Re: Narcissiscm is a destructive personality disorder.
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For those individuals who suffer organic disorders, it is, indeed, NOT a choice! However, the narcissists that I have known are well aware that their behavior choices are damaging to themselves, and others, hence the denial of any accountability and the extensive measures that they take to hide or refute any wrongdoing. To my understanding, narcissism is not an "organic" disorder - it is a learned behavior, almost exclusively from a narcissistic parent.
We can use the same sort of platform for the alcoholic who, for all intents and purposes, is now being broadly diagnosed by the psychiatric/psychological community as being bipolar. It is the choice of the alcoholic as to whether he/she will take a drink, regardless of the impulse or compulsion. And, bipolar disorder is an organic disorder with genetic links that can be managed with different techniques, along with medications, though I feel that any medication should be a short-term solution, only, and not the basis of management.
There is no known medication to address narcissism - it is a learned behavior and only individuals who are willing to recognize the damage that their choices inflict will find healing.