Harry, You may want to shot this to your wife. It appears NYOB is correct,
the treatment options and success rate are bleak.

SHOULD WE CALL THEM HUMAN?

Treatment Options

Aims of Treatment should focus on aiding the narcissist to increase his
empathy for others, helping him learn to accept slights and rejections from
others without feeling threatened, and developing a more realistic view of
his abilities.

Personality disorders are a challenge to treat. This is because an
individual is defined by his personality and personality is an essential
part of a person's self-perception. A narcissist does not willingly seek
treatment because he does not wish anyone to think that he has any
weaknesses. He experiences needing help as demeaning. When a narcissistic
individual does present for treatment it is usually at the insistence of a
family member, upon the occurrence of a major life crisis, or issues other
than personality problems.



Since a narcissist does not tolerate discomfort well, he has difficulty
coping with depression or anxiety (two of the issues which might precipitate
his presenting for therapy of his own accord). If you want the narcissist to
seek treatment then make sure he is lacking in narcissistic supply. He could
go into a dysporia (depression) and perhaps seek treatment.



Narcissists will present with a wide range of pathology. No matter the
pathology the narcissist possesses, however, he does not see his difficulty
interacting with others as part of his problem. He projects his relational
problems onto others and describes others as having trouble interacting with
him.



Treating the narcissist is difficult because the narcissist attempts to
sustain an image of perfection and indestructibility. Underneath this facade
is an insecure person with low self-esteem. By presenting with this seemly
secure self-image, the narcissist is protecting himself from his worse
fear--that people will find out that he has imperfections and weaknesses
just like everyone else. Coping skills to improve interpersonal
relationships and to aid the narcissist to focus on his actual abilities
(not those that he fantasizes he has) are usually dealt with in
psychotherapy.



Pharmacological Intervention


No specific pharmacological intervention for NPD has been found. Underlying
symptoms of Axis I diagnoses are usually treated with antidepressants or
other drugs.



Individual Therapy


Long-term psychodynamic therapy has been found to be the most effective in
working with this disorder. The therapist must create an accepting
environment, thus allowing the patient to develop an idealizing transference
toward the therapist. An active confrontation of the patient's anger, envy
of others, specific need to be self-sufficient, and exploitation of other
difficulties can inflict a narcissistic injury. If this occurs then the
patient will in all likelihood terminate therapy.



Usually most therapists treat the co-existing mental disorders and not NPD
itself except in cases of crisis. A therapist should be aware that he/she
must help sustain the narcissist's self-image and help the patient use their
narcissistic characteristics to develop a self-image which is not based on
fear.



In order for therapy to be successful, a strong alliance must exist between
the therapist and the patient. This can only be accomplished in long-term
therapy. A general non-defensive and non-competitive atmosphere must be
created in the therapy room. When working with NPD a therapist will have to
deal with the unreasonable demands of the patient, their expectations, and
their criticisms. NPD patients do not accept their own defects and aiding
the patient in learning how to acknowledge these defects is an important
part of the therapeutic intervention. However, the NPD patient will run from
any situation where his self-esteem is diminished. Therefore, any
confrontation by the therapist must be clear, direct, repetitive, and firm
to break through the defense mechanisms used by the NPD patient.



During therapy the patient will scrutinize not only the verbalizations, but
also the non-verbal behaviors of the therapist searching for ways that the
therapist is responding negatively to his self-aggrandizement or arrogance.
He will take any such signals as rejection. Even during extended therapy
only small changes should be expected in the patient's personality. The
therapist should also be aware that it is impossible as therapy progresses
not to disappoint these patients.




Group Therapy


Group therapy is rarely the primary tool for NPD. In group therapy
narcissists tend to dominate the group or tire the other members. It can be
valuable as an addition to individual therapy. Patients are encouraged to
explore their behavior toward others and to experience empathy with other
groups members. Narcissists, however, tend to see groups as competitive and
feel that they are not receiving enough of the group leader's attention.
This makes them think that their own need for empathy is not being met.
Narcissists also do not tend to respond well to critical feedback which
might come from other group members. They tend to drop out of group of the
first sign of criticism.



Hospitalization


Patients with severe NPD are frequently hospitalized. Some are very
impulsive and self-destructive and have poor reality testing. This comes
about because of comorbid diagnosis on Axis I. Hospitalization should be
brief and specific to the treatment of the presenting symptoms.



Prognosis


Treatment of the narcissist does not usually have positive results except
for reducing the side effects of depression and anxiety which are treated
with medication. The narcissist does not usually stay in treatment long
enough for therapy to be beneficial.

"Sir Rodney Smithers" Ask me about my knighthood. wrote in message
news:...
Harry,
PS - This behavior is very characteristic of those suffering from
Narcissistic Personality Disorder. While NOYB might be correct that their
is no cure for NPD, you may want to ask your wife, as a social worker, she
might be able to refer you to someone who can help.


"Sir Rodney Smithers" Ask me about my knighthood. wrote in message
...

"Harry Krause" wrote in message
...
Nice try, crapbrain, but the reality is, I simply declined to supply you
with information.

Harry,
Don't you get your panties in a wad whenever someone does provide you
with personal info, such as real name, what they do for a living, where
they went to school, where they live, what their marital status is etc.

It is funny you bring up a topic on shotguns, then decide it isn't fair
game for discussion, but you want to know personal information on
everyone in rec.boats.