One of the more common beliefs about narcissism is that it cannot change. Once someone is labeled a narcissist, many assume there is little that can be done and that meaningful psychological growth is impossible. In short, you cannot “heal” narcissism.
From a psychodynamic perspective, however, the question of whether you can heal or treat narcissism is not whether narcissism disappears overnight. Rather, the question is whether the defensive structure organizing the personality can gradually become more flexible. Understanding what that change actually looks like requires looking beyond stereotypes and examining the subtle internal shifts that occur in treatment over time.
How Does Narcissism Defend Against Vulnerability?
To understand how narcissism changes, it is first necessary to understand what the narcissistic structure is organized around. One of the most central features of narcissism is the inability to truly depend. Psychoanalysts have often referred to this as the “stonewall of indifference.” In other words, there is a dismissive, detached, self-sufficient quality that develops psychologically.
The person may appear confident, independent, superior, or unaffected. Others may appear detached in a more withdrawn, insecure, or aloof way. Beneath these different presentations, however, there is often a profound fear of dependency and vulnerability. To depend on another person emotionally means risking disappointment, rejection, humiliation, or injury.
This is also what can be understood as the grandiose structure or grandiose sense of self. At a deeper level, its function is defensive. It protects the individual from feelings of need, longing, helplessness, inadequacy, emotional exposure, and dependency on other people. Rather than risking vulnerability, the narcissistic solution often becomes: “I don’t care” or “I don't need anyone.”
Why Is Asking for Help So Difficult in Narcissism?
A prototypical example of this often emerges in the treatment of more detached narcissistic individuals. These are individuals who can initially feel extremely difficult to reach emotionally.
For example, when dealing with this scenario in my practice, there may be periods in treatment where I feel as though I barely matter. Comments are dismissed, questions rarely seem genuinely considered, and there is very little room for another mind in the relationship. Rather than taking something in from another person, there is a tendency to brush it aside or remain emotionally untouched by it.
Over time, the work often focuses on helping the individual observe how quickly dependency and emotional reliance are blocked within the relationship itself. What gradually becomes apparent is that this pattern extends beyond the therapy room. The same need to ward off dependency appears in marriages, friendships, and professional relationships. Reliance on another person is experienced as threatening, making emotional connection difficult to tolerate.
Why Does Dependency Feel Threatening in Narcissistic Relationships?
As the treatment progressed, the individual made a comment that proved especially revealing: he explained that he would always rather give something than receive something.
At first glance, this can sound generous or selfless. Psychodynamically, however, it revealed something much deeper about the narcissistic structure (1). For him, directly needing something from another person immediately placed him in what he unconsciously experienced as a “one-down” position. To ask, to need, or to rely on someone else stirred feelings of being:
- dependent
- vulnerable
- rejectable
- emotionally exposed
Dependency itself felt diminishing. It was experienced as though needing another person made him somehow “less than.” Rather than risking this position, he unconsciously reversed the dependency dynamic. By becoming the giver, others became dependent on him rather than the other way around. In this way, giving functioned not only as generosity but also as protection against vulnerability.
How Does Emotional Reliance Create Tension in Relationships?
As treatment continued, another layer of the dynamic became visible. When he spoke about feeling indebted to someone, he was not simply describing the experience of receiving help. Emotionally, indebtedness carried a much deeper meaning.
To receive something from another person often felt like a submission, as though the other person now had something over him. Dependency created an imbalance that felt deeply uncomfortable and humiliating. As a result, he worked hard to remain on the side of the relationship where he was owed rather than owing.
This also helped explain how aggression and control could become subtly embedded within caretaking. On the surface, his giving appeared highly generous. Unconsciously, however, it also allowed him to:
maintain control → avoid dependency → preserve emotional autonomy
By positioning others as dependent on him, he could avoid the far more threatening experience of needing someone himself. What appeared to be generosity was also functioning as a defense against vulnerability.
What Does Change Actually Look Like in Narcissism?
One of the most important developments in treating narcissism involved understanding how splitting helped maintain this defensive organization. His internal world had been organized around an ideal of absolute autonomy. On one side was an idealized self-representation: completely independent, invulnerable, self-sufficient, and needing no one. On the other side were ordinary dependency needs, which were experienced as threatening, shameful, or destabilizing.
For much of his life, these two states could not easily coexist. Whenever dependency emerged, it was experienced as evidence of deficiency. Yet something important began to happen during treatment. At one point, he expressed appreciation for me as his psychotherapist and acknowledged that the relationship had been useful to him. What made this clinically significant was not simply the appreciation itself, but what it represented psychologically.
For the first time, previously separated self-states were beginning to coexist in the same psychic space. He could recognize the value of another person without immediately turning that experience into devaluation or self-attack. Dependency was no longer entirely split off. This represented a small but meaningful reduction in splitting and a movement toward integration. Change began to appear in the growing capacity to tolerate:
- dependency
- need
- vulnerability
- appreciation
without immediately experiencing them as humiliation or loss of self.
Conclusion
Healing narcissism rarely begins with dramatic transformation. More often, it begins through small emotional experiences in which dependency, vulnerability, and need become increasingly tolerable rather than automatically defended against.
From a psychodynamic perspective, change occurs when previously split-off experiences can be held together rather than rejected. As this capacity develops, the rigid defensive structure begins to loosen, allowing for greater psychological flexibility, emotional connection, and genuine reliance on other people.
Continue The Journey
If you or your loved one is in need of support, contact us today and take the first step toward understanding, growth, and emotional balance.
For further insights and support, explore:
The Narcissism Decoder Podcast: get a deeper understanding through expert discussions and real-life stories.
These resources can provide additional guidance as you navigate your journey toward healing and personal growth.