People like Ms S can be frustrating and annoying to be around: a lot of us would categorise them as “difficult people”. This challenging group usually falls into a cluster of mental disorders called personality disorders. Ms S had a type of personality disorder called Narcissistic Personality Disorder.

Is narcissistic personality disorder the same as narcissism?

The narcissistic personality was first described in 1925 by Robert Waelder, a noted Austrian psychoanalyst, and the term Narcissistic Personality Disorder [NPD] came into use in 1968. The term Narcissism originates from Greek Mythology: a hunter named Narcissus known for his beauty, fell in love with his own reflection and was so mesmerised by it that he became rooted to the spot. Soon, unable to bear this unrequited love, Narcissus lost his will to live and committed suicide.

Narcissism essentially refers to a set of traits where there is pursuit of gratification or egotistic admiration of one’s idealised self-image and attributes. It was also at one time called megalomania—people who are arrogant, self-centred and manipulative. However, people with Narcissistic Personality Disorder are not in the truest sense narcissists. While their external behaviour may resemble the qualities of narcissism [grandiosity, exploitation, arrogance] internally they are people with self-esteem issues, with a tendency to be shame-sensitive, vulnerable, inhibited and anxiety-prone [Gabbard, 1989]. The external superior behaviour is frequently just an armor [or even a fragile shell] that covers an extremely vulnerable self.

The Diagnostic and Statistical manual [DSM-5] indicates that persons with narcissistic personality disorders usually display some or all the following symptoms, typically without the commensurate qualities or accomplishments

1. Grandiosity with expectations of superior treatment from other people
2. Fixated on fantasies of power, success, intelligence, attractiveness, etc.
3. Self-perception of being unique, superior, and associated with high-status people and institutions
4. Needing continual admiration from others
5. Sense of entitlement to special treatment and to obedience from others
6. Exploitative of others to achieve personal gain
7. Unwilling to empathise with the feelings, wishes, and needs of other people
8. Intensely envious of others, and the belief that others are equally envious of them
9. Pompous and arrogant demeanour.

How does NPD develop?

People with narcissism may have a naturally strong bent toward competitiveness. The meaning children make out of their childhood experiences—especially overtly traumatic events or very negative and chronic experiences—may increase the expression of these inherited tendencies. Research finds that narcissistic personality disorder has higher prevalence among men and roughly occurs in 6% of the general population. NPD symptoms usually decrease with age, around the 40s, like most personality disorders.

There are two subtypes of NPD [Gabbard, 1989; Caligor et al 2015] recognised in the clinical setting. The grandiose [overt] tend more toward displays of self-importance, grandiosity, attention seeking, entitlement, arrogance, fantasies of admiration, denial of weakness, and exploitative behaviour. The vulnerable [covert] are more likely to be shy, self-effacing, “fragile” or thin-skinned. They are hypersensitive to the evaluations of others while chronically envious and evaluating themselves in relation to others. It is theorized that the subtypes develop because of the different approaches of earlier caregivers: overly indulgent with extravagant praise versus cold with excessive expectations. Both types are extraordinarily self-absorbed.

The narcissistic beliefs about the Self

It is important to note that the traits of narcissism can also characterise highly successful individuals with high self-esteem [American psychiatric association, 2000]. However, people with high self-esteem are confident of their personal worth because their esteem is based on realistic self-appraisals of demonstrated talents and achievements. Corrective feedback does not trigger a dramatic loss of self-esteem. For the person with NPD, self-esteem is established by outward success and they remain firmly rooted in the importance of a flawless or powerful image, like Narcissus remained rooted to the spot while admiring his reflection. Without a flawless image, core beliefs of inferiority become activated.

People with NPD thus swing between two extreme internal views of self. When others are disregarding or critical, their internal dialogue is “I am inferior, nothing, a piece of garbage”. On the other hand, when receiving accolades or special treatment they swing the other way believing “I am superior”. In a similar fashion, they view the world also with disdain [people are more inferior than me] and swing the other way when others gain success [people are superior, hurtful, demeaning].

Soon there is erosion of their functional world—their success becomes dotted with evidence of difficulties in the workplace, inappropriate anger, exploitation of others [e.g., deceit, sexual harassment], legal difficulties, and financial problems resulting from grandiosity and entitlement.

Dealing with a person who has NPD

Recovery for people with NPD is usually difficult as they bring to therapy the same strategies that they use to cope with the outside world- trying to impress the therapist, punishing the therapist when feeling slighted [through criticism, snide remarks], demanding entitlements and treating the therapist as an inferior. Creating an alliance with the NPD patient requires special skill because the main internal relationship pattern [dyad] embedded in the patient’s mind is that of a superior person in relation to an inferior one.

As a therapist, I learnt the following mantras when communicating with people diagnosed with NPD. Some of these may be useful to you when dealing with a loved one who has NPD:

Develop a thick skin

I typically ignore slights and put-downs and use either respect or humour to manage the attack. A client with NPD, came in early to his first session and examined every certificate in my waiting room. He then picked one of my award trophies, carried it to the therapy room and sneered “Are you sure you didn’t buy this for 1000 bucks at a store? Just kidding doc”. My response [grinning] “Let’s make sure the organisers of that award don’t hear that”

Lay limits without judgment

I adopt a strategy of firmness with politeness when setting limits with NPD clients [which is usually quite often]. Eg: Speaking loudly on their phone in the waiting area is managed with a “Hope the sign was visible outside stating silence in the waiting area as it disturbs the client in the therapy room”

Defer to them

I often have a client with NPD showing off their designer watch or giving me advice on furnishing my office more tastefully. I usually reply “Oh that’s a nice watch” or “Yes, you are right, the colour scheme of this room can be changed”. Using the assertiveness principal called fogging which means “agree in part, or in principal”, is helpful to deal with such messages.

Be a good person

Look below the surface to the pain and low self-esteem that lies below. A patient was affronted because I didn’t accept her friend request on social media. “It’s nonsense that you don’t want your patients on social media because of ‘boundaries’. In reality you are afraid people will see that you hardly do any real work, unlike your other colleagues. You are trying to hide the fact that you are a second-rate psychologist”. While this attack was harsh, I framed the discussion such that the reasons for her statements emerged. One of the questions I asked her “What did it mean to you when I refused your friend request?” Slowly, her rejection sensitivity came to the surface.

Recovery is possible

People with NPD have been conditioned since childhood to over-use certain coping strategies. They believe that demanding special treatment from others, being hypervigilant to insults, punishing others when feeling hurt, trying to impress people and trying to compete, is “normal” expected behaviour. Many people with NPD do not know that their behaviour and feelings are abnormal because they have nothing to compare it to. It could be very late in their life when they first start to realise that a lot of people don’t feel the way they do.

In their journey towards recovery, people with NPD need to develop ways to blend in with the general population, discover their own unique potential and feel truly confident about themselves. Some of the replacement strategies they need to develop are:

• Cooperating with others toward achieving a common goal.
• Being comfortable with others’ achievements
• Tolerating inconveniences, frustration, lack of recognition.
• Developing an attitude of optimism
• Meeting others’ expectations without great benefit to self.

When I see a client with NPD slowly changing their ways of thinking and developing true inner confidence, this quote by Mother Teresa comes to mind “If you are humble nothing will touch you, neither praise nor disgrace, because you know what you are.”

Examples cited are modified in order to protect the client’s identity.

The post How to communicate with someone who has narcissistic personality disorder appeared first on Complete Wellbeing.

Narcissistic family: What it really means

Dysfunction in families is caused by many issues. Alcohol, drug abuse, poor financial situations, and religious fundamentalism are the easy to identify causes of troubled families. However, there is a type of family dysfunction that is insidious, little understood in society, and more prevalent than you would suppose. At the heart of this type of family dysfunction is narcissism. In these families, at least one of the core caregivers is a narcissist and the whole family is taken hostage around this parent’s veiled pathology.

From the outside, the normal range healthy family and the narcissistic family may seem identical to the untrained observer, but the realities of these two families are in stark contrast to each another.

Healthy family versus narcissistic family

No family is perfect, but in a healthy family, the parents nurture their children and take pleasure in looking out for their wellbeing. Emotionally healthy parents have an acceptance of their own infallibility. They have the ability and intent to modify their behaviours and expectations to align with being a positive influence in their children’s upbringing. They use honest communication to establish order in the home and refrain from emotionally manipulating their children.

A narcissistic family, on the other hand, gives the illusion of being picture perfect. But in it, a narcissistic parent, used the family as a vehicle for his or her pathology. Make no mistake: the narcissist often appears as an epitome of perfect parenthood. However, the priority in these families is not the children but the parent with the personality disorder. What should be a nurturing environment for the children is hijacked. The narcissistic parent redirects this vital family energy into untold number of charades.

For instance, when Katie secured a scholarship she had been working hard at and broke the news to her family, her father downplayed it by talking about his achievements when he was in school. This was despite the fact that her father had never taken any interest in Katie’s life and she had almost raised herself.

Children’s emotional development

Rather than planning how to nurture each child on their individual paths the narcissistic parent will ponder what roles these children can play in bolstering his/her personal grandiose visions, with absolutely no regard to the impact this may have on the child. This may play out as narcissistic parents forcing the child to choose a profession that will make the parent proud, even if it makes the child unhappy.

The narcissistic parent will often hinder the proper emotional development and independence of children, in order to keep them in the dysfunctional orbit around this parent. Sometimes children may be pushed to succeed on a very high level so the narcissistic parent can live vicariously through their glory, or the jealous personality disordered parent may adopt a strategy to sabotage the child’s ability to be more successful than this parent themselves. Sibling rivalry is usually a given, as the narcissistic parent will employ favouritism, forcing children into feuds, and often subtly pitting them against each other.

The Enabler, the Golden Child and the Scapegoat

In the narcissistic family, all family members will orbit around the narcissist in a dysfunctional dance and will be assigned certain roles. The three key roles are that of the enabler, the golden child, and the scapegoat. These roles maybe static for life or can be reassigned at certain stages by the narcissist. The enabler parent may also assign their own personal scapegoat or golden child.

The role of the Enabler

Shane’s mother who otherwise was a loving woman would never stand up for him or support him against the atrocities of his narcissistic father. His father abused him physically and deprived him of food and money, yet his mother would always tell him how much his father actually loved him but was unable to express to him. Shane knew that this was a lie and his mother was just saying it to make the father appear good to him.

The enabler, like Shane’s mother, is usually the narcissist’s spouse or the other parent but in certain situations it can be a child. This parent often has come from a dysfunctional family, or some previous trauma. They may be naïve, brainwashed from being gaslighted over many years, dependent or codependent in nature.

Not all narcissist’s spouses become enablers. Those spouses that stay with the narcissist for life in a fairly congenial manner, are the strongest enablers, and are usually inverted narcissists, or are narcissists themselves. The role of the enabler is to tend to the narcissist needs. S/he is the narcissist’s marketing department. They manipulate the family’s perceptions of the narcissistic parent in a more positive way and make excuses for the narcissistic parent’s bad behaviours, and is often the mouthpiece for the narcissistic parent. The enabler parent often plays the go-between in the well-documented triangulated communications prevalent in these types of families. The enabler parent also neglects their duties towards the children as their overwhelming major concern is their narcissistic spouse. The enabler parent will accept even outrageous acts perpetrated by their narcissistic spouse towards their own children, and on some occasions even join forces with the narcissistic parent in attacking the scapegoated child, or may choose to attack the scapegoat on their own will. Sometimes this behaviour will be interspersed with random acts of kindness, thereby causing much confusion to the scapegoat. The enabler will often downplay their innate good characteristics, thus reframing from clashing with their narcissistic spouse’s grandiose pathology. It is the enabler parent’s job to hide the true nature of the narcissist and constantly work on damage control.

An additional note: At certain times the narcissist may scapegoat their enabler spouse as well, but the enabler refuses to see this and always goes back for more.

The role of the Golden Child

Rita was the first born to her parents and she had a younger brother Nick. Nick was the recipient of all the love and attention from her mother and was put on a pedestal. Her mother called him the ‘angel child’ and he could do no wrong. Nick grew up to be financially and emotionally dependent on his mother and could never make decisions by himself.

The role of the golden child is to be a vessel that the narcissist can live vicariously through. The golden child is seen by the narcissistic parent as the fruit of their loins, and therefore an added glorious projection of themselves. This child will be treated better than all the other children, and will be seen by the family, no matter what the reality is, as wonderful, intelligent, good looking, hard-working, or whatever is important to this particular narcissist. The golden child is the most likely to grow up and become a narcissist too. Due to innate survival instincts in the other children including the golden child, they will blind themselves to any injustices that take place within the narcissistic family. The exceptions being those perceived to be perpetrated by the scapegoat, or against the narcissistic parent. It is the job of the golden child to be the fake poster board for the perfect family.

The role of the Scapegoat

In the above example, Rita was the scapegoat who got blamed for everything that went wrong in the family. Her mother found faults in everything that she did. She never received love from her mother and kept trying tirelessly to win her approval. Her relationship with her brother was also manipulated by her mother.

The narcissistic parent needs somebody in the family to dump their rage on—this is the scapegoat. Pathological narcissists are unable to acknowledge faults or flaws in themselves or what they have created, therefore they require a scapegoat to download all their unacceptable faults on. The role of a scapegoat is usually assigned to the most sensitive, outspoken, or different child. Sometimes a child that is impaired in some way is picked as they are shameful to the narcissistic parent. The scapegoat is mistreated by the whole family no matter what they do, or how hard they try. The scapegoat endures a lifetime of blame, shame, ostracizing, neglect and emotional abuse by the entire family. It is the scapegoat’s job to be sacrificed so that the other members of the family can blind themselves to the terrible and traumatic truth that their entire life is actually a lie.

Is there any hope for the victims?

Children coming out of narcissistic families have severe emotional scarring and the degree of damage depends on the roles they played and the severity of their situation. Family members orbit around the narcissist in their casted roles for years together and some don’t ever realise that it is pathological. Due to this, the emotional damage can continue for many years undetected, even by the victims themselves. This results in untold pain and suffering to the victims, plus now also to society, as these children unknowingly spread the pathology as possible narcissists, inverted narcissists, enablers or codependents.

However once these victims recognise that they are part of a pathological situation they may choose to work a way out of it. With the help of support groups, expert therapists and modalities like EFT, victims can deal with their situation and grow out of it. Greater public knowledge of narcissism amongst the general population is our best defense in curbing this destructive and ever-growing epidemic.

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