Because attending therapy is an implicit admission of imperfections, it is unusual for narcissistic persons to initiate therapy themselves. When they do, it is usually because their narcissistic sense of superiority has been compromised through events such as divorce or loss of employment. Interpersonally, they are likely to remain aloof and often be competitive with the therapist. They might question how someone who is less talented than they are could possibly be of assistance. Alternatively, they might elevate and inflate the status of the therapist because their association with someone who is so accomplished can be used to bolster their own sense of self-esteem. The easiest tactic for returning them to their previous level of functioning is to encourage and support them in recounting their previous successes and achievements. However, this may do them a disservice in the end because they will not learn new strategies of coping and relating. A particularly useful technique might be cognitive reorientation, in which they are helped to challenge the need to be perfect and desensitized to criticism. Group and family therapy might support them in achieving more realistic and adaptive interpersonal skills. Given that they are likely to deny imperfections and resist change, either paradoxical interventions or approaches that use nondirective or self-directed techniques are likely to produce the best outcomes.