Find a Narcissism Therapist

What narcissism is and how it commonly affects people

Narcissism refers to a pattern of thoughts, feelings and behaviours centred on a heightened focus on the self. It exists on a spectrum - some people show certain narcissistic traits at times, while others live with persistent patterns that shape how they relate to themselves and to others. For many, those patterns include a strong need for admiration, sensitivity to criticism, difficulties with empathy and a tendency to prioritise self-image over emotional connection.

Because narcissistic behaviour influences relationships, you may notice effects across different areas of life. Personal relationships can feel strained if there is a mismatch between vulnerability and presenting strength. At work, interactions may become competitive or marked by conflict about recognition. Internally, you may experience cycles of inflated self-worth followed by shame or emptiness, especially when expectations are not met. Therapy does not aim to label you; it helps you understand how these patterns developed and how they influence what you want from relationships and from yourself.

Signs that someone might benefit from therapy for narcissism

You might consider counselling if recurrent conflicts, emotional distance or dissatisfaction in relationships are affecting your wellbeing. You may notice a tendency to react strongly to perceived slights, to manage difficult feelings by withdrawing or by asserting control, or to find it hard to accept feedback without feeling attacked. Some people recognise that efforts to maintain an idealised self come at the cost of intimacy and want to change that pattern. Others come because partners, family members or colleagues have suggested therapy as a way to improve communication and repair relationships.

Therapy may also be helpful if you find it difficult to tolerate vulnerability, if you often feel exhausted by maintaining a certain image, or if alternating periods of self-assurance and low mood are interfering with goals. You do not need to meet a particular label to benefit from therapeutic work - the focus is on the difficulties you are experiencing and the changes you want to make.

What to expect in therapy sessions focused on narcissism

When you start therapy the first sessions typically involve an assessment of your history, current concerns and what you hope to achieve. A counsellor will ask about relationships, family background and how you cope with difficult emotions. Together you will set goals, which may include learning to tolerate vulnerability, improving empathy, managing anger or changing interpersonal patterns.

Therapy tends to be exploratory and gradual. Early sessions are often used to build rapport and establish boundaries so you feel able to reflect openly. As you progress you will work on recognising triggers and habitual reactions, practising new ways of relating and testing different behaviours in everyday life. Progress can feel uneven - moments of insight often alternate with discomfort as established defences are challenged. Your counsellor will help you pace the work and develop practical strategies alongside deeper emotional processing.

Common therapeutic approaches used for narcissism

Several evidence-informed approaches are used to address narcissistic patterns. Psychodynamic therapy explores how early relationships and unconscious expectations shape current behaviour, helping you understand emotional needs beneath defensive postures. Cognitive behavioural therapy focuses on identifying unhelpful thoughts and beliefs that drive behaviour, and on practising alternative responses in real life. Schema therapy combines elements of cognitive, behavioural and attachment-focused work to address long-standing self-defeating patterns and to build healthier ways of meeting emotional needs.

Mentalisation-based treatment supports your capacity to understand your own and others' mental states, improving empathy and reducing impulsive reactions. Compassion-focused approaches help cultivate self-kindness and reduce shame, which can be central when perfectionism and self-criticism are present. Group therapy can offer a helpful mirror - interacting with others in a therapeutic group gives you immediate feedback about how your behaviour lands and creates opportunities to practise new relational skills in a contained setting. Often therapists integrate techniques from several models to suit your needs.

How online therapy works for this specialty

Online therapy for narcissism works in much the same way as face-to-face work, but the sessions happen via video call, phone or secure messaging. You and your counsellor agree on a format that fits your life and the goals of therapy. Video sessions allow for eye contact and non-verbal cues which are useful when exploring relational patterns. Telephone sessions can feel less exposing for some people, enabling focus on internal experiences without the visual aspect. Messaging or email-supported programmes can supplement live sessions by allowing you to reflect between meetings and receive prompts for practice.

Online work is convenient if you live outside major urban centres, have caring responsibilities or prefer to avoid commuting. It also allows you to access counsellors who specialise in narcissism even if they are not local. To get the most from remote therapy consider setting a regular space for sessions, minimizing distractions and treating the appointment as you would an in-person meeting. Technology can sometimes cause interruptions so it helps to agree a backup plan with your counsellor in case of connection issues. If certain topics are emotionally intense, discuss how you and your counsellor will keep you emotionally steady between sessions.

Tips for choosing the right therapist for narcissism

Choosing someone to work with is a personal decision and finding a good fit matters. Start by checking qualifications and registrations - many UK counsellors and psychotherapists are registered with BACP, HCPC or NCPS, and some hold additional training in specific approaches such as schema therapy, mentalisation-based treatment or compassion-focused therapy. Profiles will often list areas of specialism, relevant training and years of experience so you can see who has worked with similar concerns.

Read how clinicians describe their approach and their expectations for therapy. Some emphasise insight and reflective work, while others focus on skills and behavioural change. Decide which style feels most likely to help you. It is reasonable to ask about experience with relationship difficulties and personality-related patterns during an initial enquiry. Many counsellors offer a brief introductory call or consultation - use that time to see whether you feel heard and whether the counsellor’s explanations make sense to you.

Consider practicalities such as session frequency, fees and cancellation policies, as well as whether you prefer online, face-to-face or a combination. Think about cultural fit too - a counsellor who understands your background and identity can make it easier to discuss sensitive material. Trust your sense of rapport; if you do not feel comfortable or understood after a few sessions it is acceptable to discuss this with your counsellor or to try someone else. Effective therapy depends as much on the relationship as on the techniques used.

Getting started

If you are ready to explore these patterns, begin by browsing the counsellor profiles below. Look for accredited professionals who outline their approach and experience with narcissism or relationship issues. Booking an initial consultation allows you to ask questions about their methods and to see whether the therapeutic relationship feels like a fit. Therapy is a process - with patient, reflective work you can develop greater self-awareness, improve how you relate to others and move toward relationships that feel more genuine and satisfying.