It is observed quite often that many people seek therapy to navigate the challenges posed by those who refuse to do the same.
Cassie, a 35-year-old mother of two, was one such patient. Blind-sided by the abrupt end of her decade-long marriage, Cassie described her estranged husband, Michael, as a “full-blown narcissist” – charming, grandiose, entitled and self-centred. A senior barrister, Michael represented a slew of high-profile clients and was renowned for his arrogance, both in and out of the courtroom.
“He’s a narcissist, right?” Cassie asked, adding that friends and family had gone so far as to insist he had a narcissistic personality disorder.
“He sure does sound difficult,” I replied, mindful of not offering a diagnosis or clinical opinion based on secondhand information. “Either way,” I added, “we’ve got to find a way to manage your interactions with him.”
This is a common therapy scenario – the person seeking help may not be the one with disordered behaviour. Dealing with a narcissist – be it a partner, ex-partner, parent, adult child or boss – can prove to be laborious and emotionally exhausting. Attempts to change a narcissist’s behaviour are usually ineffective.
Like all personality traits, narcissism exists on a spectrum. Narcissistic personality style and disorder are two separate but related constructs. Narcissistic personality style is typified by inflated ego, self-centredness and self-assuredness. This personality style can be quite common in western culture, particularly in medicine, law, entertainment and politics.
Further along the continuum, a narcissistic personality disorder is set apart by severity and intensity of behaviour and characteristics, including grandiosity, entitlement, manipulation or exploitation, attention-seeking and lack of empathy. Narcissistic personality disorder is relatively rare and is typically diagnosed in males.
Like the Greek mythical figure Narcissus, for whom the personality style and disorder are named, narcissists are consumed with themselves and their own image. Narcissists bask in the glow of their own reflection. An over-inflated ego makes the narcissist feel invincible. This can be an attractive trait to others too; romantic partners, friends and colleagues are often charmed by the narcissist’s allure.
The narcissist’s sense of confidence is initially taken as an indication of reliability and fidelity. But this appeal invariably gives way to fractured relationships and destruction of personal and professional ties, as narcissists are typically unable to concede mistakes and lack skills necessary for negotiation or compromise.
Unsurprisingly, narcissists do not often present for therapy. They see nothing problematic with their behaviour, nor do they demonstrate genuine remorse for hurt inflicted on others. A narcissist may be prompted to engage in therapy for other reasons – perhaps at the behest of a long-suffering partner, or when the fallout from fractured personal or professional relationships becomes insurmountable.
Narcissistic individuals are often erroneously categorised as “untreatable”, such is the bewilderment and sense of hopelessness inherent to those left in their wake. While narcissists make for challenging therapy patients, long-term treatment can assist with developing new perspectives and modification of interpersonal behaviour.
Whether due to personality style or personality disorder, the impact of narcissistic behaviour can be devastating. A narcissist’s shadow is a cold and lonely place to find oneself. Understandably, “no contact” is often preferred for those who have borne the brunt of a narcissist. But this is not a feasible option for many, who must maintain contact and communication due to obligations related to co-parenting, family or work. To this end, therapy needs to move beyond a postmortem of the narcissist. The development of coping skills and management strategies is essential.
Limit contact to necessary interactions. Make communication succinct and unambiguous. Avoid aggression, pettiness or personal insults. These all fuel the narcissist’s supply, leaving narcissists energised and their victims depleted. Instead, take the high road; it is less crowded and the view is nicer.
Do not look to a narcissistic person for comfort or compassion, as perceived weaknesses may be used as fodder to bolster the narcissist’s own ego. The so-called “grey rock strategy”, in which a neutral tone and facial expression is adopted during interactions with the narcissist, can encourage them to lose interest.
Setting and enforcing boundaries around contact and communication is essential but likely to rile a narcissist. Loss of control is the ultimate insult. Difficult behaviour is therefore likely to escalate. But like a toddler throwing a tantrum in a supermarket, yielding to unreasonable demands is easy in the short term but ultimately leads to the problematic behaviour patterns becoming further entrenched.
Dealing with a narcissist can feel all-consuming. But, both in therapy and other contexts, it is necessary to resist sole focus on the narcissist and their behaviour. Patients such as Cassie can benefit from exploration of their own attachment style and relationship patterns that may have predisposed attraction to a narcissistic person. This can assist in rebuilding a depleted sense of self and, most importantly, help ensure healthier future relationships.
Dr Bianca Denny is a clinical psychologist based in Melbourne. She is the author of the forthcoming book Talk To Me: Lessons from Patients and their Therapist