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Couples Therapy For Narcissistic Abuse: When Is It a Bad Idea? | Chicago Narcissism Therapist Explains

Couple sits on a mustard sofa talking to a person with a notebook. Plant and table in the background. Calm, neutral setting.

Couples Therapy for Narcissistic Abuse: A Complex Consideration & Dilemma


You might really want your relationship to work, even if your partner seems narcissistic. I get it—I really do. I've even been there myself. Even though you recognize the signs of narcissistic abuse, you might remember a time when things weren’t so bad. You actually might remember a time when things seemed pretty great. Most people in narcissistic relationships, at some point, will ask themselves these questions: Could couples therapy help us? Maybe more specialized therapy might help me understand how to better manage this dynamic? Could we repair things if we just had better communication or relationship tools?


Hoping is not a crime. The problem is, it can hold you back from the reality of your situation. The truth is that in the vast majority of cases, couples therapy is a bad idea when narcissistic abuse is present. And not only is it a bad idea, it’s a very bad idea and can actually make things much, much worse. But don’t stop reading here—there are exceptions to this rule, and while they are rare, it’s important to consider certain key details.


As a therapist specializing in narcissistic abuse recovery and narcissistic personality treatment here in Chicago, I’ve seen how couples therapy can cause more harm than good if not carried out with extreme caution. That said, I have also helped a handful of couples reduce the levels of antagonism in their relationships when separating was not an option (and it’s important to remember that leaving is NOT always an option for everyone). 


This blog post will explore:


  • Why couples therapy is usually contraindicated in narcissistic abuse cases


  • How couples therapy can become a playground for more antagonism 


  • The rare situations where couples therapy might be beneficial


  • How some manifestations of lighter narcissistic traits differ from full blown narcissistic personality disorder (NPD)


  • How attachment patterns/backwards attachment learnings can complicate this work


  • What truly trauma-informed, ethical therapists will consider before proceeding with couples therapy for narcissistic abuse 



*Disclaimer: I am not suggesting that couples therapy is appropriate in all situations involving narcissistic abuse. Rather, this post is meant to support informed, harm-reducing choices for those who are already considering this option and to encourage a level of clinical care that fully acknowledges the risks and complexities involved.



Why Couples Therapy Is a Bad Idea Probably 99% of the Time


It’s important to understand that narcissistic abuse is not a communication problem, and it’s also not just a “toxic” or classically difficult relationship. It’s a much more pervasive pattern of overt/covert antagonism, coercive control, manipulation, gaslighting, blame-shifting, invalidation, and idealization/devaluation. 


In couples therapy, narcissistic partners often:


  • Manipulate the therapist to appear reasonable or even charming while undermining the survivor


  • Attempt to dominate the space (or even scare the therapist) if they find that they can’t manipulate the therapist


  • Use the therapy space to further gaslight, belittle, or control their partner


  • Shift blame, complicate the dynamic further, and avoid accountability


  • Perform for the therapist to create confusion about what is really happening behind closed doors


Even HIGHLY trained, HIGHLY skilled couples therapists can struggle to manage or understand these dynamics if they do not have a thorough background in narcissism and severe antagonistic relational patterns. For survivors, the risk is significant: couples therapy can re-traumatize them, worsen trauma bonds, make them feel more helpless/misunderstood, and/or create a false sense of hope that meaningful change is happening or possible when it is not.



Narcissistic Traits vs. Narcissistic Personality Disorder


It is only fair to mention that not everyone with narcissistic tendencies is abusive or incapable of change. Some people develop a tendency towards narcissistic behaviors after being raised by narcissistic or emotionally neglectful caregivers or after being in a long-term, abusive relationship. These learned behaviors are not always quite as fixed as a personality style or stable temperament.


These traits can include:


  • Difficulty tolerating vulnerability or intimacy


  • Defensiveness when rejection or potential for pain is perceived 


  • A limited ability to hold or explore perspectives that feel “too different”


  • Hyper-focus on image and judgment


  • Intermittent empathy, dependent on mood or context


Key developmental periods avoided, it is possible to adopt narcissistic traits without them sinking in too deeply. When narcissistic traits arise solely from a later period of relational trauma (like living with a narcissistic person for a number of years & learning to “fight dirty” to match their tone), they can shift slightly over time with:


  • Insight-oriented, trauma-informed individual therapy


  • A genuine and persistent willingness to do deeper personal work


  • Openness to relational therapy (building a healthy relationship with their therapist)


  • Accountability and behavioral changes


By contrast, Narcissistic Personality Disorder (NPD) involves a much more rigid, pervasive pattern of entitlement, exploitativeness, issues accessing empathy, and deeply ingrained superiority or victim narratives. In cases of full-blown NPD with active abuse, couples therapy is both ineffective and dangerous. 



When Might Couples Therapy Help (Rare Cases)?


There are rare cases where couples therapy can support healthier relational dynamics when narcissistic tendencies are present in one or both clients, but treatment is only appropriate under very specific conditions.


Couples therapy may be cautiously considered when:


  • The narcissistic partner is already in consistent individual therapy with a narcissism-competent therapist and intends to stay there long term


  • They demonstrate genuine, measurable progress in accountability, empathy, distress tolerance, and emotional regulation


  • The more narcissistic partner continuously displays efforts at true cooperation


  • There is a clear willingness to explore attachment wounds and relational patterns without weaponizing the process


  • The couples therapist is highly trained in working with narcissism and complex trauma


  • Both partners have adequate individual support outside of their couple's work


  • A thorough safety plan is created individually with the narcissistic client’s partner



In these situations, couples therapy can:


  • Help both partners better understand relational patterns and skills 


  • Encourage vulnerability in healthy doses 


  • Help the non-narcissistic partner identify when to walk away


  • Support healthy boundary-setting (when applicable…boundaries do not typically work with very narcissistic folks)


  • Address attachment dynamics in a more contained, skillful way


Please keep in mind: these cases are the exception and not the rule.



Damaging Narcissistic Behaviors vs. Emerging Defense Mechanisms


It’s also important to understand that not every relationship involving intense conflict is a case of narcissistic abuse. Sometimes, couples get stuck in high-conflict, emotionally immature patterns/cycles where both partners:


  • Fight dirty and fight to be “right”


  • Struggle to tolerate vulnerability or repair that requires deeper discussions


  • Engage in significant defensiveness, blaming, or avoidance


These behaviors can feel extremely painful and mind-boggling, but they don’t always reflect an intentional pattern of abuse driven by narcissistic entitlement or exploitation. In some cases, what looks like narcissism may actually stem from:


  • Unresolved attachment wounds or attachment trauma


  • Defense mechanisms (learned behaviors from family dynamics or past relationships)


  • Inability to regulate shame, fear, or distress


When this is the case, and when both partners are willing to do their own individual work, therapy can sometimes help to shift or soften these patterns. However, if one partner shows consistent patterns of belittling, cruelty, betrayal, gaslighting, exploitation, calculated manipulation, and a lack of empathy, that then crosses the line into truly damaging narcissistic behavior. Again, couples therapy is unlikely to be safe or effective in these cases.



Couples Therapy for Antagonistic Relationships: Harm Reduction


In some relationships, often where separation is not currently an option due to:


  • Children/pregnancy


  • Financial constraints


  • Religious beliefs


  • Cultural pressures


...trauma-informed couples therapy can be used for harm reduction (in appropriate cases where infrequent narcissistic behaviors are mild to moderate and where clients intend to seek couples therapy elsewhere, regardless of warnings).


In these cases, the goal is not necessarily “relationship repair” or reconciliation, but rather:


  • Minimizing overt harm


  • Educating


  • Increasing clarity around boundaries


  • Reducing cycles of escalation


  • Supporting the survivor in recognizing relational realities


Again, this type of work should only be undertaken by therapists who deeply understand:


  • Gaslighting and reality distortion


  • Trauma bonding


  • Antagonistic dynamics


  • Coercive control


  • Intermittent reinforcement


  • The unique needs of abuse survivors


Without specialized training, couples therapists often risk doing more harm than good.



How Attachment Patterns Can Complicate Couples Therapy


Many survivors of narcissistic abuse carry attachment wounds that make them vulnerable to:


  • Self-blame


  • Overfunctioning in the relationship


  • Considerable hope that the partner will finally change (one of these days...)


  • Difficulty tolerating the idea of separating or leaving


At the same time, narcissistic or antagonistic partners often have fearful/dismissive avoidant attachment styles that fuel:


  • Emotional withdrawal


  • Punitive behaviors


  • Intimacy-phobia masked by control


These patterns can create a highly volatile couples therapy dynamic if not carefully managed. Again, attachment-based therapy can be helpful only when:


  • Both parties are very engaged in meaningful individual work


  • The couples therapist is skilled in managing complex trauma and attachment injuries


  • There is strong therapeutic containment to prevent reenactment in the therapy room



What Ethical, Trauma-Informed Therapists Will Do


A therapist competent in narcissistic abuse dynamics and antagonistic relationships will:


  • Screen VERY, VERY carefully before agreeing to couples therapy (VERY!)


  • Conduct thorough individual assessments of both partners


  • Evaluate for safety, gaslighting, and any active abuse


  • Set VERY clear boundaries around what will and will not be tolerated in sessions


  • Interrupt when a narcissistic client begins being manipulative


  • Stop the couple's work immediately if it becomes unsafe or re-traumatizing (and offer individual resources for both clients)


  • Prioritize survivor empowerment and clarity, not simply prioritize “saving the relationship”


Couples therapy should never become a playground for further abuse or distortion. An ethical therapist will name this dynamic clearly and take protective actions immediately if needed.



Why I Take a Harm Reduction Approach to Couples Therapy in These Situations


I’m very well aware that some people believe couples therapy for narcissistic abuse is unethical and that no narcissistic person can ever change. I can mostly respect these perspectives and understand why they exist. The risks are real, and many survivors have been harmed by inappropriate or poorly handled couples therapy. While I believe some clients with narcissistic tendencies are absolutely capable of change, I do my best to not encourage hope where there isn't any.


That said, the reality is that many couples impacted by narcissistic traits will seek couples therapy anyway. And if they land in the office of a generalist therapist who doesn’t understand antagonistic relationships, narcissism, and the effects of antagonistic relational stress, the results can be devastating.


Offering some amount of couples therapy to select, screened couples is harm reduction, not unlike providing condoms to teenagers. The goal isn’t to promote a particular outcome, but to acknowledge reality: some couples will pursue therapy anyway, and it’s better they do so with a specialist who can help minimize harm rather than with a generalist unaware of the risks.


Again, this is why I approach this work from this harm reduction framework and view it through a harm reduction lens. I do not believe that couples therapy should be used to "save" abusive relationships. I do believe that, in very carefully selected cases (and with the right clinical containment), couples therapy can help:


  • Prevent further harm


  • Support clearer boundaries


  • Offer important education


  • Reduce volatility


  • Clarify relational reality for both partners


Someone needs to be available to provide this kind of informed, transparent care because the alternative is leaving vulnerable couples to therapy spaces that do not acknowledge or address the complex dynamics at play.


For certain survivors, couples therapy also serves as a pivotal part of the reality-testing and grounding process. The therapeutic space can reveal patterns that are hard to fully grasp (or face) in private, and sometimes, the experience of seeing these horrifying dynamics unfold in front of a neutral party helps a survivor come to terms with the need to step away from the relationship. Self-determination is often imperative in these cases or survivors will return to the relationship (if pushed to leave before they are ready).


Final Thoughts: Choose Couples Therapy Cautiously In These Situations


If you’re navigating a relationship impacted by narcissistic behaviors, it’s essential to proceed with great care and caution. Yes, couples therapy is usually contraindicated and can be dangerous in these situations. If couples therapy is being considered, both partners should be engaged in ongoing, meaningful individual work, and the chosen therapist should have deep specialization in narcissistic abuse and relational trauma.


For many survivors, individual therapy is the safest and most effective first step. It provides the space to:


  • Process trauma & build self-trust


  • Learn about narcissism


  • Clarify what you truly want and need (values exploration)


  • Heal attachment wounds


  • Build internal strength before making major decisions


If you’re unsure whether couples therapy is appropriate in your situation, I encourage you to seek consultation with a therapist who understands narcissistic abuse inside and out.


At Two Lights Therapy, I offer individual therapy for narcissistic abuse recovery and consultation for clients and professionals navigating these complex dynamics. Virtual couples therapy for narcissistic abuse in Chicago may be available at my practice. If you’d like to explore what safe and effective therapy might look like for you, I welcome you to reach out by emailing: hello@twolightstherapy.com or by visiting: https://www.twolightstherapy.com/contact 



Virtual Couples Therapy for Narcissistic Abuse in Chicago, IL


If you’re looking for support, you can learn more about my Narcissistic Abuse Recovery services in Chicago:






Related Blogs on Narcissistic Abuse:







Two Lights Therapy Center PLLC | Chicago, Illinois.

Narcissistic Abuse Recovery Therapy


Please Note: The information provided in these blog posts is for informational and educational purposes only. It is not intended to be a substitute for professional therapy or therapeutic services. While licensed psychotherapists write these blogs, readers should not use this content as a replacement for individualized advice or treatment. If you are experiencing a crisis or need immediate assistance, please call 911 or contact other emergency services in your area. 


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