Narcissistic Personality Disorder (NPD) is often misunderstood — not just by the public, but even within clinical settings. Many associate the term narcissist with selfishness or arrogance. But in truth, NPD is a deeply rooted psychological condition that often stems from unhealed emotional wounds.
According to the DSM-5, NPD is defined by a persistent pattern of grandiosity, a constant need for admiration, and a lack of empathy. Individuals with NPD often have difficulty forming genuine connections and may experience emotional emptiness beneath the surface of their confidence.
Is Healing from NPD Really Possible?
This is one of the most common — and controversial — questions in psychology: Can a narcissist change?
Some experts argue that because personality disorders are ingrained in an individual’s psychological makeup, full recovery is rare. Others, however, maintain that change is absolutely possible, especially when a person is willing to do the inner work.
As Dr. Elsa Ronningstam of Harvard Medical School explains in her research, “Change is possible, particularly when narcissistic traits are recognised as defensive adaptations rather than fixed traits.” (Source: Harvard Health)
While transformation takes time, therapy, and commitment, recovery is possible — especially when supported by skilled clinicians and a strong therapeutic alliance.
What Causes Narcissistic Personality Disorder?
While there’s no single cause, experts believe that NPD often develops from a combination of:
- Childhood trauma, neglect, or excessive criticism
- Overindulgent parenting or unrealistic praise
- Genetic and neurobiological factors
- Dysfunctional early relationships and attachment issues
These experiences may cause a child to develop an inflated self-image as a way of protecting against deep-seated feelings of inadequacy or shame.
Can a Narcissist Change? Yes — But It’s a Journey
The short answer is yes, narcissists can change — but not without self-awareness, motivation, and the right support.
NPD is resistant to change largely because individuals may struggle to see their behaviours as problematic. Many people with NPD live in denial or defensiveness, using these mechanisms to avoid shame or vulnerability.
But when they are willing to reflect, take accountability, and engage in therapy — especially during times of emotional crisis or relational breakdown — change becomes not only possible, but deeply meaningful.
Treatment Options for Narcissistic Personality Disorder
Healing from NPD is not about “fixing” someone. It’s about creating space for growth, insight, emotional resilience, and more authentic relationships.
1. Psychotherapy (Talk Therapy)
Psychotherapy is considered the gold standard in NPD treatment. It helps individuals uncover the emotional pain beneath their defensive personas.
Common modalities include:
- Cognitive Behavioural Therapy (CBT): Focuses on identifying and changing distorted thinking patterns.
- Dialectical Behaviour Therapy (DBT): Helps with emotion regulation and distress tolerance.
- Psychodynamic Therapy: Explores unconscious motivations and early developmental trauma.
Read more about therapy options for personality disorders via the National Library of Medicine.
2. Group Therapy
Though intimidating for many with NPD, group therapy can offer profound benefits. It allows individuals to:
- Receive honest feedback in a supportive setting
- Practise healthy social interactions
- Witness how others manage similar issues
Group work helps to gently erode the grandiose self-image and promote relational healing.
3. Medication for Co-Occurring Conditions
There’s currently no medication approved specifically for NPD. However, many individuals with NPD experience co-occurring mental health issues, such as:
- Depression
- Anxiety
- Borderline features
- Substance misuse
In such cases, antidepressants or mood stabilisers may help manage distressing symptoms, making it easier to participate in therapy.
4. Boundary Setting and Self-Care Practices
Learning to set healthy emotional and relational boundaries is a major part of the healing journey — both for individuals with NPD and those in relationships with them.
For individuals with NPD, this means:
- Respecting others’ emotional space
- Recognising the impact of their actions
- Practising self-regulation and accountability
Self-care might also include:
- Meditation or mindfulness
- Journaling for self-reflection
- Compassion-focused therapy
- Time in nature or creative hobbies
5. Motivation to Change: The Key Ingredient
No amount of therapy or support can create lasting change without motivation. This is often the biggest hurdle.
A skilled therapist will help foster this motivation by:
- Exploring underlying emotions
- Helping the individual connect with authentic vulnerability
- Highlighting the consequences of narcissistic behaviours
- Encouraging new relational experiences
Explore this research article on change processes in NPD.
Recovery Is Not Linear — But It Is Possible
Healing from NPD is not about perfection. It’s about making progress: learning to see oneself more clearly, treating others with greater care, and building a more authentic self.
Common challenges on the road to recovery may include:
- Resistance to feedback
- Difficulty tolerating vulnerability
- Periods of regression
- Shame and guilt surfacing
But with perseverance, support, and a willingness to grow, individuals with NPD can experience meaningful transformation.
For Loved Ones: Supporting Someone with NPD
If someone in your life has NPD, supporting them can be emotionally draining. You are not responsible for their healing, but your role matters.
What can help:
- Setting clear boundaries
- Avoiding enabling behaviours
- Seeking support for yourself (e.g. therapy or support groups)
- Encouraging professional help, without forcing it
Your wellbeing matters too. Take care of your emotional safety and don’t be afraid to walk away if the relationship becomes toxic or abusive.
Final Thoughts: The Possibility of Healing
Narcissistic Personality Disorder can feel like a barrier to connection, empathy, and emotional fulfilment — but it doesn’t have to be a life sentence. With time, therapy, motivation, and compassionate support, healing is possible.
If you or someone you care about is struggling with narcissistic traits, don’t lose hope. Reach out to a qualified therapist with experience in personality disorders. The road may be long, but every step towards insight and connection is a powerful act of courage.