therapy guides
How to Advocate for Yourself in Therapy
Therapy can be transformative, but for people with narcissistic traits or those in recovery from NPD, it often starts off frustrating, invalidating, or even retraumatizing. The clinical world is still catching up when it comes to treating narcissistic traits without shame or blame—and many therapists are working from outdated models. That’s why learning to advocate for yourself in therapy is not just important—it’s essential.
Why Advocacy Matters
People with narcissistic traits often enter therapy with a complex mix of deep self-awareness and deep mistrust. You may:
• Fear being pathologized, shamed, or misunderstood
• Downplay or mask symptoms to avoid being “found out”
• Struggle to tolerate vulnerability or rejection
• Be highly sensitive to power dynamics or invalidation
• Know more than your therapist about NPD and its nuances
Advocating for yourself isn’t about being combative. It’s about creating a space where actual progress can happen—without being misdiagnosed, silenced, or forced into a box that doesn’t fit.
People with narcissistic traits often enter therapy with a complex mix of deep self-awareness and deep mistrust. You may:
• Fear being pathologized, shamed, or misunderstood
• Downplay or mask symptoms to avoid being “found out”
• Struggle to tolerate vulnerability or rejection
• Be highly sensitive to power dynamics or invalidation
• Know more than your therapist about NPD and its nuances
Advocating for yourself isn’t about being combative. It’s about creating a space where actual progress can happen—without being misdiagnosed, silenced, or forced into a box that doesn’t fit.
1
Know What You’re Looking For
Step 1: Know What You’re Looking For
Before even starting therapy, get clear on your goals, needs, and non-negotiables. Some examples:
Goals
• “I want to work on emotional regulation and self-perception distortions.”
• “I need support exploring entitlement and empathy issues without being shamed.”
Needs
• A therapist who understands NPD beyond DSM stereotypes
• A balance of structure (skills/tools) and depth (core wounds)
Non-Negotiables
• No blaming language like “you’re just being manipulative”
• Not being treated like a danger or moral failure
Before even starting therapy, get clear on your goals, needs, and non-negotiables. Some examples:
Goals
• “I want to work on emotional regulation and self-perception distortions.”
• “I need support exploring entitlement and empathy issues without being shamed.”
Needs
• A therapist who understands NPD beyond DSM stereotypes
• A balance of structure (skills/tools) and depth (core wounds)
Non-Negotiables
• No blaming language like “you’re just being manipulative”
• Not being treated like a danger or moral failure
2
Interview Your Therapist
Step 2: Interview Your Therapist
Yes, you get to ask the questions. Therapy is a service. You’re allowed to vet them. Ask:
• “What is your experience working with narcissistic traits or personality disorders?”
• “How do you handle clients who struggle with shame or grandiosity?”
• “Are you familiar with Schema Therapy, DBT, or trauma-informed approaches?”
Watch for red flags like:
• Excessive focus on labeling you
• An assumption that narcissistic traits = abusive
• Claims that personality disorders can’t be treated
Yes, you get to ask the questions. Therapy is a service. You’re allowed to vet them. Ask:
• “What is your experience working with narcissistic traits or personality disorders?”
• “How do you handle clients who struggle with shame or grandiosity?”
• “Are you familiar with Schema Therapy, DBT, or trauma-informed approaches?”
Watch for red flags like:
• Excessive focus on labeling you
• An assumption that narcissistic traits = abusive
• Claims that personality disorders can’t be treated
3
Clarify Your Boundaries and Preferences
Step 3: Clarify Your Boundaries and Preferences
This might feel awkward at first, but it’s worth it. You can say things like:
• “I need direct feedback, but not in a shaming way.”
• “Please ask before interpreting my motives—sometimes it feels invasive.”
• “I tend to intellectualize. I want help getting to the emotional layer without being forced.”
Advocating like this isn’t “being difficult”—it’s modeling the self-awareness and boundaries that recovery is all about.
This might feel awkward at first, but it’s worth it. You can say things like:
• “I need direct feedback, but not in a shaming way.”
• “Please ask before interpreting my motives—sometimes it feels invasive.”
• “I tend to intellectualize. I want help getting to the emotional layer without being forced.”
Advocating like this isn’t “being difficult”—it’s modeling the self-awareness and boundaries that recovery is all about.
4
Re-Evaluate Regularly
Step 4: Re-Evaluate Regularly
Not every therapist is a good fit—and that’s not a failure. You’re allowed to outgrow your therapist. Signs you may need to re-evaluate:
• You feel infantilized or pathologized after sessions
• You start masking more instead of less
• They avoid talking about narcissistic traits or only view them as abuse-related
• You’re making no progress and feel stuck
Not every therapist is a good fit—and that’s not a failure. You’re allowed to outgrow your therapist. Signs you may need to re-evaluate:
• You feel infantilized or pathologized after sessions
• You start masking more instead of less
• They avoid talking about narcissistic traits or only view them as abuse-related
• You’re making no progress and feel stuck
5
Use Written Advocacy if You Freeze in Person
Step 5: Use Written Advocacy if You Freeze in Person
If direct confrontation makes you shut down, use writing. Draft an email or bring a written note to session. You can say:
“I’m struggling to feel understood when we talk about shame and self-worth. I have a lot of fear around being judged or dismissed. I want to work on this, but I need to know we’re on the same page.”
You can even bring this page with you.
Remember: Self-Advocacy Is the Work
For people with narcissistic traits, advocating for your needs is one of the most vulnerable—and healing—things you can do. It’s not selfish. It’s not arrogant. It’s practice.
You’re showing up for yourself in the exact place where the old story says you don’t deserve to. And that’s how change starts.
If direct confrontation makes you shut down, use writing. Draft an email or bring a written note to session. You can say:
“I’m struggling to feel understood when we talk about shame and self-worth. I have a lot of fear around being judged or dismissed. I want to work on this, but I need to know we’re on the same page.”
You can even bring this page with you.
Remember: Self-Advocacy Is the Work
For people with narcissistic traits, advocating for your needs is one of the most vulnerable—and healing—things you can do. It’s not selfish. It’s not arrogant. It’s practice.
You’re showing up for yourself in the exact place where the old story says you don’t deserve to. And that’s how change starts.
Finding a good therapist is not about finding someone who “fixes” you. It’s about finding someone who sees the whole picture — the defenses and the longing underneath them — and stays with you while you figure out what healing actually looks like.
