Intervention for Narcissistic Personality Disorder

When done properly, an intervention is an expression of love and support for someone who is going through a challenging time.

Unfortunately, for someone with narcissistic personality disorder, an intervention can have an entirely different interpretation of the purpose of the process. To them, it’s an expression of the family’s weakness or inability to see how wonderful the target of that intervention really is.

While almost anyone with an addiction or a mental illness could react in this way, it is a common response in people who have narcissistic personality disorder (NPD). People like this can and should be approached through intervention, but a professional interventionist might be the best option when the time comes to plan and carry out an intervention for someone with this disorder.

NPD Signs and Symptoms

People with NPD display an exaggerated sense of self-worth. According to the Mayo Clinic, common symptoms of this mental health disorder include:

  • Exaggeration of talents or accomplishments
  • Inordinate demands for attention
  • Jealousy
  • Manipulation of others
  • Basic inability to recognize or value the feelings or emotions of others1

Struggling with Low Self-Esteem

While people with NPD disorder might seem as though they’re just bursting with confidence all of the time, they’re really struggling with low self-esteem. They might believe, deep down inside, that they’re inferior to others but that no one has noticed this fact quite yet.

As a result, a person with NPD puts on an elaborate act that demonstrates confidence and superiority. However, if they sense any kind of criticism or judgment coming from others they might express extreme anger toward those they love the most.

Someone with narcissistic personality disorder might also place the blame for their difficulties on others. He or she might think that if the people around her would just get it together, then she’d be able to accomplish all of her goals and make something of her life. She might even blame her current troubles on episodes that took place long ago, to the point of even blaming people who are no longer alive.

A person with NPD might not take responsibility for their actions at all, and might feel entitled to behave in a specific way, simply because she feels as though she’s been wronged in the past.

It’s easy enough to assume that someone with NPD will succeed in life, because he puts on an elaborate display of confidence that others have no choice but to believe. However, research suggests that those with NPD tend to have an intense amount of difficulties as they age.2 For example, they might struggle to keep healthy relationships intact or they lose their jobs. When this happens, it’s common for those with NPD to struggle with depression, and as they age, their risk of suicide increases.

NPD Intervention Basics

While consequences of narcissistic personality disorder can be hard for the person to bear, their appearance provides the family with an opportunity to hold an intervention. In an NPD intervention, the family discusses the consequences of the behavior and how an underlying mental illness might play a role in the struggles the person is facing at the moment.

The idea isn’t to blame the person or to make light of the difficulty. Instead, it provides the family with an opportunity to discuss why treatment might be helpful and to urge the person to get care.

Reducing Anosognosia

For people with narcissistic personality disorder, an intervention can help reduce a sense of anosognosia. According to the National Alliance on Mental Illness (NAMI), this condition is somewhat common among people who have mental illnesses, and it represents a basic inability to understand that a mental illness is in play.3 For people who have this feature of NPD, there is no problem that stems from the behaviors of the person. Others are always to blame.

While assisting with NPD anosognosia isn’t easy, NAMI suggests that using a supportive approach can be helpful. Families can focus on the goals the person has regarding health, wealth or happiness, and then discuss how treatment might help someone to reach those goals. Arguments aren’t helpful but focusing on goals might help people with these mental health difficulties to accept the need for care.

A professional interventionist can help families to practice their speeches, so the moment of the intervention won’t be so intimidating. During the intervention planning stage, families can learn more about what phrases, terms and techniques work best with people who have NPD, and they can work up prepared speeches that contain phrases that might be effective.

Problems in NPD Interventions

People who have narcissistic personality disorder are good at manipulating conversations. They tend to pick on specific words and twist and turn them until the speaker feels wrong or guilty for speaking up at all. It’s a defensive mechanism, and people who have NPD have likely been using this technique for years or even decades in order to avoid the need for change.

Similarly, some people who have NPD monopolize conversations by interrupting, walking out or reacting with rage. Again, these are techniques they have used for years to keep their critics at bay. Often these techniques are quite effective in getting people to stop talking or drop the conversation in mid-sentence.

It’s not surprising that people who have NPD would lean on these tips and tricks during an intervention. These people are extremely sensitive to the slightest whiff of blame or judgment, and they can feel extraordinarily pressured during an intervention. Leaning on techniques they know seems reasonable when emotions are running high.

An interventionist can help families practice for these outbursts. Interventionists can name and stop these behaviors when they appear during an intervention.4 With the proper preparation, families should be able to continue to calmly and repeat what they’ve written for the intervention without getting sucked into an argument.

Sticking to the script at all costs is important. This might mean letting the person with NPD talk without interruption, and then delving back into the topic at hand. It’s also reasonable to allow the person with NPD to take a break and walk away from the intervention room from time to time. This can help when feelings of sadness and anger threaten to overwhelm the person the intervention is trying to help.

When Intervention Isn’t Successful

It’s important to understand that not all interventions involving people with narcissistic personality disorder are successful. Even when presented with the evidence that should lead a person to treatment, sometimes a person with NPD will not allow himself to get the help he needs.

If an intervention isn’t successful, family members can find treatment of their own. Family therapy can help loved ones understand how to set limits while living with someone who has no respect for limits. In some cases, family members might even be moved to break ties with people who can’t or won’t seek to get better with care. Therapy sessions might provide loved one with the freedom they need to develop a healthier relationship with someone who won’t give back.

Finding Help for Narcissistic Personality Disorder

Some interventionists stay attached to their clients when an intervention isn’t successful, and they suggest counselors or support groups that can help. Sometimes these interventionists even help families to hold follow-up discussions about addiction or mental illness at a time in which the person seems more comfortable with the idea of getting care.


Sources

“Narcissistic Personality Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 18 Nov. 2017.

“Narcissistic Personality Disorder: Rethinking What We Know.” Psychiatric Times. Accessed July 25, 2018.

“Anosognosia.” National Alliance on Mental Illness, NAMI Accessed on July 25, 2018.

“What Is an Intervention? Learn About Intervention.” Association Of Intervention Specialists, AIS. Accessed July 25, 2018.

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