Therapy 101

If you are new to recovery from Narcissistic Personality Disorder, or if you think you may have hit some snags, this article is meant to help steer you in the right direction. Whether you want to understand the therapy process or determine how to find a suitable counselor, the information below may be useful.

Why Therapy?

Therapy, also called mental health counseling, is a goals-driven process, informed by diagnostic information, your personal readiness, and evidenced-based treatment strategies. This endeavor is crystalized within a working relationship between a client and a licensed clinician in a mental health discipline. Therapists have highly specialized training and thousands of hours of experience diagnosing and treating mental disorders.  Therapy is an opportunity to set mental health-related goals, process emotions and experiences, get feedback, and develop greater insight. There are many kinds of therapy, and what is most beneficial for you will be a combination of the right clinician with the right training, as well as a goodness of fit for your specific situation. Therapy is a valuable, if not indispensable tool for personal growth and transformation.

Therapy for NPD

Individuals with Narcissistic Personality Disorder have a unique set of needs and considerations when starting in therapy. First, you should know that therapy for NPD is a long-term commitment. Because NPD is characterized by problematic personality traits, distorted beliefs about self and other, and impaired empathy and interpersonal functioning, there is considerable effort that must be made to successfully manage symptoms and reduce the negative impact of the disorder in one’s life. A qualified therapist will choose an appropriate treatment approach, and will collaborate with you to develop a plan of action for therapy that is related to your stated goals and needs. Recognizing that therapy is a foundational support for your recovery journey, it will be useful to search for a provider who is best-suited for a long-term connection in the therapeutic context.

Choosing a Provider

When searching for a therapist or counselor, start with the basics. Choose someone who is licensed to practice where you live. Evaluate your personal cost/ insurance needs, location, and other logistical variables that might impact your ability to see a therapist.

Next, an important consideration is specialization and training of the clinician. It is highly encouraged  that you find a therapist that is trained in working with individuals with NPD, or personality disorders. Because personality disorders can be challenging to work with in terms of a diagnosis, you will benefit from working with someone who has already invested in training specific to these disorders and can maintain compassion in the face of at-times difficult challenges clinically, as well as in the therapeutic dynamic. It can also be helpful if your chosen therapist has worked in substance-abuse counseling or with depression and anxiety, as they are frequently comorbid with NPD.


Look for a therapist that will be a good match in the long run. Do NOT choose a therapist you are highly attracted to, one that you sense you could “game” or manipulate after a consultation or first meeting, or anyone that you have a negative association with. For example, if you are male and you find that you tend to overly sexualize female gendered friends or acquaintances, you may find that a male therapist can help you make more progress by removing that challenging dynamic from the relationship altogether. Conversely, if you tend to feel very competitive with masculine individuals in your life, you might find you prefer an individual whose gender or personal presence you do not find threatening or activating. It won't be possible to find someone who matches your needs or ideals for a therapist in every way, but it is worthwhile to consider some of these potential issues from the outset. And, whoever you choose to work with, make a commitment to increasing your self-awareness around issues that you do encounter internally so that you can communicate them openly with your therapist.


Above all, notice if the therapist helps you feel hopeful. Remember, with NPD, authenticity is frequently placed on the margins in order to prop of a version of oneself that feels powerful, superior, and invulnerable. This version is a false self. The false self believes that he does not need to change. A therapeutic relationship where an individual suffering from NPD feels hope for recovery is paramount in the task of countering the persistent push-back of the false self against change.