Treatment for Narcissistic Personality Disorder
It is not rare that patients are hospitalized when they are diagnosed with severe narcissistic personality disorder. One group of these patients' impulsive behavior is the result of Axis I symptoms. Hospitalizations should be brief, and the treatment specific to the particular symptom involved.
Another group of patients who live in the hospital have poor motivation for outpatient treatment, fragile object relationships, chronic destructive acting out, and chaotic life-styles. An inpatient program that includes individual psychotherapy, family involvement, and a specialized residential environment might help them.
Health care professionals must bear in mind that they have to acknowledge the patients sense of self-importance and that they must respect the patient, so that the patient can reestablish a coherent sense of self.
The individual with narcissistic and related personality disorders is likely to present with Axis I symptoms and disorders at various times in his or her life. These should be treated as described elsewhere. Caution should be observed, however, not to over diagnose psychotic decompensation as Schizophrenia unless all DSM-III criteria are apparent. The same caveat applies to the pharmacological treatment of depressive symptoms in the absence of clinical signs of Major Affective Disorder. When treating presenting symptoms and Axis I disorders in patients with Narcissistic Personality Disorder and other similar conditions, attention should be paid to the consequences of removing symptoms in a patient whose underlying character is primitive and or fragile.
To help the patient develop stronger self-esteem regulation, the therapist will gradually point out the realistic limitations of patient while also offering an empathic ambience to cushion patients in their efforts to accept and integrate these experiences.