Can Couples Therapy Help if My Partner is a Narcissist?

As a couples therapist, it’s not unusual for someone to call for help, declaring that the marital problem is their narcissistic partner. When asked what the client means by “narcissist” and what that looks like in their relationship, clients typically say the partner is selfish, controlling, or demeaning. They may convey that their spouse thinks they’re superior, “God’s gift to the earth,” the boss or expert, right at all costs, and never wrong.

They describe attempts to confront the aversive behavior as being met with denial, gaslighting (turning back the accusations on the accusing spouse), and threats such as, “If you don’t like it, get out,” or “Do you think anyone will help you? You can’t afford to live without me.” or “YOU’re the one that needs help, not me.”

As for how it shows up in the day-to-day, the negative behavior typically includes criticism, commands, shouting, stonewalling/ignoring/giving the cold shoulder, name-calling, cutting off or limiting financial access, drinking or drug use, and boundary crossings that can run from airing the couple’s dirty laundry in public (humiliation) to prohibiting the spouse’s contact with their support systems such as family, friends and even therapists. Faced with intolerable antics, a complaining spouse may find themself fighting back vigilantly or crumbling in fear, panicked at the thought that no relief is in sight.

Such a case is not for the faint of heart. It presents obvious challenges and it’s important for your therapist to understand what those will include. When taking on this type of case, I want to assess the levels of safety at the outset and may require safety contracts and other limitations on the relationship as an ongoing condition for our work. I also participate in peer consultation to navigate both clinical and potential ethical challenges.

How to work with narcissistic behavior in Couples Therapy

Some practices I find important in working with the narcissistic behavior:

Setting Clear Boundaries.

To manage a narcissist’s sense of entitlement and disregard for the feelings and needs of others, it's important for the therapist to set clear boundaries with the narcissist and hold them accountable for their behavior. This may involve written safety agreements, contingencies in the event boundaries are broken and clear rules around communication, conflict resolution, and respect for each other's needs and feelings.

Building a Strong Therapeutic Alliance.

A strong therapeutic alliance between the therapist and the couple is critical for any effective therapy. Notwithstanding all the negativity the couple may present, focusing on the couple's strengths and building on them can help to create a sense of positivity and hope, and encourage the couple to work together towards a common goal. When goals are met, we celebrate; when they aren’t, we evaluate what keeps happening to both spouses. I remind them: If nothing changes, nothing changes. We can’t control others, but we can manage our own big emotions.

Validating (NOT agreeing with) the Narcissist's Vulnerabilities.

Narcissists often struggle with feelings of insecurity and vulnerability, which can be masked by projecting a false sense of superiority and confidence. As a therapist, it's important to acknowledge and validate these underlying feelings while also holding the narcissist accountable for their behavior. Validation does not mean acceptance, nor does it mean agreement. It lets the partner know I heard them, and I’m still there. I still expect a more effective response, but I’m open to accepting a repair.

Focus on the Couple's Goals.

The chaos of escalated conflict can turn a therapy session into a circus, so structure and focus are the therapist’s friend in these circumstances. I ask couples to identify shared goals and work towards them collaboratively, and we measure what’s working and what happens when setbacks occur.

The challenges presented by narcissistic behavior can test our limits, and success cannot be guaranteed, especially when couples have waited years to address the problem. I remind the couple they have options beyond therapy and, where I can, make referrals for other professional assistance when requested.

Regulating Behavior/Establishing Safety and Limits.

Controlling or aggressive behavior in a narcissist can be triggered by feelings of fear/insecurity, jealousy and anger. Their partner may experience anxiousness, fear, helplessness, anger or rage. I find both partners benefit from psychoeducation and in-session practices to self- and co-regulate behavior.

We need the couple to learn how to de-escalate emotional reactions, take necessary breaks when tempers rise, and avoid further escalating behaviors, even if that means a cold stop and exit. I like to recommend Dr. Alan Fruzzetti’s book, The High Conflict Couple, as a resource.

It's important to help the narcissist develop coping mechanisms to regulate their emotions and avoid impulsive or destructive behavior. From my Gottman toolkit, Relaxation and Listening Exercises are available to down-regulate conflicts. I may also utilize DBT skills for mindfulness and emotion regulation or incorporate certain couples hypnosis interventions (like visualization) to promote connection. Couples further learn the antidotes to communication patterns eroding the relationship. These interventions aim to help the couple become more self-aware and manage their emotions more effectively.

Adjunctive Therapy

A study published in the Journal of Marital and Family Therapy in 2017 found that individual therapy was more effective than couples therapy in reducing narcissism in a sample of men with narcissistic personality disorder. Depending on the challenged partner’s level, intensity, duration and reinforcement of narcissistic traits, a referral for individual work may be discussed.

I sometimes recommend that one or both partners engage in their own individual therapy either before commencing couples work, or throughout our work together. These adjunctive services are intended to reinforce growth and boundaries that better enable the couple to respond to each other’s reasonable needs.

Counseling Can Help!

Overall, couples therapy with a narcissist can be challenging, and often requires both partners to contribute to change. My hope is that, even if therapy does not result in the couple staying together, clients leave understanding more about their strengths and challenges in the relationship, and gain benefit from interventions aimed at improving communication, reducing conflict, and keeping the couple moving in the direction of their goals.

If you or someone you know has difficulties with narcissistic behaviors in their marriage or relationship, I invite you to contact me at 954-391-5305 for your complimentary consultation to see how I can help.

I provide counseling for adults and couples at our beautiful offices in Fort Lauderdale and Plantation, Florida. I also offer online counseling for those who reside in Florida. For more information about my services, click here.

I look forward to speaking with you!