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September 18, 2012

Help for Families When a Loved One has Narcissistic Personality Disorder

Narcissistic Personality Disorder (NPD) describes individuals who demonstrate an exaggerated sense of self-importance or uniqueness, and a preoccupation with receiving attention.

Do you have a loved one currently in treatment for NPD? A recent Psychiatric Times article outlines several psychotherapy tips for clinicians working with patients diagnosed with NPD. With a little tweaking to fit the family setting, these same basic tips could prove helpful as you support your loved one’s recovery.

Here’s a look:

Word Criticism Carefully: Individuals affected by NPD often over-emphasize their achievements and talents, or exaggerate the nature of their problems. Beneath all this, many narcissists display a very fragile self-esteem, a trait revealed by how strongly they value the perceptions others have of them. When faced with criticism over their actions, individuals may feel rage, humiliation, and shame. As a result, the narcissist may become closed off to further communication.

Tip: Try using neutral language when voicing displeasure with your loved one or pointing out examples of narcissistic behavior. Ask your loved one’s therapist to help you develop appropriate phrasing when feedback is needed.

Demonstrate That It’s More Than Appearance That Counts: Individuals with NPD are often preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. What they tend not to focus on the work it takes to reach these states. According to the Psychiatric Times, “the very pleasure of a craftsman is to sense clay taking shape under his hands, above and beyond the triumph of seeing the final product admired by others.” This is a concept that individuals with NPD may have a hard time grasping.

Tip: To reinforce the idea that “process over product” counts in obtaining one’s goals, enroll in a pottery class or other activity that teaches a skill (automechanics, carpentry, learning a foreign language, etc. are some other options).

Don’t Force Empathetic Behavior: Lack of empathy, or the inability to recognize how others feel (i.e., unable to appreciate the distress of someone who is seriously ill) is one of the hallmarks of narcissistic behavior. As self-awareness improves, “empathic attunement” will likely flow more freely. In the meantime, direct attempts on your part to increase his or her feelings of empathy will likely backfire.

Tip: Try something basic like starting a garden and working together to tend and care for the plants. Keep the lines of communication open and be in listening mode with your loved one to gauge their state of mind. Over the course of treatment, subtle verbal clues may let you know that feelings of empathy are on the rise.

Promote Self-Awareness: Accurately appraising one’s own actions and desires and developing a better understanding of the impact relationships have on the self are important aspects of healing for individuals for NPD.

Tip: To promote self-reflection, encourage your loved one to keep a journal. Make sure it’s a journal that won’t need to shown to anyone or put on display or judged; it’s for their eyes only.


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