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:: 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.

:: Because Aunt Alex gets mail.

Dear Aunt Alex:

The flaming narcissist ex has a new girlfriend, and she seems (from a distance) to be a nice person.  I feel like I should warn her.  How should I do this? Write her a letter, give her a call?  And when is the right time?
    Signed, Alice

Dear Alice:

Well, aren’t you an altruistic dear.  Aunt Alex loves that about you.

However, come on over here and sit in this chair, Dear, and let the Army cadets wrap this rope around you until these helpful feelings of yours pass.

Nothing about this is a good idea, and here’s the worst part of this not-good idea: You’re staying engaged.  You’re staying involved, and I do daresay that your wanting to stay involved in his life is the main reason you want to warn this poor woman about the mess in which she’s finding herself.

But, we needn’t rank your motives in any order, or even look at them more closely than that.  How should you do this?  You shouldn’t.  When is the right time?  Never.  She won’t listen and has to find out for herself.  You need to detach, mourn the loss of your hopes, and put all of this love and concern into your own life and future.  

Now, you let me know if those ropes are too tight, and I’ll go get you some nice rice pudding with cardamom.