What kind of therapy will help a narcissistic person change?

I’m going to be starting a new book project and I’d like your help. The working title is: What Every Woman Needs to Know….and teach her daughter. So this week’s question is: What are the kinds of things you wished your mother would have taught you? What did she teach you either by example or through her words that have made the greatest impact on you as an adult woman?

For example, some of the chapters I’m planning are along these lines: Every woman needs to know how to manage her emotions. Every woman needs to know that failure isn’t fatal. Every woman needs to know how to discern real people from fake, the sheep from the wolves. Every woman needs to know how to stick up for herself and when it’s necessary to do so. Every woman needs to know how to say “no” without feeling guilty. Every woman needs to know how to make a good decision for herself instead of depending on others to tell her what to do. Every woman needs to know how to have healthy relationships. Every woman needs to know how to love herself well and that that self-hatred isn’t just unhealthy, it’s sinful . And more…

If you have some thoughts or experiences/stories that you’d like to share, please e-mail me privately at leslie@leslievernick.com or share them in this blog.

Today’s Question: I’ve e-mailed you privately before but since I last wrote, the situation has escalated and I am now separated. My oldest daughter confided in one of her teachers regarding some things that had been going on in our home. This resulted in a DFACS investigation and their involvement is ongoing.

The agency required some mental assessments for my husband, my daughter, and me. The results were that my husband was diagnosed with Narcissistic Personality Disorder and my daughter and I suffer from Post Traumatic Stress Disorder. Our therapist professes to be a believer and understands our biblical views and is working with our pastor to bring about healing to our family. However she is still coming from the clinical side of things, and sometimes I am very confused by her approach (validating his pain, hurt, etc. to build his trust and then patiently working with him to the point that she can hopefully open his eyes to the truth of his pain etc) My pastor on the other hand, is skeptical of this approach and is concerned that she is just “feeding his frenzy” and that the deeper issues of sin are not being addressed, therefore, making the healing process very slow.

My question to you is this –given your training, biblical background, and experience – what thoughts do you have that a person with NPD will likely be able to truly see and deal with their sin issues? Would you be inclined to use a more direct approach? Also, if you can, what counsel would you give me in dealing with a person like this?

I realize there are many details that have not been provided to you. I am not looking for a detailed answer – just some general thoughts about NPD and it’s “victims” (if that’s possible).

Answer: I want to answer your question because I think many people in counseling struggle to understand why their therapist is taking a certain approach yet feel afraid to just ask him/her. As a therapist myself, if someone is unhappy with my approach or is confused by why I am doing something, I would welcome their question and I think most therapists would also. As a part of your own healing, as well as for the sake of your marriage and family, I’d encourage you to speak up and talk with your counselor about your concerns.

I am very uncomfortable making comments or giving an evaluation on the approach of your therapist with your husband because I do not know all the facts of the situation but let me give you some of my thoughts.

1. Working with a person diagnosed with NPD is a long slow process and there is not a high success rate. From the literature that I’ve read and my own personal experience, validating his pain does work to build his trust but it doesn’t always transfer into his ability to validate the pain he’s caused other people.

For a narcissist it is about his pain and his pain only. When you try to talk about your pain, it may get a nanosecond of acknowledgment but it quickly reverts back to his pain.

Empathy for another person is lacking in NPD and an ability to view you or your daughter as separate people is very minimal. You are there to help him, serve him, meet his needs, and make him happy. His pain, when you fail, will always be a justification for his hurtful actions towards you. Because you are human, you will always fail in some way and so everything always becomes about him.

2. Taking a more direct, confrontational approach with a narcissistic doesn’t work either. They will feel judged, misunderstood, unheard and will stop going to therapy. They are blind to their sin and no matter how much you say it, they don’t hear it. Remember Jesus with the Pharisees? Jesus called them a “brood of vipers” yet they did not repent or acknowledge he was right. They just got defensive, angry, and more aggressive.

3. I think it is very tricky to try to work with a narcissistic person on their narcissism and on their pain while also trying to do marital therapy and treatment for Post Traumatic Stress Disorder in the other family members. If the therapist validates your pain, the narcissistic person feels threatened, neglected and/or wounded. On the other hand, when she validates his pain, you get confused. It’s hard for you to understand why she validates his pain instead of helping him take responsibility and show concern and remorse about the pain he has caused you and your daughter.

My recommendations are this: If your goal is healing for the family, you will need to lower your expectations for the change process. It is slow going whatever approach you take. Talk with your therapist and see if perhaps you and your daughter need separate help dealing with the PSTD and learning how to set appropriate boundaries so that you can minimize the traumatic effect his behaviors have on you.

If your husband doesn’t stop his rages and/or physical abuse, continued separation is best. You indicated that you still have daily contact because of a family business but you need also emotional separation. Your pastor may be able to help you work through an agreeable work arrangement so that negative contact is minimized.

You concluded in your e-mail that the “sad part is he doesn’t really understand why – he just thinks I’m acting out of anger and bitterness”. You’re right, he doesn’t understand. I’m sure you’ve told your husband “why” again and again and again but he never “get’s it” and everything still is your fault. That is the nature of the narcissistic personality and you must learn not to engage or take in his poisonous barbs when he directs them toward you. You are not a perfect person, nor is he. The difference however is that you are aware of your failures and are willing to take responsibility for them and change and grow, he is not. Until he can empathize with you and your children for the pain he’s caused and allow each of you to have your own separate feelings, needs and choices as well as cope with his own hurt and/or disappointment when you don’t do what he wants you to do, there is not much hope for true healing in your family.

There is a lot of work to be done but the first step is acknowledging the problem. If your husband can get to a place where he sees that he is part of the problem, there is hope for your family. If not, then the goal of therapy is to help him see. How long that takes no one can predict.


  1. Anonymous on August 3, 2010 at 1:36 am

    Praying for the family involved in this post. Regarding your new book…What every woman needs to know? I'll pray for you.


  2. Anonymous on August 3, 2010 at 3:52 pm

    I am in the process of figuring out just how to separate from my NPD husband. This was a very timely read and reminder for me. Leslie, the book The EDR was a gift from God and keeps me grounded in my truth and moving forward. Thank you. Keep working and helping others for God's glory.

  3. Amy on August 3, 2010 at 7:12 pm

    Great post! I don't think it is impossible for a narcissist to change, BUT only if they are able to first acknowledge they have a problem, and second that they can take responsibility for their problem without blaming everyone else around them. Unfortunately, a narcissist is someone that can be quite charming too and quite easily persuade those around them that they have changed, or don't have a problem in the first place. The one time my almost-ex husband went to counseling with me at my insistence, he had won over the therapist in the first visit. After seeing this man a total of 4 times, I said no more, and my husband said we could quit as long as I never brought up anything ever again. I agreed that everything was "great" just so I didn't have to continue being in a situation where the therapist was drawn to my husband's side.
    My husband left a year ago and I am in the process of filing for divorce because I have not seen any true change in him.
    It is not an easy decision, but I have come to realize that staying in an abusive relationship does not honor God and some would have tried to convince me for years, and I've had to leave my church because of too many people siding with my husband and failing to provide protection and support to the true victims, myself and my sons.
    A true narcissist cannot see his problem and will blame his victims for how things turn out. Even my youngest son who is 15 said the other day, that his dad has never taken responsibility for what he did all those years and acts as if we should all just move on and forget it, while he puts on his "poor me" attitude.
    I am now trying to heal after 20 years of living with someone that showed little empathy for myself and our sons, and who was mentally and verbally abusive. And my 15 year old son has had a lot of damage done to him and is just now saying he wishes his father would just disappear and never be in his life again. It is sad and so damaging to a family.
    My advice is to seek good wise counseling for yourself and your children if you live with a narcissist, do not go to counseling as a couple, and to get out if necessary to main your mental and physical health. God loves you too much as His child to see you continue to stay in a situation that is damaging, and it is NOT honoring to God.

  4. Anonymous on August 5, 2010 at 2:52 am

    Narcissists are abusive and need to be dealt with as such. Counselors who cannot make this distinction only exacerbate the problems of those involved.

    From how you describe it your counselor's approach does not seem helpful. Unfortunately, too many counselors try to help in areas in which they are not competent. I would advise you to seek out help from someone who can show that they are experienced in dealing with NPD.

    Whatever path you take you have a long road ahead. I believe that God can work to bring about change in anyone, but the time and effort required are big factors to consider. You should look at what you truly want and are willing to give at this point.

    Take a look at Lundy Bancroft's book, Why Does He Do That?

  5. Anonymous on August 5, 2010 at 2:52 am

    Thanks for your comments/thoughts regarding difficult situation involving NPD. Am in process of studying and understanding the disorder because of the boundary separation initiated right to divorce papers last November 09 by my spouse. I was not included in my spouse's counseling last year & she informs me this is diagnosis her counselors/peers gave me. In studying this disorder I also see these characteristics in my spouse especially the controlling part. Leslie, thanks for your ministry to those of us in relationships with difficult issues.

  6. Anonymous on August 10, 2010 at 1:52 pm

    Narcissists are USERS. They suck you in with their charm, and nearly smother you with affection and attention in the beginning… but it's only a tactic to USE you for their own gain. I agree with the other posts that change is slow, if not impossible. Thought it's not a "christian" site, I have found some help and hope at lovefraud.com. Read with caution, but know you're not alone. Our prayers are with you and your family.

  7. Anonymous on August 10, 2010 at 1:55 pm

    Hi Leslie,

    I love the idea of your book "What Every Woman Needs to Know". My idea sounds silly, even to me! But I grew up with a real lack in femininity. My mom didn't help us learn to dress well, apply makeup, etc. There was always a sense of shame or an aura of "sinfulness" associated with trying to look your best. It's left me confused and struggling to feel "normal", even at 40 years of age. Blessings on you as you work to provide this resource for women.

  8. Anonymous on August 12, 2010 at 7:31 pm

    I too love the idea of your book. I have struggled to know how best to share my experiences with my daughter – not wanting her to repeat my mistakes! I wish my mother had taught me what it means to be Biblically submissive. Many of the ideas for your new book seem to fall under that but if I had understood Biblical submission so many of the other issues would not have been such issues. God bless you.

  9. Anonymous on August 16, 2010 at 2:52 am

    I am also separated from a narcissist.Yes, he also wants to comeback and also claims to change. Eventhought he stills comes when he feels like to and it is ugly, i am not planning to give my peace away. The one thing I am recovering is the love for myself. It takes two for a relationship to work and they are uncapable of loving anyone. My kids are also better, in peace. I thank you Leslie for letting us know that at no moment God wants us to loose our dignity.
    For your book, I always tell my daughter "Nobody has the right to hurt anyone". We are all responsible not only of what we say, but also of how we say it.

  10. Anonymous on August 16, 2010 at 4:11 pm

    love the book idea. i wish my mother taught me what submission means.

  11. Anonymous on November 8, 2010 at 3:22 am

    I just read ERD today…Yes, I read it in one day…I am currently separated from my husband of 24 years who is in rehab right now but will be coming home the end of the year. He claims to have changed but letters home are still all about him…no asking my son about his recovery from spinal fusion surgery, no concern for my 15 year old daughter he verbally and emotionally "raped" and no real concern for my other children and what they are going through…it's all about him…I am learning to navigate and trust God more and more but it's hard and will be harder when he returns to the area and we have to work together (we too own a business together). I look forward to your new book because as the mother of 4 daughters, I have not been a good example in staying in an abusive relationship all these years but I know that I can be an example now and with God at my side show my daughters what God wants for their lives….

  12. KAthy on March 24, 2014 at 11:16 pm

    Is npd lke having I curable cancer? I am confused. Can’t npd be like being a emotionally destructive spouse? Same thing. And it can be healed with Gods intervention, however that comes.

    • Leslie Vernick on March 26, 2014 at 8:19 pm

      You can’t get cured of cancer unless you first admit you have it. Then you must submit yourself to your doctor’s treatment plan for however long is necessary to treat the cancer. NPD’s can get help but unfortunately most of the time they don’t admit they have a problem (it’s everyone else’s fault) nor will they submit to a treatment plan that could actually help them gain empathy and insight.

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