This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:


peer-reviewed publication


Narcissism and its impact on psychotherapy

Narcissism and its impact on psychotherapy
Narcissus (painting by Caravaggio, 16th century) fell in love with his mirror image. Narcissistic traits can have a negative impact on psychotherapy, as a recent study from Jena and Münster yields. Credit: Galleria Nazionale d'Arte Antica, CC BY-SA

Narcissistic personality traits are related to poorer response to psychotherapeutic treatment. This is the result of a German multi-site study with more than 2,000 participants receiving inpatient and outpatient psychotherapy. The findings of the research team at Jena University Hospital and University of Münster, now published in the journal The Lancet Psychiatry, can contribute to further individualization of psychotherapy.

After Narcissus, the figure from Greek mythology, a person with particularly high sense of grandiosity and entitlement is called a narcissist. In a Germany-wide study with more than 2,000 patients from inpatient and outpatient psychotherapy, a team of researchers from Jena University Hospital and the University of Münster examined how narcissistic dimensions affect the treatment of mental health complaints. To this end, the study team recorded the participants' level of narcissistic personality traits and before and after the treatment with two different psychotherapy methods.

Strong narcissistic rivalry is associated with more severe depression symptoms before the start of therapy in both groups, the study team found. In contrast, the need to be admired was related to lower depression severity. Maike Richter, first author of the study, summarizes the study's main findings, "In the group of patients treated with , narcissism was associated with a poorer response to treatment, even when a was not fully developed." In particular, the rivalry dimension had a negative impact.

Narcissism affects therapeutic relationship

However, in treatment with psychoanalytic-interactional therapy, which was developed specifically for people with difficulties in , adverse effects of narcissism on treatment response were not found. The researchers assume, that this difference between the treatment methods was due to interpersonal behavior patterns between patient and therapist.

According to Prof. Nils Opel, Jena University Hospital, further analyses support this hypothesis. "We found evidence that the negative effects of narcissism are based on a weaker therapeutic relationship," says Opel.

The authors consider the findings an important contribution to the understanding of narcissistic personality characteristics and their inclusion in the therapy of mental disorders in general.

"Narcissism can be a relevant factor for mental health, leading to being less effective," says Prof. Mitja Back, University of Münster. The researchers therefore recommend that therapists carefully assess their patients' narcissistic tendencies and pay special attention to the therapeutic relationship.

More information: Maike Richter et al, Narcissistic dimensions and depressive symptoms in patients across mental disorders in cognitive behavioural therapy and in psychoanalytic interactional therapy in Germany: a prospective cohort study, The Lancet Psychiatry (2023). DOI: 10.1016/S2215-0366(23)00293-6

Journal information: The Lancet Psychiatry
Provided by Universitätsklinikum Jena
Citation: Narcissism and its impact on psychotherapy (2023, October 16) retrieved 21 April 2024 from
This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Explore further

How many types of narcissist are there? A psychology expert sets the record straight


Feedback to editors