Have been diagnosed with NPD.Therapy or not?

I was in a ward for over 2 months now.
My inability to sleep slowly chipping away my energy and will to live. I was looking for sleep meds and some insight into this particular problem.Turns out being in a ward is boring as hell,and playing victim loses its entertainment value after a while. I then gradually dropped my mask, and answered more truthfully to questions posed. Some ward changes happened due to the suspiscion of a prodrome of schizopheria.Lots of talks with different doctors, MRI, different tests, etc.
On the day of my transfer to the psychiatric day clinic, a whole group of people entered the room and the doctor hinted at a personality disorder and the prospects of "learning to live with it". I didnt ask what it was. I then went to her alone and talked her into telling me the truth. She told me its NPD and/or ASPD(due to my past criminal behaviour, irresponsibility, and a whole lot of other reasons).She was sure on the NPD part though, but didnt want to label me(Fear that I might use it for whatever reasons).

I didnt go to the appointment for further treatment. I know what sleep meds work now. I did some research on the disorder and realised how predictable my interactions(love bombing,devaluing,trashing), my general behaviour, etc. are. It was a bit eery to have an explanation for the dissonance between my persona(which I identified with) and my affect.Cluster B disorder seem to also run in my family, and a lot of them having been in a ward at some point(Wasn't much of a shocker for them that I ended up there). My father being the only one not having been officially diagnosed.Due to having spend too much time with him alone, and his history of leaving a trail of human misery behind him. I'll safely put him into NPD territory.
I am wondering what kind of advantages such a therapy would have?
NPD and ASPD seem to have very limited success in treatment, also due to the fact that most of those affected do not seek treatment for it( results might be skewed?). It's just a tough sell for me due to the limited success rate, my unwillingness to really change(apart from the insight) and the amount of effort needed.

Kernberg says everybody can benefit from psychotherapy. It is always better to know yourself more and have a better decision making ability.

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I don't know if you are being serious about this or not, but there are only a few ways to fully change yourself. The best one is called Bioenergetic analysis. This is a form of body psychotherapy (body-oriented Reichian psychotherapy), based upon the work of Wilhelm Reich. It's a long process that takes time but surely helps. If you are cooperative, you will fully throw away your false image that you project and get back your true inner self.

Heraklines wrote:NPD and ASPD seem to have very limited success in treatment, also due to the fact that most of those affected do not seek treatment for it( results might be skewed?). It's just a tough sell for me due to the limited success rate, my unwillingness to really change(apart from the insight) and the amount of effort needed.

In terms of benefit there would be quit a list. I have posted a thread here about psychological health with a talk by Nancy McWilliams a bit ago, where she lists a lot of things that define mental health in a person, which would also be beneficial. Some of them, like increased affeect tolerance, ability to work with stress, ability for happiness etc. should be obvious, but for pwNPD there is also stuff like the ability to [deeply] relate, which might be so alien that it will not be immediately apparent, why thsi would even be a benefit. In any case it's an interesting video, maybe check it out. If you can't find it, holler, I will try to grab the link again.

In terms of therapy, I am not sure where kaloyy gets the idea with bioenergetics from, in the literature on NPD its not really mentioned. All of the case examples that I've seen where people have improved are from analytic therapy, so authors like Kernberg, Ronningstam, but also Meltzer. There was also some data on schema-therapy reducing symptoms, but I'm not sure if there were any follow-ups done. What is true definitely is that such a therapy will, depending on the depth of the problem, take quit ea while and - which is one of the hard aspects - become not increasingly easier like in the case with simple neurotic patients, but increasingly harder and oen might feel overall worse for a long while. I have started psychoanalytic therapy two months ago and I find it pretty challenging to say the least. There are no accepted timelines because of the differences in therapist approaches, skills and patients, bu if you read the literature on NPD there they are definitely taking about years of intensive therapy. So if not purely from the side of motivation, if you're in a country where you have to pay for the whole treatment, it will also be an economical choice if the possible outcomes are valuable enough for you to go thru with such an ordeal.

Therapy has helped me accept the NPD. The most important part is acceptance so you don't end up in the ward again. You can learn to "cope" with it so when it flares or narcissistic injury happens, you are able to calm it down.

In addition, you will learn more about yourself and be able to potentially "control" yourself better.

Hello. I’ve been doing DBT and a therapy known as ExRP, which is mostly targeted at OCD.

I think DBT can be useful for helping with emotion regulation and getting out of extreme emotional reactions that could be linked to Narcissism (eg, anger, depression). Doing DBT or other mindfulness work can also be useful for noticing when you jump to conclusions or react overly-strongly to social interactions and perceived slights/attacks.

I think exposure type therapies can be useful for narcissists with comorbid anxiety or individuals of the more covert/compensatory type. Basically, the idea is that you intentionally put yourself in a stressful situation and let yourself experience negative emotions and distress, without engaging in self-soothing (be that OCD, narcissism-related, or otherwise). Learning to sit with anxiety without resorting to either running away or mentally devaluing everyone and everything around me has been a nice asset.

As for actually confronting and changing grandiosity, lack of empathy, etc. that’s a whole other beast. I’m getting ready to start in with psychodynamic therapy and some people find that useful. The idea is to gain a better understanding of why your defenses exist and how they play out, with the eventual hope that insight and catharsis will allow you to move past defenses that are no longer needed and may be inadvertently making you miserable.

psyguy wrote:Hello. I’ve been doing DBT and a therapy known as ExRP, which is mostly targeted at OCD.

I think DBT can be useful for helping with emotion regulation and getting out of extreme emotional reactions that could be linked to Narcissism (eg, anger, depression). Doing DBT or other mindfulness work can also be useful for noticing when you jump to conclusions or react overly-strongly to social interactions and perceived slights/attacks.

I think exposure type therapies can be useful for narcissists with comorbid anxiety or individuals of the more covert/compensatory type. Basically, the idea is that you intentionally put yourself in a stressful situation and let yourself experience negative emotions and distress, without engaging in self-soothing (be that OCD, narcissism-related, or otherwise). Learning to sit with anxiety without resorting to either running away or mentally devaluing everyone and everything around me has been a nice asset.

As for actually confronting and changing grandiosity, lack of empathy, etc. that’s a whole other beast. I’m getting ready to start in with psychodynamic therapy and some people find that useful. The idea is to gain a better understanding of why your defenses exist and how they play out, with the eventual hope that insight and catharsis will allow you to move past defenses that are no longer needed and may be inadvertently making you miserable.

Very nice feedback. I may need to take up on a few of those suggestions as well. Are you in a consistent DBT class?