The question of whether a narcissist can be treated and improve through therapy is a complex one. It requires an understanding of what narcissism is, the different types of narcissism, and the various therapeutic approaches available.

Narcissistic Personality Disorder (NPD) is a mental condition characterized by an inflated sense of self-importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others. However, behind this mask of extreme confidence lies a fragile self-esteem that's vulnerable to the slightest criticism.

The first thing to note is that narcissism exists on a spectrum. On one end, you have healthy narcissism, which is a normal level of self-confidence and self-esteem. On the other end, you have malignant narcissism, which includes antisocial behavior, paranoia, and aggression. In between these two extremes are various degrees of narcissistic traits.

Now, can therapy help? The answer is yes and no.

Yes, because therapy can provide tools and strategies to manage some aspects of narcissistic behavior. Cognitive Behavioral Therapy (CBT), for instance, can help individuals recognize harmful patterns of thought and behavior. It can teach them how to replace these with healthier ones. Dialectical Behavior Therapy (DBT) can also be beneficial in helping individuals manage their emotions better and improve their relationships.

However, it's important to note that therapy cannot 'cure' NPD in the same way antibiotics can cure an infection. Narcissism is deeply ingrained in an individual's personality structure; it's not just a set of behaviors but a way of seeing and interacting with the world.

The 'no' part comes from the fact that many individuals with NPD do not seek treatment or do not believe they need treatment because they do not see their behavior as problematic. This lack of insight or unwillingness to change can make therapy challenging.

Moreover, even when individuals with NPD do seek therapy, they often have a hard time accepting feedback, which is a crucial part of the therapeutic process. They may also manipulate the therapist or use the therapy sessions to seek admiration or validation, rather than to work on changing their behavior.

In conclusion, while therapy can potentially help individuals manage some aspects of narcissistic behavior, it is not a cure-all solution. The effectiveness of therapy largely depends on the individual's willingness to change and their ability to engage in the therapeutic process. It's also important to remember that therapy is not a quick fix; it requires time, patience, and commitment.

Lastly, if you or someone you know is dealing with narcissistic behavior, it's crucial to seek help from a mental health professional who has experience in this area. They can provide guidance and support throughout the process.