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.