How should narcissism be treated best?

Grandiose narcissism is characterised by two distinct self-regulatory processes: the need for admiration (eg, being a very special person gives me a lot of strength) and the need for rivalry (eg, I want my rivals to fail). There is no evidence-based treatment for narcissistic personality disorder, 1 Roepke S Vater A Narcissistic personality disorder: an integrative review of recent empirical data and current definitions. Curr Psychiatry Rep. 2014; 16: 445 Crossref PubMed Google Scholar but many clinicians believe that for patients with narcissistic traits specific strategies that focus on the therapeutic relationship, such as psychodynamic therapy, can be beneficial. 2 Kealy D Goodman G Rasmussen B Weideman R Ogrodniczuk JS Therapists perspectives on optimal treatment for pathological narcissism. Personal Disord. 2017; 8: 35-45 Crossref PubMed Scopus (17) Google Scholar Narcissistic dimensions and depressive symptoms in patients across mental disorders in cognitive behavioural therapy and in psychoanalytic interactional therapy in Germany: a prospective cohort studyAs narcissism affects depression severity before and after treatment with CBT across psychiatric disorders, even in the absence of narcissistic personality disorder, the inclusion of dimensional assessments of narcissism should be considered in future research and clinical routines. The relevance of the therapeutic alliance and therapeutic strategy could be used to guide treatment approaches. Full-Text PDF