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Dr. Keane
Dr. Keane, Therapist
Category: Mental Health
Satisfied Customers: 1319
Experience:  Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
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My 17 yr old son has displayed almost all the characteristics

Customer Question

My 17 yr old son has displayed almost all the characteristics of being narcissistic. He refuses medical treatment, disdains mental health and refuses to participate informing me that only "crazy" people go to therapy. Is there a way that I can possibly get through to him and help him work out issues he doesn't even acknowledge are there?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Dr. Z :

Hello

Dr. Z :

I believe I can help you with your concern today

Dr. Z :

I am so sorry for this difficulty with your son, I can understand how distressed you are right now

Customer :

Thank you

Dr. Z :

If your son does display traits of Narcissistic Personality Disorder (NPD) then it is extremely difficult for him to want to go to therapy as most individuals with NPD feel that there is nothing wrong with them and that everyone else is wrong. The best form of treatment for this personality disorder is called Cognitive Behavioral Therapy (CBT), but even with intensive treatment (usually lasting 1-3 years) the success rate is still not positive or optimistic

Dr. Z :

Now because he is a minor, there is a possibility that you can compel him to go to therapy by using ultimatums and forcing him there, but again he may not respond positively to therapy unfortunately

Customer :

Is there anything that can be done? He used to be such a sweet young man and a blessing to be around. Now his sisters (younger) and his brother (older) dislike him, don't want to be around him.

Dr. Z :

This is one of the most difficult personality disorders to treat successfully and I am a Forensic Psychologist, so I actually see and treat this disorder more often than the average therapist, so believe me when I say it will take a lot of effort to try to get him help.

Customer :

He has gone to therapy several times, he refuses to speak during these sessions. The only thing he seems to care about is his "friends at school" and I have never met them. They have never come over and he has never gone out with them.

Customer :

do people with these types of behaviors usually change from sweet to this in a matter of weeks?

Dr. Z :

Well you can try family therapy where you speak about him and this will compel him to talk in defense of himself, that would be one option

Customer :

I spoke to a family counselor and she informed me that because we have had family meetings where we were all airing out issues with everyone and he didn't seem to care or change his behavior in the least, that she would probably not be able to help us.

Dr. Z :

It is not typical to change that rapidly to NPD, so most likely he is projecting narcissistic traits as a defense mechanism to mask something, most commonly low self-esteem or low sense of self-worth

Dr. Z :

Well the family counselor may be correct, individuals with NPD need to be motivated to want to change, but this is very difficult as they do not see anything wrong with how they are behaving

Dr. Z :

Also individuals with NPD are very under represented because they frequently do not seek therapy at all

Dr. Z :

I would like to recommend these books for you that may be able to help shed light on this disorder if you would like

Dr. Z :

But ultimately there is not much that can be done for your son if he is not willing to seek out therapy as he cannot truly be forced to comply with it

Dr. Z :

Do you have any questions or concerns at all? I know this is difficult to hear about your son, but it is the most accurate advice based on current research of this disorder

Dr. Z :

I see that you are offline right now, but when you get back online I would be very interested in continuing this discussion with you and talking about anything further you would like to share regarding your concern, so if you respond in the chat box I will be able to get back to you as soon as possible.

Dr. Z :

I also wanted to mention a unique approach to therapy to help individuals with similar disorders and traits, which is called Wilderness Therapy. This is an adventure based therapy where usually adolescents and young adults must learn to be cooperative and work as a team to help achieve certain goals. This type of therapy is meant to teach empathy, trust, communication skills, and also acknowledgement of other's emotions. It is primarily for disruptive children with conduct disorders and Antisocial Personality Disorders (ASPD), but research has shown that it is effective for young adults with traits of NPD

Dr. Z :

So that can be something that may be a good approach for your son who has been so resistant to therapy

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Dr. Keane
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Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.