How do you tell someone they need therapy?

OCD is just the beginning. I believe my wife suffers from NPD. She is very critical of me and others (I don't do laudry or the dishes "right"), and it is getting worse! For some background, 5 years ago we were living on 2 separate coasts, and I wanted to join them out here in CA. She resisted, and I held onto our children when they visited me in MA, and filed for divorce. If I had known that she was suffering from these things, I wouldn't have done what I did. It has been 5 years, and she claims she "can't" forgive me (and denies doing anything to hurt me!!)I am not an impulsive person, and felt desperate at the time, with no where else to turn. I feel I received bad advice from a lawyer, and the whole thing was unnecessary. I went to therapy for 3 years, and have come to understand my wife (and me) better. I never argue with her, let her do what she wants, and help out as much as I can with chores and the kids. It SHOULD be getting better after 5 years, but she is getting worse. She does not handle stress well, and the wear is showing. She blames me for ALL of our problems, and I need to know what to do. I love her, and want to help her. How do I get her therapy?

Hi Okeenan, I appreciate your

Hi Okeenan,

I appreciate your desire to help your wife. However, I am wondering how you came to the conclusion that she has NPD. Did the therapist you worked with for 3 years suggest that based on the things you told him / her?

The reason I ask is because being critical, blaming you for all the problems, and denying doing anything to hurt you don't necessary make her a narcissist. A lot of people who don't have NPD would fit that description. So, I am assuming there is more to the picture...

If she does have NPD, then you are in a very tough situation. I'm not at all surprised that it's not getting better after 5 years. Sadly, it will probably never get better and life will be pretty miserable for you.

It's extremely difficult - and often futile - to get a narcissist to go to therapy. When they do go, it's usually because they have had a crisis and are depressed, or because they are seeking affirmation that they're "right" and that everyone else (in this case, you) is wrong about them.

Even when they do go to therapy (which is rare), they usually don't stay in therapy long enough to make any progress. It takes an extremely skilled therapist to navigate the minefields that come with attempting to treat a narcissist. Preferably, it would be someone who specializes in the treatment of personality disorders.

If your wife is unwilling to take any ownership for some of the problems in your relationship, then she's highly unlikely to be willing to go to therapy. Narcissists, by the very nature of their disorder, don't see themselves as the cause of problems in relationship. So, they're not motivated to go to therapy to work on themselves. If you suggest therapy, you'll probably just make her very angry at you.

The bottom line is, if she truly has NPD, you are most likely in a no-win situation that will never get better. I won't say it's impossible, but the odds are poor. If you're doing things that your former therapist suggested, and it's only getting worse, then my two best recommendations would be to 1) work with a new therapist who can help you figure out how to make this relationship more workable for you (you can't change her, only how you react to her and handle situations) or 2) cut your losses and get out of this marriage. (If you stay in it, then do so accepting the fact that she will most likely never change.)

A third, but risky, option would be to tell her that if she wants the marriage to continue, then she needs to go to marriage counseling with you. However, giving a narcissist an ultimatum could easily blow up in your face. She would have to be feeling some degree of vulnerability and have some genuine investment in the marriage in order to agree. And then, again, you would want to work only with a very experienced therapist who really knows how to work with narcissists.

I don't know if this has helped much. I'd like to give you hope, but if she really has NPD, it's just not a very hopeful situation. It is extremely difficult to be in a relationship with someone with NPD, as they are very poor relationship partners who inevitably make the other person's life absolutely miserable.

Dr. Lane

Thank you very much for your

Thank you very much for your comments. My therapist told me my wife had a "harsh inner critic", and probably was traumatized in her teens, which could lead to NPD. I looked it up on wikipedia and she exhibits ALL the symptoms it says there, including reacting harshly to the slightest criticism; exaggerate their own importance and talents; unrealistic fantasies of success (45 yr old aspiring actress); constant attention; lacks empathy; trouble maintaining healthy relationships......I will not get out of the marriage, I need to learn coping mechanisms - I can handle the sarcasm and derision (we have 2 kids together, and she has 2 from a previous marriage). THEY need me!!! In addition, I love her, and want to be with her. I plan to make an appointment with my old therapist, as we worked very well together, and I don't want to have to tell my "story" all over again. I will just continue to go on, and hope someone who she "trusts" will see what I see. Thank you again, and I have no problem communicating further, if you find the time!!

Hi Okeenan, I am dealing with

Hi Okeenan, I am dealing with this very issue with my husband. I would love to stay in touch with you. Perhaps we can help each other by providing feedback along with what works and what doesn't work. I am trying to get mine to therapy as well. So far, the book I gave him to read is still sitting by the bedside. He is an absolute narcissist and blames everyone for everything! Including if HE bangs his head on something, it was my fault for not watching him. It's so ridiculous and frustrating to live under constant pressure from him that I've often thought of leaving, but the other side of him is so wonderful that the decision is very difficult. Therapists all say the same thing, to work on myself. I have done that and I'd have to say that we don't rub off each other the same anymore and I don't give into his "stuff" like I used to, so it has gotten a bit better.
My email is ejsoden@gmail.com

 
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