Narcissists Can Achieve Fulfilling Relationships with High Investment – Psychotherapist


Lee Hammock, who labels himself a “self-aware narcissist,” recognized his narcissistic personality disorder (NPD) after being diagnosed in 2017 following his wife leaving him for the second time. He’s part of a growing group acknowledging their narcissistic traits and seeking ways to improve relationships. Despite the challenges, experts believe that individuals with NPD can change, though it’s neither easy nor cheap.

Dr. Ramani Durvasula, a clinical psychologist, works with people with narcissistic and antagonistic personality types. She sees two childhood pathways to narcissism: one involving trauma or neglect, where change may be possible, and the other characterized by indulgence and entitlement, which often presents more difficulties in changing.

Narcissists’ low self-awareness and inability to recognize others’ needs hinder therapeutic progress. A person must acknowledge causing harm to others, which only a small fraction of narcissists do. Changing personality traits, even for people with NPD, is challenging.

Treating NPD is complicated by cost and accessibility. Many insurance plans inadequately cover mental health treatments. The lack of therapists and long wait times exacerbate the situation. Effective treatment for narcissists requires ongoing sessions and commitment akin to addiction treatment. High-quality therapy, recommended for sustained behavior change, can incur substantial costs.

Hammock, who spends $150 per therapy session, acknowledges therapy hasn’t cured him but has helped manage his behaviors. He now handles situations better by questioning his reactions. Durvasula notes that any change for narcissists will manifest in their actions, not logic. Progress can mean shifts in behavior rather than complete personality transformation.

In some cases, success may be unconventional. Durvasula shared an example of a deeply narcissistic client who, through therapy, became self-reflective about his actions but ultimately chose to avoid romantic relationships due to his inability to empathize with others’ emotions.

Overall, overcoming NPD requires a shift in behavior and ongoing commitment, but success can be measured in improved interactions and self-awareness.