How Do We Help Our Son With Narcissistic Personality Disorder?

Reader’s Question

Our 20-year-old son has been involved in many self-defeating activities in the past, but recently the incidents have become so serious that his father and I sought out the assistance of a forensic psychologist hoping to get some answers as to why he behaves the way he does. Our son never showed up at the two sessions we scheduled. However, we decided to pursue counseling without him. Based upon the information we provided, the psychologist’s preliminary diagnosis of our son is that he suffers from a narcissistic personality disorder. We understand that it is now up to our son to make productive changes in his life, including counseling. Could you please provide some information as to treatment for this disorder? Also, what role do the parents of an adolescent adult with this disorder take?

Thank you!

Our Clinical Psychologist’s Reply

Treatment for Narcissistic Personality Disorder (NPD) is limited. NPD is a personality disorder, not a chemical imbalance, and does not typically respond to medications. Mental health professionals often encounter NPD patients but often only when depression, anxiety, or stress is also present. In short, we see them when they get into trouble or their self-defeating behavior has caused temporary emotional distress. Most treatment focuses on dealing with the ongoing crisis or with managing narcissistic behaviors that create problems. We have more success in training the NPD individual to control their behavior than to control their narcissistic attitudes and thoughts.

For concerned parents, a son with NPD can be very difficult. Adults with NPD rarely accept responsibility for their misbehavior and in fact, have a tremendous sense of entitlement. They are preoccupied with their selfish agenda and exhibit little concern for how their behavior can damage the family. NPD’s can be the “spoiled brats” of the adult world.

As parents, we must love and support them at a safe distance. Over the next years, you’ll be dealing with the consequences of his self-defeating behaviors. With each consequence, he will be looking to you to rescue him, only to return to the same behaviors immediately after the crisis is over. He will likely be highly manipulative and may place you in financial difficulty if you don’t protect yourself. You must take a position of “tough love” and be supportive but not always a rescuer. Set limits to the extent you will help repair his self-defeating behaviors. Keep in mind, what we call a self-defeating behavior is probably a scheme that didn’t work out the way he’d have liked.

There are support and discussion groups on the Internet for parents and friends of individuals with NPD. Participating in these groups will remind you that your situation is not unique. You may also obtain some guidance and helpful hints from the experience of other parents.