Family & Friends

Helping a Friend with Narcissistic Personality Disorder

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Helping friend with NPDWe’ve all been in the situation where someone we know is so thoroughly preoccupied with their own life, that they cannot stop railing about how interesting and amazing their life is. They cook the best lasagna in the world and their Boston terrier is the coolest dog in the neighborhood because it made it to “America’s Next Top Dog.”

While it’s not abnormal for people to sometimes brag about themselves or their achievements, the behavior can be indicative of a diagnosable personality disorder – Narcissistic Personality Disorder. While most people know narcissists as those who are obsessed with themselves, there’s more to their disorder than that. People with NPD are overly self-important, have a great need for admiration, display no empathy for others, and are often envious of other people.

Narcissists can be anywhere, from the exuberant orator at your local Toastmasters club to the super-ambitious, L.A.-bound choreographer ex of yours. An estimated 1 percent of the population suffers from Narcissistic Personality Disorder. 

Narcissists, like people with other personality disorders, may be under the impression there’s nothing wrong with them. So how do you get help for someone with Narcissistic Personality Disorder?

Help them recognize their personality disorder. People struggling with Narcissistic Personality Disorder are often unaware that they even have a disorder and are unlikely to seek treatment on their own. “Although narcissistic individuals are strikingly aware of their unhappiness, feelings of emptiness, and intense need to compare themselves to others, they are not always aware that these characteristics are ‘narcissistic,’” says Anthony F. Tasso, assistant professor at the Department of Psychology and Counseling at Fairleigh Dickinson University in New Jersey.

“However, the more they can become aware of their feeling of inner emptiness and their tendency to take more than they give in relationships, the more they can attempt to control these destructive forces,” he continued.

No one said convincing a person with Narcissistic Personality Disorder that they have a psychiatric disorder that needs attention was easy, but you’ve got to start somewhere.

Help them find personality disorder treatment. If your friend decides to enter personality disorder treatment, you’ve made it to a vital step. One of your most important roles will be to help them choose the right kind of personality disorder treatment, which can be provided in a residential or outpatient setting.

Psychotherapy is the way to go for most people with Narcissistic Personality Disorder. There are three types of therapy that are beneficial to people with Narcissistic Personality Disorder:

  • Cognitive Behavioral Therapy (CBT): CBT helps people with Narcissistic Personality Disorder identify unhealthy and negative thoughts and behavioral patterns and replace them with healthy, positive ones.
  • Family Therapy: Sessions of family therapy involve bringing in the family of the person with Narcissistic Personality Disorder. Therapists discuss conflicts in the family members’ relationship with the narcissistic individual, and teach them how to cope with the specific symptoms of the narcissistic individual.
  • Group therapy: In group therapy, therapists bring together a group of people diagnosed with Narcissistic Personality Disorder. Listening and talking to other people with Narcissistic Personality Disorder may help your friend understand others better and learn to more effectively relate to people and respect their feelings and points of view.

Depending on the severity and nature of the disorder, a therapist will ask your friend to go for one or more of these options. While there are no medications that can treat Narcissistic Personality Disorder itself, there are medications that can mitigate symptoms such as depression, anxiety, and anger.

Offer unflinching support. If you’ve decided to help a friend treat their Narcissistic Personality Disorder, be prepared to be in it for the long haul. It may take months, or even years, to bring about any noticeable change in your friend’s behavior. However, with the right kind of personality disorder treatment, change is possible.


  1. diagnosedborderline

    CBT is a short-term therapy. Personality disorders need therapy long-term (e.g., two years). NPD and BPD are rooted in abuse and trauma and the need to develop trusting relationships is paramount.

  2. diagnosedborderline

    I was in Dialectical Behaviour Therapy for two years. Although as a committed Christian I wasn’t so happy with the mindfulness side of it, I did generally find it very helpful. Although my label was Borderline PD, I see from what I read about NPD that there seems to be similarities in many ways between people with BPD and people with NPD. Perhaps DBT could help Narcissisists too? It would be long-term enough to meet the deep need for a long-term constant figure (in their therapist) who is there for them.

  3. diagnosedborderline

    This isn’t to criticise CBT. I think CBT is excellent. I had some CBT, too, years ago. I just think it is too short a course of therapy for something so deeply entrenched and trauma-based like NPD or BPD. Anyway I’m getting sick of the sound of my own voice now so I will shut up. :)

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