Tag Archive | idealization and devaluation

PART I: MY PARENT HAS A BORDERLINE PERSONALITY DISORDER (BPD)

In this series of articles I won’t talk about BPD but I will focus on the dynamic that is created when you are raised by someone who is struggling with BPD. Until now there was a belief that more women than man suffer from BPD. That’s why I will talk about mothers in this articles. But lately there have been studies that have shown misdiagnosis in male population. It is now believed that percentage between man and women with BPD is close to equal.
From the birth on, the connection between you and your child is very important. It is crucial for physical survival but equally important for psychological well-being of the child. Unfortunately not everyone is having luck with their parents which can lead to serious mental disorder.
Most people would not believe what goes on in Borderline families. The dynamics are intense, destructive, subtle and not readily apparent to the casual observer. BPD is fragile and unpredictable personality. They can be very successful but they struggle with interpersonal relationships. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse.
People with BPD are often described as a child in an adult’s body. These individuals can be incredibly immature and seem to be stuck at an early age of psychological and emotional development. Consequently BPD parents frequently parentify their children-meaning they make them responsible for their emotional and physical needs which is a form of a child abuse. While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression and anxiety that may last only hours, or a day at most.
A mother with personality disorder often lacks empathy, feels entitled, rejects personal responsibility for her behavior, engages in bullying and intimidation, is dishonest, has the relative morality of a small child, has chaotic and extremely dysfunctional relationships, has no sense of fair play and is completely self-obsessed. The borderline parent lacks insight and believes that she is the fine parent of an ungrateful child and goes to any length to prove that this is the case. But how is it to be on the other side? On the side of a child?

What dynamic is in BPD Family?

No space for you
Children of BPD learn to sacrifice their true selves because they need to be focused on her BPD parent in order to survive. They are emotionally or physically abused if they feel differently as their mothers. If they reject her offering (advice, suggestion, emotion) they are portrayed as a bad, ungrateful, disloyal children. Because of the attachment issues borderline mothers tend to smother their children and treat them as small extensions of themselves. Child learns quickly that it is best to get along otherwise there will be a conflict or the emotional cut-off. For a child who is dependent on their mother there is no other way then to sacrifice his identity and go along with her. The child interacts out of obligation. Autonomy, the freedom of self-direction and self-expression, is not welcome. The following examples shows how every situation turns out to be about her:

  • Teenager child is telling her Mom that he feels depressed. Her response: “What do you have to feel depressed about? You know what I was going through when I was your age”. The feelings and potentially serious condition of a adolescent are ignored and denied. “Mom, I cannot make it to dinner tonight, I don’t feel well.” Mother: “You don’t feel well? I am still suffering from the Cesarean Section they gave me so that you could be born.”
  • “Even when trying to confront the issue, any issue, it gets made all about her pain.”

Splitting

Common defense mechanism of BPD is splitting. Which means that a person splits off the good and the bad in themselves and projects bad onto others. This can also be a reason why your mom is denying all the bad she has done and has chosen to see only the good in her. 
In families splitting often occurs by having a good and a bad child. Borderline mother forced teams with the good child whom is required to behave like her. The all good child often feels guilty that they survived the abuse especially relative to a no-good child. This dynamic causes a toxic, estranged relationship between siblings. The lack of closeness is creating isolation, every member of the family is on it’s own. 
The splitting also occurs by being good one moment (idealized) and being completely bad the next.

  • “In our family my brother was always priced by my mum. He could get away with everything. Everything that was wrong felt on me and my sister. We were taking her emotional abuse. But to think about his relationship with our mom. He needed to be there for her in every moment, listening to her, defending her and sleeping in her bed till early teens.”
  • “My Mom always priced me when I brought home the good note. She couldn’t stop giving me the compliments. How smart I am, how she admires my determination and motivation for school. The moment I brought home a bad note, well it wasn’t really bad, but it was not the best, I needed to sit and listen how lazy I am, how I will never become anything.”
  • “I sometimes wonder if she will ever be able to have a conversation with me without saying something along the lines of, “You’ve hated me since you were a little girl.” And then she just calls up one day and all is well, as though she hadn’t just threatened to end our relationship a day before. Usually, I get split back to the light side (as I call it) when she needs something that she knows I can provide. Then I’m back to being a good person.”

She loves to help
With borderline dynamic there are three kinds of things connected to help.

1. She is often a valid member of a community. Willing to help everyone and give all she has to them. Sometimes she can literally give your things to somebody else in a name of help.

2. When it comes to helping you it often comes with a high price. The problem is the help is not being offered for truly altruistic reasons, but rather it is being offered to support the mother’s desired image of being a good mother. In case you reject her help it can be taken as an offense. Once you ask for help they can control you with that and try to win a fight with throwing it at you even years after. “oh, you can’t do this for me but I could help you get a job during collage.” The child quickly learns not to ask for help and tries to avoid his/her mom helping them because they know they will have to pay for it at some point or they will be paying for it forever.

  • “Besides the fact that she’s done this so many times it’s turned into crying wolf at this point, her method of asking for help “with a knife to my throat” also takes away any of the warm feeling that I might get from helping her.”

3. She expects of her children to help her or better said save her from every emotional or physical problem she is having. They often play “I am your mother” card. “oh, you don’t want to do this for me but I am your mother. You should take care of your parents.”

Neglect
Physical and emotional neglect is very often in Borderline families. People with BPD can be so absorbed in their own pain that they are incapable of taking care of their child. They can also escape to substance abuse or other addictions while leaving the child to take care of him/herself.

  • “My mom locked herself in her room for days. I was very afraid that she will do something to herself. I was forced to take care of myself and younger siblings and also spending my energy to convince her to come out of the room.”
  • “She rarely showed affection. She would also get onto my brother and me if we said, “I love you”, as she would scold us and say to only say that phrase if you REALLY mean it. She would never come to you and show affection. We would go to her for hugs and kisses. I remember trying to hold her hand in the movie theater and her pulling her hand away, looking at me funny.”

Rage
Rage outbursts are very common in BPD families.

  • “Once my father moved out and I became a preteen, something changed. My mother and I started fighting. We fought the way I remembered my parents fighting: brutal, out-of-control arguments that would last for hours. I couldn’t tell if this was normal or not.
  • “My mother would fly into rages, telling me how awful I was for hours, and then, moments later, would coolly ask me what I wanted for dinner, appearing to not even remember that it had happened. She acted like I was crazy, and so I assumed that I was. She took me to a child psychologist to deal with whatever supposed defects I had that led to us fighting so often. Then she pulled me out of therapy after a few sessions, when she got into a screaming fight with the receptionist.”
  • “My mother could turn her rages and sadistic behavior on and off like a light switch. She would instantly become “normal” the moment another person entered the room. My mother could be nasty as a snake to my brother and me and then turn it off and be sticky sweet to whoever is at the door or on the phone. Even at a young age, this behavior made me sick.”

Criticism
Mothers with Borderline Personality Disorder often put-downs, insults and criticize their children.

  • “This is a woman who criticizes everything about me. From my “boring, plain, unadventurous” taste in clothes (not boring, just not enough like her), to my “annoying, inconvenient” pescetarian diet, to my need for a spiritual life (“religion is for weak, stupid people who need a crutch to get through life”). Although I am gifted with artistic talents that have won awards and put me on famous stages, nothing I do is ever done without a touch of criticism on my performance.”
  • “I became keenly observant of her methods, never questioned her authority, and strived to be the best at everything, because anything less was a massive disappointment in her eyes.”

But on the other hand they are unable to accept the criticism. They can even go against the law of physics if necessary.

  • “She didn’t see reason to change course if her direction conflicted with the instruction manual, or, say, the natural laws of physics.”
  • “In college, I finally grew brave enough to tell her she had a drinking problem, but after three pointless attempts at an intervention, my efforts seemed futile. Her reality, no matter how factually incorrect or emotionally unjust, was all she could see.”

Blame and guilt
BPD parent can use guilt tripping for many different occasions to achieve what they want. Often they use it because they are afraid of the separation and are making their child feel bad every time s/he wants to do or go somewhere on their own. They of course don’t forget to mention “how alone they feel and how bad of a child you are because you are not spending more time with her”. Although the time that is spend with her is mostly in conflict.
Consequently you grow up blaming yourself for everything-for your mothers mood, for unsuccessful relationships that you are having, for wanting to have time for yourself, for eating too much, for eating too little, for not being “more” successful, for…

  • “I proceeded to ask her why she always has to twist things to make me feel bad, and she proceeded to tell me that I should be ashamed of the way I treat her, and blamed me for making her feel bad. The meeting ended with her throwing her Christmas present, a check for the wedding (which she initially refused to contribute to in any way, and wanted me to invite about 5 of her personal friends) and some of my stuff through the window of my car, and tell me that she’s done.”
  • “Out of the blue my mom asks me what I think about my new Mother in Law. I tell her that I’m very happy with her, and that she is a kind, patient, gentle woman, who listens and gives good advice, and always roots for me. Well, I might as well have crashed the car at that point, because my mother’s reaction was horrific, and completely manipulative. She said, “Oh good. You must be so happy to finally have a mother that cares for you.”

Abandonment
Abandonment issues are at the core of borderline personality disorder. They view separation as betrayal. They can use many forms of manipulation to try to prevent it. One of the most common manipulations is playing a victim, making you feel guilty, threatening with suicide and having an angry outburst. Abandonment doesn’t have to be real it can be something completely normal for child’s development. Like having a sleep over at a friend.
There are also other ways that BPD mother tries to prevent abandonment. One of them is to make the child her best friend. They develop a relationship with a child that is preventing him/her to become an individual. She may look to this child for comfort and validation rather than the other way around. It’s difficult to tell where the boundaries are between the mother and the child. Both tend to cling to each other in fear that the other one will leave.
It can also take the form of infantilizing their children. The mother is unable to tolerate her child’s developmental growth toward healthy independence. They find it difficult to adjust their parenting strategies to match the developmental needs of their children. Oftentimes, children who are being infantilized may develop depression, anxiety, developmental delays and may even be misdiagnosed with an autism spectrum disorder. In the extreme form infantilization can lead to Munchausen by Proxy.

  • “My mother always had a problem with either my Dad leaving (business trips, trips to see his family, extracurricular athletics) or her present husband (my step-father) going away. She stays home all the time, and presently has little to no friends.”
  • “There will usually be some kind of message or voicemail that doesn’t leave you the option of ignoring her, sometimes over-dramatizing what is going on to the point where it will make me panic, or at the very least, make it clear that I’m a horrible child if I don’t respond right away.”

Parental alienation
A mother with BPD may not be able to tolerate a loving relationship between her kids and their father. It is not uncommon for these mothers to speak poorly about their dads in an attempt to turn their children against them. The child can be used as a weapon to carry out her push/pull relationship with the father.

  • “Throughout my life, she looks for signs that I am “betraying” her with my Dad. She asks leading questions or comment about how I should or shouldn’t do something that might involve my Dad, testing me to see where I stand.”
  • “When my Dad showed me attention or gave me money to buy something nice for myself. She always punished me for it by silence for days or not giving me lunch money: “because your father already give you some.”

Jealousy
Mother with BDP is often jealous of her own children and sees them as a competition for attention, love, admiration and resources. The possibility that her child may be smarter, more attractive or popular can be very threatening to her.

  • “Even before that I could never bring anyone around my mom because she’d always find a way to make it seem like she was the perfect mom. The sickest part is that people would think she was this wonderful Christian women that could be the mom they never had. These people would confide in her and tell their deepest secrets and she’d share them with me. Trying to hurt me by showing me how much everyone loved her and wanted her.”
  • “I understand jealousy all too well. My mother actually slept with my first boyfriend to break us up. And she had a hand in my marriage crumbling as well.”

Control
There is a high need of control with BPD parents. They believe that they are entitled to unilateral control over the children. It is common that BPD mother sees the children as her property. She feels that everything that is going on in the family needs to go through her. In BPD families there are times with over-involvement, intrusive behavior and periods of withdrawn, avoidant behaviors. These behaviors may also manifest as oscillations between hostile control and coldness. It is quite common for parents with BPD to attempt to control their children’s behaviors, feelings, and actions to a degree that inhibits their child’s ability to develop independently.

  • “I always thought I had a great and loving mother who only wanted the best for me until I recently went to college. I realized it was more about controlling my life than actually wanting to help me. She was practically living through me. Every time I tried to tell her that she needed help, she became the victim and talked about how horrible of a daughter I was and all the lies I create.”
  • “I can’t make my own decisions because she always made them for me.”
  • “She always told me what to do and how to do it. How I should dress, who I should visit, with whom should I be friends, how should I prepared the food. She always corrected me in every way possible.”

Distraction
It is very common for BPD personality to find a way to distract themselves from reality of life. They turn to any kind of substance abuse and addictions, overspending, workaholism. Basically they can make every item their current obsession until they move on to a new one. They distract themselves from being left alone with their thoughts. It is very common that they struggle at nights when everything calms down.

  • “My mother is a shopaholic, and buys incredible amounts of stuff. She has purchased hundreds of hat boxes but she doesn’t wear hats. She purchased hundreds of shoes but she rarely leaves the house. As far as the eating, she is very, very overweight and binges on food through the night. She stays up all night and sleeps all day.”
  • “She also tends to really focus in on things that can distract her. When she was working, she obsessed with her work and left no time for any social life, and when she retired, she found new ways to stay constantly distracted”.

Center of attention
BPD personality demands attention at all times. They often creates high drama in order to get and keep the attention.

  • “On my wedding day my mother make it all about her. How her daughter is leaving her. She wept so loudly that we needed to stop the ceremony in order to calm her down.”

In Part I we saw what kinds of dynamics can occur in Borderline Families. In the second article (Part II) we will take a look at what kind of psychological burden a child who was growing up in Borderline Family takes with him/her.

In case you want to deepen your understanding of your relationship with your parents, please take a look at my online workshop “Mending our childhood wounds and patterns” HERE.

This workshop will help you with understanding the patterns, roles and attachment you are having in your family dynamic and will shine the light on your behaviors and wounds you are carrying with you. It will also teach you how to deal with your emotions that will evoke through this self-discovery.

NARCISSISTIC PERSONALITY DISORDER (NPD)

  1. Definition of Narcissistic personality disorder (NPD)

The term narcissism was first used in relation to human psychology by Sigmund Freud in his essay “On Narcissism” after the figure of Narcissus in Greek mythology (Golomb 2003: 18).
The Myth: One day Narcissus was walking in the woods when Echo (mountain nymph) saw him, fell deeply in love, and followed him. Narcissus sensed he was being followed and shouted “Who’s there?”. Echo repeated “Who’s there?” She eventually revealed her identity and attempted to embrace him. He stepped away and told her to leave him alone. She was heartbroken and spent the rest of her life in lonely glens until nothing but an echo sound remained of her. Nemesis, the goddess of revenge, noticed this behavior after learning the story and decided to punish Narcissus. Once, during the summer, getting thirsty after hunting, the goddess lured him to a pool where he leaned upon the water and saw himself in the bloom of youth. Narcissus did not realize it was merely his own reflection and fell deeply in love with it, as if it was somebody else. Unable to leave the allure of his image, he eventually realized that his love could not be reciprocated and he melted away from the fire of passion burning inside him, eventually turning into a gold and white flower (Source: https://en.wikipedia.org/wiki/Narcissus_(mythology))
Narcissism is “a pattern of traits and behaviors which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition.” (Vaknin 2003:18) The narcissist constantly tries to repair his injured self-esteem by adoring and admiring his gilded self. (Golomb 2003: 18)

  • Diagnostic criteria

There is a whole range of narcissistic reactions, styles, and characteristics – from the mild, reactive and transient to the permanent personality disorder. NPD is commonly diagnosed with other personality disorders, such as Histrionic, Borderline, Paranoid, and Antisocial Personality Disorders (Vaknin 2003).
The ICD-10 (International Classification of Mental and Behavioural Disorders) defines NPD as “a personality disorder that fits none of the specific rubrics”. It relegates to the category “F60.8 Other specific personality disorders”, together with eccentric, “haltlose” type, immature,        narcissistic, passive-aggressive and psychoneurotic (ICD-10).
American DSM-IV-TR defines NPD as “an all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation and lack of empathy”.
The DSM specifies nine diagnostic criteria. Five (or more) of these criteria must be met for a diagnosis of NPD.
Proposed Criteria:

  • ‘Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognized as superior without commensurate achievements);
  • Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
  • Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
  • Requires excessive admiration, adulation, attention and affirmation – or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);
  • Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favorable priority treatment;
  • Is “interpersonally exploitative”, i.e., uses others to achieve his or her own goals;
  • Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
  • Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;
  • Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, being “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.’ (Vaknin 2003: 19)

1.1.2. Short comparison with other personal disorders
As mentioned earlier NPD is commonly diagnosed with other personality disorders. In this chapter I will introduced short comparison with four other personality disorder.
Opposite from patients with the Borderline Personality Disorder (BPD), the self-image of the narcissist is stable, he or she is less impulsive, self-destructive and concerned with abandonment issues. Also they are not as clinging as BPD patients (Vaknin 2003). Borderline and narcissistic patients both idealize and devalue others. But there is a different between them. BPD patient alternates between idealization and devaluation. For example, first they will idealize you, you will be the best therapist they ever had, and in the next session they will devaluated you, you will be the worst person they had ever know.  Nevertheless, the borderline patient cares about others. The narcissistic patient is more exploitative. Idealization is connected with expectation to satisfied patient’s grandiose fantasy. The minute expectations are not met, narcissist abandons you and looks for another one who will meet his grandiose fantasies (MacKinnon and others).
In short, on surface functioning of the narcissistic personality is much better than that of the average borderline patient. In general, NPD individuals are more capable of high, sustained achievement and will have more successful work history than the person with Borderline Personality Disorder. Both kinds seek attention, but unlike borderline, who seek nurturing attention, narcissist feel they deserve admiring attention because of their superiority (http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
Histrionic Personality Disorder (HPD) and NPD: Both personality types tend towards the demonstrative, exhibitionistic, dramatic and seductive in their behavior. Contrary to the histrionic patient, the narcissist is achievements-orientated and proud of his or her possessions and accomplishments. Narcissists also rarely display their emotions as histrionics do and they hold the sensitivities and needs of others in contempt. While the characteristic distinguishing feature of Histrionic Personality Disorder is coquettishness, the feature of NPD is grandiosity. Person with HPD is warm, playful, and spontaneous and can be dependent on others. These individuals are capable of love, empathy whereas those with NPD are not (Vaknin 2003; look at http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
While persons with NPD and Antisocial Personality Disorder (ASPD) share tendencies to be tough-minded, glib, superficial, exploitative, and unempathetic, NPD are less impulsive, less aggressive, and less deceitful. All ASPD are assumed to have a narcissistic personality structure, but not all narcissists are ASPD. Unlike a person with ASPD, the person with NPD has not learned to be ruthless or competitively assertive and aggressive when frustrated. A critical distinguishing feature is that in ASPD, there are no feelings of guilt or remorse and as opposed to ASPD, few narcissists are criminals (Vaknin 2003; see http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
Patients suffering from the range of obsessive-compulsive disorders (OCD) are committed to perfection and believe that only they are capable of attaining it. But, as opposed to narcissists, they are self-critical. However, someone with NPD is more likely to believe that he has actually achieved perfection. Shortly, the OCD seeks perfection, the narcissist claims it. The value systems of these two personality types differ as well: person with OCD has deeply held, rigid but genuine moral and socio-political beliefs. In contrast, the person with NPD might exposed such deeply held values but actually lacks any true commitment to them (Vaknin 2003; see http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).

1.1.3. Defense mechanism
Over all narcissists intended to protect true self from hurt and trauma. He creates False Self which is omnipotent, invulnerable, and omniscient, through which he regulates his self (Vaknin 2003). To maintain that state, narcissists develop different defense mechanisms. There are three defense mechanisms that are the most common for narcissists: splitting, graciosity and isolation/distance.
Graciosity: narcissist creates relationships only with people who admire them or who he admires. Consequently he is afraid that others will disappoint him or demand attention for themselves. When attention is turned away from them, they distance themselves and leaves the relationship (Praper 1996: 180).
Distance and isolation: narcissist doesn’t realize that he is hurt and wounded. When they got the feeling that others don’t see them as perfect, feeling of inferiority is awaken in them. They are unable to take criticism and take a distance when this happens (Praper 1996: 180).
Splitting or black and white thinking can be seen as a developmental stage as well as a defense mechanism, which is also common in NPD. Narcissist believe that they need to be admired by others. The ones who don’t admire them are categorized as bad. Their ego is not capable of accepting good and bad objects in one person (Praper 1996, see http://en.wikipedia.org/wiki/Splitting_%28psychology%29#Narcissistic_personality_disorder).

1.1.4. Types of narcissism
We all go through narcissistic developmental stage in our lives. As infants and toddlers we all feel that we are the center of the Universe and it is impossible to imagine that our needs wouldn’t be met (Praper 1996). Here we talk about primary narcissism, where toddler doesn’t separate the mother from himself and he depends on her to satisfy his primary needs (Lasch 1979: 79). Both self and others are viewed immaturely-as idealizations (Vaknin 2003). Gradually toddler gains experiences that everything cannot be the way he wants. He realize that there are obstacles in the world, which brings him little disappointments and make him overcome primary narcissism (Praper 1996).
Secondary or pathological narcissism is a pattern of thinking and behaving in adulthood. It manifests in the chronic pursuit of personal gratification and attention, in social dominance and personal ambition, bragging, insensitivity to others, lack of empathy and/or excessive dependence on others to meet his responsibilities in daily living and thinking (Vaknin 2003). Lasch says that this type of narcissism tries to destroy painful disappointments in childhood and cover the childs rage towards people that hurtled him. (Lasch 1979: 79)
Manfield differentiates the exhibitionist type and cover narcissism, both belonging to secondary narcissism (Praper 1996: 178):
The first type is exhibitionistic type. Children during childhood get a lot of support in their grandiosity but there is no room for individuality and true feelings. This type is common for families with one child. Investment in one child raises grand expectations. The child should be born genius, and should use every opportunity to demonstrate this to others. When not acting as expected, he can be roughly rejected by his parents. Avoiding rejection, he continues to be brilliant, perfect, sweet. He also requires that others treat him as special (Praper 1996: 178).
The second type is the disguised type. The child has experienced that grandiose ideas are unacceptable. He learns to hide any such feeling and behaviors. However, he still develops perfectionism and hypersensitivity to criticism. The need for superiority is suppressed while suffering from feelings of inferiority. The truth is that he in fact doesn’t believe that he is inferior (Praper 1996: 179). The disguised type appears humble and modest, so impressively weak that it isn’t difficult to overlook the hidden grandiose self (Praper 1996: 223).
Also Millon distinguish 4 subtype of secondary narcissism in the following photo:

Table: Narcissistic Personality Subtypes (available at: http://www.millon.net/taxonomy/summary.htm)

  1. Origins of narcissism 

NPD has been considered as pathology of self as formation of pathological development of identity (Praper 1996: 175). Considering the work of Otto Kernberg, narcissism is an ego distortion. Ego functions enable us to observe our self and environment. With narcissism, the ego is unable to develop observations from environment in to cohesive picture of self (look Praper 1996: 176). Kernberg sees narcissism as a defense against feelings of individual anger and abandonment, stemming from the child’s rejection. As a result narcissists are distrustful and incapable of relying on others. Their relationships are marked by jealousy, control, and withdrawal (Žižek 1987: 118-119).
By Kerenberg, pathological narcissism originates from the serious frustrations in separation phase (Praper 1996). Kernberg points out that narcissism is a result of permanently cold parental figures, which express indifference or hostility towards the child. This inadequacy is reflected in their tendency to inflate their self-image (Otway and Vignoles 2006).
Kohut believes that narcissism is a normal aspect of infantile development. The child’s self-grandiosity is supported by mirroring and idealizing relationship between child and parent. If these needs are not met, the child as an adult may appear poorly adapted to adult forms of narcissism (Otway and Vignoles 2006). He also believes that the loss of the object that would allow binding and idealized mirroring force the person to direct fantasy only to himself. Therefore, the NPD is looking for a person who would idealize him. Hoping that through the binding with others, he will achieve the feeling of coherent self. In reality he is looking for mother’s admiration that was not there (Praper 1996, 177). The secondary narcissism happens because the process of archaic infantile narcissism to a healthy adult narcissism is interrupt. (Otway and Vignoles 2006).
By Winnicottu, the reason for narcissism is the lack of empathy and harmony between parent and child. Another reason can be overly intrusive behavior from the parent. Child develops a false self, which protects the true self from intrusion and damage. Therefore, narcissists always offer impeccable false self and protect himself against feelings of inferiority (Praper 1996:177).
Millon’s theory opposes to mentioned theories which believe that negative relationship between child and parent is reason for narcissism. Instead, Millon says that the reason is the excessive attention of parents, over-pampering, forbearance and admiration. Parents show unrealistic judgment of the child’s abilities, thereby increasing children’s self-image, which the environment does not necessarily support. Despite the differences in the theories, all believe that narcissism is a result of dysfunctional childhood experiences. (Otway and Vignoles 2006)

  1. Personal attributes

Main personal characteristics which are normally found in NPD:
Sensitivity to criticism: patients with NPD feel injured, humiliated and empty when criticized. They often react with devaluation, rage, and defiance to any5 real or imagined criticism. They are incapable to tolerate setbacks, disagreement, and criticism. (Vaknin 2003)
In personal relationships narcissist is not capable of attachment to others. He depends only on recognition from others. He doesn’t t trust people because he has pathological fear of over-dependency on others. That’s why he usually have short love relationships that in his mind shouldn’t be too stressful or emotionally demanding (Žižek, 1987). The relationships are typically impaired due to their lack of empathy, disregard for others, exploitativeness, sense of entitlement, and constant need for attention (Vaknin 2003).
Narcissist is unable to enjoy because he connects enjoyment with others. Enjoyments starts when others notice his enjoyment. A narcissist is totally external, which indicates inner emptiness and loss of their identity.
Narcissist is incapable of mourning. They are not able to converting rage, because of the loss, to the mourning. He is only able to forget the lost object, or to determine that in fact he didn’t like them anyway. After that he directs his energy towards new person.
For narcissist, the availability of people is taken for granted. To this type of person you are not a person with feelings, you are a ‘thing’ to feed off and sustain their existence.
Narcissist use manipulation to get what he wants. He knows exactly which manipulative tactic is going to work best in which situation. When he wants something from us he pays attention to us but the moment he doesn’t need us anymore he acts indifferent toward us. Narcissists work within win-lose strategy. They believe their world is positioned to serve their insatiable needs. (Žižek, 1987; Tonia Evans 2008)
Being perfect: narcissist has a fear of failure, for example loneliness and aging. That’s why they take care of their body, trying to stay young  and be under the spotlight-so they won’t get lost in the crowd of average people (Žižek, 1987).  They are either “cerebral” (intelligence or academic achievements) or “somatic” (physique, exercise, physical or sexual prowess and romantic or physical “conquests”) (Vaknin 2003). Which means they are trying to be perfect in physical appearance or in intellectual accomplishments.
Narcissist in society: narcissist sees himself as some kind of an exception. He seems adapted to the social norms but he doesn’t take them seriously. He plays this game just to avoid punishment and be successful in the society. He is convinced that everybody else is doing the same-“everyone is wearing masks, social life is just a game” (Žizek, 1987). A narcissist sees the admired person as “an extension of themselves.” If that person refuses them, they “immediate experience hatred and fear, and devaluate previous Idol” (Lasch 1979: 155-156). A narcissist avoids intimacy and associates only with people who are, like himself-perfect (Praper 1996: 180). Žižek mentions three types of other people, separated by the narcissist:

  1. The ideal-other: they expect approval and recognition, he identified with them
  2. Enemies, who are preventing his narcissistic affirmation, so they must be destroyed
  3. All the rest, the mass of people, ”suckers”: a grey average, which is here only to take advantage off and then reject them (Žižek 1987: 111).

 

  1. Narcissist as a patient

Several different approaches to individual therapy have been tried with NPD patients, ranging from classical psychoanalysis to Gestalt therapy. The emerging consensus is that therapists should set modest goals for treatment with NPD patients. Most of them cannot form a sufficiently deep bond with a therapist to allow healing from early-childhood injuries as a matter of fact they rarely turn to therapy at the first place (Frey, 2010).
“As of 2002, there are no medications that have been developed specifically for the treatment of NPD. Patients with NPD who are also depressed or anxious may be given drugs for relief of those symptoms (Frey, 2010).
Kerenberg noticed that narcissistic patients shows excessive self-centeredness, over dependency on admiration from others, prominence of fantasies of success and grandiosity. They avoid facts that are contrary to their inflated image of themselves. A narcissistic patient due to the pain of isolation protects himself with a position of self-sufficiency. They don’t let people emotionally close (Kerenberg, 2007, 505; Praper 1996:223).
They suffer from inordinate envy, which is conscious and unconscious. They show greediness, exploitative behavior, entitlement, devaluation of others, and incapacity to really depend on others. But ironically they need the admiration of others. They show a remarkable lack of empathy, shallowness in their emotional life and lack of capacity for commitment to relationships and goals. Also their self-esteem is regulated by severe mood swings. They have chronic sense of emptiness and boredom which they try to escape through eating, drug and alcohol use. In addition, their tendency to criticize and devalue their therapists (as well as other authority figures) makes it difficult for therapists to work with them (Kerenberg, 2007, 505, Frey 2010).
Patients with NPD may present typical complications of this disorder, including sexual promiscuity or sexual inhibition, drug dependence and alcoholism, social parasitism, severe (narcissistic type) suicidality and parasuicidality (=their aim is not to die). For instance, a patient with NPD tends to become depressed when his feelings are badly hurt, when his defenses have let him down and when he believes his world is collapsing. When wounded, he is at the greatest risk of acting out, either against himself or others. A patient experiencing a narcissistic rage may become homicidal, particularly if he has a need to seek revenge. Under conditions of severe stress and regression, a narcissist can experience significant paranoid developments and brief psychotic episodes (look Kerenberg, 2007, 505; http://www.lmars.com/n-personality-disorder.htm).
Using Heinz Kohut’s self-psychology model, the goal of therapy is to allow the patient to incorporate the missing self-object functions into his internal psychic structure. This process is called transmuting internalization. In this sense, these patients’ psyches are “under construction” and therapy is their building time. Empathy is being the key for making changes in therapy. Without it, the patient whose self is too weak to tolerate more aggressive interpretation, would not benefit from therapy and in fact may suffer more damage (McLean, 2007).
Therapists can recognize narcissistic patients by contratransfer. By feelings of boredom and emotional desertion. The therapist may become sleepy, absent, experiencing shame. He can react as all-knowing expert on life, competing with all the therapists that client had left earlier. When the client devalues him, he feels inadequacy and helplessness (Praper 1996:223).
“The prognosis for younger persons with narcissistic disorders is hopeful to the extent that the disturbances reflect a simple lack of life experience. The outlook for long-standing NPD, however, is largely negative. Some narcissists are able, particularly as they approach their midlife years, to accept their own limitations and those of others, to resolve their problems with envy, and to accept their own mortality. Most patients with NPD, on the other hand, become increasingly depressed as they grow older.” (Frey 2010)

References