Therapy, in most cases, cannot cure the Narcissistic Personality Disorder (NPD), only mitigate and ameliorate the condition by modifying some of the narcissist's behaviours.

Only narcissists, who go through a severe life crisis, tend to consider the possibility of therapy at all. When they attend the therapeutic sessions, they, usually, bring all their rigid defence mechanisms to the fore. The therapy quickly becomes a tedious – and useless – affair for both therapist and patient.

Most cerebral narcissists are very intelligent. They base their grandiose fantasies on this natural advantage - namely, on their intellect. When faced with a reasoned analysis, which shows that they suffer from NPD, most of them accept the new information. But they also have to face it and strive to change themselves – and this is the difficult part: all narcissists are deniers of reality.

Moreover, cognitively assimilating the information that one is a narcissist, that one suffers from a personality disorder amounts to a mere process of labelling. Cognitive insight (knowing something) is not like emotional insight (feeling something). It has no psychodynamic effects. It does not affect the narcissist's behaviour patterns and interactions with his human environment. These behaviour patterns and interactions are the products of well-entrenched and rigid defense mechanisms.

Narcissists are pathological liars. This means that they are either unaware of their lies – or feel completely justified and at ease when lying to others. Often, they believe their own confabulations and attribute to them "retroactive veracity". The very essence of the narcissist is a huge, contrived, lie: his FALSE Self, his grandiose FANTASIES, and his IDEALISED objects.

Personality disorders are adaptative. This means that they help to resolve mental conflicts and the anxiety, which, normally, accompanies them. Narcissists, therefore, have little incentive to get rid of their disorder. It shields them from the inevitable hurt of coping with the outside world.

Narcissists sometimes contemplate suicide (suicidal ideation) when they go through a crisis, but they are not very likely to follow through.

Narcissists are, in a way, sadists. They are likely to use verbal and psychological abuse and violence against their closest, nearest and "dearest".

The NPD is a newcomer to the zoo of mental disorders. It was not fully defined until the late 1980's. The discussion, analysis and study of narcissism are as old as psychology – but there is a great difference between being a "mere" narcissist and having a NPD. So, no one has a clue as to how widespread this particular personality disorder is – or, even, how widespread personality disorders are (estimates range between 3 and 15% of the population, but I think that 5-7% would be a fair ballpark figure).

Author's Bio: 

Sam Vaknin ( ) is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East.

He served as a columnist for Central Europe Review, Global Politician, PopMatters, eBookWeb , and Bellaonline, and as a United Press International (UPI) Senior Business Correspondent. He was the editor of mental health and Central East Europe categories in The Open Directory and Suite101.

Visit Sam's Web site at