Marlene is a 35-year-old female who is in therapy primarily to develop coping mechanisms

Advice for narcissistic personality disorder


Marlene is a very loving wife, and wants to make the marriage work. She strives to walk the fine line of being empathetic and supportive of her husband’s needs even when these needs are unreasonable. It can be difficult for family members and close friends of someone with narcissistic personality disorder to see a sweet and caring side; this often happens because the narcissistic person presents one face to the public, and another very different face in private.

Marlene, patients with narcissism are extremely fragile, so you must proceed gently the best you can. Make him dinner, praise him for his little achievements, and let him take the lead in the relationship. I’ve seen it work quite effectively before.”

Nurses, PMHNPs and other health care professionals must recognize that patients with narcissistic personality disorder have extremely fragile egos. They are also famous for using manipulative tactics in order to get what they want. But, there are ways to effectively work with many patients who have NPD and maintain your own sense of self and purpose.

Marlene is 35 years of age and married, with two small children. The focus of her therapy is her husband, whom she describes as “deeply insecure,” which she attributes to his narcissistic personality disorder. Having grown up in a turbulent home, he acts out his feelings of unworthiness through disparaging others. In the morning at breakfast, he often passive-aggressively criticizes her parenting skills when she’s not around childcare professionals such as teachers and coaches. Advice for narcissistic personality disorder

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Patients with narcissistic personality disorder have extremely fragile self-esteem, and external negativity can lead them to become very upset. They may have a wide range of symptoms, including depression and suicidal thoughts, poor concentration and decision-making ability, interpersonal problems, irritability, low self-worth, anxiety, eating disorders and other self-defeating behaviors.

To help prevent your husband from living up to his illusion of being a superior person, the counselor advises that you treat him with respect but without awe. Avoid complimenting his achievements, and do not give in to his attempts to control you. Deny him the power that he seeks by not giving in to his demands, using your therapist as an ally whenever necessary. Speak up when people praise him excessively; then tell others how selfish he was to exploit their adoration. Tell yourself that he is human and has flaws like everyone else. Stay away from friends who tell you how privileged they feel just by knowing him so that their admiration does not undermine your own self-esteem. Advice for narcissistic personality disorder

Your husband’s disorder will make it difficult for him to feel empathy for others and may cause him to behave in belittling ways that negatively impact your relationship. For example, because he does not have the ability to appreciate how you are feeling, he might not understand that six months of therapy with neither of you making any progress is frustrating for you. He may be more likely to criticize you than to show compassion. This can result in decreased self-esteem and confidence on your part. Narcissistic personality disorder patients often try to seek praise from people who are outside of the relationship, friends and family members who don’t witness the problematic behaviors. There is a higher rate of infidelity among patients with narcissistic personality disorder. Religious leaders can become targets for admiration and praise, especially if they bolster your husband’s narcissism, by deferring to him and praising his work when they meet. Yet other times, people with narcissistic personality disorder become angry at religious leaders if they feel that he or she are not giving them the attention they deserve or if he or she thinks that their work is being criticized or criticized directly. Being hyper-sensitive to criticism can lead them to lash out, verbally or physically. Advice for narcissistic personality disorder

Narcissistic personality disorder is a psychological condition in which people are consumed with feelings of self-importance, and have an excessive need for admiration and attention. They generally lack a sense of empathy toward others, and frequently exploit other people for their own benefit. They have little regard for anyone but themselves, and are often unable to maintain healthy, long-term relationships due to their unwillingness to compromise. An estimated 8% of the population has some degree of narcissistic personality disorder. It is most common in men, and typically first appears in early adulthood.

Marked by an inflated sense of self-importance, a preoccupation with fantasies of unlimited success, a need for excessive admiration and a lack of empathy, the narcissistic personality disorder makes relationships challenging. The trouble often starts at home. If you have a loved one suffering from this condition, there are ways to protect yourself from becoming a doormat.

Why is the narcissist suddenly so fragile? Why is the narcissist no longer able to cope with criticism as most people can?

Clinical pearls: Key points for patients and families in the primary care setting  include cultural sensitivity, empathy, compassion, good communication, cooperation, and relationship-building.

Dear Marlene,


Marlene is a 35-year-old female who is in therapy primarily to develop coping mechanisms for living with her husband, who has a narcissistic personality disorder. She is committed to the marriage and loves her husband, but finds his inflated sense of self-importance and complete lack of empathy to be especially difficult. She believes he has a good side, but most of her friends have only ever seen extreme arrogance, and she is embarrassed by that. While counseling Marlene, the PMHNP advises her that patients with narcissistic personality disorder have extremely fragile:

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