Narcissistic Personality Therapy in San Jose
Build healthier relationships by changing long-standing patterns
Narcissistic Personality
Understanding Narcissistic Patterns and Creating Lasting Change
Narcissistic Personality Disorder (NPD) is often described in ways that make people sound selfish, arrogant, or uncaring. Narcissistic patterns can involve entitlement and a strong need for admiration, but they can also be tied to shame, sensitivity to criticism, emotional deprivation, and a sense that your worth depends on being exceptional.
You may be successful and confident in some areas of your life while repeatedly struggling in relationships. Here are a few traits of NPD:
- Being controlling or needing things to be done your way.
- Becoming defensive, dismissive, or difficult to disagree with.
- Feeling that others don’t recognize or appreciate what you contribute.
- Becoming angry, critical, or withdrawn when you feel criticized or rejected.
- Having difficulty recognizing another person’s needs or perspective when they conflict with your own.
Laura Johnson, LMFT, LPCC, provides Schema Therapy for Narcissistic Personality Disorder. Schema therapy is designed to address long-standing personality patterns at a deeper level. Laura is an advanced certified schema therapist and certified cognitive behavior therapist with expertise in personality disorders. People seek her out across California for her unique specialty. Laura can provide you using video therapy if you live anywhere in California including San Jose, San Francisco, Sacramento, Los Angeles and San Diego.
Could I Have Narcissistic Personality Disorder?
People rarely come to therapy saying, “I think I have Narcissistic Personality Disorder.” More often, something has stopped working. A marriage may be in trouble. A partner may have threatened to leave. There may be repeated conflicts at work, or success may no longer provide the satisfaction it once did.
You might recognize some of these patterns:
- You feel deeply frustrated when other people do not recognize your abilities, effort, status, or accomplishments.
- Criticism feels unusually personal, unfair, or humiliating, and you quickly defend yourself or criticize the other person.
- You expect other people to accommodate your needs and become angry when they do not.
- You compare yourself with other people and need to feel that you are doing better than they are.
- You have difficulty apologizing, admitting you were wrong, or seeing a conflict from another person’s perspective.
- Relationships may start intensely but become disappointing when the other person no longer makes you feel special or admired.
Having some narcissistic traits does not mean you have NPD. Narcissistic traits exist on a spectrum, and a diagnosis requires a persistent pattern that causes significant problems across areas of life.
What Is Narcissistic Personality Disorder?
Narcissistic Personality Disorder is a personality disorder with a long-standing pattern involving an exaggerated or unstable sense of self-importance, a strong need for admiration or validation, entitlement, and difficulty consistently recognizing other people’s needs and perspectives. Some people present with obvious confidence and grandiosity. Others have a more vulnerable presentation and may be highly sensitive to rejection, criticism, or feeling overlooked.
This is why I do not reduce narcissism to “having a big ego.” A person can look extremely confident on the outside while depending heavily on achievement, admiration, attractiveness, intelligence, money, or status to maintain that confidence. When something threatens that foundation, the emotional reaction can be surprisingly intense.
Common Symptoms of Narcissistic Personality Disorder
NPD can look different from one person to another, but common patterns include:
- An inflated sense of importance, achievement, talent, or uniqueness.
- A strong need for admiration, attention, recognition, or validation.
- Expecting special treatment or believing ordinary rules should not always apply to you.
- Difficulty recognizing or responding to other people’s feelings when they conflict with your own needs.
- Frequent comparison, envy, competitiveness, or concern with status.
- Using relationships primarily to meet emotional, practical, or status needs.
- Becoming defensive, contemptuous, angry, or withdrawn when criticized.
- Difficulty maintaining close, reciprocal relationships over time.
The important question is not whether you recognize one or two traits. I look at the overall pattern: how rigid it is, how long it has been present, and what it is costing you.
How Schema Therapy Helps with Narcissistic Personality Disorder
Schema Therapy combines cognitive, behavioral, and emotion-focused techniques to address the deeper patterns that keep NPD traits alive. Cognitive techniques help you trace longstanding beliefs back to their origins, understand how they continue to shape your life, and build a healthier perspective based on your needs and experiences today. Behavioral techniques help you practice responding differently – listening without immediately defending yourself, tolerating not getting your way, apologizing, or allowing another person’s needs to matter equally. Emotion-focused techniques help reach the vulnerable feelings that intellectual insight alone often cannot change.
Schemas are deeply held patterns about yourself, other people, and relationships. They usually develop early and then influence how you interpret situations as an adult. Not everyone with narcissistic traits has the same schemas, but several appear frequently. Here are a few schemas I often see with narcissistic personality disorder.
- Entitlement/Grandiosity: You may feel your needs or opinions should take priority and rely on feeling successful, important, or exceptional to maintain your self-worth.
- Emotional Deprivation: You may expect that others will not truly understand, support, or meet your emotional needs, leaving you feeling unappreciated or uncared for.
- Defectiveness/Shame: You may fear being inadequate or flawed and respond to criticism or rejection with shame, defensiveness, anger, or withdrawal.
- Unrelenting Standards/Hypercriticalness: You may hold yourself and others to very high standards, leading to perfectionism, criticism, and frustration when expectations aren’t met.
Below are some common core beliefs that I see in people with NPD. Yours may be a little different.
| Schema | Core Beliefs / Statements |
|---|---|
| Entitlement / Grandiosity | “I am special or exceptional.” “I deserve special treatment.” “My needs should come first.” “Other people should recognize my abilities and what I contribute.” |
| Emotional Deprivation | “Other people won’t really understand me.” “I won’t get the emotional support or appreciation I need.” “I have to rely on myself because other people will disappoint me.” |
| Defectiveness / Shame | “If people see my weaknesses, they may think less of me.” “If I fail, it means I’m not good enough.” “I can’t let people see me as weak or inadequate.” |
| Unrelenting Standards | “I have to be highly successful or competent.” “Mistakes and failure are unacceptable.” “People should meet my standards.” “If something can be done better, it isn’t good enough yet.” |
Why Work with Laura Johnson?
I specialize in helping people with personality disorders understand and change patterns that can create conflict, disconnection, and dissatisfaction in their relationships. With narcissism, you may feel misunderstood or unappreciated, become defensive when criticized, or struggle when other people don’t respond the way you expect. Schema Therapy helps us look beneath these reactions to understand the emotional needs driving them and change your responses when a schema is triggered.
I’m one of the few therapists in California who is both an Advanced Certified Schema Therapist and a Certified Cognitive Behavior Therapist. People seek me out across California for my unique specialty. I can help you using video therapy across California including San Jose, San Francisco, Sacramento, Los Angeles, and San Diego.
Frequently Asked Questions about Obsessive-Compulsive Personality Disorder
Can People with Narcissistic Personality Disorder Change?
Yes, meaningful change is possible. Change requires enough motivation to look honestly at your behavior, tolerate uncomfortable feedback, and practice different responses repeatedly. The realistic goal is greater flexibility: less defensiveness, more empathy and reciprocity, a more stable sense of worth, and healthier ways of responding when you feel disappointed, criticized, or overlooked.
What is the difference between narcissism and Narcissistic Personality Disorder?
Narcissistic traits can occur in anyone. NPD involves a persistent, inflexible pattern of narcissistic traits that significantly affects relationships, work, or emotional functioning.
What is covert or vulnerable narcissism?
Vulnerable narcissistic traits may appear less openly grandiose. You may be highly sensitive to criticism, feel easily slighted or overlooked, withdraw when you do not feel appreciated, and privately compare yourself with others while still depending heavily on validation.
Can someone with NPD have healthy relationships?
Yes, but healthier relationships require reciprocity, empathy, boundaries, accountability, and the ability to tolerate disagreement. These are skills and emotional capacities that can be strengthened in therapy.
Do people with narcissistic traits seek therapy?
They do, although the reason for starting therapy may be relationship conflict, anxiety, depression, work problems, or a major life transition rather than narcissism itself.
How long does Schema Therapy take?
There is no single timeline. Long-standing personality patterns generally take longer to change than a circumscribed problem because we are working on patterns reinforced over many years. I tailor treatment to your goals and progress
Take the First Step to Get Help with Narcissism in San Jose and California
Narcissistic Personality Disorder can create painful patterns that leave you feeling misunderstood, criticized, or unappreciated. I can help you understand these patterns, respond differently to criticism, and build healthier relationships. I offer secure video therapy throughout California, including San Jose, Sacramento, San Francisco, Los Angeles, Orange County, and San Diego. Reach out today to begin making meaningful changes in yourself and your relationships.