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Suggest treatment for narcissistic personality disorder

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Posted on Mon, 25 Jul 2016
Question: Hello Doctor yes would be grateful I think my husband have Narcissistic PD. He always wants to be the best and have the An excessive sense of self importance, with an expectation of being seen as superior for no reason Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or love Excessive belief that he or she is special or unique A need for excessive admiration A sense of entitlement to special treatment or compliance with their wishes A tendency to take advantage of others to achieve their own goals Lacking empathy for the needs and feelings of others he also have his good points like we all have but I just cant live with the things that he is doing and I don't have control over it I will find out when some one contact me and tell me he owes them money then I pay if I can but some amounts is to big. I still try to get the money back for the people who believe him and went in this with him but he do not want to let go and believe that the people he invested took him for a ride. And he keep on telling me that he is finished with it.
doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
psychotherapy is only alternative

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern for your husband.

You have mentioned diagnosis of Narcissistic PD. I think you have consulted psychiatrist already as diagnosis of personality disorder is difficulty to establish without professional evaluation.

One limitation is that such persons cannot be convinced that there is problem in them and they do not become ready for treatment/psychotherapy.
Most of the patients are brought by relatives.
Transference Focused Psychotherapy (TFP) is indicated in treatment of such cases. It is modified psycho dynamically oriented approach, highly structured with rigid twice a week sessions.

Let me know,

- Have you consulted psychiatrist?

- Does he feel that he has some problem?

- Is he ready for psychotherapy?

- Is there any episode of mania or hypo mania which suggests possibility of bipolar disorder? If it is there, chances of improvement with medicines are there.[Symptoms are- Needing less sleep in order to feel rested, Talking very rapidly or excessively, Distractibility, Fast thoughts, Tendency to show poor judgment, such as impulsively deciding to quit a job, Inflated self-esteem or grandiosity -- unrealistic beliefs in one's ability, intelligence, and powers; may be delusional,Reckless behaviors (such as lavish spending sprees, impulsive sexual indiscretions, abuse of alcohol or drugs, or ill-advised business decisions)].

I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Chintan Solanki (1 hour later)
Doctor thanks for your answer. No I have not consulted a doctor I have just looked on the the internet for personalities and this is exactly the way he is. He'll never go for treatment because he thinks there is no such thing as depression or physogo diseases and do not like pathetic people or people with disabilities and with any abnormality may it is just a front, I do not know, but I want him just use his intelligences into the correct direction and enjoy the work and be happy with what we have we live good enough I am not a materialistic person.
My integrity is worth a lot to me and the people who took part in this and wanted to make money with him and did not ask me my opinion now what me to pay as well and also the business however I am the sole owner of the business I cannot afford bad publicity. My clients trust me and I have never done them bad or want to do that. I will rather done myself bad.
I have tried everything to persuade him to accept and to repay all he took money from and pay them with his salary monthly. However it was there choice to say no to him. This is my 2nd husband and my daughter and son-in-law are both also Chartered Accountants, and I must think of them. But we have a lot of good times together as we play tennis together and like the same food, movies, holidays, etc. But every day I realized as it is now the only way would be to split but he also works in the business, there are customers who would like to ask him advice and we visit our clients together and if we split means I should inform all the clients and I believe they would support me but I do not want to do that to him. He will no longer be able to work in the firm and will not easily get work again and yet he is good at marketing and operations and he is intelligent and helps me in the house and cook when I have to work. He always comes home 16:00 put his phone down to 16:00. I do love him and so much just want him to be the person I know he is without this disorder. Is there any hope for me.
doctor
Answered by Dr. Chintan Solanki (16 hours later)
Brief Answer:
you can try professional help

Detailed Answer:
Hi,

Sorry for delayed response. I appreciate your attitude towards him.

To diagnose personality disorder detail history since adolescent age is required. In that case I suggest consulting local psychiatrist once with your in law parents for possibility of diagnosis of Narcissistic PD. If diagnosis is confirmed, I already told that it is difficult to treat.
However few persons are convinced by professional(psychiatrist or psychologist) that he/she has some problem and it needs treatment for improving quality of life. Considering his history he needs psychotherapy.

Your caring attitude may help to change his personality. It needs help of professional and long time. But the crux is he should become ready to accept that some change is needed. You can try it.

In conclusion consult psychiatrist first without him and after that psychiatrist can guide you what do after establishing diagnosis.

Hope is there though little bit.

Take care.



Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest treatment for narcissistic personality disorder

Brief Answer: psychotherapy is only alternative Detailed Answer: Hello, Thanks for writing to us. I can understand your concern for your husband. You have mentioned diagnosis of Narcissistic PD. I think you have consulted psychiatrist already as diagnosis of personality disorder is difficulty to establish without professional evaluation. One limitation is that such persons cannot be convinced that there is problem in them and they do not become ready for treatment/psychotherapy. Most of the patients are brought by relatives. Transference Focused Psychotherapy (TFP) is indicated in treatment of such cases. It is modified psycho dynamically oriented approach, highly structured with rigid twice a week sessions. Let me know, - Have you consulted psychiatrist? - Does he feel that he has some problem? - Is he ready for psychotherapy? - Is there any episode of mania or hypo mania which suggests possibility of bipolar disorder? If it is there, chances of improvement with medicines are there.[Symptoms are- Needing less sleep in order to feel rested, Talking very rapidly or excessively, Distractibility, Fast thoughts, Tendency to show poor judgment, such as impulsively deciding to quit a job, Inflated self-esteem or grandiosity -- unrealistic beliefs in one's ability, intelligence, and powers; may be delusional,Reckless behaviors (such as lavish spending sprees, impulsive sexual indiscretions, abuse of alcohol or drugs, or ill-advised business decisions)]. I will be happy to help further after your response. Regards, Dr.Chintan Solanki.