Many people with NPD don't seek out mental health treatment. Some might not recognize their negative traits and behaviors. Others might feel criticized or judged in therapy. Still, people with NPD can benefit from psychotherapy, including family counseling, support groups, one-on-one treatment, and couples’ counseling. In talk therapy, people with NPD can improve their relationships, build self-esteem, learn to set more realistic goals and expectations, and work through past traumas.