People with NPD do go to therapy, sometimes when given an ultimatum by a person close to them or due to other symptoms such as stress or anxiety. Current treatments are slow and long with significant changes taking place in 5 to 10 years. A narcissist will need a therapist who understands narcissism and how to treat people who have it.

There are approaches that can be tried. Please see ‘Having a Relationship with a Narcissist‘.

It seems that people who develop NPD are born with certain inherent characteristics but they also have to have additional trauma in their early childhood and there is a high probability of one of their parental figures also having NPD.

Often, people in relationships with narcissists will feel ‘trapped’ with their partner. There are many reasons for this such as low self-esteem or the relationship feeling ‘normal’ because one of your primary caregivers also had NPD. Counselling, self-development and healing will help to change your feelings around this.

Many people with NPD can function quite normally in society and often it will only be the family who is aware of the extent of the destructive behaviour. Narcissists do have very poor reality perception as they view everything through their lens of narcissism and their low self-esteem causes them to be continually triggered into devaluing behaviours towards those people around them.

People with NPD are very controlled in their behaviours and are often brutal to their children and partners in private but are more subtle in their techniques of devaluing others in public. This would suggest an awareness of what is and is not acceptable.