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How Does Narcissism Affect Treatment and Recovery?

How Does Narcissism Affect Treatment and Recovery?While a level of self-love is necessary for healthy living, extreme feelings of self-importance are commonly part of narcissistic personality disorder (NPD). The delusions and dysfunctions that come with NPD complicate drug addictions and become a challenge to their treatment.

Intersection of Narcissism and Addiction

Narcissists may project, and even believe an image of confidence and superiority. However, their thoughts are often quite conflicted. Their confidence and self-esteem depend upon the admiration of others, so their self-image is insecure and vulnerable to rejection. Substance abuse can become very important to people with NPD, especially when the external validation they need is absent. In times of failure or rejection, people with NPD may use drugs for the following reasons:

  • Calm anxiety
  • Soothe depression
  • Renew imagined feelings of strength and control

A 2008 study published in the Journal of Clinical Psychiatry looked at the rate of substance abuse among those diagnosed with NPD. Of those who were diagnosed with NPD, 40.6% of them had abused substances within the last 12 months.

How Narcissism Affects Addiction Treatment

When a person suffers from both NPD and substance addiction, she has co-occurring problems. The symptoms of narcissism create many barriers to addiction treatment, so addiction treatment must overcome the following issues of NPD:

  • Superiority – A patient may believe he is above such problems like addiction
  • Fantasy of control – Narcissists will persistently see substance use as under their control
  • Rationalization – Narcissists may portray their substance abuse as a controlled experiment or a tool for creative output
  • Irreverence – Productive therapeutic relationships are often characterized by mutual respect, but narcissists classify therapists as inferior
  • Manipulation – Addiction therapy, particularly group sessions, can generate praise for the narcissist, even while she ignores the treatment content

Substance abuse may become an indispensable coping tool for those with NPD. This need for the substance, coupled with an overwhelming unwillingness to see a problem, means that those with NPD will generally avoid counseling. Depression or anxiety may lead them to seek help rather than the more basic problems of addiction and NPD.

How to Treat NPD and Drug Addiction

It is difficult to treat NPD when it occurs alone, but addiction makes each problem more difficult to address. However, skilled clinicians can treat these co-occurring disorders by playing to an individual’s strengths and trying different approaches. For example, appealing to an NPD person’s sense of superiority, a counselor may be able to encourage a period of drug abstinence. This remission of addiction can provide an opportunity to use antidepressants to control depression and clear the way for treating the personality disorder.

In other cases, psychotherapy may help understand the problems his narcissistic attitudes have created. This step can lead to better coping mechanisms, which open the door to addiction treatment.

Find Help for NPD and Addiction Treatment

If you or someone you know suffers from addiction and NPD, call our 24 hour, toll-free helpline to learn more about treatment options. Our admissions coordinators can help you recover if you reach out for help.