There’s a particular kind of confusion that can show up in a relationship sometimes. Maybe it’s the way one partner always seems right. Maybe it’s how small the other feels after even the simplest disagreement. Or maybe it’s the growing feeling that the love you share has started to feel more like strategy than safety. 

The therapists at GGPA in Los Angeles sometimes see these moments of emotional imbalance leading people to quietly (or loudly) ask themselves: Is my partner a narcissist? And would therapy even help if they are? 

These are not easy questions. The internet may be flooded with one-size-fits-all answers and lists of ‘red flags,’ but real relationships are more layered than that. And when narcissism is involved, those layers get even harder to name, let alone repair. 

In everyday conversation, “narcissist” gets thrown around easily – often used to describe someone who’s self-centered, controlling, or just a bit too into themselves. But in the therapy world, narcissism isn’t a blanket term. It exists on a spectrum, and understanding that difference is key, especially when you’re considering couples therapy. 

Healthy, or adaptive, narcissism is something most people carry. It’s what allows someone to believe in themselves, set boundaries, and take pride in their accomplishments without diminishing others. A person with adaptive narcissism can celebrate their strengths and show care for someone else’s needs. 

By contrast, pathological narcissism is more rigid and disconnected. It often involves inflated self-esteem that masks insecurity, a deep need for control or admiration, and, most notably, a consistent lack of empathy. There’s often a sense of entitlement and little interest in mutual care. 

This distinction matters, especially in a therapy setting. While one type of narcissism can strengthen relationships, the other can quietly erode them from within. 

It’s a common hope that with the right therapist, the right tools, or the right timing, a relationship can find its way back to balance. But when a partner shows traits of pathological narcissism, the path to therapy often looks very different. 

And when they do, it’s rarely about growth. It’s usually more about managing their image, reducing stress, or controlling outcomes. There’s often a sense that they believe they already know themselves fully, and the therapist is simply there to help them fine-tune the world around them. 

These clients might not show up seeking feedback. Instead, they come to reinforce their own narrative, leaving little room for relational insight or emotional accountability. 

Still, not all hope is lost. There are moments when a narcissistic partner may become open to reflection, often after significant relationship breakdowns. But lasting change takes more than one session or a single breakthrough. It requires humility, safety, and often, an entirely separate space for individual work. These can be difficult for a pathological narcissist to engage with. 

Couples therapy needs to be a safe place: a space where both partners can be heard, where conflict is untangled with the help of a neutral guide (the therapist). But when one partner exhibits traits of pathological narcissism, that very space can become unsafe. 

In narcissistic abuse dynamics, what looks like conflict on the surface is often part of a deeper pattern – one where manipulation, gaslighting, and control shape the relationship. In these cases, bringing both partners into the same therapy room may not level the playing field. Instead, it can tilt the power dynamic even further in the narcissistic partner’s favor. And empirical research regularly backs up these clinical findings. 

In these moments, therapy becomes less about communication skills or compromise, and more about harm reduction. And sometimes, that means saying no to joint therapy for now, and instead pursuing individual therapy. 

When this is the case, Grazel recommends that the non-narcissistic partner begin with individual therapy. Not because they’re the problem, but because it gives them a protected space to explore what’s happening, build internal clarity, and decide what kind of support they really need. 

And that processing matters. For someone in a harmful dynamic, just being asked “How are you doing, really?” without someone else in the room to overrule the answer can begin to shift things and began to build resilience. 

Individual therapy can help untangle what’s real from what’s been distorted. It can help rebuild self-trust. And it can prepare someone to make informed choices about whether, and how, they want to continue in the relationship. 

This is often the question the non-narcissistic partner will carry quietly. Is there hope? Can things change if they really want to? 

The short answer is yes, change is possible. Long-term therapy that includes empathy training and accountability frameworks shows measurable reduction in narcissistic traits over time. But it doesn’t happen easily, and it rarely happens because someone else asked for it. For individuals with pathological narcissism, the desire to change usually emerges later in life, often after patterns repeat and relationships end with a lingering sense of emptiness, when the weight of evidence points to them needing to change somehow, rather than the world around them. 

Even a small crack in defensiveness, a moment of softness or curiosity, can be a starting point. But that moment has to be real, not performed. And it has to be met with skilled support. 

Realizing that something feels off in your relationship can be overwhelming, especially when you’re not quite sure what to call it. Maybe your partner isn’t yelling or throwing things. Maybe they’re charming to others, generous even. But behind closed doors, you feel erased, blamed, or emotionally starved. 

If you’re wondering whether your partner might be narcissistic, you don’t need a clinical diagnosis to justify your hurt. 

Relationships shaped by narcissistic traits can leave people second-guessing themselves long after the conversations end. Even in therapy, it can be hard to find your footing, especially if the person across from you seems confident, composed, and certain they have nothing to work on. 

But therapy isn’t just about sitting in a room together. It’s about emotional safety, honest reflection, and the capacity for both people to show up with vulnerability. When that’s not possible, when one partner feels dismissed or harmed, therapy needs to look different. 

GGPA’s approach to Los Angeles couples therapy centers on that safety. Sometimes, that means helping one partner begin individual therapy first. Sometimes, it means waiting until both people are genuinely ready to do the work. And sometimes, it means acknowledging that the healthiest next step might not be couples therapy at all. 

This isn’t about blaming or diagnosing. It’s about giving each person the space to ask: What am I experiencing? and What do I need to feel okay again?