Published on July 11, 2025 – by editorial team
A narcissist usually seeks therapy not out of self-awareness but due to external pressures or consequences.
Psychological profile of the narcissistic personality
They often feel fragile and inadequate, fear betrayal, and see others as both helpful and threatening.
To diagnose narcissistic personality disorder, several symptoms must be present, including grandiosity, lack of empathy, and need for admiration.
Contributing factors include family dynamics, emotional neglect, excessive protection, or past bullying.
Therapeutic approaches
Cognitive-behavioral therapy helps narcissists understand their dysfunctional patterns and restructure their thinking.
Pharmacological treatment
Narcissism: what it is, how it manifests and what are the typical symptoms
These individuals do not engage in self-criticism and refuse to question their behavior or identity.
Narcissism can lead to personal, social, and professional issues. Lack of admiration often results in rage or manipulation.
Medication is used only for secondary conditions such as anxiety or depression.
Narcissism and personality
The narcissist, in moments of failure or emotional breakdown, may begin to perceive a strong sense of loneliness. This emotional void, combined with external pressures or interpersonal crises, often becomes the true engine that pushes them to seek therapy. It is not a matter of deep self-reflection, but rather a reaction to the collapse of their grandiose image.
When narcissists seek out a therapist, their internal world is often filled with conflicting emotions and behavioral issues. These reactions stem from real-life situations in which their sense of grandiosity was not acknowledged or accepted by others. Events such as lack of professional recognition or a breakup are perceived as personal failures, triggering sadness, fear, and anger. Cognitive-behavioral therapy is used to help the patient identify the dysfunctional thoughts and behaviors responsible for their distress. Therapy then moves on to a mental restructuring process in which the therapist does not attack the narcissist’s grandiose self-perception directly, but works on reshaping their view of themselves and those around them.
In daily life, narcissistic individuals may experience subtle difficulties in maintaining long-term relationships. Their need for constant validation, coupled with a lack of empathy, often leads to misunderstandings and tension in both personal and professional settings. While they might present themselves as charismatic and confident, underneath lies a fragile self-image that reacts strongly to any form of perceived rejection or failure.
Despite the challenges posed by narcissistic traits, with appropriate therapeutic support and long-term commitment, individuals can achieve significant improvements in self-awareness and relational functioning. Building a more balanced self-image and fostering empathy are gradual but attainable goals in the therapeutic journey.
Socially, their interactions may appear superficial or manipulative. While they may initially attract attention or admiration, close relationships tend to suffer due to their inability to genuinely connect or acknowledge the needs of others. This pattern frequently results in isolation or volatile interpersonal dynamics.
In professional environments, narcissists may struggle to function within team dynamics. Their tendency to dominate conversations and disregard others' input can undermine collaboration. This behavior, while sometimes masked by surface-level charm, often creates friction and deteriorates group productivity over time.
Pharmacological treatment is not aimed at changing the narcissist’s distorted personality traits. Instead, it addresses secondary conditions that may arise as a consequence of the disorder, such as:
They often surround themselves with well-known or socially influential individuals. However, these are superficial and opportunistic relationships, lacking authenticity. If they don’t receive constant praise or admiration, they respond with anger or aggressive behavior.
There are also a number of deeply rooted beliefs in this type of individual. For example, they believe that if one is attacked, they must defend themselves; if one is in need, they should seek help. The narcissist believes that when facing a crisis, support is necessary, but at the same time is convinced that trusting others will inevitably lead to betrayal.
These issues arise from an attitude in which they place themselves at the center of everything. Feeling grandiose and superior to others leads them to view rules—those that apply to everyone else—as not applicable to themselves.
Another distinctive trait is the desire to reinforce their own position. They regard their superiority as an objective fact, almost a status. Therefore, they engage in behaviors and actions that aim to confirm what they consider to be an immutable and unquestionable condition.
In these cases, medications such as anticonvulsants and mood stabilizers are commonly prescribed.
Events such as lack of professional recognition or the end of a romantic relationship are perceived by the narcissist as personal failure. These experiences often trigger feelings of sadness, fear, and anger.
Another theory involves children who have suffered bullying, humiliation, or verbal abuse. Over time, their reaction to such stimuli may lead to the construction of an inflated self-image as a defense mechanism.
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Narcissists often suppress empathy as a defense mechanism to protect their fragile self-image, making genuine emotional bonds difficult to maintain.
Experiences like emotional neglect, bullying, or overvaluation in childhood can contribute to the formation of a grandiose persona as a coping strategy.
The need for validation and superiority often leads to manipulation, poor teamwork, and superficial social interactions, resulting in isolation and conflict.
Rather than self-awareness, therapy is usually sought after a crisis—like a breakup or job loss—that shatters their idealized self-image.
Yes. With long-term cognitive-behavioral therapy, individuals can gradually improve self-awareness, develop empathy, and build healthier relational patterns.