How To Treat Narcissists in Couples Therapy

In my last post, I described the narcissistic habits commonly found within one of the partners in couples therapy. In this post, I will describe recommended ways to intervene, according to Susan Heitler, PhD.

The Goal…Bilateral Listening

A sign of emotional health is the ability to listen bilaterally. This means being able to hear your partner as well as yourself. As I described in my last post, narcissists are generally unable to listen to other people. Instead, they only listen to themselves. Compounding the problem, in order to adapt their partners do the opposite: they tend to listen to the narcissist and not themselves.

If you think about couples therapy, you will be able to see how this can create problems. Since we treat couples systemically, we need to be able to change both partners in the system. If the narcissist can’t hear their partner, it is going to be difficult if not impossible to get them to change. This is the goal for narcissistic clients. Likewise, the non-narcissistic partner is reinforcing the pattern by enabling the narcissist.

The Reality…Dismissive Listening

A sure sign of someone with a dismissive listening habit is the use of the word “but.” Narcissists do this all of the time. Rather than respond to their partner’s thought or concern, they will dismiss it by changing the focus of the conversation. An example:

Non-narcissistic partner: “I feel unloved by you when you don’t listen to me”
Narcissistic partner: “But you know I love you! Think of all the presents I buy for you.”

Did you hear the dismissal? Well, so did the non-narcissitic partner. They routinely feel dismissed.

How To Intervene

  1. Seat the couple at right angles. Do not seat the couple facing each other, this will encourage confrontative behavior on the part of the narcissist.
  2. Learn to interrupt. As a therapist, you may have been taught not to interrupt. When dealing with a narcissist, this will cause problems. Although it may be easier not to interrupt (the narcissist does not like being interrupted) you are not working to establish safety for the non-narcissitic partner.
  3. Teach the narcissist about the term “but.” Susan Heitler does this by placing several visual aids on the table, then making a statement followed by “but,” each time knocking one item off the table to show the narcissist how “but” tends to negate the statement made right before it. Then teach them how they can say the same thing using the word “and,” which adds instead of subtracts. For example:

    Non-narcissistic partner: “It’s a beautiful day.”
    Narcissistic partner: Instead of: “But I like it when it’s cloudy”, tell them to say: “Yes, it’s beautiful outside, and I like it when it’s cloudy.”

  4. Ask the narcissist what they were feeling when they used the word “but.” By helping the narcissist address the feelings underneath, you can help them change their behavior. Help them identify a time in their life when they felt similarly, and how they learned to cope…but this coping pattern they have developed is now causing issues in their relationship. Then work with them to find a different way to cope.
  5. Help the non-narcissistic partner focus on herself. The tendency will be for that partner to focus on the narcissist.
  6. Yours in the Joy of Knowledge,

    Dr. Barbara LoFrisco

    * Good Therapy teleconference, September 19, 2014 with Susan Heitler, PhD