:: Because Aunt Alex gets mail.
Dear Aunt Alex:
I’ve heard that there are therapies, like Dialectic Behavioral Therapy, and Schema Therapy, that work on people with personality disorders. This gives me a lot of hope. Should I go ahead and make the narcissist an appointment?
Signed, Beth
Dear Beth:
Yes, I admit it — of course you should! The sooner the better! Hang in there, Beth, and best of luck!
OK, now, Beth is going to keep that nincompoop busy for a good while longer, so we needn’t worry about him bothering us any time real soon. So, for the rest of us, here’s the thing about psychotherapy and narcissists:
1. They probably won’t go to real therapy, ever, unless it’s for some stupid fake reason like, “I want to figure out why I keep settling for such unworthy women.” Narcissists very rarely acknowledge that there’s anything wrong with them, much less anything as rigid, assclownish and difficult to help as NPD. Even if they say they’ll go to therapy, that’s still a far cry from their actually going and sticking with it.
2. If they do go to a therapist, it’ll be about three weeks (out of a two-year intensive treatment plan) before they’ll be calling themselves cured and quit therapy. “I got all I need out of it. I can self-manage from here.” They’ll fake all the psychobabble stuff, just like they fake everything else, and be exactly the same as they were before — except a little more smug and a lot more annoying. (“Look, I went to therapy for you, and the therapist said I didn’t even need it. Now, what have you done for me lately?”)
3. If the therapist is new, or kinda soft, the narcissist will snow her with little effort and manipulate the therapist into telling him everything he wants to hear — he’s amazing, it’s all your fault, and maybe they should go and discuss this more over drinks. (OK, therapists don’t say that last part, but the narcissist will think she (or he) did.)
I’m sorry, I really am, but narcissism does not respond meaningfully to psychotherapy, drugs, inpatient care, or anything else psychiatry or behavioral health have to offer. You can’t treat it with vitamins, an exercise regimen, antidepressants, or herbs. Meditation? Great for you, useless against NPD. Family counseling, an intervention, rational-emotive behavioral therapy, gestalt therapy, an ice bath, a colonic cleanse? I’m sorry, Cadet. When Mister Turtle is dead, he’s dead, and needs to be buried. When Mister Toad is a narcissist, well, you need to let go of him, too, and cut your losses, because therapy bounces right off, drugs can’t sustain, and a girl has gotta get real, and move on.