Do Narcissists Ever Change? What Research Can and Cannot Tell Us: The Evidence

Narcissistic traits are not the same as a diagnosis

Some people with narcissistic traits or narcissistic personality disorder change, including during psychotherapy. Improvement can involve greater accountability, steadier self-esteem, and healthier relationships. Research cannot predict whether a particular person will change or become safe to live with. Decisions about a relationship should reflect current behavior and your own needs.

People use narcissist to describe many behaviors: self-centeredness, entitlement, defensiveness, or lack of consideration. Those observations may identify a relationship problem, but they do not establish narcissistic personality disorder, or NPD.

NPD involves an enduring pattern assessed by a qualified clinician in the context of a person's functioning and history. Confidence, an argument, or one hurtful action is not enough. Equally, you do not need proof of a disorder to decide that a behavior is unacceptable.

Clinical descriptions include grandiosity, vulnerability, shame, and unstable self-esteem. Understanding those experiences can inform treatment while the person remains responsible for intimidation, repeated humiliation, or controlling behavior.

What the research actually shows

A case series by Weinberg and colleagues examined people with NPD who had improved during psychotherapy. Their symptoms and everyday functioning changed. Because the researchers selected people who had improved, this study demonstrates that improvement is possible; it cannot estimate how likely improvement is for everyone who enters therapy.

Maillard and colleagues studied processes during clarification-oriented psychotherapy. Changes in patients' in-session processes were associated with treatment outcomes. This offers a closer view of how therapy may work, but an association in a naturalistic study does not establish a guaranteed treatment effect.

A randomized trial published in 2026 compared schema-focused therapy with the unified protocol. Both groups showed reduced NPD symptom severity, with different patterns of change across features. The abstract reports a comparison of active treatments, not a test of whether any particular partner will become safe. One trial does not settle which treatment is best for everyone.

The literature includes different treatments, samples, and definitions of improvement. A reduction in diagnostic symptoms is not automatically the same as sustained kindness, a repaired relationship, or freedom from abusive behavior. Research should inform hope without becoming a forecast about your partner.

It is also unhelpful to claim that people with this diagnosis are incapable of change. That claim can discourage treatment and oversimplifies the evidence. Possibility and predictability are different questions.

What treatment may work on

Psychotherapy can address how a person understands themselves, responds to criticism, and relates to other people. Goals need to be concrete enough to review. A person might work on acknowledging a mistake without attacking someone else or tolerating disappointment without demanding special treatment.

Schema-focused therapy examines persistent beliefs and coping patterns, including ways a person protects against painful feelings. Mentalization-based work helps the person become more curious about their own mental states and those of others, particularly during conflict.

Clinicians have adapted these approaches for pathological narcissism. Their evidence bases differ, and results for other personality disorders cannot simply be transferred to NPD. Ask a clinician about their experience, the rationale for the approach, and how they monitor outcomes.

Other difficulties may also need attention, such as mood symptoms or substance use. A clinician can assess these and discuss appropriate care. A partner is not responsible for selecting treatment, supervising sessions, or keeping the person engaged through repeated harm.

What observable change could look like

Look for actions that persist outside a reconciliation conversation. Does the person name what they did without adding that you caused it? Can they hear an impact they did not intend? Do they respect a limit when it inconveniences them?

Consider a hypothetical example. After repeatedly shouting during disagreements, someone apologizes and proposes taking a break when voices rise. The useful evidence comes later: they take the break without threats, return as agreed, and accept that you may still feel hurt.

A gift, an emotional promise, or learning therapy language can coexist with unchanged conduct. Attending appointments is a step, but it is not proof that the relationship is becoming safer. Notice what happens when you disagree or decline something.

You do not need to create secret tests or continually monitor someone. If you find yourself documenting every conversation to decide whether your experience counts, individual support may help you regain clarity. Your wellbeing belongs in the assessment too.

Plan for the behavior you are experiencing now

You can hope for change while making decisions based on current conditions. Ask what you need to feel safe, what you can accept, and what you would do if the pattern continued. You do not owe someone an indefinite trial period.

A boundary describes your action. In an otherwise safe relationship, that might be, "If the conversation includes insults, I will end it and discuss the issue another time." It is not a technique for making the other person develop empathy.

Consider practical constraints, including housing, finances, and access to support. If someone monitors you, threatens you, or retaliates against limits, announcing a boundary may increase danger. Seek confidential help with safety planning instead of relying on a confrontation.

The CDC describes psychological aggression and controlling behavior as possible parts of intimate partner violence. Abuse is a behavior and safety issue, not a diagnosis. Couples work may be inappropriate where coercion or fear prevents honest participation.

If you are concerned about yourself or a partner

If you recognize patterns in yourself, bring a specific incident to a licensed clinician and describe the impact without minimizing it. You do not have to decide whether NPD is the correct label before seeking help. The narcissism self-check is an educational screening for self-reflection, not a diagnosis.

If your concern is a relationship, the partner-patterns self-check focuses on experiences you observe. It cannot diagnose another person. Individual therapy can help you consider options without making you responsible for someone else's recovery.

If you are in emotional crisis or thinking about suicide, call or text 988 in the US. For immediate physical danger, call emergency services. You can seek support whether you stay, leave, or are still deciding.

Support for your own decisions

The setting boundaries worksheet can help clarify your own actions in a safe relationship. If limits provoke threats or retaliation, seek confidential safety support before acting. Read about defense mechanisms and attachment theory for background, or return to the psychology concepts hub.