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Understanding Narcissism
Page Seven


You should know, however, that change will take a rather long period of time for these truths to take hold in and for the narcissist to change internally. The relational patterns of the narcissistic personality were learned and reinforced over many years and are not easily dismantled and replaced, even for the Christian. The dismantling process can be quite painful for the narcissist, as well as disquieting to those around him or her. It will also probably take a very good therapist who has significant experience working with narcissistic individuals because they need a rather different type of counseling than most people.

Therapists with a lot of experience with narcissistic individuals have learned that it usually doesn’t help to try to confront the narcissist’s pride or arrogance directly. Since the narcissist’s problems are rooted in the very early painful childhood experiences that made him extra sensitive to any hint of criticism or correction, the therapist will need to spend most of his or her time empathizing with the narcissist’s feelings of woundedness and being misunderstood or unappreciated. Only as the counselor helps the narcissistic person become comfortable with his or her underlying woundedness and need can the narcissist grow. A skilled Christian therapist will help the narcissist realize that both the therapist and God understand his feelings of shame or inferiority and how disappointed and angry he feels when others don’t understand him or appreciate him. If the narcissist continues with a counselor like this, he can gradually give up his defensive pride and grow to accept himself and others as God intended him to do. If this process occurs, counseling can be radically life-changing.

Marital counseling can sometimes be a helpful adjunct to individual counseling. One aspect of successful marital therapy with a narcissistic partner is for the mate of the narcissist to be willing to also address his or her dependency issues. Very often, spouses of narcissists have very low self-esteem. They may have married a narcissist because they thought they needed someone strong and confident to compensate for their poor feelings about themselves. Unfortunately, in the intimacy of marriage, the narcissist’s partner begins to realize that her husband thinks she is supposed to be an extension of him, and that he is taking advantage of her quiet, self-effacing nature. Marital therapy can help both spouses address their contributions to this and other unhealthy relational styles.

In marital therapy, the spouse of the narcissist will also need to learn to express his or her own needs and to establish better boundaries. This will challenge the narcissist’s long-term, controlling patterns of relating. Issues of power and control, independence and dependence, and closeness and distance will likely surface and need to be addressed.

It usually takes an experienced therapist
to come alongside the narcissist and
carefully help him become aware of
the painful feelings about himself....

Family and Group Therapy

Family and group therapy are generally not the best forms of therapy for narcissistic individuals because they so easily feel wounded and misunderstood. It usually takes an experienced therapist to come alongside the narcissist and carefully help him become aware of the painful feelings about himself that have led him to develop a narcissistic style and to become insensitive to the needs and feelings of others. In group counseling, the narcissist’s self focus and defensiveness can trigger anger and direct confrontations by group members. This just evokes the narcissist’s rage and defensiveness and makes it even harder for him to look at himself. Because of dynamics like this, a narcissist should probably not engage in family or group counseling until he or she has made good progress in individual counseling.

It is also generally not helpful to refer a pathological narcissist to a small support or care group which is not led by a trained therapist. In these types of unsupervised groups, the narcissist is likely to monopolize and manipulate the group until everyone quits or the group members kick the narcissist out for being arrogant, self-focused, and uncaring.

Medication

Medication alone is not suggested for a person with a narcissistic personality disorder. In conjunction with psychotherapy, however, medication is, at times, appropriate if the narcissist is struggling with intensive anxiety or depression. But the premature use of medication can mask the depression underlying the narcissists’ maladaptive character style and eliminate his main motivation for seeking therapy. Instead, the narcissist needs to become aware of his internal pain so that he can learn to face it, rather than trying to ward it off through a narcissistic way of relating to others.


For Further Reading

Among the best books for helping lay persons understand narcissism is Why Is It Always About You? Saving Yourself From the Narcissists in Your Life, by Sandy Hotchkiss, The Free Press, New York, 2002. The book is not written from a distinctly Christian perspective, but gives a wonderful understanding of the problems of narcissism, its causes, and very practical suggestions for living with a narcissist.

Two of the most helpful books on narcissism for professional psychotherapists are The Narcissistic and Borderline Disorders by James Masterson, Brunner/Mazel, Inc., New York , 1981, and The Personality Disorders, also by Dr. Masterson, Zeig, Tucker and Thiesen, Inc. Phoenix, Arizona, 2000.

Notes
1. Adapted from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV). Washington , D.C. American Psychiatric Association, 1994.


Paul Floyd is an attorney in private practice with a specialty in consulting with psychologists, medical, and other health care providers. He holds a J.D. from William Mitchell College of Law, a M.Div. from Bethel Seminary, and has taken graduate study in marriage and family therapy.

Bruce Narramore, Ph.D. is a licensed psychologist, the President of the Narramore Christian Foundation, and Distinguished Professor of Psychology at Rosemead School of Psychology, Biola University.  

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