In the face of a narcissist’s insensitivity and aggressiveness, it’s crucial to balance direct self-disclosure and limit-setting with a concern for creating the sense of safety that comes when the client feels your determination to hang in through all the twists and turns of forming a therapeutic bond. When the narcissist says disdainfully, “This therapy is a waste of time,” it’s crucial not to take that statement too personally, but to see it as an opportunity to explore the links between what’s going on in the moment and the client’s unacknowledged vulnerabilities. So one way of responding might be, “Why would you say that to me? And why in that disgusted tone of voice? You may not have been aware of how hurtful that sounds, but wow! I think there’s something important going on for you, but it’s hard to hear that when I’m sitting here trying to protect myself. Now, please tell me again. What’s making you so upset? What’s going on? But tell me respectfully.”
Bringing the Past to Life
Given narcissists’ unwillingness to explore their feelings and histories, experiential tools can come in handy when trying to deepen the process and bring formative memories into the treatment room. Here are some of the methods I’ve found most useful.
Photographs. To maintain a two-track awareness in sessions linking moment-by-moment client behavior with their history, I’ve found working with clients’ photos can be invaluable in opening doors to buried emotional experiences. After looking through an array of photos, clients and I typically select some that depict the innocence and vulnerability they felt early in life, along with images that reveal transitions into survival modes as they grew older. From my perspective, superimposing the image of a little child over the face of the scowling man sitting across from me makes it easier to maintain an empathic therapeutic posture and not withdraw into defensiveness. For clients, looking at photos of the little, helpless, vulnerable children they once were can bring alive for them the forgotten pain of never receiving unconditional love and the longing to be just ordinary kids.
For instance, a client who professed not to recall much about his childhood immediately responded to a photo of himself in a starched dress shirt. “Don’t let the smile fool you, I was miserable that day. My mother insisted I wear that shirt because a friend designed it, and it made her feel special. But I hated it. Look at the other kids in the background dressed in play clothes. I felt like a freak!” It was the first time I’d heard him express some genuine emotion in all the months we’d been working together. Another time, a narcissistic client startled me by becoming tearful as he viewed the photo of his father holding him when he was an infant. “I don’t think he ever held me again,” he said as he welled up. “He worried it would make me a sissy or gay.”
Photos offer countless opportunities to see the development of the clients’ psychological survival mechanisms. Looking at a photo from when he was 5 years old, a client recalled, “I think that’s when I learned to shut down my feelings. It didn’t take me long to understand that Mom was Queen Bee and my ‘achievements’ were going to make the world recognize what a special mother she was.”
With my client Richard, I recall using photos of him to help me in a session in which he accused me of not caring about him because I’d changed an appointment time. I knew that I’d triggered some of his early life experiences and steadied myself before I responded by holding up a photo that we’d previously looked at together. “Listen, Richard, I know that in the world where you grew up, you were given the message that you had to do everything right, with no mistakes or second-best efforts,” I said. Handing him the photo, I continued, “But look, you were just a small boy with burdens that shouldn’t have been placed on your shoulders. Eventually, you grew to become this boy.” I held up the photo of the overbearing 13-year-old bully he became. “This boy was mad at the world.”
Richard became visibly upset, squirming in his chair, driving his pen into his shoe. Noticing this behavior, I added, “Richard, I’m not the enemy. I get you and care about you. Just because I changed our appointment time doesn’t make it OK for you to make me a target for your anger and disdain. Is this how you speak to others when they disappoint you?”
Richard gave a small nod.
“The people in your world—your family, your coworkers—aren’t trained to understand how your life was organized once upon a time. They can’t get why you so often show such repugnance for them. Even I—someone who gets you—can feel the sting of your hurtful words.”
Richard replied, “Yes, I know. But this is just who I am. I can’t change who I am.”