Narcissistic Personality Disorder: What is the treatment of choice?

• A. Individual psychotherapy
• B. Pharmacotherapy
• C. Medical - nondefensive
• D. Group therapy

Answer: (A)

Individual psychotherapy is the treatment of choice for Narcissistic Personality Disorder. This condition features grandiosity, a constant need for admiration, and a lack of empathy, underpinned by fragile self-esteem and defensive coping. Psychotherapy helps by challenging inflated self-views, increasing insight into how defenses maintain symptoms, and teaching healthier ways to regulate emotions and relate to others. Long-term psychodynamic or cognitive-behavioral approaches are commonly used, with a strong emphasis on building a trusting therapeutic relationship, since patients may resist feedback and be defensive. Medications don’t address the core narcissistic traits, though they can help manage comorbid mood or anxiety symptoms. Group therapy is generally less effective because interactions can provoke defensiveness or rivalry for admiration, making it harder to achieve lasting change.