I’ve been deeply interested in NPD and the possibility of their healing for a while now, because I believe some of them can heal under the right circumstances (they must be both self aware and willing). NPD is usually the result of early trauma, rejection or neglect by one or more caregivers. The narcissist constructs a false self as a stand-in for their real self, which they send into exile. Narcisists were almost always extremely sensitive children who couldn’t find other, less extreme ways, to cope with hurt and rejection. Being exposed as vulnerable is their greatest fear, and they act in abusive or manipulative ways toward others to make sure their false self stays intact. They feed off of other’s emotions for a steady source of “food” to keep their false self alive. They learn to project their own problems and faults onto others, since they cannot tolerate being anything less than perfect. If they suffer a sudden loss of narcissistic supply, their false self atrophies and they are likely to become extremely depressed and anxious. Only then will they consider getting help.
Following is a fictional account of a narcissist, David, who has been in therapy for several years, following his divorce and the loss of his two children to their mother. He is allowed no contact with them, due to his abusive behavior. Following the divorce, he was so depressed by the sudden loss of narcissistic supply that his attendance at work suffered, and he began to become abusive toward his colleagues when he was at work. This led to his firing. Today he is employed, but in a position that pays much less and which has a lot less status than his old job. He struggles financially and although isn’t poor, his living standard is much lower than his previous one. He lives alone in an apartment in town now that his wife won their McMansion in the divorce. He has no hobbies or any real interests. He became so depressed he finally decided to enter therapy.
David is exceptionally bright, and is aware he is a narcissist. He hates it because he knows his narcissism has prevented him from being able to love and accept love from another woman–or from anyone. He is lonely and starved for affection but has difficulty admitting this, even to his therapist. He desperately wants to change, he wants to know what it feels like to really love someone and be able to feel all his emotions, which he knows are hidden behind his tough, emotionless exterior. He is willing to do the work, but there are often setbacks due to his powerful defenses against his own vulnerability.
David was fortunate to find a therapist who is experienced and successful at treating people with Narcissistic Personality Disorder, and who is extremely empathetic. Of all qualities a therapist must have to successfully treat a NPD patient, besides knowledge of this disorder, one must have a great deal of empathy. At the same time they must not enable the NPD patient or give them the supply they so crave. It’s a delicate balance.
It took two years for David’s narcissistic defenses to begin to break down, but they still come out when he is feeling threatened or vulnerable. Until now, whenever his therapist has attempted to connect events in his life with his childhood trauma of being cruelly rejected by his mother at the age of 6, David has deflected attention away from that event by either denying there was any abuse, becoming angry with the therapist, or changing the subject, often with humor and sarcasm. He has threatened to leave therapy when this happens, but never has.
Today was different. David’s therapist wouldn’t allow him to walk out, and took a “tough love” approach, barring him from leaving the session and forcing him to confront his original trauma. Cracks in David’s false self are showing and his true self sometimes peeks through, even though he tries hard to cover the cracks with fake bravado and aggression. What happened next is described in this story.
The story is from my own imagination, but the techniques Maria (the therapist) uses are the same techniques often used on people with Cluster B disorders, C-PTSD and NPD.
Maria (therapist): Hello, David. How was your week?
David (smiling): Oh, it was great! I may be transferred to another division where they’ll give me the responsibility I deserve. I’m really getting fed up with being treated as just another drone because I have so much more experience and intelligence than the rest of the plebians there.
Maria: That’s wonderful! How will you feel if it doesn’t happen?
David: Oh, but it will happen. They wouldn’t dare overlook me for this transfer. I’m the best thing they’ve got and they know it!
Maria: You certainly do have a lot of confidence.
David: Well, why shouldn’t I? They’re lucky to have me. Without me, that company would fall apart.
Maria: I sense some uncertainty…
David (on the defensive): what do you mean?
Maria: I don’t mean you’re not deserving. But I saw a look cross your face. For a moment you looked uncertain and worried.
David: No, I don’t think so. You need to stop reading things into every breath I take, every time I pick my nose or scratch my head. I’m just tired, that’s all.
Maria: It’s my job to read things into your body language and facial expressions. What were you feeling a minute ago?
David (angry): Nothing. I wasn’t feeling anything!
Maria: I see I have angered you. What about what I said made you angry?
David: You therapists are all the same. (mocking tone of voice) “What do you feel? What made you angry? What color is your parachute? What is your heart made of? Green cheese?” You pry and ask ridiculous, irrelevant, annoying questions. No wonder it’s a dying profession. It’s all smoke and mirrors and hocus pocus and not even based on real science. You’re no better than witch doctors.
Maria: Let’s get back to talking about David. Think about this anger. Why is David angry? Who is he really angry with?
David (rolling eyes): God! My mother always asked me those same absurd questions.
Maria: She did? You never told me this before. In fact, you never talk about your mother and when you have, you have never been critical of her.
David: Fine. Alright, fine. My mother…she was a bitch. Alright? Are you satisfied? That’s what all you therapists want to hear. (sarcastic) “Oh, my mother was so terrible, she hurt me so bad! She didn’t love me! Waaaahhh!”
Maria: Tell me about this questioning she did of you. I sense I triggered something.
David: It’s all about you, isn’t it? You therapists think you’re so important, have all the answers. You triggered nothing! You don’t have that much power over me!
Maria: You’re deflecting…I asked you about your mother, not about me.
David (sighs): My mother…alright, fine. My mother never wanted me. She told me I ruined her life, she told me I ruined her plans for a career as a singer. I was an accident. She always told me that.
Maria: I see. I’m sorry she said those things. What about the anger? You said she always asked you why you were angry.
David: Right. I was angry because I knew she was full of shit. I knew her “love” was bullshit. She loved her stupid birds more than me. One time I was so angry I choked one of her stupid birds to death. I didn’t regret it either. I felt no remorse. I do now, sort of. It wasn’t the stupid bird’s fault. But I was so angry at her because she didn’t come to the school play I was starring in and she didn’t get why that made me mad. Those birds always came first with her. Then my dad. Then my sister. Then her friends. Last, me. She hated me. She locked me in a closet for choking her bird. I guess I deserved it, but the way she treated me didn’t stop after that. She punished me for showing any emotion, ever. My anger got on her nerves, she punished me for it. She punished me for being angry, for being sarcastic, for laughing. She punished me when I cried—
Maria: –When you cried?
David (nervous, fidgeting, looking frantically around the room as if looking for an escape): I mean–when I whined or complained…I didn’t cry. Well, not when she could see it anyway.
Maria: All young children cry, David. Her dismissal and disapproval of your feelings must have been very painful for you. It would be natural and normal for you to have tears over that.
David: Listen…I don’t feel well. I have to leave. (Gets up to leave).
Maria gets up and blocks the door, leads David back to his seat. David stares at Maria, dumbfounded but seemingly over his rage.
David (confused): Why did you do that?
Maria: Because you’re paying me to help you get to the bottom of your narcissism, and it means a lot to me to help you do that. I want to help you do that. And I know that’s what you want, otherwise you wouldn’t be here.
David (puffing up): I could sue you for “false imprisonment”–blocking my way out of here.
Maria: Yes, you probably could. But you won’t.
David (challenging): Oh, no? Why wouldn’t I?
Maria: Because you want to feel. You want to love. You want to heal.
David: How do you know what the hell I want?
Maria: Because you told me yourself.
David: And you really think you can help me do that?
Maria: Yes, I do.
(To be continued)
Part 2 will be posted later tonight.