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10 Transformative Ways Online Therapy Can Help a Narcissist

Katherine Cullen - Writer for Top10
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A psychiatrist conducting an online therapy session
Online therapy is one of the most effective ways for individuals with narcissistic personality disorder to enhance self-awareness and nurture empathy for personal growth.

Top online therapy services provide a pathway for those struggling with narcissistic personality disorder (NPD) to get support. As a psychotherapist, I understand the difficult inner dynamics that can drive behaviors like self-absorption, validation-seeking, and even exploitation.

The good news is that increased self-awareness and empathy can help tremendously. My role is to uncover the underlying wounds compelling these patterns and equip you and your loved ones with practical tools for healthier relationships.

» Coping with NPD? An online service like Cerebral can help.

1. Developing Insight

Understanding where symptomatic behaviors come from can help people with NPD. Narcissistic behaviors usually stem from early childhood experiences, brought on by insufficient or excess praise and validation.

Therapy can help them develop greater self-awareness and compassion. Through therapy, they can explore their childhood memories and re-parent their younger self to heal wounds from narcissistic abuse received in the past.

Since they don't have to be face-to-face with the therapist, it can be easier for them to reflect more on their thoughts and feelings. What's more, homework assignments and journaling encouraged by the therapist can promote further self-reflection between sessions.

2. Improving Reflective Ability

I often encourage my NPD patients to sit with feelings of shame and self-doubt in therapy to help them build tolerance for these feelings in their everyday lives.

Upon reflecting on their actions, patients can recognize when they're unintentionally recreating the emotional abuse they endured in childhood in current relationships. Thus, therapy can play a pivotal role in fostering empathy, enabling NPD sufferers to understand the impact of their behavior on others' emotions.

» Here are ten signs you're dating a narcissist and how to get out.

a woman sitting at a desk in front of a laptop computer

3. Increase Empathy

A major task of therapy with NPD clients is to help them learn and enforce empathy to boost emotional intelligence. Online therapy platforms like BetterHelp accomplish this by modeling empathy in sessions and prompting clients to think about their actions.

Many of the NPD clients I've worked with lacked the reinforcement necessary for showing empathy and didn't witness it growing up in their families.

4. Challenge Unhelpful Thoughts

Narcissistic behavior is often fueled by core beliefs that rationalize the exploitation, manipulation, or mistreatment of others. If therapists can gently challenge these beliefs in traditional cognitive behavioral therapy (CBT) fashion, they can help NPD clients substitute these cognitions with adaptive ones that give rise to prosocial behaviors.

CBT can help with several mental health conditions, including NPD. And many therapy clients can find accessible, affordable CBT treatment on Online-Therapy.com.

5. Treat Substance Abuse

Research shows that people with NPD often suffer from substance abuse and other personality disorders. NPD can lead to feelings of inadequacy and vulnerability, which people might try to mask with substances.

Online therapists use motivational interviewing, CBT, and behavioral modification techniques to foster self-awareness and empathy.

6. Manage Anger

Seeing an NPD client's narcissistic rage can be scary. It often involves intense outbursts of anger or passive aggression grossly disproportional to provocations.

Teaching anger management techniques to NPD clients can help them identify triggers and practice coping mechanisms. This way, they can feel less threatened.


7. Bolstering Interpersonal Functioning

Research shows up to 5% of Americans may have narcissistic personality disorder. And most NPD clients I've treated struggle to have healthy relationships—a consequence of their difficulties with empathy, cooperation, and respecting boundaries.

Interpersonal skills, like those taught in dialectical behavior therapy (DBT), can enhance their capacity to connect with others and help them build more meaningful relationships.

8. Enhance Mentalization

Mentalization-based treatments help people with NPD better understand the link between their inner emotional states and outer behaviors. It allows them to pause and reflect instead of acting impulsively when faced with intense emotions.

This helps NPD sufferers to better understand themselves and others by encouraging curiosity and openness toward emotions and thoughts.

emotional regulation

9. Support Emotion Regulation

Therapy focusing on emotional regulation can help narcissists become less reactive. I've supported patients with narcissistic tendencies by guiding them in mindfulness techniques like deep breathing and meditation to cultivate self-awareness and reduce reactivity to intense emotions.

These practices help reduce the intensity of their emotions and encourage positive behavior—both of which support prosocial behavior. Prosocial behavior encompasses voluntary actions meant to benefit others, from donating to charity to providing emotional support or standing up for someone being bullied. It has benefits for both the giver and society.

» Try these meditation apps to get you through tough times.

10. Foster a Sense of Agency

Though they may not admit it, many of the narcissistic patients I've worked with fear losing control or being seen as incompetent. Working with them to improve their sense of agency and trust in their abilities (not just the surface-level appearance of success) is key.

Understanding these underlying anxieties and fears can help individuals develop healthier coping mechanisms and become more emotionally attuned to others.

Transform Yourself Through Online Therapy

Not everyone who exhibits narcissistic traits and behaviors meets the criteria for NPD. Nevertheless, the same treatment approaches will help both.

If delivered with adequate empathy modeling, validation, and boundary setting, therapy with NPD clients can indeed prove transformative in sparking personal growth and improving their mental health—and treatment of others.

» Check out these ten hacks to get the most out of an online therapy session.

Katherine Cullen - Writer for Top10
Katherine Cullen is a psychotherapist in New York City and co-author of The Truth About Exercise Addiction: Understanding the Dark Side of Thinspiration. Her work has been published by numerous outlets, including Psychology Today, Cosmopolitan, and Self.

The author of this article has been paid by Natural Intelligence to write this article. Neither the author nor Natural Intelligence provide medical advice, diagnosis, or treatment. If you think you may have a medical emergency, call your doctor or your local emergency number immediately.