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Narcissists in Therapy and Group Settings

10/27/2015

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Narcissists in Therapy and Group Settings by Elizabeth Galen, Ph.D.
Narcissistic Personality Disorder (NPD), an official diagnosis in the DSM-V, is a rarely diagnosed condition for many reasons. Most narcissists have a grandiose sense of self and don’t believe there is anything wrong with them. At most, they believe are victims of others’ imperfection. Thus, getting a narcissist to a therapist can be very difficult. Once in a therapist’s office, many narcissists are able to perform beautifully. They know how to act in order to maximize the sympathy of those around them including therapists who aren’t clued in on what is going on. Being in couple’s therapy with a narcissist can be demoralizing and defeating if the therapist cannot see through the narcissist’s delusions about themselves and others.

Many narcissists also are blatant liars, adapting the truth to meet their needs. Because they have convinced themselves that the new story is the truth, it’s often hard to pinpoint when narcissists are lying and when they are telling the truth. With my mother, I know that there is some root of truth in anything she told me, but quite often, the stories she shared were highly exaggerated or distorted in order to meet her needs. This is not simply a matter of having misremembered things because time has passed. Instead, narcissists manipulate their tales in order to gain the most attention and to have whatever they are relating make them look like heroes.

Because it is difficult to be able to diagnose someone who is so proficient at manipulating the truth and acting out a role as a victim rather than a perpetrator, therapists often miss the diagnosis. It takes time in individual therapy to get to know someone well enough to see through their shenanigans. Only those who have lived with, spent copious amounts of time with, or extensively worked with narcissists are likely to see their true personalities and realities. When only spending an hour a week with narcissistic clients, therapists often don’t have enough data in a short time to be able to see through the lies to the truth.

What I have found time and again is that those with severe narcissistic personality disorder are often easy to spot in group settings rather than in one-on-one or couples’ sessions. Within thirty minutes of a group meeting with someone with severe NPD, everyone in the group can usually tell that something is not quite right with those who have NPD even if they can’t pinpint what the problem is. Narcissists will dominate group conversation, pulling all attention towards themselves any way they can. They find a way to be authorities on a topic even if they have no real experience, and if they can’t succeed in doing that, they quickly switch the topic to something they do have experience in. I’ve also repeatedly witnessed narcissists extensively relating others’ authority-related stories about a given topic in order to connect themselves to the conversation which they otherwise could not speak on.

When this particular type of narcissist is commandeering a group setting, they often talk non-stop for many minutes on end, effectively babbling onto things that aren’t relevant. Even when redirected by a group leader, the narcissists will find a way to commandeer the discussion again so that they are the focus of attention. They really aren’t there to help others or learn from others as they might have said at the beginning of the group meeting. Rather, they are there to gain attention in whatever means they can, be it through sympathy, pity, authority, or flat out domination of the evening.

There is little that can be done to work with narcissists with extreme NPD in a group setting. The best solution is often to remove them from the group and work with them one-on-one. However, narcissists often don’t stay in therapy or coaching for long because of the nature of their disorder. They decide after a short time that they have mastered the situation and know more than their therapists. Alternatively, they find an excuse such as their therapists persecuting them when in reality the therapists are actually calling the narcissists out on their issues and trying to guide them in a direction of honesty and growth. Since most narcissists will not examine the true roots of their problems, preferring to blame all their issues on others, they find fictitious reasons to abandon any healing work that might have helped them grow. Those who do stay in therapy often do so with weak therapists who don’t insist on the narcissists doing personal work. Instead, therapy becomes another avenue for narcissists to get attention from someone who will support everything they say.

Narcissism is a mental illness, and it is a difficult one to live with and work with. Most of the time, there is no cure for it because narcissists see nothing wrong with themselves and are unwilling to work on healing. Most therapists who are educated on narcissism are unable to help narcissists change because the narcissists are unwilling to admit that they need to change. That means that those who spend time with narcissists are left with the options of putting up with the narcissists’ distorted and often abusive reality or ending their relationships with narcissists altogether rather than suffer from the consequences of their disease.

© 2015 Elizabeth Galen, Ph.D., Green Heart Guidance, LLC

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