Narcissism: Symptoms, Causes and Treatment

“Idaho Nobility” by Mimi Stuart©

Symptoms of Narcissism

There are degrees of narcissism, ranging from excessive self-importance to full-fledged Narcissistic Personality Disorder (NPD.) For people suffering from NPD, the craving for admiration, status or power is the primary drive in their lives. As a result, they display extreme selfishness, a lack of empathy, and grandiosity.

Narcissists are preoccupied with self-aggrandizement to hone public opinion of their image. They seek power, fame, status, money, or sexual conquests and are often envious of others who have an abundance of these resources. To obtain “narcissistic supply”—adulation, power, fame, etc.—they will exaggerate and misrepresent their talents and accomplishments. Grandiose and arrogant, they demand that others treat them as special or superior.

High-functioning narcissists present themselves well and are socially adept, having worked hard at creating their image. However, in intimate relationships, they frequently display envy, arrogance, entitlement, and cruelty. They protect themselves from criticism, humiliation, and rejection by over-reacting with contempt, outrage, and abuse.

Narcissists use their charm and charisma to attract people into their orbit, but they often end up exploiting them to serve their own needs. Their attitude of superiority and their tendency to blame others for their own misdeeds do not promote mutually-satisfying, long-term loving relationships.

Causes of Narcissism

Healthy narcissism is a stage that very young children need to experience to gain the confidence required to grow up, take care of themselves, and be able to initiate social interactions. Children generally grow out of this phase if they experience adequate mirroring-receiving empathy and approval from one’s caregiver, and idealization—being able to look up to a caregiver as a respected person separate from oneself. If they don’t experience adequate mirroring or idealization, their development may become arrested in the narcissistic stage.

Lack of mirroring occurs in one of the following ways:

1. Approval is erratic or lacking all together. The child is ignored.

2. Admiration is too unrealistic to believe, while realistic feedback is lacking. “You’re the cutest, smartest…”

3. Criticism for bad behavior is excessive. “You are bad, evil, stupid!!”

4. The parents are excessively permissive and overindulge the child, implying a lack of caring. “Sure, have a bowl of candy, more juice, toys, throw your food if you want to, I don’t care.”

Children are deprived of idealization in one of the following ways:

1. The parents are unpredictable, unreliable, or lacking in empathy.

2. The parents are emotionally or physically abusive.

3. The parents have no interest in the child’s needs, but exploit the child to feed their own self-esteem.

When children do not experience mirroring or idealization, their psychological development can be arrested in the narcissistic phase. They do not develop empathy for themselves or others. They feel flawed and unacceptable. They fear rejection and isolation because of their perceived worthlessness.

To cover their feelings of worthlessness, they focus on controlling how others view them by embellishing their image, accomplishments and skills. Their deep shame causes them to develop an artificial self. We all develop an artificial self to some degree, but narcissists identify fully with their artificial self.

They suffer from low self-esteem, although they and those who have fallen under their spell may not believe that they have a problem with self-esteem. People with adequate self-esteem are usually willing to look at themselves with honest self-reflection and consider areas in which they could improve. They have empathy for the flaws and inadequacies in both themselves and others.

Narcissists, however, loathe and conceal their flaws, believing that only perfection and superiority can be displayed. Thus, they view themselves and others with a perspective that swings from over-valuation to repugnance. In their quest for approval and acceptance, they use their charm and charisma. Once dependent on others’ approval, the smallest hint of disapproval can send them into a state of cruel vengeance.

Praise and admiration boost the narcissist’s self-esteem, but only temporarily, because it merely reflects the false self. When faced with criticism or solitude, shadow feelings of worthlessness grow in corresponding proportion to the narcissist’s grandiosity. To fight off this inner doom, the narcissist doubles his or her efforts in pursuit of self glorification. The cycle is never ending and unfulfilling.

Treatments for Narcissism

Narcissists feel ashamed when confronted with a criticism or failure, and may become enraged at the suggestion that they should get treatment. Thus, narcissists are generally not interested in healing. Yet they will seek therapy when they have hit rock bottom or when they are compelled to by the courts or an irate spouse.

There are no known medications to treat narcissistic personality disorder, although there are medications to treat depression and anxiety disorders, which may accompany NPD.

Psychotherapy, or talk therapy, can help a motivated narcissist understand and regulate feelings of distrust, envy, and self-loathing. Generally, psychotherapy, which focuses on strengthening the ego and developing a more realistic self-image, is a long-term endeavor. Cognitive Behavioral Therapy in particular aims at identifying cognitive distortions and false beliefs with more realistic beliefs and replacing harmful behaviors with healthy behaviors.

A new treatment called Cold Therapy has been developed by Sam Vaknin, author of “Malignant Self-love & Narcissism Revisited” and other books about personality disorders. Cold Therapy’s treatment of Narcissistic Personality Disorder, Antisocial Personality Disorders and certain mood disorders is based on two premises: (1) That narcissistic disorders are actually forms of complex post-traumatic conditions, and (2) That narcissists are the outcomes of arrested development and attachment dysfunctions. Consequently, it borrows techniques from child psychology and from treatment modalities used to deal with PTSD.

by Alison Poulsen, PhD

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“My husband is a gossiper. He even has the nerve to gossip about me.”

“Sorcery” by Mimi Stuart ©

“My husband is a gossiper. He gossips about everything and everybody. He even gossips about his daughter to his sister and has the nerve to gossip about me to all of them. I have caught him on the phone doing it. It is sickening.

He did not gossip when we were dating or in the beginning of our marriage. Now everything is out on the table and I’m wondering what is what. How do I handle this without destroying my marriage?”

The Harm in Gossip

While your husband is probably not intentionally trying to hurt you, he is hurting you. Moreover, he has lost your trust and your respect — two of the most crucial components in a long-term loving relationship. Therefore, I think that his perpetual gossiping is a very serious matter and that you should treat it that way.

If it were merely harmless gossip on occasion, then it might not be so bad. After all, everyone has some flaws. But persistent gossip, particularly when it is negative and about private matters concerning you and his own child, is offensive and damaging to your relationship. He doesn’t seem to realize that such gossip simply broadcasts his own insecurity and is only appealing to those who are equally insecure.

You must let him know how seriously this affects you and your relationship. You will be forced to withhold your private thoughts in an effort to protect yourself. As a result, you will become isolated and feel increasingly repelled by him. Under such conditions, the relationship will inevitably whither.

I would take a two-pronged approach including 1) a frank discussion about the matter, and 2) speaking up each time you catch him gossiping in an inappropriate manner.

1. Having a Discussion

Sit down with your husband. Let him know clearly how serious the matter is. Be kind. Start by telling him what you like about him or what initially attracted you to him. Then tell him that you don’t intend to hurt or criticize him, but that you need to tell him how your feelings about him are changing due to his behavior.

For example,

“I am concerned that I am losing my respect and love for you because you gossip so much. When you talk about others and especially about me to others, I feel uncomfortable and repelled. I think you should know that it is causing me to lose my trust in you, the core of our relationship. I don’t want to criticize you and hurt your feelings. I want us to go back to cherishing our relationship and our private life. I am asking you if you are willing to stop gossiping with others. I am telling you this because I need you to know how much it is affecting me, and it is also affecting our relationship.”

If he gets defensive, remain calm and listen to what he has to say. Repeat the above if necessary. If he will not converse, write it down in a compassionate letter. There is also a lot of resource material available online. You might want to share a couple of articles or a video on this topic with him.

2. Responding to specific instances of gossip

Let harmless gossip go unchallenged, it is common. But each time you hear him gossiping inappropriately or maliciously, say something like the following:

“I heard you talking about me (my sister, my father, our daughter) to X, which makes me feel terrible. If you have something you want to talk to me about, please talk to me, but not to anyone else. I want our relationship to be special, appropriate and private. Let’s be a team and avoid bringing other people into our relationship.”

If he continues despite your speaking up over a period of time, then I would let him know that the trust is gone, causing the connection to be broken, and that you want to attend counseling with him in order to try to rescue the relationship.

by Alison Poulsen, PhD

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New Book Announcement:
“Desire & Desirability: Transform the Pursuer/Distancer Dynamic into a Mutual Loving Relationship”

Desire & Desirability
Transform the Pursuer/Distancer Dynamic into a Mutual Loving Relationship

Over the past seven years, I have had the pleasure of responding to many questions and comments from readers of my blog “So what I really meant….” I have been struck by how frequently readers express the value of understanding the Pursuer/Distancer dynamic and the benefit of learning how to overcome it. This inspired me to write this book called “Desire & Desirability.”

Often in a relationship one partner seeks more intimacy than the other. When the Pursuer seeks too much connection or attachment, the Distancer can feel trapped and anxious about losing his or her independence, which may ultimately lead to withdrawal from the relationship leaving the Pursuer heartbroken.

Perfect balance in a relationship is impossible to achieve, yet we can learn to modify our behavior to move toward better symmetry. Real-life examples described in this book illustrate ways to transform your desire based on need into desirability based on fullness. The examples focus primarily on couples in romantic relationships but the principles discussed hold true for all types of relationships including those between friends, co-workers, and parents and children.

It is my hope that understanding the strategies laid out in “Desire & Desirability” will give you the tools to empower you to sustain a more balanced, reciprocal, and fulfilling relationship.

I want to thank my readers for the many thoughtful comments and questions sent over the years that have inspired me to think about relationship and psychological challenges in new and deeper ways.

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Anger: “I have a right to be angry.”

"Kej" from the Mayan Collection by Mimi Stuart ©       Live the Life you Desire

“Kej” from the Mayan Calendar Collection by Mimi Stuart © Live the Life you Desire

Anger as a signal

When you feel anger rising in your belly, your subconscious is generally warning you to pay attention and perhaps to take action in order to avoid potential pain or loss.

Anger can be a powerful emotion. In threatening circumstances, it can be effectively channeled to help defend yourself or others, to command action or to set and maintain boundaries. In many circumstances, however, showing raw anger prevents understanding and perpetuates suffering — yours and others.

Beneath the anger

When you view anger as a signal, then the most effective response is to pause and reflect before taking action. Assessing the emotion and thoughts underlying the anger is generally the best way to plan how to rectify the situation or avoid further injustice.

Often it is helpful to figure out specifically what is underlying the anger. Generally, anger is triggered by fear of immediate loss, pain, or future damage, or by the recognition of an injustice. For example, you might fear being physically or emotionally hurt, or being abandoned or losing someone you love. You might fear financial insecurity or being ridiculed. Anger is also triggered when you see others hurt or treated unfairly.

The other individual

To be most effective, first consider the perspective of the other individual(s) involved even if you don’t agree with their perspective. You can communicate much more effectively if you can find common ground and if you use a solicitous tone of voice and effective choice of words.

For example,

“Perhaps you meant to help…”

“I imagine this promotion means a lot to you…”

“I know economic times are rough…”

“You seem to have a lot going on in your life…”

How to communicate anger effectively

The best communication occurs when people show their vulnerability while remaining self-possessed, in other words, if they don’t give in to the underlying vulnerability and they don’t go ballistic. So, don’t attack, cry, beg or whine. Stay neutral, find common ground, and state your case or make your point.

Here are some examples of bad vs. better communication:

Bad: “How dare you talk to me like that!”

Better: “I know you’re upset, but I feel pushed away when you talk to me like that. Would you explain what you want without raising your voice so much.”

Bad: “How selfish of you not to call until the last minute!”

Better: “I know you’ve got a lot on your plate, but when I didn’t hear from you, I was disappointed and decided to make other plans rather than be angry with you.”

In summary, when you feel anger, don’t become reactive, but do the following:

1. Understand what is motivating your anger, so you can be clear about what you want.

2. Find common ground to keep lines of communication open.

3. Express the feelings of fear or sadness that cause your anger without becoming overwhelmed by fear or sadness.

4. Maintain a calm demeanor, that is, maintain your self-respect and self-control.

5. Make a request, not a demand of the other person, if appropriate.

In certain life-endangering circumstances, however, using the full power of your anger could just be the most effective way to prevent harm.

by Alison Poulsen, PhD

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Random Thoughts from So What I Really Meant

"Wisdom of Laughter" — Einstein by Mimi Stuart © Live the Life you Desire

“Wisdom of Laughter” — Einstein by Mimi Stuart ©
Live the Life you Desire

Passion

Passion is the feeling of exhilaration in the face of mystery. It arises from the heat generated by the intermingling of two people pursuing their own individual passions. So if partners sacrifice their own personal passions, interests, and friends for the sake of their relationship, that relationship will probably lose its passion.

Jealousy

A jealous partner may have experienced abandonment in his or her life and be easily triggered. Getting angry won’t help the situation. Be considerate and reassuring, but don’t start constricting your life to pander to the jealous partner’s fears, if they are unreasonable. Tell the jealous person that the suspicions are hurtful and are causing you to feel defensive and suggest focusing on his or her positive desires instead.

Feeling controlled

Those who are susceptible to being controlled need to stop fearing the other person’s reactions. That doesn’t mean becoming confrontational. You simply cannot let the fear of another person’s anger dictate your willingness to stand up for your values and needs. Calm, candid, honest communication is best to avoid developing a relationship based on fear and resentment.

Perfectionism

There is no reason you can’t have both the desire to excel and the ability to accept and enjoy the moment, which may be less than perfect. Laughter is much better for your health and your relationships than the anxiety of having to control for the perfect outcome. You rarely hear about the perfect dinner party, but an over-spiced, smoke-filled, ridiculously-problematic dinner tale gets a lot of mileage in laughter-filled stories long after the smoke clears.

Stress

Focus primarily on difficulties you can do something about. Taking control requires taking positive steps to deal with challenges, not ignoring the problems, suppressing the stress, or allowing yourself to be consumed by stress.

Taking control includes prioritizing situations in your life, changing your situation, and changing your perspective, and, just as important, relieving the mounting tension in healthy ways such as exercising, relaxing with friends or family, and developing a sense of humor. In cases where you cannot take physical action, you can take action by consciously changing your attitude and the way you think about the situation.

Difficult times

Feelings of fear and worry are important signals meant to get our attention in times of danger. Once we are alerted to difficulties, however, we need to harness fear and worry in favor of our personal power. The most useful powers in times of difficulty include courage, love, and clear thinking.

Experiencing vulnerability, including fear and sadness, is a crucial part of being able to feel empathy and love. However, we should not allow feelings and vulnerability to take over and engulf us in panic. Worry and anxiety are contagious and paralyzing. It is the power of our capabilities, our thinking, our courage, and our optimism that can best handle the inevitable difficulties of life.

by Alison Poulsen, PhD

Watch “Pursuing your passions in relationship.”

Watch “How to Deal with Controlling People.”

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The Path to Managing your Empathy.

“Enlightenment” – Dalai Lama by Mimi Stuart ©

Empathy can be a wonderful trait if you can choose wisely when to be empathetic and to what degree.

When Empathy is Helpful

The ability to sense, imagine, and feel what someone else is feeling allows us to tune into other people’s emotions and to know when someone who is suffering can use some help. That help might involve showing sympathy and warmth, or it might involve making a plan and taking action. Someone whose family member has passed away probably needs warmth, understanding and sympathy, whereas someone who has lost a job or is sick may need help brainstorming job opportunities or help arranging a doctor’s appointment. Communities facing hardship such as hunger or unemployment may need people with money or logistical support.

When practical action or critical thinking is needed, too much empathy can get in the way. (See “Can you have too much empathy?”) If empathy tends to overwhelm you, it is wise to learn how to tune down your empathetic responses in situations where you need to be quick thinking, practical, or ready to take action. People can learn to moderate their immediate responses through awareness and practice.

How People Develop Empathy

We all develop specific traits and response mechanisms as a result of our own specific life experience. Some individuals are the responsible ones, others are funny, accommodating, bossy, or empathetic, etc. People who are very empathetic have often experienced an environment where a keen sensitivity to others’ suffering helped them avoid potential insecurity or danger. Examples include having a volatile or depressed parent that needed appeasing. Empathetic people develop a fine sense in detecting the emotional state of others as well as a strong drive to soothe another’s needs and emotional suffering.

Every personality trait has a good and a bad side. It generally becomes harmful when a person’s tendencies become too strongly ingrained and responses become automatic and impulsive.

Generally in adulthood, we find out how our personality traits may be making life difficult for us or those around us. Someone who is overly empathetic, for instance, may become overwhelmed by sadness or despair for the hardships of others to the point where their life becomes pure anguish. Another danger for the empathetic person is being manipulated by narcissistic or self-serving individuals. Imagine someone who sulks or dramatizes feeling hurt in order to exploit the empathetic person’s desire to ease their suffering. The use of guilt or exaggerated suffering to manipulate another person is a form of emotional fusion, which ultimately leads to misery.

Developing Choice

Often the understanding that empathy can be harmful in certain cases is enough to give you permission to tune down your empathy. When you realize that empathy is not always helpful to others, you will no longer feel driven to dwell on the suffering of others. The goal is not to stop being who you are, but to develop awareness and see all of the choices you have in a given situation.

First, decide whether others will benefit from your empathy, more practical help, or indifference. Sometimes a show of warmth and sympathy is much needed and will be appreciated, but in some situations injecting too much heart-felt emotion can exacerbate the situation, distracting from practical and constructive strategies.

Second, beware of individuals who try to exploit you by calling you “uncaring,” or “cold,” the very labels that are most likely to bother you. They are trying to manipulate you. Beware also of those who want you to suffer when they are suffering. True friends may benefit from your empathy, but they will not want you to suffer.

Third, find a friend who is balanced, that is, not overly empathetic but not unempathetic, to consult when you are unsure of your reactions.

Fourth, when you need to tune down empathetic tendencies, change your focus by using the rational part of your brain. Read, plan, or figure out what specific action you can take. It is difficult to be overwhelmed by emotion when you focus on the specifics, What, Where, When and How. Just try doing a complex math equation to prove the point.

Therapy and Practice

Most people are able to intentionally adapt and adjust their personality depending on any given situation. For example, someone who is generally light-hearted and funny can regulate those traits during a serious business meeting. Military officers can modulate their tendency to use their authority when dealing with family or friends.

Problems only tend to arise when people have trouble tuning down their primary personality traits when it’s appropriate to do so. If you have trouble tuning down your empathy when you want to, “Voice Dialogue” or “Cognitive Behavioral Therapy” can help you learn and practice controlling the amount of empathy you experience and show.

In Voice Dialogue, you learn to access different parts of yourself at will, and thereby develop a stronger “Aware Ego,” which allows you to have better control over your automatic tendencies and behavior. Any particular “self” or personality trait has a whole conglomeration of thoughts, feelings, and physical and behavioral aspects.

A therapist can guide you to embody different parts of yourself at will, and have you practice turning up and down the volume, so to speak, of any particular personality trait. For example, you would embody your empathetic self to 80% and then tune that down to 20%, and then do the same thing with a contrasting trait, such as the action-oriented rational part of yourself. You also learn to mix different parts of yourself, for example, the moderately firm parent with the mildly empathetic parent—a great mix if you want a child to take you seriously without hating you.

Cognitive Behavioral Therapy (CBT) rarely involves actual embodiment of behavior but rather focuses on learning to become aware of your reactions and behavioral patterns. The therapist helps you find effective strategies and coping mechanisms to deal with your ineffective or harmful behavior and thinking.

In essence, both therapies help you to become more sharply aware of your own tendencies and their impact on yourself and others. Dramatic practice then rewires your brain and provides you with the ability to choose how to respond to the world around you, in order to be truly more helpful and lead a more satisfying life.

by Alison Poulsen, PhD

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