Can Pathological Narcissists Change?
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It can be very difficult for an individual who abuses their intimate partner to change. The reasons for their behavior can vary. However, let’s look at one specific type of abuser that has been researched extensively – abusers on the pathological narcissism spectrum.
I view pathological narcissism to include: Narcissistic personality disorder and Antisocial personality (e.g., psychopathy). These conditions are extremely resistant to change and cannot be modified with temporary effort or will by them.
Pathological narcissists have a condition that impairs the social neuronetworks of the brain.
Let that sink in for a moment – the very regions of the brain that handle how we relate, connect, empathize, manage our emotions, take accountability, reason (socially), inhibit impulses, and practice morality are dysfunctional in this population.
There is no therapy that can improve that very complex set of social neuronetworks.
That means a pathological narcissist can have an extremely high IQ or be very talented in some regard, yet also be socially deficient. Different systems within our brain manages different functions and should work together as a cohesive system of you.
Unlike other conditions we treat in psychology, this condition impacts their social interactions, thought processes, personality and behavior. We rely on these components to be stable when we interact with others – especially our intimate partner.
When someone has deficits of this magnitude (pathological narcissism) that means most people will not be able to have a peaceful, cooperative, reciprocal relationship with them. The level of accommodation one would have to extend to maintain a relationship with them will be extreme (e.g., walking on eggshells; always submitting to a fragile ego).
We lean on our social neuronetworks within the brain (described above) to be able to connect to others; to relate to them; respect and appreciate them. Pathological narcissists cannot do any other those functions because the neuropathways of those brain regions are not functioning as they should.
Individual therapy cannot bypass this. Taking them to see a marriage counselor cannot change this.
Neuroscience has identified some of the underlying neurological (brain) correlates of narcissistic personality disorder and antisocial personality disorder and consistently found differences in comparison to normal control groups. Research findings consistently support the presence of dysfunction within the brain (varying in range) of individuals with pathological narcissism (Calzada-Reyes, Alvarez-Amador, Galán-García, Valdés-Sosa, 2013; Yang, Raine, Joshi, Joshi, Chang, Schug, Wheland, Leahy, Narr 2012; Blair, 2007).
Can they Change if they are Self-Aware and Try?
Can narcissists and psychopaths change if they exert effort; could they become safe romantic partners? If they promise to change, can’t they do that by investing in themselves?
Unfortunately, changing the way they process information, view social interactions, and ‘feel’ (emotional empathy) for others is not something they have the capacity to make happen.
However, it is not uncommon for an individual with pathological narcissism to tell their intimate partners that they will change, get better, or do better. This is usually short-lived. The brain disorder will predominate and the pathological narcissists’ manner of thinking and functioning re-emerges.
Example – You love and bond with him/her across the span of your relationship, however the individual with pathological narcissism (due to faulty social neuronetworks) will disconnect, become disinterested, and antagonistic, perhaps even hateful across that same time period. Their behavior is in complete opposition to what ‘normals’ do when they are intimately involved and care about someone.
You connect – The disconnect. How can anyone have a healthy relationship with those dynamics at play?
Neurobiological abnormalities of this magnitude cannot be altered by the narcissist’s promise to change or “be better.”
Certain neurological processes are outside of a pathological narcissist’s control to change voluntarily. Improvement is via intense treatment with a specialist or team of specialists, whose expertise lies within the area of psychopathy or personality disorders. (And there is a big caveat here.)
Even under such circumstances research indicates that the changes tend to be in relation to a small set of behaviors rather than emotional processing (Skeem, Monahan, & Mulvey, 2002). Emotional processing refers to their ability to form empathy, care, demonstrate morality, and bond. Those are unchangeable.
They will still be a callous or unkind, antagonistic partner. Therapy cannot create love or give an individual the ability to love in the face of a severe disorder (narcissistic personality / antisocial personality).
Can much be done?
We are still learning about this disorder, especially regarding treatment – where the research is minimal at best.
Psychopathy and Narcissistic Personality are conditions that desperately warrant interventions, however at this time neuroscience has no cure to offer. Blair (2008 & 2007) suggested that exploration of a treatment that activate the amygdala (i.e., “Yohimbine”) or raises “noradrenergic activities”, may be a direction for researchers to consider.
Some scientists recommend investigating the impact of intranasal administered oxytocin (the bonding neuropeptide) as a route of symptom improvement (Krueger, Parasuraman, Moody, Twieg, de Visser, McCabe, O’Hara, & Lee, 2013). However, this can come with a host of problems, particularly given that those with psychopathy could potentially respond differently from someone without a brain disorder.
Unfortunately, researchers are still within the exploratory stage with respect to treatments. And the number of research groups taking on this challenge is small. There are gains being made, but there is not a program or pharmaceutical at this time that manages primary psychopathy or narcissistic personality disorder.
Sadly, the neurobiological systems that are responsible for morality, emotional empathy, care for others, impulse control, bonding, fear responsivity, and reward are faulty for pathological narcissists. Those brain systems do not operate the way they should. Hence, the reason they cannot function with genuine love, kindness, or respect toward the people who love them.
Science continues to explore possible options to address this condition. The impact of successful psychopathy treatment will be profound, as it could lead to a safer society.
© 2013 Rhonda Freeman, PhD | All Rights Reserved
Blair, R. J. R. 2007 Dysfunctions of medial and lateral orbitofrontal cortex in psychopathy. Ann. N. Y. Acad. Sci. 1121, 461–479.
Blair, RJ. (2008). The amygdala and ventromedial prefrontal cortex: functional contributions and dysfunction in psychopathy. Phil. Trans. R. Soc. B 363, 2557–2565
Calzada-Reyes A, Alvarez-Amador A, Galán-García L, Valdés-Sosa M. (2013). EEG abnormalities in psychopath and non-psychopath violent offenders. Journal of Forensic Legal Med. Jan;20(1):19-26.
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Krueger, F., Parasuraman, R., Moody, L., Twieg, P., de Visser, E., McCabe, K., O’Hara, M., & Lee, M. (2013). Oxytocin selectively increases perceptions of harm for victims but not the desire to punish offenders of criminal offenses. Social Cognition and Affective Neuroscience. Jun;8(5):494-8.
Skeem, J., Monahan, J., & Mulvey, E. (2002). Psychopathy, Treatment Involvement, and Subsequent Violence Among Civil Psychiatric Patients. Law and Human Behavior, Vol. 26, No. 6, 577 – 603.
Yang Y, Raine A, Joshi AA, Joshi S, Chang YT, Schug RA, Wheland D, Leahy R, Narr KL. (2012). Frontal information flow and connectivity in psychopathy. British Journal of Psychiatry. Nov;201(5):408-9.