Entitlement Rage and Contempt Narcissistic Wounds and the

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Entitlement Rage and Contempt Narcissistic Wounds and the Powered By Docstoc
					    Narcissistic Wounds

         Rokelle Lerner
          South Pacific Private
          September 12,2009 
Echoes of a Reflected Self: The
Psychodynamics of Narcissism

        Rokelle Lerner
Addiction is a Narcissistic Disease

• A large majority of individuals with NPD,
  perhaps up to 50%, are substance
  abusers. (Wallach and Wallach 1998)
• Alcoholics have commonly experienced
  profound narcissistic need and
  deprivation in their families.(G.
The yearning or longing to be of sole
 importance to another human being
This yearning can never be fully met.
Narcissism is defined less by
grandiosity then by severely disturbed
4 Areas of Pathological Functioning

1. Narcissists have a basic sense of inferiority
   which underlies a preoccupation with
   fantasies of achievement
2. Narcissists have a shifting morality
3. Due to their inability to trust, feel remorse or
   empathy, narcissists have numerous shallow
4. Narcissists are unable to remain „in love‟ and
   have an impaired capacity for commitment
„Misattunement‟ during Rapprochement Phase
• During this phase, the infant experiences an
                  15-24 months
  excited „narcissistically charged‟ state of
  arousal and anticipates a shared affect state
  with caregiver
• Failure to do so results in excessive shame
  combined with the sense that excitement is
• The child cannot regulate this state of shame
  and the caregiver‟s response cannot provide
                             the child how
  the structure that teachesKohut, Mahler (1968) to
        Narcissistic Wound
   A Child is Given the Message:

“Don’t be who you are, be what I want
you to be. Who you are disappoints me,
angers me and threatens me. Be what I
  want you to be and I will love you.”
• The intense state of unresolved shame
  reflects a sudden shift from the
  sympathetic to the parasympathetic
  autonomic nervous system activity

• Brain imaging studies suggest that
  deficits in the emotional connection
  between children and their primary
  caregiver affect the development of right-
  brain areas involved in empathy and
                                A. Schore, 2000
Two Mechanisms in Families

•Over-valuation De-Valuation
      Loss of Supply Triggers Narcissistic Wound:

•    The excruciating anguish that results when a source of
     supply diminishes

•    This loss triggers a deep sense of shame and despair that
     has it‟s roots in childhood

•    The narcissist spends her life expunging this internal pain

              Narcissistic Injury: 3 Reactions

1.     Frantically gropes for alternative sources of supply
2.     Becomes enraged, depressed and/or childlike
3.     Self medicates
Cluster B Disorders
Histrionic, Antisocial
Most often BPD
Confusion in Diagnosis:

Histrionic or Hysterical Narcissist?

Antisocial or Violent Narcissist?

Borderline Personality or Thin Skinned
Differences Between BPD & Narcissism
When concerns of fragmentation
dominate, patients haven‟t have the
“luxury” of registering shame
For narcissists, shame is their central
affective experience
Although narcissists can self-mutilate,
their defensive mechanism is to mutilate
Narcissists have greater ability to sustain
relationships. (Even though their
relationships are self serving)
Splitting is much more profound in the
borderline patient
  Diagnosis of NPD and
    Narcissistic Traits

Intensity of Internal Shame
Difficult to distinguish in
treatment and early recovery

    Differences Between Narcissists

•   Cerebral: Uses Intellect to get “supply”
•   Somatic: Seduces with body, sexuality;
    provocative, obsessive-compulsive about
    his/her appearance
•   Each responds to wounding differently
 Controls a relationship w/o identifying
 their own needs
 In most cases, the motivation for a
 codependency is not altruistic, but self-
 Unarticulated anger is often misdirected
 and expressed inappropriately.
 May wear suffering like a badge of
 courage, but underneath there is
 bitterness and contempt
 Hungry for adoration, attention, adulation
                Narcissists and Addiction
 “So powerful is the draw to the silvery pool of the drug that I no longer
need food, shelter or warmth ... And slowly, day by day I pine and wither
                        away and die.” P. Joslin

  •   Alice in Wonderland + Myth of Narcissus

  •   Narcissists pre-disposed to addiction; particularly

  •   Shame and addiction are natural partners

  •   The „crack‟ between the narcissist‟s shame and the
      false self is temporarily „sealed‟ through drugs and
      alcohol (grandiosity gap)

                                               P. Joslin, 2008
2 Circumstances Motivate
Narcissists to Treatment:

1. Threat of the loss of a primary
2. They have met with some failure so
   that their strategies no longer work
     Narcissist in Treatment:
Considers herself to be above the rules
Rationalizes her/h addiction to support
her grandiose false self
Lies in treatment and does a
Manipulates therapist and patients
Participation in AA is possible
Expert at provoking abandonment
Prognosis is poor, but not hopeless
• A narcissist isn‟t in treatment because he
  necessarily thinks he has a „problem‟
• He seeks treatment or therapy because
  he expects you to restore his grandiosity
• Be aware of his attempts to heal the
  injured grandiosity rather than deal with
  the underlying emotions of
Barriers to Recovery
 The overwhelming need to feel superior runs counter to
 the treatment of addiction
 Feelings of self-sufficiency and the insistence that he/s
 can “do it on his own”
 Alcohol/Drugs fill the „grandiosity gap‟: the abyss
 between the image he projects (the false self) and the
 injurious truth. With nothing to seal the gap, relapse is
 If relapse occurs, he/s will feel ashamed to admit it
 Addicts/alcoholics who score high on narcissism are
 particularly reluctant to accept the spiritual aspect of AA
       Barriers for Addicts in
    Relationship with Narcissists
•   Trauma history/ traumatic bonding
•   High tolerance for abuse
•   Narcissistic partner has power over her/h
•   Adult child issues, borderline or covert
•   Grief issues, loss of dreams
 Who Does the Narcissist Choose
          as a Mate?
Fellow narcissist or one that feels inadequate
Child of a narcissist or child of an alcoholic
Someone who can be indiscriminately adoring
and supportive
Someone who is willing to sacrifice his/her
personality and endure confinement
There is a press for symbiotic unity that
demands a mate to hold identical perceptions
of the world..
Mate Must Have 4
Unconditionally adoring
Agree to live on unequal terms
Be infinitely flexible
Hold similar views of every situation
                              Addicts in relationship
                SHAME :

CRITICISM                     NEGLECT
 RAGE                          ANXIETY
 Unresolved or unconscious conflicts
 within the therapist that is triggered
 by the client
 Negative countertransference is
 more common with alcoholics than
 any other mental illness

Non Defensive Responses to
 Remain Silent
 “Oh?” or “Hmmm”
 “Maybe so” or “Could be” or “That‟s a very interesting
 “I want to think about what you‟re saying”
 “What are you trying to tell me/ask for?”
 “How would you like me to be different?”

                                              Brian Walker PhD
        Narcissistic Expectations and
          Non-Empathic Behavior

Narcissistic Rage         Containment, DBT
Over-Modulated Affect    Soothing-Mirroring

Cognitive Distortion     CBT

Projective ID            Group/Family Therapy
7 Major Skill Areas for Narcissists
1. Mindfulness
2. Interpersonal Effectiveness
3. Emotional Regulation
4. Self Soothing Techniques
5. Toleration of loss of omnipotence

6. The capacity to be included and tolerate being
7. Experience gratitude
Steps to Reducing Conflict and
     Narcissistic Images
De-escalate anger / blame
Awareness of triggers for wounding
Emotional Language and Shame
Practice in disclosing vulnerability
Internal Boundaries and engagement
Teach self soothing mechanisms
Involvement in 12 Step Program
Medication if needed: SSRI
Suggestions for Addicts with Narcissistic Partners

 Make a plan
 Set clear boundaries
 Practice self soothing
 Learn to walk away
 Find a support community
 Abdicate taking responsibility for the narcissist
 Don‟t take a narcissist‟s behavior personally
 Don‟t expect understanding from a narcissist
 Never use NPD as a Weapon
 Focus on the reality and not the potential
 Get reality checks from those you trust
 Stop Making Excuses and Denying the Severity of the
Bill of Rights for Relationship
I have the right to be treated with courtesy and respect
I have the right to be the only romantic and sexual interest in my partner’s life
I have the right to be informed about our assets and to manage my own
I have a right to have a say in decisions that effect myself and my family
I have a right to live without physical or emotional violence
My children have the right to be treated with respect
I have the right to have my personal property treated with respect
I have the right to choose my own friends
I have the right to make mistakes without punishment or humiliation
Narcissistic Addicts Love to

 Show them that blaming takes them
 away from what they long for
 Challenge them to find the hurt &
 vulnerability underneath the anger,
       Disclosing Vulnerability
Teach a contained format for the expression of hurt,
              resentment and anger

When you....
Like the time.....
I feel/felt.....
My Request Is...
The reason why that‟s so important to me is....
Will you do that?
        Quadrants of Engagement
Positive Engagement          Positive Disengagement
                             u Disconnecting respectfully
u    Enhances self esteem
                             u Communicating gentleness
u    Affirmation               but firmness
u    Invites participation   u Learning to self soothe

Negative Engagement          Negative Disengagement
u   Causing harm to get      u   Drugs or alcohol
    what you want or need    u   Dissociation
u   Seduction, Control       u   Withholding love or attention
u   Manipulation, Abuse      u   Neglect
Self Soothing
   Stephanie Covington PhD

                         Alone        With Others

 Daytime 4 Read                  4 Excuse myself
             4 Take a walk       4 Breathe
             4 Call sponsor      4 Sip ice water

      Maintaining Sanity: Those Involved with Narcissists
                At Home                                   At Work
                                          Nod your head as if you’re listening and
Excuse yourself and call a friend         take deep breaths until you feel calmer

Excuse yourself and say that you’ll       Use the non-defensive statements. Say
return when he/s is calmer                them confidently

If your partner treats you rudely around Shrink them down to the size of a mouse
others, simply get up and leave the scene and listen to them screech

While in conversation, envision her/h as Ask yourself who this narcissist reminds
a scruffy, messy kid with a tantrum      you of. Is the fear past or present?

Weekly support group like Alanon, Coda, Weekly support from someone you trust
some spiritual/religious fellowship     to help maintain sanity

Pursue activity that brings you joy and   Take the time to gentle down before you
relief from stress                        go home
•   Medication means that the narcissist will
    flawed in some way
•   “I‟ll lose my uniqueness”
•   “Medication effects me differently than
•   “I‟ve discovered a revolutionary way of using
    this medication that will transform society”
•   Usually Fluoxetine/Prozac
•   If SSRI‟s not taken as prescribed, could
    exacerbate rage

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