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Challenging The Narcissist

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How to Find Pathways to Empathy

By Wendy Behary

Given their arrogance, condescension, and lack of empathy, narcissists are notoriously difficult clients. The key to working with them is being direct and transparent about the roiling emotions they trigger in us.

As the morning sun warms your kitchen, you put on coffee, feed the dog, and glance at your calendar for the day’s schedule. There he is: your 3 p.m. appointment. Your heart sinks, and you begin longing for a power outage in your office building today—anything to force you to cancel on this client, Mr. I’m-Right-and-Everyone-Else-Is-Wrong.

Although you consider yourself well trained and capable of handling the challenges of working with even your most depressed, anxious, and angry clients, this one reinforces your worst fear: maybe you aren’t cut out to do therapy after all. But what exactly makes this pompous, narcissistic puff-dragon so tough? Who gave him the power to trigger you like that?

One reason narcissistic clients are so hard to treat is that they’re adept at taking charge of a session and steering the conversation off course again and again, until you feel sorely tempted to give up and let them take the wheel. Richard, one of my clients, fit the classic profile. He often shifted into self-aggrandizing monologues on his latest brilliant investment, his newly purchased, one-of-a-kind this or that, his powerful business connections, his to-die-for wine collection. Whenever I hazarded an insight into his childhood or suggested that he might be feeling scared, he tried to derail me by saying something like, “I took some psychology classes, too, you know, and I could have been a great therapist.” When talking about his marital problems, he’d say, “My wife has PMS. That’s the problem, not me. You have no idea what I have to put up with and all that I do to make her happy. But it’s never good enough.”

When our conversations ventured toward emotionally loaded material, he shifted into detached mode, denying that he had any feelings. When I tried to get him to see that this is a way of protecting himself from feeling difficult emotions, he demeaned me for my “hokey-pokey, touchy-feely therapy” that had “no relevance” to him. Rolling his eyes, he’d proclaim that he had a perfectly fine childhood and that the only reason for us to look at his past is to satisfy my need to justify myself as a therapist who’s charging a hefty fee.

In my early days of treating these tough clients, I’d want to fight back. Digging my heels into the carpet, I’d silently declare myself unwilling to be defeated by their aggressiveness and arrogant refusal to acknowledge the value of what I had to offer. With Richard, my fantasy was to shout at him, “Of course, you aren’t going to cooperate! Go ahead. Pretend that what’s happening in this room isn’t the same problem you have connecting with your wife, your colleagues, and everyone else you know.”

But blurting out visceral frustration isn’t therapy, and over the years, I’ve learned how to respond to clients’ misperceptions and callous remarks in ways that can move things forward, rather than just reinforce their old relationship patterns. Often this means translating what’s happening for me in the moment into a picture of what it might be like for other people when my clients treat them in the same way.

No matter how obnoxiously narcissists behave, it’s important to remember that their self-aggrandizement almost always covers up painful longings for true connection, intimacy, and a sense that they’re “good enough.” In fact, rather than being purely entitled and spoiled, most narcissists are wounded, deprived, and avoidant, burdened with unattended loneliness and shame. Typically, they grew up with parents who sought to achieve a more illustrious identity themselves by expecting perfection from their little “chosen one.” While these kids may not have been physically abused, they could never count on being cherished and protected without having to prove their worth.

One client of mine remembered how, from an early age, he’d had to be the “entertainer and comforter” for his mother when his father was away on business, or was simply too shut down to engage in his marriage. He said, “Dad would only come alive when he was criticizing me for upsetting my mom or not doing well enough in school—a B+ should have been an A. The slightest pout on my face rendered me a ‘faggot’ in his mind. And at the same time, Mom and Dad would be all aglow when forcing me to recite to their friends in their card-game-of-the-month club some ridiculous poem I’d memorized for school. Being special to them was terribly confusing. When I got in trouble as a teenager, there was no limit to what they’d do to get me off the hook, but there were never any hugs or any feeling that they really wanted to know me. Then again, what good is all that anyway?”

The emphasis on performance and the lack of attuned connection leads many children who develop into narcissists to become workaholics drawn to addictive, self-stimulating habits—pornography, endless Internet surfing, drugs, and alcohol abuse—all of which serve to keep them distracted and cut off from deeper emotional longings. Indulging in these habits is much easier than trying to connect with anyone honestly. For instance, when Richard’s wife, Carolyn, came in with him for a session, she declared that she was at the end of her rope in what she described as a lonely and turbulent marriage. Whenever she tried to share a story with him or get him to react to her, she said, “He’ll just bury his head in his BlackBerry.”

“What’s the big deal?” Richard asked. “I can hear her while I’m looking at my email. Besides, it’s not like she’s telling me something urgent or new.”

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4 comments

  • Comment Link Monday, 22 July 2013 07:21 posted by William M. Zangwill, Ph.D.

    Though I'm a relatively experienced therapist and have done significant work with narcissists, I found the comment on Richard's being "at risk for the postsession shame of having dropped his guard and exposed his vulnerability in the treatment room," and the need to address that risk, extremely helpful. Superb article.

  • Comment Link Wednesday, 17 July 2013 17:59 posted by Kathleen Kobberger

    Excellent article. Helpfully insight into the underworld of this difficult pt.
    And ways of effectively approaching these challenging behaviors.

  • Comment Link Saturday, 13 July 2013 19:10 posted by Carolee Kallmann, MA, LPC, LCADC

    Another helpful article by Wendy Behary, the master of treating narcissists! In addition to helping understand the underpinnings of the narcissist, Wendy offers very practical suggestions to therapists. like myself, who struggle regularly with narcissists.
    Carolee Kallmann, MA, LPC, LCADC

  • Comment Link Saturday, 13 July 2013 16:35 posted by Ofer Peled

    Great article. In a direct sturdy yet empathic way the author navigates us to the heart of the sensitive part of these people which is so hard to reach. When I read this article I could actually see the different sides of Richard and how to overcome the obstacles.