Jul 29, 2022
Narcissism is both necessary and pathological. Every individual needs some narcissism for the Ego to develop, but too much can become a personality disorder. Understanding narcissism can help us recognize the difference and better understand ourselves.
Transcript:
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[Music] welcome into the psych with mike library this is dr michael
mahon and i am here
with mr brett newcomb good morning it is the dog days of summer uh
yeah so
second or third longest day of the year or no they're starting to
shorter starting shorter yeah yeah
like a couple days ago was was equilateral 12 and 12 right 12 hours
a day like 12
hours it was the summer solstice yeah that's where for for your
wiccans out there yeah
so i have an acceleration of stonehenge for that we just yes they
do we just uh
read the news about the supreme court and roe v wade uh do we want
to comment
at all about that or wait and see what happens um i don't know what
that has to do with
providing clinical services or being a better therapist so i think
that
i would withhold comment at this point all right uh how are
you
i'm good i just wanted to say that um we had uh michelle stieg here
last time
with us and that i thought that the
material the information that the the quality of the show
was fantastic with her you're trying to say she clashes up yeah i
thought she i
thought she did a great job but then who wouldn't yeah yeah well i
mean there are a couple of people i could
think of but uh you know so i don't know that michelle listens to
this on the regular if she
does i just would like to say i i thought she did a great job i
thought she really added something to it she's
always welcome i will be sending her the links to the shows that we
did with her and i hope
that maybe we will see her again sometime all right well reach out
touch someone
oh you get in trouble for that nowadays yes you do so uh one of the
things that
was i think not was is misunderstood i think
is hugely misunderstood in the field of psychology
is the concept of narcissism would you agree or disagree i i don't
know i
i think everybody kind of has an understanding from mythology of
the
intense self-focus of the narcissist and then you know i i don't
know i can
separate myself out from my education yeah we were all taught that
everyone has
traits of narcissism uh but that those who have
complex organized traits that are that predominate in their life
pattern have a personality disorder
the challenge is always where do you make the distinction how do
you determine if what you're looking at is just a narcissistic
trait or if it's a
if was intense and organized enough to be a personality disorder
and when
you talk about our education if you go all the way back to the
early psychodynamic theorists we're
really into otto kernberg and heinz kohut if people want to look
those people up and
people like that said that it is imperative to have a
healthy amount of narcissism for the ego to be able to form you you
awesome yeah exactly and and so you're exactly right
is where is that line between what is healthy and necessary for
good ego
development and where does it become pathologic so do you have an
idea about where you see that line
uh when i look in the mirror if i'm looking at me or if i'm looking
at others
you are or are not pathological you know since it's a yes a
radical
shift in the conversation the question is what constitutes
pathology and is a behavior pathological or an
attitude or a presentation i think that i would answer that
question by saying how much damage does
it do to you or the people in your environment that's are you
behaving in ways that are
counterproductive painful destructive uh or not and i would say
that those
behavior patterns are the indicators of pathology
so the point at which it makes it impacts your life is the point
at
which where pathology would begin yeah and so when you do therapy
you
beat around this bush until both you and the client have somewhat
of the same viewpoint
perspective for what you're looking at and then you ask the
questions how painful is this
how problematic is this what's it costing you to behave this
way
and if you had an option to make changes that were
options uh to make changes that were at affordable levels would you
want to change
and so then you have a discussion about what's an affordable change
right you know i cut off my if my eye offends me
do i pluck it out or do i change jobs because working at this job
is causing me so
much stress at home that there's confrontation there's
distress
my children are not being attended to i'm not doing the things that
i want to do to be a good husband or father uh
because i'm so focused on being a good employee for this company
that i think is probably corrupt
so i'm in i'm in pain i'm in distress it's pathological or if you
have a behavior habit like an
addiction like alcoholism do i drink to the point that it
causes
me to get traffic tickets to get arrested to get into fist fights
that it causes me to have a wife that says i'm
gonna uh take you to court and take your kids away from you because
you're irresponsible and dangerous
how much problem is it causing me right and do i if i could change
it would i change it
because sometimes i have behaviors that other people say oh my god
i can't believe you're that way and i'm like you
know what i don't really care yeah i i like being this way right uh
and so well do you know what it cost you
i have a reasonable estimation and i'm okay with the price i don't
i don't
build my life around whether or not you approve right i build it
around something else and and
i think that's a legitimate point of view and i can say that it
would it would that would it depends
on who's saying that to you though because if that's your special
judge or the police or your spouse is different
than if it's just an acquaintance yeah so you know that level
of
cost to you personally right i've always said that a person who
uses substances
is going to use substances until the cost of that to them to the
person who abuses is no longer acceptable it
doesn't matter if it's not acceptable to a judge or to a spouse
it's got to be unacceptable to them so if if you had a
person so narcissism is a profound focus
on the self to the extent it comes from the greek mythology uh the
the myth of narcissus yeah
who saw his reflection in a pool of water and loved it and loved it
so much that he froze there just staring at
himself until he died yeah uh then there's a segway from that
narcissus had a cohort
called echo whose job was to listen to everything that narcissus
had
to say and accept it embrace it without challenge
uh so one of the things when you work with narcissists is you try
to determine is
there an echo in your life who is that how does that work how's it
paying off for both of you
because it's a symbiotic relationship one has to have the other to
survive although a person could function as
their own echo well that's the argument that gets made sometimes
yeah i don't know that i agree with that okay okay but so
if a person were narcissistic let's assume for the sake of argument
that they they were and
that would make it difficult for them to be in meaningful
sustainable relationships
and so they're alone and you say to them okay you're alone and they
say well that's okay with me
so then is that pathologic or not pathological how disturbed is
their life how satisfied with the balance of their
life are they it kind of goes back again to childhood development
theories if you talk about
the grandiose narcissism of the infant the newborn infant hasn't a
perspective vocabulary
awareness of other even they just have awareness of self and
everything is totally consumed with self
gratification so the argument the presumptive persuasion is
that grandiose narcissism is a natural artifact of child
development
but that as the child matures develops control over his body learns
to go through separation
individuation in eight or nine months and recognizes that there are
others there is an other and then there are
others uh he realizes he's not the only object in the universe and
so then he begins to
experience frustration because those objects in the universe don't
perfectly meet all of his needs but you can't
articulate it eight months because he doesn't have vocabulary so if
he screams and yells in rage or hunger or
frustration or disappointment then mothers and dads are like what
is it what are you hungry are you does your
stomach hurt what's going on and baby can't tell them so they try
to do things they run through a gamut of behaviors
and say well is this better you know and moms will learn what
certain cries mean the total
quality of the cry they'll say oh he's just wet or oh he just woke
up or oh he needs to take a nap
and dad's like huh because they don't spend typically as much time
around the child
um so if we all have grandiose narcissism in that kind of way which
theoretically
it's positive that we do as we mature and encounter these
other
reality points we begin to bob and weave we begin to recognize
that
there's a relationship dance that has to be done and so we become
seductive we try to seduce people with happy smiles
and gurgling laughs and cute little things that we say or do you
watch those kids grow up and and they go through
stages where they're trying to tell jokes and develop humor and
make people laugh and initially they don't have a sense of
humor and so they're really into slapstick stuff prep falls and and
knocking things over uh they
learn a joke and they understand they're given to understand oh
that's a joke then they repeat that joke 75 times
straight and finally you have to teach them the concept of funny
wants just tell me that i joke one time after
that it's not funny yeah uh so so it's all developmental but for
narcissistic personality
disorder someone who is in adolescence or beyond
who has a more complex map of where they fit in the world but who
still holds
onto that narcissistic focus of i'm the one that has to always get
his way i'm the
one that's always right i'm the one that should always be pleased
then that starts to disrupt other relationships
and destroy them so do you do you conceive narcissism as a
pathology as a
developmental artifact so yes this individual lived in an
environment where that narcissism was
fed by the other the you know projected or by the intensity of his
demand his
rage uh oh so the narcissist could have created that
responsibility
you know like the the uh seymour
in the little uh shop of horrors you know feed me yeah no matter
what and
i could be cute he could sing songs he'd be seductive he could tell
jokes but if you got in his way he'd eat you
yeah and so then when that person gets to
the therapist's office do you see the therapy for that as
we've
talked about the narcissist that comes to the therapist's office
yeah is
manipulating yeah they didn't come to therapy because they're in
pain or because they want to change they came
to therapy they didn't have any participation of some kind incoming
therapy and it's
very often uh their boss or their wife says you have to go to
therapy you don't want more of people and so they think
okay i'll go dance this dance learn to say some of the right words
or persuade and spend a lot of time persuading you
all the other people in my environment are unreasonable and they're
they're not very smart because they just don't understand or
they don't see and don't you sympathize with me they want you to
become their echo
so they recruit you as a clinician you have to be aware of that and
know how to resist it
but still invite the engagement so you have to dance with them
uh
and hope that there can be an epiphany if you can get them to feel
their
emptiness and kernberg says you can't do that until they're in
their late 40s early
50s there are too many other places where they can be fed and so
they just like they'll get a
divorce and they'll go marry somebody else that'll be echo for him
and then maybe they'll get that divorce and go marry another echo
and then they'll
generalize about the quality of women or the quality of men and
typically more men are diagnosed as narcissistic than
women yeah and women are diagnosed borderline uh so
it's uh extremely difficult to do access to personality disorder
therapy
but consistency in those situations is key consistency
on part of the therapist yolim says you have to do supportive
expressive
psychotherapy with them that's the only thing that will work which
means you have to give them enough
encouraging support and allow them to express and vent their
frustration in their world view but then give them some feedback
about where walls and boundaries are that
they're going to come up against and what's the cost of trying to
break through that wall or that boundary
so that you can make a judgment now you have to realize narcissists
are
very typically brilliant and they will convince themselves there
has to be array around this block
and they'll recruit you if they can to help justify or build an
argument or
explain a rationale for why they should be allowed to get around
the block
so let's go to our break and when we come back i'm going to ask you
another question is it about politics no
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okay we're back so one of the things that
i try and conceptually wrap my head around and i actually have an
answer for
this but i'm going to ask you first is what is the difference
between narcissism and sociopathy oh i
don't know you do too hi mike norton are you listening
no he didn't ask me that he asked me what's the difference between
a psychopath and a sociopath oh yeah yeah
i love when people say that yeah well first off psychopath isn't a
diagnostic term so
so what's the difference between a sociopath and a narcissist
yeah
as i understand it the sociopath has no
moral foundation or concerns about consequences other than
victory so they don't have they're not going to have biological
components for empathy exactly yeah
that's the difference okay and so when you're doing therapy
if you get to a point and you're thinking about a differential
diagnosis
and because a lot of narcissism can look very sociopathic
but the difference is that a narcissist does have the ability to
experience
empathy and they may not they may not it may not appear that way
but as a therapist hopefully you'll be
able to sense that that they have the ability to feel the emotions
of other so what i say
is that in in you know sociopaths are like a black hole like they
just absorb all of the emotion in the room and they
don't give you anything back with a narcissist you might get really
frustrated with the way in which they're
relating the story about their relationships and why it has to be
like you were saying they have to find a way
around the block but you can kind of sense that they have some
empathy they
understand that other people do have emotions so they
they do because it uh it gets that awareness that knowledge
gets
incorporated into their manipulation strategies narcissists
are
incredibly attractive exactly uh and seductive and often very very
bright
and determined and if something becomes too expensive they'll
abandon it
and move to the next opportunity
but without changing their strategy or their approach to life so
they burn through relationships you
know they they use them up when your container is empty i'll
discard you and get another container that will give me
the things that i need applause accolades money
power sex whatever it is and then when i use you up i'll discard
you and get me give
me another one i'm not changing i'm not changing my approach i'm
not changing what gratifies me i'm not changing my
payoff i'm changing my provider and the sociopath won't do that
the
sociopath is going to they may very may be very manipulative but
they're going
to be very on track with their agenda and they're probably not
going to be
dissuaded from that yeah so we had read an article about uh
how manipulative narcissists can be especially in terms of the love
languages chapman's love languages
and the articles postulated that they can learn
sorry i said postulated i posited i i heard the word and i
liked
it oh okay they can learn by observing acutely what your love
language is and then they can provide that to you
as a feeding source for manipulation so if your love language is
acts of
service right the exactly for you they'll cut your grass they'll
wash your car they'll cook your dinner
and then say to you well why are you beefing on me because i did
all these things for you so you
should be happy with me right and you should do whatever i want
mm-hmm yeah yeah and
if you don't it's on you but i've been so nice to you and i've done
the things that you define oh this is nice uh or or
this is love i've been very loving to you and now you're not being
loving to me loving to me is give me my way now
i think that it's important to make sure that we are recognizing
that
so first off let me start a different way so chapman's five
languages of love it's important to understand your love
language but it's more important to understand your partners yes so
it's not about you knowing what your love
language is and being able to tell the world yeah it's about
sometimes ask people what is yours i know i don't know
yeah and well i i say to people all the time once you're partners i
don't know i know mine but i don't know well then
that's that's you're missing the whole point but you're also into
checklists you know i mean i'm supposed to remember
all these things yeah i'd have to look it up every time so uh
but you could get into a situation where you are actively trying to
understand your
partner's love language speak to them through that love language if
their love language is acts of service then you're
you know you're doing the dishes and doing things like that and
then your love language is words of affirmation and they're not
giving you any kind of
positive feedback for that it's okay for you to say hey i am doing
all these things for you i
would like reciprocity yeah but that's not what the narcissist is
doing the narcissist is keeping score right yeah
and and so they're using it specifically as a tool of manipulation
that's what the [ __ ] so then the foundation of
that
is the degree of empathy yeah of which they are capable oh okay
yeah that's i hadn't thought of it that way but i
think yeah i see that go ahead no i just really say it if they
don't have
empathy then they don't really feel what you feel and so then it's
just a manipulation
it's just a strategy it's cosmetic yeah and so uh
for the partner who may be in that relationship where
they feel the first few times they're like oh okay he gets it he's
really crying and they back off
from their level of distress but when it becomes repetitive and
they
recognize well we always get to this point and then you confess and
say you're going to change
and then i back off and then nothing changes so you just bought
some more time and eventually they'll say i'm not
backing off anymore yeah either either you make a change or we're
done and then the narcissist will say i can't believe you treat me
this way this is horrible
uh see what you've made me do see what you've done you're wrong
uh
what was me but what i would encourage the partner who gets up to
that point who recognizes
the manipulation and wants to try and change that you have the
right
to ask for that in the relationship i don't believe that's going to
be very successful because as you point out the
narcissist is going to use up the tube of toothpaste and then get
another toothpaste
in those situations i really encourage you to elicit a third party
there are other toothpastes on the shelf saying pick me
pictures yeah yeah so it's easy to get another one yeah i was
talking to a friend of mine the other day about someone who has
these issues in their
lives and she was saying well this particular partner they've
attached themselves to
isn't going to put up with that they're just going to leave and
then the narcissists will be sorry i said no no
they'll just get another volunteer to do the same thing same
different day same stuff right because
they're not changing and so the partner has to understand has to be
empathic
towards the narcissist and understand that the narcissist is not
going to be
sorry you may want them to be but that's a projection of yours on
to the partner that isn't real i
think in those situations it's a really good idea to elicit a third
party and so clinically yeah the challenge for the
clinician is not to chase the rabbit right because if i'm talking
to the narcissist who
wants to talk about why his or her wife and children are inadequate
and why they behave this way and why don't they
understand what they see we're talking about there and then stuff
right those people over there why are they behaving
that way instead of the person in front of me as the client said
why are you behaving this way what are you getting
at is what's your payoff uh same thing happens if echo comes in and
you're talking to the wife and she's like why
doesn't he change and you have to come back to uh charles
townsend's book on boundaries boundaries
excellent uh reference because it's about developing and having
boundaries
you start with a premise you have a right to have a boundary and
then you have to learn how to assert that boundary in a
non-aggressive
non-destructive way but a healthy boundary can be to say no
i won't be with you anymore because you're not good for me uh my
choice i'll
pay the price right so well but but that's the rub yeah is being
willing to
pay the price yeah i mean you're absolutely right that you have the
right to say
okay this is my choice i'll pay the price but a lot of people say
that and they don't recognize
the difficulty with actually consistently following through with
that which goes back to which is why the
initial boundaries yes the cost of your choices and you can choose
to do this you can
choose to stay with this person all you're ever going to get out of
them is glass half full so if you if you're
content if you can build a life with a half full glass that's okay
that's your call
but you know he goes don't go sit in the corner and stare at your
nail and say well it's me saying hey i like having a
half full glass because he's charming he's witty everybody else
likes him i get to take
nice trips because you know we live at this level and if there
are
needs in the relationship that are not being met you have to take
responsibility for either accepting that
and owning that or finding other ways to get those needs met right
and that's a part of living with the glass half full
and that's where therapy has to go you have to do the here and now
work with the client that's in the room
about what they are experiencing what their goals and cost choices
are
and you know i think that it is fair to say
that narcissists because they are really intelligent because they
are very charming they can be good in
relationships up to a point there's going to be a limit to how much
they can give back and so if you're the
partner of somebody like that and you're going to try and remain in
that relationship and you accepting what
those limitations are then you have to be honest with yourself
you
have to accept that you if you're saying i'll live with him or her
long enough for them to change
that's probably a delusion right probably yeah absolutely yeah
yeah
but i think that people you know they think oh i'll be a martyr and
i'll live with it but they're still talking about
how to manipulate a change in someone else's life and the only
person you can change is you is you that's exactly right now
so
and i don't want to go down this tangent but but but i do want to
ask you a question you know the as we're talking about this one of
the
things that i sometimes think is that people are too quick to
separate the
couple i hear all the time people say oh these people came in for
couples therapy i told them they need to go do
individual and then come back yeah and and i don't i don't know i
mean do i
think that there's ever a point where that is therapeutically sound
advice absolutely sure and i'm not i'm not even
judging anybody if you've ever said that but i think we're too
quick to separate
the couple if the couple comes to you as the identified client i
think it's okay
to treat them that way it may be frustrating because you may be
saying to them hey could you do this and they
could say no or they could say yes and then not do it but i think
it's okay to treat the couple
as the client to to to work with that and and to try and make
that
the reality of the therapy do you agree if you come from that
perspective as your approach
to doing therapy then you should probably educate yourself about
virginia's tears and family systems
i tend to believe that the therapists
shouldn't be driving the bus from a power position i think you need
to spend enough time
getting to know people and listening to what they have to say that
you can then
help them steer but they have to make the decisions about i want to
there may be a situation where
you say i want to see you individually because you suspect there's
some abuse or something exactly that's not going to
come out in a power complex but i agree with you i wouldn't break
up the couple's therapy yeah
per se and you probably need to walk through the legalities of
confidentiality if you've come as
couples and you're coming for a single or small series of
individual sessions
about privacy and confidentiality and you probably should also talk
about if this goes to a divorce and i get
called in as a witness in the divorce none of this stuff uh is
retained under
the the right of confidentiality so we need to discuss that before
we make this decision
and i think all those are fair and valid points to make but if
you're in that
situation where you're seeing a couple and you as the therapist are
frustrated and don't know where to go that doesn't
mean you go to supervision yeah yeah that doesn't mean split them
up and say hey you guys go to individual therapy
that means you exactly go to supervision and try and figure out
ways of being able to interject more energy into and
how am i getting in my own way here what am i not seeing yeah yeah
okay so hopefully that was
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