Apparently it’s everywhere.
In the millennial selfies.
In slickly constructed and curated Instagram accounts showcasing sex appeal and perfect lives.
In the boardroom, the seats of power and at the highest levels of government.
The narcissist is your ex-partner who fights you over the children, the boss who has no empathy for your mistakes, the co-worker who steals your ideas, the neighbour who stymies your extension.
But the reality of narcissism is far different.
In “The Life of I,” cultural theorist Anne Manne provides an account of our current ills as a society sick with self-aggrandisement and solipsism.
Ranging from the evil of Nordic mass murderer Anders Behring Breivik to the phenomena of selfies and celebrities, Manne describes our obsessions and weaknesses — and that we all have a tendency towards narcissism.
In developing her argument, Manne takes on the diagnostic picture of NPD, including an allusive analysis of the DSMV, but neglects the wider clinical picture, which can be both more subtle and more complex.
Although Manne’s is one of the more thoughtful explorations of narcissism, she unfortunately adds to the current conception of narcissism as a cultural phenomenon rather than an illness.
The clinical is in danger of being subsumed by the cultural.
The real problem with this kind of cultural analysis is that it adds to the public discourse around the idea of narcissism and posits narcissism as an idea, a concept, rather than a human failing, and an illness.
People with an axe to grind, the newly divorced and the already abused — anyone with a social media account and an inconvenient ex, have created a wave of internet fury that tips everyone they don’t like into the hateful (and hated) pit of narcissism.
There is not much room in this pervasive vitriol for the reality of living with a serious illness like NPD.
The lack of substance and identity that lies at the heart of narcissism creates ongoing pain and, yes, the need to perform socially in order to be seen, and seen well. Dependant on the feedback and approval of others to keep themselves together, people with Narcissistic Personality Disorder (NPD) struggle for recognition and selfhood, two things that were denied them in their often abusive childhoods.
NPD sufferers were often the victims of parental narcissism; emotional abuse from which there was no escape.
Constantly belittled, bullied and rejected by those who should have offered love and acceptance, they develop defences which can make them unattractive - and socially challenging.
As adults, people with NPD usually find it almost impossible to be vulnerable.
Vulnerability is associated with shame and sufferers will do anything to avoid the terrible feelings accompanying any hint of humiliation or criticism, often dissociating in response to unexpected feedback from an important other. They will defend against these painful feelings, making them appear defensive and difficult. (Which they no doubt are.)
Those struggling with Narcissism don’t always present in the ways suggested by the popular stereotypes.
They are not always flamboyant or gregarious.
Nor do they always have to be the life of the party, charismatic and self-obsessed.
The shy or “covert” narcissist can be more challenging to pick and is often subtly self-deprecating, whilst still desperately seeking the assurance and approval of others to bolster their shaky sense of self.
People with NPD find it hard to come to (and stay in) therapy. They are reluctant to share their vulnerabilities and will often project difficult feelings onto others — including their therapist. They can respond with cold rejection and sometimes rage to being questioned or challenged. It can be almost impossible for employees to survive a manager with this disorder and trying to have a relationship with someone who has NPD is tough.
It’s not an easy or a pretty picture.
People close to those with NPD are often left to pick up the pieces after trying to make a relationship with a narcissist work, wondering what happened and how they got sucked into the vortex. Often there is very limited give and take, and people with severe narcissism find it hard to accept or make room for another’s world view or emotional needs — they are too constrained by their own needs for reassurance and acknowledgement, without being aware of their limitations - or their underlying lack of identity.
People with this disorder have a model for relationships that is skewed towards mutual exploitation rather than real mutuality — as that is how they were treated by their caregivers.
It can be a very lonely existence.
In contrast to those with BPD, people with NPD will avoid any acknowledgement of the need for others, although the two groups of people share a common core deficit in identity caused by early emotional abuse.
Although they overtly deny dependence needs, the reality for people with NPD is that they do need others and are critically reliant on social feedback to manage their self-esteem.
Recent studies looking at empathy in NPD have found that (in contrast to common perceptions) people with the disorder are fully capable of experiencing empathy. However, because they have experienced early relationships which were exploitative and in which they were not acknowledged as separate and autonomous beings, the pathways to feeling empathy are compromised.
Feelings of any kind other than anger can be a source of pain for some people with NPD and in extreme cases certain feelings will flood and overwhelm their system. They may experience dissociation as an unconscious coping mechanism to deal with the leftovers of primitive panic and abuse.
People with NPD can appear shallow.
It is easier for them not to feel anything. But, of course this is not a long-term solution and will compromise their ability to have meaningful relationships.
For those around them, people with NPD can seem to be a world unto themselves, with limited emotional connection or shared acknowledgement of the frailty that is part of being human.
For sufferers, life is an endless treadmill without any sense of connection or trust.
People with NPD are prone to anxiety, perfectionism and workaholism to the point of exhaustion - and self-harm.
They can compromise their health in pursuit of acknowledgement and worldly success and will suffer depression when their dreams of grandeur are deflated by reality.
COUNSELLING FOR NPD
Most people with high levels of narcissism won’t voluntarily come to therapy. They may come at the insistence of those close to them, but without the motivation that comes with an authentic desire to change, therapy probably won’t work.
Counselling for NPD involves considerable disomfort. The client must be repeatedly confronted with their hurtful behaviour, whilst the therapist must also steadily dismantle the defences protecting the narcissist from recognition of their own vulnerability and unacknowledged pain.
Its not an easy journey.
It can take a long time to develop the trusting relationship necessary for the person’s vulnerability to be brought into the therapy room.
The early trauma which can lead to the development of NPD will be layered deep inside and will be defended against. Often this vulnerability is associated with deeply painful affects including shame.
For the therapist it can be hard to withstand the strong transference and to maintain firm boundaries.
Honesty, authenticity, empathy and patience are the most important qualities to look out for in a therapist working with narcissism.
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References:
Manne, Anne, “The Life of I: the New Culture of Narcissism”, Carlton, Victoria, Australia : Melbourne University Press, 2015.
Ronningstam, Elsa, Baskin-Sommers, A.R. and Krusemark, Elizabeth “Narcissistic Personality Disorder: Clinical and Empirical Perspectives”, PRACTICE REVIEW, Personality Disorders: Theory, Research, and Treatment 2014, Vol. 5, №3, 323–333
For more about NPD and the difference between NPD and BPD, please see Elsa Ronningstam’s lecture for the NEA on Youtube.
