Narcissistic Personality Disorder: A Compassionate Approach

Narcissistic Personality Disorder

“Narcissistic personality disorder is named for Narcissus, from Greek mythology, who fell in love with his own reflection. Freud used the term to describe persons who were self-absorbed, and psychoanalysts have focused on the narcissist’s need to bolster his or her self-esteem through grandiose fantasy, exaggerated ambition, exhibitionism, and feelings of entitlement.” – Donald W Black, DSM-5 Guidebook


  1. Etiology
  2. The narcissistic dilemma
  3. The wound
  4. Issues of the Narcissistic Personality Disorder
  5. Energy Defense Patterns
  6. Essential features of Narcissistic Personality
  7. Counter-transference
  8. Transference
  9. Psychological Tasks
  10. Emotional Tasks
  11. Facilitating healing for the Narcissistic Personality
  12. Summary incorporating true self expression
  13. Bibliography

Narcissism can be seen as a variation of the Psychopathic Character. Once we understand the underlying psychic structure of narcissism, we can bring tremendous healing.

1. Etiology

  • Birth to 4 years (It can also happen later on in life even in early adulthood)
  • Narcissistic expression phase: 18-30 months old. Ambitious self-expression, magnificence and the child is also full of limitations.
  • Parental figures did not support the child in his achievements of the developing autonomous functions and his self expression, instead the child was put down or humiliated. The child’s real weakness was exploited by the parent or
  • The parents didn’t help the child confront his own weakness and the child was expected to be more than he is and live up to the parent´s expectations. In some cases the child is used to meet the parent’s need for a partner (pseudo-spouse).
  • The attempt to be who others want the child to be is the False Self. The narcissistic has buried his true self expression in response to early injuries.
  • Message: “Don’t be who you are, be who I need you to be and I will love you. Who you are disappoints me, angers me, threatens me, overstimulates me”.
  • We develop the pattern of self betrayal hiding from ourselves what is rejected by others and aggrandizing the parts of that were accepted. To fulfill what others want us to be we had to dis-identify with our limitations, vulnerability and separateness.
  • Buying into the seduction of specialness of the other when we meet their expectations and merge with the positive objectification of the other, confusing that with being loved.

2. The Dilemma

  • There is no way to realize one’s true self:
  • One can´t be as magnificent as born to be.
  • One can´t be as vulnerable as born to be.
  • This triggers unbearable feelings of worthlessness. Overwhelming attempt to stop feeling bad.
  • Must be perceived as competent, right and knowing.

3. The Wound

  • The rejection of one’s true self. () The used child
  • The wound of rejection, feelings of worthlessness are compensated with lack of humility, entitlement, inability to accept failure, striving for power and control, manipulations and a commitment to willfulness and winning.
  • Universally: Physical appearance – being ugly or intellectual capacity – being stupid.

4. Issues of the Narcissistic Personality Disorder

  • Confuses ordinariness with worthlessness. Seeks the seduction of specialness.
  • Intense fears of being controlled, humiliated and defeated.
  • True love and recognition are the narcissist’s deepest longing and forsaken hope
  • Needs healthy mirroring, appreciation, value, being seen, honest mirroring of the real self.
  • No real intimacy or friendships third and second chakra dysfunction does not allow the heart to fully open. Doesn´t relate to others in a mutually beneficial and human way. Needs to trust others and internalize love and care for self and others.
  • Idealizes and looks for the self in other. Circles from idealization to disillusionment.
  • Needs to integrate the polarities of unity/individuality and grandiosity/vulnerability
  • Conflicts with authority: It has to be MY way.
  • Ungrounded grandiosity to avoid feeling humiliation and worthlessness.

5. Energy Defense Patterns of the Narcissistic Personality Disorder

  • Upward displaced psychopath: Energy displaced upwards into the top half, weakness on the lower half of the body. This reflects an ungrounded base supporting exaggerated power, willfulness and achievement.
  • People who have had childhoods in which their boundaries were invaded (masochism) or their needs ignored (orality) are more likely to end up with a narcissistic partner which will replicate their childhood issues. Oral people are undercharged which makes them be drawn to narcissistic people who are overcharged in order to feel life force flowing through them.
  • Chameleon psychopath: no obvious distortions on the body, an idealized false self mask is presented to the world.
  • Pelvis: is rigidly held. Blocks sexual energy flow. (This is because the parental using and manipulation of the narcissistic client often involves the sexual realm).
  • Waistline: is constricted, inhibits awareness of the sexual impulse and of being ungrounded.
  • Diaphragm: is tight and constricted to inhibit feelings and full awareness of the body.
  • Shoulders: raised and tight symbolic to the “raising to the occasion” of the parent expectations.
  • Neck: tightness of the narrows of the neck to inhibit flow of feelings between body and head (This also happens in oral and schizoid characters)
  • Eyes: watchful and suspicious
  • Vertical Power Current: pulled back, will centers are overactive.
  • Back of Skull: major block that inhibits expressing feelings.
  • Chakras: First chakra contracted and third eye exaggerated.

6. Essential features of the Narcissistic Character

  • Ungrounded Grandiosity to avoid feeling worthlessness/humiliation: “Sorry losers but my I.Q. is one the highest and you all know it. Please don’t feel so stupid or insecure; it’s not your fault.”
  • Splitting: black and white thinking: you are either really good or very bad and there is no room in the middle: “Hillary Clinton is the worst secretary of state in the history of the United States”
  • Self-Centered: “I, me, my”. “It’s all about me”
  • Entitled: Feels entitled to say anything without consideration about who he hurts.
  • Denial of any faults which protect a very negative underlying self image.
  • Sensitivity to criticism: Needs to develop a psychic structure to integrate good and bad within the self.

7. Countertransference

The emotional reaction of the analyst to the subject’s contribution

  • Feeling inadequate
  • May find yourself fighting with the client
  • May collude with the narcissistic false self not noticing it is unreal
  • You may not want to show appreciation of them
  • May want to do more: intervene, change, transform the client. When you do this, the client will once again have to set expectations to live up to. He will try to accept any intervention you offer to aggrandize your own grandiose self.
  • The primary difficulty to offer the client healthy mirroring, value and care is your own narcissism, if your own issues are narcissistic, you might narcissistic-ally invest your energy on the client and unconsciously resent giving the client what you have not received. You may resent being a support for someone else’s real self when you need this for yourself.
  • If the narcissism as a therapist is unconscious, the therapist might be inclined to use the client. Example: use the client to promulgate the success of your work which only adds to the original injury of the client.
  • Being angry at the client for his attacks or devaluation towards the therapist. Useful: Respond with sympathy and empathy to the client’s attacks. (This is useful only for narcissistic clients, not for clients with borderline)
  • Most therapists report feeling anger, dread and resentment towards narcissistic clients as well as feeling devalued and criticized by the client and finding themselves distracted, avoid-ant and wishing to terminate treatment.

8. Transference

The redirection to a substitute, usually a therapist, of emotions that were originally felt in childhood (in a phase of analysis called transference neurosis ).

  • May be manipulative, elusive.
  • May challenge, dominate and control
  • May try to undermine you
  • Avoid feelings by presenting an insincere facade
  • If the therapist is grandiose and claims instant success, the narcissistic client will idealize the therapist. The client´s narcissistic idealization of the therapist colludes with the narcissistic need for mirroring of the therapist. Since both contribute to the grandiose, false, compensatory selves, there isn’t a resolution of the transference.
  • The narcissistic client needs a self-object transference: sees the therapist as someone he loves and admires and also as someone he hates and envies.
  • Initially avoiding intervening is good, if you intervene and interpret, the narcissistic client will unwelcome your interventions and experience them as a narcissistic injury, as an implication that he is stupid, in need of support, flawed or can’t figure things out by himself.
  • Merger Transference: Sees himself merged and entitled of others: Seeks out for the perfect object with whom to merge (potential mate). When merger idealization exists, the individual is looking for unity (symbiosis) which was either lost prematurely or not sufficient by the caregivers. He merges through the extension of his grandiose self. (A beautiful wife makes him more attractive). He believes he owns his wife (or therapist) and she should always be there for him, he gets angry if she is not. He merges his grandiosity with people who will reflect his own intelligence, beauty and success.
  • Twinship Transference: Forms Twinship relationships, idealization of the alter ego transference: Separateness is acknowledged but he assumes that the other is very similar to what he likes or dislikes. (Tends to find oral/symbiotic character styles who will fulfill this expectation) An example of this is young romance and part of the function of this attachment is the discovery of self. Twinship in the healthy sense can help a narcissistic person with accurate empathy and acceptance, it helps the narcissistic person feel less isolated and confirm that he belongs to the human community and that his feelings are part of the human experience.
  • Mirror Transference: Needs someone to look up to, believe in, imitate (The perfect role model). The other is used to aggrandize the false self with attention, prize, and respect. This helps the development of a separate self but not the discovery of the real self. Needs others to confirm and strengthen the insecure self. Narcissism is other-related. The self is almost entirely defined by the other’s response to him. When there is no gratifying response there is emptiness and depression which is the narcissistic underlying emotional state. Needs constant mirroring. Example: Gets angry if you don’t notice his new haircut or prize his accomplishments. Healthy mirroring: We need people to understand, value and really see us, when the mirroring is for real, then we can relax and are encouraged to be our real selves.

9. Psychological Tasks for the Narcissistic Personality

  • Letting go of the idealized self by using others to discover and strengthen the ordinary real self instead of using others to aggrandize the false self.
  • Do a realistic assessment of one’s abilities and achievements while also doing a realistic assessment of one’s limitations and weaknesses.
  • Realize that one’s magnificence is found in ordinariness, this being the capacity to feel human feelings and that the gift is found in one’s humanness and not on one’s specialness.
  • Establish trust in the real self and trust for others. See others as allies instead of seeing them as obstacles.
  • Heal through the human community to experience real autonomy with real people and experience a greater support system.

10. Emotional Process Tasks for the Narcissistic Personality

  • Feel the depth of the worthlessness and falseness is a seed for healing.
  • Mourn the injury and the loss of the real self and build a true sense of self.
  • Access feelings of rage in response to the early injury.
  • Nurture and internalize empathy and love for others.
  • Access the need to merge, idealization, twin-ship and mirroring and assist in the maturation of these needs.
  • Explore the grandiose false self: feelings of superiority, entitlement, pride, disgust with others.
  • Feel the void, fragmentation, emptiness, and discontinuity of the real self.
  • Making the decision to grow up which is to give up the hopes for magical fulfillment, fulfillment without effort, without compromise, without limitations, without connection with reality. My way, right or wrong, is the infantile demand.
  • A great healing can anchor in expressing moments of unhappiness and raw feelings that arise. One of them may be the realization that one of those feelings is love. ¨If I could feel love, I was lovable”.
  • Learn social behaviors that communicate empathy and understanding of others, teach the client to let in the warmth and human caring that others provide.

11. Facilitating Healing for the Narcissistic Personality Disorder

  • Be yourself in the most genuine and realistic manner because the objective for therapy of the narcissistic person is to be himself. The narcissistic person can perform but cannot be himself.
  • Seeing the false magnificence of the client as well as the vulnerability can be tremendously healing for the client.
  • Model acceptance of your own limitations and forgiveness of one’s errors as therapists. Perfectionism about being a perfect therapist is a narcissistic adaptation.
  • Avoid being manipulated yourself by the client and avoid using the client to serve you.
  • At the very beginning of therapy with narcissists indulge their grandiosity
  • Client will tend to idealize or devalue the therapist but usually they start by idealizing. Let it be. Remember that narcissistic people are very fragile.
  • Let the relationship build and help the client understand how they developed some of the issues they’ve got.Don’t mention the word narcissism.
  • Help the client understand their problems naturally, that is in the family history they were probably criticizeda lot, put down and they developed this worthlessness feeling and they had to defend against that by the grandiosity.
  • Help the client understand what’s wrong, where it came from, honestly: ¨There is nothing wrong with you, you are a normal human being who just went through this kind of history and this is what happens when you have that kind of history, you come out with a self esteem issue and rather than spend your time in worthlessness, you defend and spend your time in the other side.¨
  • Narcissistic clients Split and have black and white thinking: really good or very very bad. Help the client be comfortable with the middle: being comfortable with being good in some things and not so good in other things.
  • Be free of pressure or demand on the client to achieve your wishes and fulfill your values.
  • Be mindful that any source of negative feedback might seriously re-injure or provoke rage.
  • Be a reliable mirror for the client, really see, understand, value the client. When the mirroring is for real the client is encouraged to be his real self and can relax.
  • Help the client see their child consciousness: entitlement, grandiosity and objectification of others. See and understand who they are to help them feel the real and vulnerable person inside
  • Emphatically help the client when experiencing his chronic pain and hurt, re-frame the pain as a signal of the emergence of the true self where there is deeper and softer pain to be feel.
  • Watch within yourself when you judge the client´s false self and the intense archaic demands of the client’s real self.
  • Working with the legs in a playful way that involves the other: feet to feet, leg to leg.
  • Work with the experience of coming down. Learning to ground.
  • Bring lower and upper body together.

12. Summary incorporating true self expression:

Narcissism can be seen as a reminder of our own humanity. Narcissistic people tend to evoke anger and criticism from others and by remembering that a narcissistic person was painfully injured, criticized and put down, we can respond in a different way, this is by being human and deeply connected to our hearts. “We are just walking each other home”.

The narcissistic injury happens when it’s not ok to be who you are, and you have to be something else…so you build this fake personality and forget your human self. Life is a constant striving to win appreciation, acceptance and to aggrandize the self so that you won’t feel the other parts of you that are were not welcomed. You had to be strong, the best in everything and couldn’t be vulnerable and soft, for example. So being comfortable with making mistakes and with being good at some things and not so good at other things is called reality!

Now, as you were used by your parents, you learned to use others as well but at the end of the day you are searching for love. Opening to receiving warmth from your fellow human beings and caring for them helps you feel part of this community of humans and in this way you won’t be isolated anymore.

We spend all our life trying to feed our ego but at the end of the day, no matter how high above others we are, we will feel emptiness and learning to be ok with emptiness is a doorway to feeling fulfillment if you stay with it long enough.

Healing ourselves doesn’t have to be hard; it’s all about seeing our feelings as feelings and our thoughts as thoughts. Feelings are like waves, they come and go. Thoughts are like clouds, they come by and say hi and then they dissipate. So if you are not your feelings or your thoughts, then, what are you?

Pondering on this can bring immense freedom. There is this little ego that strives to be the best and wants it´s way and then there is something way bigger and vaster than that…that is you!

13. Bibliography

Humanizing the narcissistic style, Stephen Johnson

Characterological transformation, Stephen Johnson

Character Styles, Stephen Johnson

Barbara Brennan School of Healing Handouts

The Search for the Real Self, James F. Masterson

Meditation and the dilemma of narcissism, Epstein

Countertransference phenomena and personality pathology in clinical

Countertransference and its Influence on Judgements of Fitness for Analysis