Tag Archives: narcissistic personality disorder

Therapy for narcissism


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Photo by Victori∀

Therapy for narcissism

Narcissism is one of the more difficult disorders to treat (Young et al, 2003).People with narcissism find it difficult to give and receive genuine love. They were often emotionally deprived in childhood and as a result have learned to overcompensate for this by developing a conceited, self serving personality. They often appear entitled and expect a lot form others whilst giving little in return. Their motto seems to be “What’s in it for me?” They rarely practise self sacrifice and have little real empathy for others.

Not all narcissists are diagnosed with Narcissistic Personality Disorder (NPD) but many have traits consisting of: seeing themselves as defective.  They believe that any exposure of a flaw will lead to rejection. Many narcissists  have a ‘lonely child’ within them. They often have little awareness of this though. Feeling average is one of the worst feelings for a narcissist and this is why they surround themselves with high achievers and like to exaggerate their wealth, intelligence etc. Underneath all their bragging they are often excruciatingly insecure.

Therapists tend to work with the ‘lonely child mode’ and help the client to identify their inner loneliness and emotional deprivation and find ways to help the client to self soothe and nurture this inner void. Many narcissists cope with this void by being aggressive and lashing out at the slightest criticism. They also use dominance and bullying to protect themselves from being ‘found out’ and scared and vulnerable. They get so used to this pattern of behaviour that they begin to identify with this false persona and this makes therapy even more tricky.

Childhood origins of narcissism:

Loneliness and isolation

Insufficient limits (set by parents)

History of being used or manipulated

Conditional approval (by parents)

In treating clients with narcissism, therapists overarching goal is to help them learn how to get their core emotional needs met. Narcissists find it hard to accept genuine love, They can accept admiration, approval and attention but cannot take in love. They can often choose loving partners though but give very little back. They only give in order to get.

The three most common modes of narcissism:

Lonely child – they feel unloved and unloveable. Feelings of inadequacy dominate. This is the underlying feeling.

Self aggrandizer – Overcompensation for lonely child mode to protect themselves. In this mode they behave in an entitled, abusive way. They also seek status and behave in insensitive ways. This is the mode they use to deal with others.

Detached self soother – When alone, they usually flip into this mode of detached self soother. In this mode the shut off their emotions and engage in activities that will soothe them or distract them from feeling. In the absence of validation from others, the Lonely Child tends to surface and the detached self soother is a way to avoid the pain of the lonely child.

Narcissists and relationships

Narcissists often choose partners that will make them look good to compensate for their feelings in inferiority. They often devalue their partners in order to feel superior and boost their own self esteem. Some even become sadistic and humiliate their partners. The more the partner tries to please the more it backfires. The more the partner fights back, the more the narcissist will value their partner’s approval.


Therapy for narcissism

Therapy involves the therapist bonding with the lonely child, creating a safe environment without judgement. The therapist values the client for expressing vulnerability and gives the client unconditional positive regard. Clients are often not very self aware and don’t even realise they have problems establishing true intimacy. Through therapy, clients can begin to realise that they have been lacking true connections with others. The therapist encourages the client to stay in lonely child mode and meet those early needs in therapy. The same message is always given by the therapist – “It is you I care about, not your achievements or performance”.

Sooner or later the client begins treating the therapist the same way they treat everyone else – in a condescending or challenging manner. It is important for the therapist to stand up to the narcissistic client or else they will lose respect. The therapist needs to be appropriately assertive and set limits for their client.

  1. Therapists empathise with narcissistic point of view and are tactful in confronting entitlement.
  2. Therapists neither defend themselves nor attack back when the client’s devalue them. A therapist must rise above the content and not get ‘sucked’ into the narcissist’s world.
  3. Therapists assert their rights nonpunitively. Example: “You are probably not intending to hurt me, and deep down what you are feeling is misunderstood, but I am not comfortable with the way you are speaking to me”.
  4. Therapists do not allow themselves to be bullied by clients into doing things they do not want to do.
  5. Therapists establish that the therapy relationship is mutual, based on reciprocity, not on master-slave principle.
  6. Therapists look for evidence of underlying vulnerability and point it out each time it occurs.
  7. Therapists rise above specific incidents and ask the client to explore the motivation behind entitlement, self aggrandizing, devaluing or avoidant statements. They do not get caught up in the content of arguments. Rather, they address the way the client is behaving and the effect this has on others.

One of the best ways therapists can show narcissistic clients that it is okay to be vulnerable is to be vulnerable themselves. Acknowledge when they feel hurt, admit mistakes are are willing to be imperfect. Even if these clients view this as weakness, it is still important for the therapist to express appropriate vulnerability. Narcissistic clients take time to shift their thinking and behaviour but with effective therapy and client motivation, a lot can be achieved.

Mandy X

Mandy specialises in Cognitive Behavioural Therapy and helps clients with Narcissism. Get in touch if you require Skype counselling or would like further information.


Are you dating a narcissist?

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Are you dating a narcissist?

Many couples come to see me regarding problems in their relationships and I have found a large proportion of these cases to be affected by a narcissistic element. Often, one person exhibits many narcissistic traits, making the success of the relationship more of a challenge.

So what exactly are the typical traits of a narcissist?

1) “It’s all about me”

Dating a narcissist can be extremely challenging because they are mainly motivated by what’s in it for them. They are motivated by self interest – pure and simple. If they do not see any gain for themselves, they will be unlikely to do it. If it means they can make their partner happy but there is no specific gain to them directly, their interest will be low or non-existent. Of course, if they sacrifice and then know they will be widely seen as a wonderful person, they might still do it for the recognition. A relationship often serves to enhance a narcissists image. The bottom line though is that they only engage in activities where there will be some type of gain for them. They do not engage in purely selfless acts for the benefit of others.

2) Narcissists lack empathy

Narcissists do not think in a healthy and balanced way. They lack genuine emotional connections with others. Despite this, they are incredibly adept at acting the part of a caring person, at least initially or when acting the part is called for. One thing that I have noticed time and time again is that narcissists don’t feel the natural, normal emotions many feel. What they have to do is act out what they think would constitute a caring, empathic person.

So, in the beginning when dating a narcissist, they will be very attentive, very romantic and appear wonderful in many ways. They will write cards, be thoughtful in sending flowers or other gifts, writing loving texts and arranging romantic dinners. A narcissist cannot sustain this behaviour however, as it does not come naturally to them. They do all the caring stuff as a means to an end – to capture the other person’s affections and gain emotional control. Once the other person is hooked, they can go back to being their normal selfish behaviour.

3) Narcissists are excellent at manipulation

Narcissists seem to have a 6th sense when it comes to uncovering other people’s weak spots. They are adept at figuring out another person’s vulnerabilities and they use this to achieve their personal goals. If you are insecure about the way you look, they may initially make you feel as if you are the most gorgeous person ever, but after a while they will use this against you. They will possibly drop the odd hint about how there are so many good looking people where they work or they will insinuate that their partner is not taking enough care of themselves. They do this to establish value. In this way, the slowly  influence their partner to feel they are not good enough and that they are lucky to have someone who stays with them. It’s subtle most of the time, but their subtle negative comments do the job of keeping you full of self doubt.

4) Narcissists never take the blame

Narcissists are not good when it comes to receiving constructive criticism. As far as they are concerned they are victims of others people’s ineptitude, lack of competence and/or other people’s negligent actions. They are unable to see their role in things going wrong. Instead they will lash out and convince others that it is their fault, that they are the one with the problem. Narcissists are very good at creating a mindset for themselves that  involves denial of reality. As I mentioned before, their thinking is distorted. They twist reality to fit their way of seeing things, Dating a narcissist means you will very rarely be allowed an audience with an objective person who will see your side. Don’t expect to hear them say “sorry” either.

So what do you do if you suspect that you are dating a narcissist?

Narcissists can still be loveable even though they give very little back in a relationship. They are often charismatic and charming.

1) Understanding and context

Try to understand why your narcissistic partner is the way they are. Sometimes, you can see obvious signs from a dysfunctional childhood. Some narcissists use the bravado to hide their own sense of shame and inadequacy. Understanding promotes tolerance of their behaviour.

2) Don’t try to change them

Trying to argue with a narcissist is often a waste of time as they tend to be very set in their ways. They have rigid thinking and are not swayed easily. Trying to get them to see your way of thinking is a futile exercise. Instead, accept who they are and what they are willing to give. If you feel resentful at their behaviour in a relationship, trying to change them is not an option.

3) Highlight the benefits to them

As narcissists are  motivated by personal gain, you may be able to influence them in this way. Show them how something will benefit them and you might be able to get their cooperation. Work with them and play to their interests.

4) Stand up for yourself

Let your narcissistic partner know when they annoy you. The more you allow them to mistreat you, the worse it will get. Be assertive and let them know when you are not happy with their behaviour. Your responsibility is to communicate your needs. If you find that your requests are repeatedly ignored, it might be time to rethink the status of the relationship.

5) Ask for what you need

Dating a narcissist can be a lonely experience and you need to be quite resourceful and self sufficient to cope. As narcissists often lack empathy, they need to be told what is expected of them. Ask for what you want and make instructions as clear and precise as possible.

There are many types of narcissistic behaviour, severe and long standing narcissists are often diagnosed with Narcissistic Personality Disorder. Some narcissists have less severe characteristics and they have the most chance of enjoying a successful relationship.

Mandy X



Photo by laudu

The Difference Between Narcissism and Egocentrism


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Egocentrism and narcissism have similar traits although egocentrism is seen as a more ‘innocent’ form of narcissism. Egocentrics don’t know how to understand others and show empathy (an inability) whereas narcissists don’t care (lack of interest) about understanding others. Piaget described most children as being egocentric. Egocentrism is a cognitive bias that refers to our innate ability to see the world according to our own perspective. We do not experience the world/reality directly but rather through our perceptual filters that are made up of our past experiences, attitudes and genetic predispositions. It takes extra effort to see the world from any other perspective than our own.  According to Piaget, the egocentric child assumes that other people see, hear and feel exactly the same as they do.

Egocentrism manifests in adults as an inability to fully understand or to cope with other people’s opinions. The fact that reality can be different from what they are ready to accept can cause extreme tension and anxiety. Egocentrics struggle to communicate and often lack empathy for others as they can only see the world from their point of view. Adults can come across as arrogant but often their behaviour is misunderstood. Often, they suffer from low self esteem which has arisen from their lack of being able to socially interact effectively. Permissive parenting and inappropriate praise (exaggerated) leads to egocentrism in adults.

Narcissism on the other hand often develops from egocentrism. Narcissistic personality disorder is not simply about taking normal egoism to extremes, it is seen as a failure of character development.

Narcissism does have positive characteristics in that it fuels drive and ambition, a desire to be recognized for one’s accomplishments and a sense that one’s life has meaning and value. The problem occurs when narcissism becomes the primary principle of someone’s personality. Its most extreme form is narcissistic personality disorder, a psychological condition that impairs a person’s ability to form normal relationships and wreaks havoc on those who have close encounters with it.

Narcissists have skills and qualities ”confidence, extraversion, a desire for power”that propel them into leadership roles but when true narcissists are in charge they constantly want admiration from others and the attention has to be on hem. There is no space for others in the ‘spotlight’. Narcissist don’t tend to do well in counselling as they very rarely accept responsibility for anything and blame others for their predicaments. Narcissists are very good at self denial.

Empathy, the ability to instinctively understand how another person is feeling, is a crucial human attribute, part of what makes us a social species. A chilling lack of empathy is a hallmark of narcissists. Shame, that painful sense one has acted in an unacceptable way, is another necessary emotion that is also largely missing from the person with Narcissistic Personality Disorder.

Instead of trying to change a narcissistic person, acceptance is key to life with this type of person. As long as they see benefits to a situation they will be more likely  to cooperate. Stay independent and be assertive. Remind yourself that narcissists are emotionally unhealthy people and have not developed a mature, full set of emotions. Do not take what they say personally and keep perspective in your dealings with them.

Mandy X



Photo by videocrab

Personality Disorders

personality disorders

Personality disorders relate to the way a person THINKS. Their thinking patterns tend to be distorted on some level, according to the type of personality disorder they possess and these ways of thinking are habitual and difficult to change.

Signs that someone has a personality disorder could be erratic behaviour and rigid thinking. Behaviour can be destructive with the individual not taking any responsibility for their actions. Very often,those suffering from personality disorders have had a traumatic childhood and the creation of the disorder could be as a result of coping mechanisms founded as a child to cope with trauma. The brain chemistry is affected by unsettling and disturbing childhood experiences and this may lead to distorted and ingrained thinking that is resistant to change as an adult.

Personality Disorders:

Cluster A personality disorders (odd or eccentric disorders)

  • Paranoid personality disorder: by nature sufferers will experience a distrust of others as well as irrational suspicions.
  • Schizoid personality disorder: defined by a disinterest in engaging in social relationships and spending time with others. Also often unable to find pleasure in enjoyable activities and will spend time contemplating ones own mental and emotional state.
  • Schizotypal personality disorder: typical characteristics include odd behaviour or thinking.

Cluster B personality disorders (dramatic, emotional or erratic disorders)

  • Antisocial personality disorder: characterised by an ignorance of the entitlements of others, the absence of empathy, and (generally) a pattern of consistent criminal activity.
  • Borderline personality disorder: extreme ‘black and white’ thinking and long term unstable emotions – particularly when involving relationships, identity and behaviour. These feeling can lead to both self-harm and impulsive behaviour.Self harm is common.
  • Histrionic personality disorder: attention seeking behaviour that often includes inappropriate seductive conduct and superficial or inflated emotions.
  • Narcissistic personality disorder: characterised by the consistent need for praise and admiration and a belief that they are special and ‘entitled’. Extreme jealously, arrogance and a lack of empathy are also usually present.

Cluster C personality disorders (anxious or fearful disorders)

  • Avoidant personality disorder: feeling socially inhibited and inadequate is common, as is extreme sensitivity to any form of criticism or evaluation that may be interpreted as negative.
  • Dependent personality disorder: an extreme psychological dependence upon others.
  • Obsessive-compulsive personality disorder: this is not the same as obsessive-compulsive disorder, and is characterised by conforming to rules and moral codes on a severe and unyielding basis. Excessive orderliness is also usually present.


Fortunately, there are ways to treat Personality Disorders. Medication, such as anti depressants are sometimes used as well as talking therapies such as CBT (cognitive-behavioural therapy)  which is one of the most commonly practiced forms of psychotherapy  today and DBT (dialectical behavioural therapy) which emphasizes the psychosocial aspects of treatment — how a person interacts with others in different environments and relationships.

The treatment that’s best depends on the particular personality disorder, its severity and the particular life situation. Often, a team approach is appropriate to make sure all psychiatric, medical and social needs are met. Because personality disorders tend to be chronic and can sometimes last much of one’s adult life and may need long-term treatment.

Mandy X