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3 Basics of Working (Mindfully) with a Narcissist in Therapy: A Balancing Act, 1 of 5

1 balancing tight ropeIn response to a recent post, How to Identify a Narcissist in Therapy, several readers requested a follow up post that outlines a few essentials of working with a client who presents with narcissistic “tendencies” or npd (narcissistic personality disorder) in couples or family therapy, so as to disarm or minimize the potentially destabilizing effects of these problematic behaviors both in the sessions themselves — and on therapeutic processes and outcomes in general. Other readers also wanted to know what a person in a relationship with a narcissist (at home or work, or between sessions) can do to neutralize, or block the crippling effects that these npd behaviors can have on one’s sense of sanity — and self — emotional, mental health and wellbeing.”

Before sketching out a few solutions, this post highlights three interlocking starting points, or critical understandings, essential to those who work or live with npd clients to realize optimal results.

What “optimal results” do we mean?

In a nutshell “optimal results” are to remain grounded in your ability to speak and feel the truth, which means to remain as human as possible, in a nutshell, to “guard your mind and heart” in order to remain disentangled from the lies, agenda and emotionally manipulative attempts of a narcissist to impose a topsy-turvy view the presenting problem.

In my experience, a narcissist dares you to change or heal them! It’s how they ensnare their victims! And it’s likely how they lure unsuspecting others to unwittingly participate as accomplices. And thus clients and therapists alike need to retain a “healthy emotional detachment” by expecting that the narcissist will often act “confused” — only because this works to get caring human beings to step in, explain, clarify or find alternative ways to “get through” and keep healing processes energized. 

A therapist’s key job is to avoid that trap, to remain aware and authentically connected to the degree that they may also support the “codependent” client to do the same. The bottom line for all who live or work with narcissists is to stay connected to your truth of what it means to be human! The narcissist poses an alternate worldview, one that fosters self-doubt, disconnect, hatred, bitterness, and the like.

The work itself, if there are any benefits, is one that trains you to retain an optimal state of mind and body to be a healing presence for yourself first and foremost.

These critical starting points have to do with cultivating a mindful understanding of:

1. What narcissism is and isn’t …

This is a vital first step and requires much frontal cortex activity and reflection! It’s likely no coincidence that there is an epidemic of misinformation and mislabeling. Naricssists always play reverse roles mindgames, by blame-shifting and mislabeling their victims as “evil” and themselves simultaneously as the one wronged. Confusion should always be flag. Acting confused and stirring confusion in others directly serve the narcissist’s goals and agendas, and confusion also is what the effectiveness of mindgames and gaslighting rely on.

2. The current mindset of the narcissist … 

The mindset of narcissist is not easy to understand as it is literally set to attack or disdain and scorn key vital attributes of being human, such as caring, compassion, kindness, mutual understanding, emotional connection, growth and transformation, on and on. In contrast the mindset of the codependent makes possible for narcissists to delude themselves into thinking they are superior in intelligence and stature on the basis that they feel no remorse for inflicting pain, causing severe emotional distress and literally stealing another persons sense of self and ability to stand up, identiy or speak for themselves and their own human needs or pain.

3. The destination of new possibilities …

Without question, one of the most problematic patterns a therapist deals with in therapy contexts (couples, family, work, etc.) has to do with the destabilizing effect of an npd client’s behaviors, not only on the relationship and the partner or spouse, but also on the therapeutic processes themselves.

For those who love or have to live with a narcissist, the challenges to their sense of self can be overwhelming, and in more extreme cases, debilitating or even dangerous. It’s critical to cultivate a way of authentically relating to self … one that cuts off any dependence on what a narcissist thinks or believes about themselves and their partner (or therapist).

The narcissist is not likely to change. This fact is distressing to the narcissist’s partner. The partner will need therapist to help them understand and let go, indeed to grieve this as a loss, in most cases a fantasy that was always an illusion. In a normal human relationship two persons may resist change, however, they each regard growth and change as essential to relational harmony and personal happiness alike.

It’s a balancing act. All relationships are, and for that matter so is all of life. Recent findings in neuroscience now tell us, the human brain is a relationship organ.

And, an npd‘s behaviors are destabilizing at least in part because: balance is both their greatest need, yet also what they most actively and desperately fight against in themselves and others. Nevermind the outer calm they present, the fragility of their wounded ego speaks volumes.

These three starting points provide a mindful understanding of npd, first and foremost, as a set of learned problem behaviors driven by a certain mindset (belief system, thoughts, etc.) from which the therapist may invite the npd client and their loved one(s) to work as a team, inspiring them to create new possibilities. This starting place:

  • Shifts away from judging or condemning the npd client to identifying the “problem behaviors” that, in effect, predictably always produce the same effects, and include negative ones for the npd as well, for example: they push those they love away from them; and isolation, knowingly or unknowingly, is the cruelest of punishments to human beings. For the narcissist, abandonment can be their greatest fear. If this seems puzzling, consider this: their current mind set associates “avoiding vulnerability” with “status” and illusions of “power,” etc., which explains why they desperately need to shift to a mindset that would better their higher needs to relate authentically as human beings. The new mindset, for example, would recognize the ability to be vulnerable as a relationship-building strength! (Warning to codependent partners: This is not your job; it’s theirs alone.)
  • Allows the focus of what needs to change to remain on the “problem” mindsets and behaviors, and the cultural and familial contexts in which they flourish. Additionally, this focuses on “judging” behaviors, not persons (and disarms the npd of one of their primary weapons — blame). Instead all are invited to not only take blame off the table, but also to (humorously) team-up to “blame” blame itself for much unnecessary suffering.
  • Places primary responsibility on therapist, and increasingly on those interacting with an npd client for their part of the interaction, and that is, to remain present, observant and thoughtfully responsive rather than judging, reactive, anxious to fix or to please, etc., because reactivity “feed” the npd problem-behaviors. 
  • Last but not least, this shift to a new mindset emphasizes the reality, that: all human beings are hardwired to yearn to matter and feel they contribute value and meaning to life around them. The destination mindset is a way of thinking that makes therapy (and relationships) a place where each is primarily responsible for relating to self and other in ways that promote authentic, wholehearted ways of loving self and other. Most npds are more capable of empathy than they’d care to admit. Thus, for those interacting with an npd client, it’s important to keep reminding themselves that npdare human thus fully equipped with human capacities (just more or less misguided or addicted to a false sense of power they gain from their current mindset, reinforced by major cultural institutions, media, entertainment, etc.)

As a therapist (or loved one), there are no quick fixes. The best hope of being a healing presence that has a balancing effect on your relationship with others starts inside you — your mindset, and relationship with your self.

To develop your capacity to stay present in mind and body, connected to both your compassion for yourself and the other, you must learn to “let go” and not fall into the trap of making the npd’s “problems” your own, and yet do so in a way that also keeps you thoughtfully engaged and active, rather than passive or detached.

It’s not easy, yet totally doable, like a walking a tightrope. When you’re on, you cannot afford to be “thinking” about how to micromanage another’s tightrope walk so that they reach the safe destination! Your focus needs to continually be on your staying on your walk of life, so that, step by step, you may reach your destination of safety on the other side.

In Part 2, the three key identifying behaviors that identify narcissism in terms of what warrants a diagnosable condition of narcissistic personality disorder (NPDversus misinformation or mere “tendencies” in this direction.

3 Basics of Working (Mindfully) with a Narcissist in Therapy: A Balancing Act, 1 of 5

Athena Staik, Ph.D.

Relationship consultant, author, licensed marriage and family therapist, Dr. Athena Staik motivates clients to break free of anxiety, emotion reactivity, and other addictive patterns, to awaken wholehearted relating to self and other. She is currently in private practice in Northern VA, and writing her book, What a Narcissist Means When He Says 'I Love You'": Breaking Free of Addictive Love in Couple Relationships. To contact Dr. Staik for information, an appointment or workshop, visit, or visit on her two Facebook fan pages DrAthenaStaik and DrStaik

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APA Reference
Staik, A. (2019). 3 Basics of Working (Mindfully) with a Narcissist in Therapy: A Balancing Act, 1 of 5. Psych Central. Retrieved on August 9, 2020, from


Last updated: 29 May 2019
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