Yes, it is possible for someone with narcissistic traits or narcissistic personality disorder (NPD) to change, but it requires sustained effort, professional help, and genuine motivation. Change doesn’t look like a personality overhaul. It looks like gradual improvements in self-awareness, empathy, and the ability to maintain healthier relationships. The reality is more nuanced than the simple yes/no answer most people want: change is possible but uncommon, slow, and incomplete in many cases.
What the Research Actually Shows
A two-year study tracking 96 patients diagnosed with NPD found that 53% no longer met the diagnostic criteria at follow-up. That’s a meaningful number. It means more than half of people in that sample improved enough that their narcissistic patterns no longer qualified as a clinical disorder. But “no longer meeting diagnostic criteria” isn’t the same as becoming a fundamentally different person. It means specific behaviors, like exploiting others, lacking empathy, or needing constant admiration, decreased enough to fall below the diagnostic threshold.
Separately, a large meta-analysis published in 2024 looked at how narcissistic traits naturally shift over a lifetime. Narcissism typically declines from childhood through old age, with the most combative and hostile features (what researchers call “antagonistic narcissism”) showing the steepest drop. The grandiose, self-promoting side also decreases, just more gradually. So some degree of mellowing happens on its own as people age, independent of therapy. That said, the underlying traits remain moderately to highly stable over time, meaning the core tendencies don’t vanish. They soften.
What Kind of Therapy Works
Not all therapy is equally effective for narcissistic traits, and standard talk therapy often falls short. Two approaches have the strongest evidence.
Transference-focused psychotherapy (TFP) works by using the relationship between the therapist and the patient as a mirror. The therapist pays close attention to how the patient treats them in the room, because those patterns reflect how the person behaves in all their relationships. A clinical case report on TFP for NPD documented improvements in self-reflection, empathy, the ability to tolerate normal disappointments, and the formation of more flexible, less rigid ideas about themselves and other people. Those are exactly the areas where narcissism causes the most damage.
Schema therapy takes a different angle. It targets deep emotional patterns, called schemas, that formed in childhood and continue driving adult behavior. A multicenter randomized controlled trial found that schema therapy produced significantly higher recovery rates than standard treatment for personality disorders. Patients in schema therapy also had lower rates of depression, better social functioning, and were less likely to drop out. The results held across different personality disorder diagnoses, including narcissistic presentations.
Why Change Takes So Long
Personality disorders aren’t like depression or anxiety, where someone can feel noticeably better within weeks of starting treatment. Narcissistic patterns are woven into a person’s identity, their sense of who they are, how they relate to people, and how they protect themselves emotionally. Clinicians who specialize in this work describe patients with narcissistic pathology as having formed “entrenched adverse relational patterns” rooted in early childhood experiences. These patterns are largely unconscious, hard to surface, and slow to shift.
Many people with significant narcissistic traits grew up with parents who had similar traits, meaning the patterns are multigenerational. Therapy for NPD typically requires years, not months. The therapeutic relationship itself becomes the vehicle for change: a sustained connection with someone emotionally responsive, within clear boundaries, over a long period. There’s no shortcut. Quick interventions and short-term programs rarely produce lasting results for this specific issue.
The Biggest Obstacle Isn’t the Disorder Itself
The central challenge with narcissistic change isn’t that the brain can’t adapt or that effective therapies don’t exist. It’s motivation. Narcissism, by its nature, protects the person from seeing the problem. The grandiosity, the dismissal of criticism, the tendency to blame others: these aren’t just symptoms, they’re a defense system. Asking someone to give that up is asking them to feel vulnerable in a way they’ve spent their entire life avoiding.
Most people with NPD enter therapy not because they want to work on their narcissism but because something else forced their hand: a spouse threatening to leave, job loss, depression, or a substance abuse problem. Dropout rates in personality disorder treatment are notoriously high. When therapy starts confronting the deeper patterns, discomfort increases, and many patients leave before the hardest, most productive work begins. Schema therapy’s lower dropout rates suggest that its approach, which validates the emotional needs behind the behavior rather than just challenging the behavior, may help people stay engaged longer.
What Change Looks Like in Practice
If you’re hoping someone with narcissistic traits will become warm, emotionally generous, and deeply empathetic, you’ll likely be disappointed. Realistic change looks different. It looks like someone learning to pause before reacting defensively. Recognizing when they’ve hurt someone and being willing to sit with that discomfort instead of deflecting. Developing the ability to see other people as full, separate human beings rather than extensions of themselves. Tolerating ordinary disappointments, like not being the center of attention, without spiraling into rage or withdrawal.
These shifts are meaningful. They can be the difference between a relationship that’s unbearable and one that’s workable. But they tend to be incremental, inconsistent, and vulnerable to backsliding under stress. Someone doing genuine therapeutic work on narcissistic patterns will have good stretches and bad stretches. Progress isn’t linear.
How to Tell If Change Is Real
If you’re evaluating whether someone in your life is genuinely changing, look for a few specific things. Real change involves accountability without prompting. The person acknowledges harmful behavior on their own, not just when confronted. They demonstrate curiosity about your experience rather than steering every conversation back to themselves. They stay in therapy consistently over a long period, not just attending a few sessions after a crisis and then stopping.
Be cautious about dramatic declarations of transformation. Narcissistic patterns can temporarily shift during periods of crisis or when someone is highly motivated to keep a relationship, only to return once the pressure eases. Sustained behavioral change over months and years, visible across multiple relationships and not just with you, is the most reliable indicator that something real is happening. Words alone, especially eloquent, emotionally charged promises, are not enough. The change has to show up in behavior, repeatedly, over time.