at first and make sure the narcissist is forced to confront his own emptiness. This will be extremely painful to them. They may leave, but if the narcissist is desperate enough he will probably stay. However, he will likely become angry at the therapist (transference) and rage. Still, the therapist must not show any reaction. When even their rage fails to elicit a response, the narcissist has no choice but to regress to the infant he really is.
Stage Three: Catharsis/”Remothering”
This would be a breakthrough point, and the point at which some real therapy could possibly be done. Becoming an infant will turn the narcissist into a blubbering, sobbing, needy, vulnerable mess. And this is where I can begin to see why in “People of the Lie,” M. Scott Peck, in his chapter about “Charlene” (a narcissist who entered therapy voluntarily because of her inability to maintain a relationship), wanted her to become vulnerable and baby-like so he could become her surrogate “mother” and give her the maternal nurturing she never had as a child. This might have worked too, had Charlene been ripped of all her sources of narcissistic supply and been undergoing a narcissistic crisis. Dr. Peck’s mistake was affirming her too much in the beginning of therapy and engaging her fantasies. By the time he realized his mistake, it was too late.
At the time I read Dr. Peck’s thoughts about how he should have “mothered” Charlene and held her in his arms (in a nonsexual way), I thought it sounded very odd and even unethical. But knowing more about narcissism than I did when I read that book, and more about why they’re the way they are, I can understand why Dr. Peck’s wish to “mother” Charlene may have worked. But not only did Peck start out all wrong, Charlene was not depressed enough to be open to such a technique.
So a vulnerable narcissist stripped of all their elaborate defense mechanisms, reduced to a dependent infant, is going to be going through an emotional catharsis as the true self (which was arrested in infancy and is still an infant) begins to emerge. They are going to be in unbearable terror and pain. A good (and very strong) therapist can offer maternal support through holding the patient during catharsis, stroking them in a nonsexual manner, but still must not tell them anything they want to hear, such as how they’re not a bad person, how they don’t deserve their pain, and the like. The therapist must remain quiet and let the patient go through the catharsis and only offer support by their mere presence.
Stage Four: Retraining and Internalizing the Conscience
I’ve elaborated a lot on what Vaknin says about curing a narcissist in this post, and I’m going to elaborate even further. Because the narcissist, while rendered virtually harmless at this point in therapy, still doesn’t have a conscience. They would still go right back to their old ways if they stop therapy now or their circumstances suddenly improve. Psychologically, they are infants and an infant has no conscience: they must be taught by their parents and caregivers the difference between right and wrong.
So after a few sessions of this cathartic crisis (however long it lasts–by its nature it will eventually exhaust itself), I would propose something like the sort of treatment that was given to 6 year old Beth Thomas in the documentary “Child of Rage,” who at first wanted to kill her parents and brother and who tortured animals, but was cured of incipient psychopathy early enough that she was still able to develop a conscience and become an adult with normal levels of empathy and no desire to hurt anyone.
The narcissistic patient, if at all possible, should be in a setting, such as a hospital or residential treatment setting, where they are closely monitored and supervised by trained professionals. Any good behavior is to be rewarded, any bad behavior punished. Any privileges at all would have to be earned. Just like a small child, reward and punishment will train their brain to develop a conscience. This is basically the same thing as the cognitive-behavioral therapy currently used on narcissists, but it cannot cure a narcissist who hasn’t first been broken down by a narcissistic crisis and catharsis, because all their masks are still on. A narcissist who has been through the process of crisis and catharsis has lost their masks, and therefore cognitive-behavioral retraining would become internalized rather than just a “positive” mask they can wear to make them more bearable to others.
Disclaimer:
I am in no way a professional (though I did major in psychology in college). I’m certainly not qualified to propose new methods of treatment, but this process I’ve described isn’t one I made up: it’s basically a combination of Vaknin’s proposed method of breaking down all the narcissist’s defenses so they become infantile (with a little M. Scott Peck thrown in), followed up with cognitive-behavioral techniques for retraining the patient’s conscience in a highly supervised setting.
It would be a difficult and expensive therapy at the very least, but I really think it could work. Of course, it also requires the narcissist to voluntarily enter therapy, which means they would have to have suffered a grave loss that threw them into deep depression in the first place (the narcissistic injury or crisis).
I’d be interested to hear your thoughts.
Lucky Otters Haven 
Wouldn’t the narc have to have already been diagnosed for this to happen? My reasons for this question is that the narc that invades my life has already been through years of CBT and it obviously didn’t work
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I’m no expert but sure, they would have to be diagnosed first. CBT doesn’t work–it changes outward behavior only and only if the narc is getting something out of it. It helps those around the narc more than the narc him or herself. It doesn’t get to the root of the problem. To actually cure a narc, much more would be needed to address the root of the problem before CBT could have any lasting impact or the narc could begin to internalize it. Just my 2 cents.
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To be cured, wouldn’t a narcissist have to admit there is a problem and they are less then superior to all other beings? I think some mild narcissists who aren’t turned over to perdition or seared, could change. However this would take some introspection. The malignants who have made years worth of choices for evil, I see this as very rare. I don’t think reparenting would work, but I do not believe in the “inner child” concept.
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Hi FHPP! 🙂
Of course someone with mild narcissism would already have some empathy/conscience already (even if not that much) and may not even need such an intensive treatment experience. They could probably even benefit some from traditional therapy usually reserved for people with neuroses like anxiety or mild depression. But yes, it would probably work better on someone low on the narc spectrum because their masks are fewer and more easily broken.
Like you said, the more malignant (or evil) the narcissist, the harder it would be to change them. Psychopaths may be too far gone. Also any kind of treatment like this has to be initiated by the narcissist himself–and that would only happen if they’ve become depressed due to loss of their primary source of narcissistic supply. Even then there’s no guarantee it would work. I don’t know if this combination of treatments has even been tried on any narcissist but I think it should be. It would probably help people with NPD who are not psychopathic or only a little psychopathic. How nice if narcissism was proven to be curable in some cases.
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Reblogged this on ally1lakeside and commented:
I sincerely believe that narcs must have had some serious trauma emotionally or mentally in younger years. Life is cruel and reading more and more about living with a narcissist or treating them I find it shocking that there are so many around and that it is extremely hard to get them treated due to the condition making them believe they are right and there is nothing wrong with them. A very sad and cruel condition to have. I send love and support to anyone who has a relative suffering narcissism, but also to the sufferers because they genuinely cannot be happy. To other victims I say stay strong and do not let these people get to you in your head because if they do you will get dragged down like they are.
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We can’t allow ourselves to pity them too much (and get sucked into their mind games), but sending them positive thoughts and prayers (if you believe in God) can’t hurt.
That being said, we are all God’s children, even the worst narcissist in the world, and there is no person in the world without a soul God has given them. If they had no soul they would be dead. But for someone with NPD it’s like their true soul is almost too deeply buried or atrophied to be accessed in a normal way. But since it’s still there somewhere then it has to be accessible. When they have suffered a grave loss and are temporarily vulnerable, I think a window opens for healing. I’ve always believed even the worst MN has moments of clarity or at least vulnerability.
Thanks for your comments and for reblogging this.
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Thank you very much for sharing. I realize now that these people too deserve empathy.
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Empathy only enough to want to help them be cured of their disorder though.
Sam Vaknin explains it best, from the inside, because of his incredible insight and he’s an amazing writer who expresses what it feels like so well. NPD really is a tragic disorder and these people really do live a hellish existence and everyone just assumes there is no hope for them. I think there is hope for SOME of them.
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This is really a great article. And gives me hope for myself. See, I am a narcissist. For years, I was in denial that it was a disease, I almost thought it was good trait to have, to brag about. I never realized how much damage this illness has done to me as a person or to those I love or have loved. As the article foretells, I hit rock bottom this year and for months sat around blaming everyone else for everything–the end to a great relationship, the loss of a great job, not continuing my education. Typical narcissistic behavior. But for some reason, I came to a conclusion that in order for my life to get better and stay better, I had to look back on life without hurt, without bias or anger or anything else other than calm emotion. When I did, I saw the problem–the common denominator–me. Even still, I wasn’t sure why I did some of the things I did. So I read, researched analyzed, analyzed some more. I did a lot of soul searching. Being a narcissist (and having a few other mental issues) has led me to behave in ways that have been severely destructive in life. To me and to others. Most narcissists are in denial they even have an illness but like many other narcissists who are no longer in denial that they have an illness, I found that I used my illness as a “license to kill”. As I said earlier, it was almost something I was “proud of” except for narcissists, myself included, we don’t have pride; we have validations that boost the low self esteem and ego of our true self. When I realized some of the damage I have caused, I was no longer “proud” of it, I was ashamed of it. I knew then I had to seek the root of it and in my case, the narcissism is a mask for a low self esteem that I developed in childhood–a torturous hell at the hands of a tyrant for a father. These are issues I know I have to work on as well. I can’t just say, “I’m a strong person and I’m over it and it doesn’t affect me anymore” as clearly it does for one and for two, I’m not a strong person–I’m weak. I need a lot of work on myself and it’s something I have to stick to; I can’t allow myself to ever get to a point where I believe “I’m cured” as there is no cure for this. There is only treatment and bettering. It’s a long road ahead but I’m in it for the long haul. I ask no pity from anyone though. As an adult, it’s my responsibility to seek help.
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KWWL–thank you so much for having the courage to speak up here. I don’t know how old you are but you sound quite young but yet your writing is very mature and insightful. much like Sam Vaknin’s (who I am sure you know about). Regardless of your age, it’s incredible to have so much insight if you have NPD. I think insight could be a key to overcoming this disorder. You already have suffered narcissistic crisis and it does sound like you are still in that “vulnerable” depressed, anxious state that follows it. I will say prayers for you (I do not know what your spiritual beliefs are) that God finds a way to get rid of your “demons” and show you your true self.
You also seem to have a lot of shame about having this, which is one step away from having a conscience. You COULD just be bluffing here and this could all be BS (after all, you are a narcissist) , but I have a strong feeling you are being absolutely honest here. Please keep posting–it’s always great to read well written, civil posts from people from”the other side.” 😉
To understand something is to know it, and to know it is to not be stupid about it (I made up that quote lol)
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Narcissists have tons of shame. In fact, narcissism is a coping mechanism for dealing with unbearable shame. Maybe you are confusing narcissism with psychopathy?
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It’s possible. I wrote this post a long time ago, when I was still a little confused about the difference between psychopathy and narcissism and tended to use the terms interchangeably. I’ll read over this post and make any corrections that need to be made, since I’m clear about the difference now.
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I am also taking the liberty to repost this comment in my next post. Sure, this might feed your narcissistic supply so maybe I shouldn’t do that, but I think it’s interesting enough and well written and stands out because it’s coming from the “enemy” so to speak.
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There are actually quite a few books about successful treatments of narcissists in therapy. For example, Stephen Johnson’s Humanizing the Narcissistic Style, James Masterson’s The Emerging Self, Otto Kernberg’s Borderline Conditions and Pathological Narcissism, Heinz Kohut’s The Analysis of the Self, and several others I’ve read. A lot of what is out there about narcissists is unnecessarily pessimistic, and contains the notion that “a narcissist is a narcissist is a narcissist” i.e. that there is no difference in the severity and kind of problems experienced by people who are given this label. In reality, many of them can be helped, and they are not one size fits all.
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Interesting. I’m glad to know I’m not the only one who feels that many (if not most) narcissists could be cured (not merely their behavior being modified, but actually CURED) under the right conditions. Lucid dreaming is an alternative therapy that has been discussed by some–see this: https://otterlover58.wordpress.com/2015/01/01/do-narcissists-cry/
It’s in the last half of the article. Sam Vaknin provides some links about this too in the comments. Sure, it’s unconventional and may not work for everyone, but it’s a skill that could be learned and for a narcissist with insight or who can access the true self during dreams, the true self could possibly be harnessed and worked with.
I don’t believe I ever saw your blog before but I’m followng it now. BPD is of interest to me because it’s a cluster B disorder with many similarities to NPD (my daughter is probably BPD)
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THanks. If you read some of the case studies in those books, you might think even more hopefully about NPD’s treatability.
As for BPD, I don’t believe it is a valid or reliable diagnosis. In fact, that is my opinion about NPD also – i.e., as strange as it might sound (given how we are told all the times that these disorders are real), there is no strong scientific evidence that the symptoms supposedly making up the “Narcissistic personality disorder” occur reliably at anything more than a chance level from person to person. Also, it hasn’t been proven that psychiatrists are able to reliably diagnose NPD from person to person; and it remains questionable as to how one can judge when any given symptom has reached a necessary threshold of intensity or duration to warrant inclusion in the diagnostic picture, as well as why there are 9 symptoms rather than any other arbitrary number.
For both BPD and NPD, I’ve tried to develop a more continuum or spectrum based way of thinking about them, one which acknowledges individual differences and the unique history that created the problems a person has, but even that is difficult to do reliably.
Having said all this, I see that NPD does have value to some people as a (sometimes literal) metaphor or symbol for the problematic way that certain people relate. So, if it is useful in that way; it’s not always a bad thing.
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There’s an excellent website you may have heard of that focuses on the Cluster B personality disorders– Dr. George K. Simon’s “Manipulative People.”
He has frequently written about BPD as well as NPD. BPD seems like somewhat of a catchall category and is recognized as one disorder by the DSM–but people with BPD can either be very much on the narcissistic, unempathic side–or on the neurotic, anxious side (with lots, maybe too much, guilt and empathy). BPD has been explained by some as a personality that “never came together”–that seems a little vague to me. What they have in common is a history of unstable relationships, magical thinking, black and white thinking, and emotional instability. Histrionic narcissists can be very similar to borderlines. The categories are so confusing. And is it true the DSM wants to REMOVE NPD as a mental disorder? Would that be because the traits of NPD have become so adaptive in western society today? I certainly hope not!
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Thank you for your post. I am in a relationship with someone that I have labeled as a “covert narcissist”. I also believe on the inside that people can heal, if THEY want to. I am going to check out the books that you mentioned in your post and see if he is willing to read them. I think he will because we have been reading other books and websites online. It does get depressing because they have this label put on them and most all articles make it sound like there is no hope at all. I believe there is but it is very, very difficult for me to trust this person since I have caught them in so many lies. I am his victim and I know it is my fault for getting involved, but I did believe his lies as he is a great actor. I was the one that removed his many masks because after I started living with him, I was getting vibes that something just was not quite right with this person. He is in a terrible way right now after discovering that the reason for his problems was his highly abusive father. He has a very difficult time with talking about what he is feeling. He bottles things up and then explodes and turns into someone that I fear. He doesn’t hut me, he just starts acting all crazy and talking nonsense, especially when he blames ME for being the problem in our relationship. He does admit that he has issues also, but he just can’t talk easily about what’s going on in his head. He also seems like he wakes up in the mornings and wants to just start a new day without going over the problems from the day before. I hate his father for what he did to him. His father used to beat him alot and call him names from the age of 5. His father used to beat him even more because he would cry. he was taught to not cry or show any emotions at all and thats what he does now. He became a sexual deviant pervert and I believe that’s because it was his only way to get any kind of “feel good hormones” going on in his head. I also do realize and acknowledge that I have my own issues stemming from an abusive childhood also. I am just not as bad as he is. I have empathy and I do not put on an act for anybody, but I do have self esteem issues. Thank You for your post.
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Jane, at the risk of annoying narc-haters, I am going to say I feel very badly for the man you are with. His story is tragic, and it does sound like he wants to heal from his disorder. Yes, Cluster B’s are very much vilified and stigmatized. While i would put Psychopathy/sociopathy/ASPD and Malignant Narcissism in the “evil and hopeless” category, lower spectrum N’s like your man and borderlines are unfortunately also vilified and bashed constantly. The sad part is that many of these people want to get better, and want to feel normal emotions like empathy and love. I have received the most heartbreaking letters from a few (of course, they may not be cluster B’s at all but have some other disorder) but a few have been diagnosed. They live very empty, unhappy, painful lives. Covert narcissists are dangerous, but openly hate themselves instead of acting grandiose. yes, they are manipulative and play mind games, and yes, they can be extremely self-centered. But they are hurting inside. The same goes for Borderlines (who I see as being not very different at all from covert N’s). Having BPD myself, I hate the stigma and I’ve had people tell me I have no right to have an ACON blog at all because I’ve been honest about my disorder (which is asymptomatic because I use DBT methods to control it and now it’s second nature to not “act out”). I can’t stand that judgmental and holier than thou attitude that puts me (and your sad boyfriend and many others) in the same “no hope” box with MNs and psychopaths.
There is one blogger, BPD Transformation (I’m not sure where he’s been lately) who thinks all PD labels should be trashed and only the symptoms treated. While I don’t entirely agree I can see why he believes this.
There is also some evidence that BPD may actually be the same thing as C-PTSD which is not recognized as mental disorder by the psychiatric community or the DSM. The symptoms are identical but it’s considered a personality disorder instead of PTSD because the trauma started at an earlier age and/or was continuous rather than a single traumatic event, like being in a war. That’s the only difference. As for covert narcissism, these people are in a great deal of pain and their behavior is very Borderline. They become that way due to trauma and abuse and there’s no reason to think that may not also be a form of complex PTSD.
All mental illnesses have a stigma, of course, but only the Cluster B’s have the “bad, evil and hopeless” stigma as well as the “crazy” stigma. I’m not sure which is worse.
I remember one therapist I felt very comfortable with in the intake session but he said he had to order my psychiatric records before we could start. A few days later he called me and said he “didn’t treat borderlines” because of my BPD dx.
That’s the kind of thing we’re up against. Many therapists don’t want to treat Cluster B’s and just assume we are all trouble, even if we’re begging for help. And even if they accept us as patients, most insurance companies won’t cover treatment for a “Cluster B.” No wonder Cluster B’s “can’t get better.” They aren’t even given a chance to!
That being said, I don’t think we have any businessdealing with high spectrum (malignant) narcissists, people with antisocial PD, psychopaths and sociopaths. I think almost all of them are too far gone for any human help–for them, only an act of God could help them. ‘They don’t want help–I’ve never known an MN or a psychopath who has–and because the desire isn’t there, I agree with you they cannot get better. The willingness MUST be there.
I’ve gone on about this long enough. I appreciate your thoughts on this and hope you can understand my rambling reply.
I hope the books I suggested are helpful to him. I would also suggest James Masterson’s books because he has written extensively and treated people with covert narcissism (and even classic narcissism) using psychoanalytic techniques rather than just behavior modification such as CBT and has has success. There is a very moving case study he wrote in his book “The Search for the Real Self” about a man named Frank who had NPD (non-malignant) who was determined to be healed and after 5 grueling and painful years of therapy with Dr. Masterson, he was actually able to start feeling genuine empathy, love, and guilt. So yes, they can be healed–if that’s what they want. It may take years but it can be done.
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