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Is your spouse aware they are narcissistic in their behavior? If not, it is difficult to tell someone that they are a narcissist. You will most likely get an angry response or a denial. If they are not in denial and admit the problem, then it is a very good sign that they can get better. A person with narcissism has to realize they are narcissistic and want to get help. In most cases, when someone has a personality disorder, it is almost impossible to get that person to understand what you are seeing. They cannot understand why there is anything wrong with their behavior. And if you try to confront them, they will see you as the problem.That does not mean they will not ever see it or ever get better. But it is something they will have to see for themselves. In other words, they need to have insight into their own behavior in order to see that it needs changed. Narcissists feel the world is about them. It's not that they don't want good things for others, they just feel they are first. They know more than everyone or they are the best at everything, etc. What you can do about your spouse's behavior is to work on how you deal with them. Don't feel bad if you need to remove yourself from a situation when their behavior bothers you. You are not obligated to join in when they expresses their thoughts or act out. If your spouse wants to know why, be honest. Say "you are acting narcissistic and I don't want to be exposed to it". Your spouse needs to understand the effect they are having on others.
There is treatment available when your spouse is ready for it. Treatment is long term because of the complexity of the disorder. Individual therapy works well with a therapist who is trained and experienced with this disorder. Group therapy is also an option. You can find a therapist by contacting your spouse's doctor for a referral. Or you can talk with your pastor if you attend church. Also, you can search on line at http://therapists.psychologytoday.com/rms/. You can search for a therapist with certain experiences on this site. Although they do not list personality disorders specifically, try the anxiety section of therapists first. They may have more experience with this disorder. And feel free to ask any therapist you contact if they have experience with narcissism. They expect that and should be able to help you find a therapist if they can't help you.There are also some books that will help you. The more you know, the better able you will be to deal with your spouse's behavior. One book is called The Wizard of Oz and Other Narcissists: Coping with the One-Way Relationship in Work, Love, and Family by Eleanor D. Payson. Another is The Object of My Affection Is in My Reflection: Coping with Narcissists by Rokelle Lerner. You can find these on Amazon.com or your local library may have them for yo.
I hope this has helped you,