Can Narcissists Change? Insights from Psychological Experts

The question of whether narcissists can change has gained attention from mental health professionals, who explore the complexities of narcissism and its treatment. Research indicates that individuals with narcissistic traits may struggle to adjust their behavior, particularly when faced with criticism or perceived threats to their self-esteem.

Understanding narcissism begins with recognizing its two primary types: grandiose and vulnerable. Grandiose narcissists often see themselves as superior, while vulnerable narcissists tend to be hypersensitive to criticism. Both can exhibit self-centered and arrogant behavior, and in extreme cases, these traits may lead to a diagnosis of Narcissistic Personality Disorder (NPD). This condition is characterized by a persistent pattern of grandiosity, a constant need for admiration, and a lack of empathy.

Research shows that narcissists can react defensively to criticism, which often pushes others away. This behavior can lead to feelings of rejection for the narcissist, creating a cycle of isolation. The impact of their actions is not only felt by those around them but also deeply affects the narcissists themselves. Treatment options for narcissism typically include psychological interventions that aim to manage symptoms rather than provide a cure.

Treatment Approaches for Narcissism

The most common initial treatment for narcissism is Cognitive Behavioral Therapy (CBT), a talking therapy that helps individuals identify and challenge unhelpful thoughts and behaviors. In a study conducted in 2015, therapists expressed a preference for introspective relational techniques, which encourage clients to explore their emotions and motivations in a nonjudgmental environment. This approach is particularly important since many narcissists fear vulnerability.

The process of building rapport between therapist and client can be challenging. Narcissistic clients often feel the need to project confidence, making it difficult to admit weaknesses. Feelings of inadequacy and shame can lead to defensiveness, complicating the therapeutic process. A significant concern is that drop-out rates for narcissistic patients can range from 63% to 64%, compared to 10% to 50% for therapy in general.

Therapists note that narcissistic individuals rarely seek treatment voluntarily. More often, they seek help for related issues such as job loss or emotional distress rather than for their narcissistic traits. Most advancements in treating personality disorders have stemmed from research on borderline personality disorder, with some of those strategies adapted for narcissists.

Methods such as Dialectical Behavior Therapy, Mentalisation-Based Therapy, and Schema Therapy have shown promise. Dialectical Behavior Therapy helps clients challenge negative thoughts while accepting their identity. Mentalisation-Based Therapy aids in connecting thoughts and beliefs to behaviors. Schema Therapy focuses on altering unhelpful mental frameworks, such as those formed from childhood neglect.

New Approaches and Future Directions

Despite the potential benefits of these therapies, limited evidence exists regarding their effectiveness for NPD. The barriers encountered in traditional therapeutic approaches, including long treatment times and difficulties in rapport, persist.

In April 2025, researchers Alexa Albert and Anthony Back proposed an innovative approach involving the use of psychedelic substances, specifically MDMA, during therapy sessions. They suggest that MDMA could enhance empathy and emotional receptiveness in clients, potentially creating a more conducive environment for change. While MDMA-assisted therapy has shown promise for conditions like post-traumatic stress disorder, it also carries risks, including the potential for worsening mental health.

The introduction of substances into therapy raises additional concerns about the necessity of trust and rapport, especially when clients are under the influence. Furthermore, MDMA is classified as a Schedule 1 substance in the UK, meaning it is not recognized for medicinal use, which complicates its potential therapeutic applications. Efforts to reclassify it to Schedule 2 for clinical trials have yet to yield results.

Although the recommendations from Albert and Back remain theoretical without completed clinical trials, they highlight the ongoing search for effective treatment methods for narcissism. For now, therapists must rely on their skills to foster a supportive environment, working through the barriers that narcissistic clients present.

In conclusion, while the possibility of change exists for narcissists, achieving meaningful progress requires patience and a skilled approach from mental health professionals. The journey toward transformation is complex, but with the right interventions, there is hope for improvement.