This discussion came up as a comment on another post, and I decided it would make an interesting topic for a new post.
A frequent commenter (Mary Pranzatelli) pointed out that among psychotherapists, there is little understanding of the Cluster B disorders, including NPD, which may be one of the reasons why these disorders are so difficult to treat. They wind up treating the wrong disorder, or more accurately, they stop short by treating the presenting disorder (depression or anxiety) but not the underlying one that led to it (the personality disorder).
An example of this would be a narcissist (or a borderline) who comes into therapy for depression caused by the end of a relationship. The therapist sees the dysphoria and depressed body language, and the client is only interested in relief of their depression. They have no interest in getting treatment for their narcissism because the way they see it, the personality disorder that led to the end of their relationship (and resulting depression) isn’t a problem. In most cases they don’t even know they have a personality disorder.
The therapist, knowing little about NPD or personality disorders, treats the client for the depression only, and when the client feels a bit better, they leave, only to wind up in a new relationship that is also destined to end because the underlying NPD will still cause them problems in their next relationship.
Mary also pointed out that therapists unknowingly aid narcissists in the abuse of their victims. I agree because I have seen this happen with my ex. My ex (unlike most narcs) has always been open to therapy, but only for his depression/anxiety, not for his narcissism. Being a “willing client” aids him in his “victim” mask. He isn’t in therapy to get any real help, but to “look good,” eg, look pathetic and abused. It helps his case.
All his therapists aided him in his gaslighting of me. He had them believing HE was the victim and I was the abuser. Once when we were in marriage counseling (which was my idea!), he had the marriage counselor scolding me for trying to “control” him. Ha! This was shortly before I was hospitalized for major depression (and diagnosed with borderline PD myself).
In this way, some narcissists use therapy as a way to gaslight their victims (who become their “abusers”) and the therapist becomes a flying monkey!