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Narcissists Hate Therapists

Uploaded 1/17/2014, approx. 6 minute read

My name is Sam Vaknin, I am the author of Malignant Self-Love, Narcissism Revisited.

The narcissist regards therapy as some kind of competitive sport.

In therapy, the narcissist usually immediately insists that he or she is equal to the psychotherapist in knowledge, in experience, or in social status.

To substantiate this claim and level the playing field, the narcissist, in the therapeutic session, spices his speech with professional psychological lingo and terms.

Lingo makes appearance, appearance makes substance. This is the narcissist's motto.

The narcissist is actually sending a message to his psychotherapist.

The narcissist says, there is nothing you, the psychotherapist, can teach me. I am as intelligent as you are. You are not superior to me. Actually, we should be collaborating as equals in this unfortunate state of things in which we inadvertently find ourselves involved.

At first, the narcissist idealizes, but then he devalues the therapist.

The internal dialogue of the narcissist goes something like this.

I know best. I know everything. The therapist is less intelligent than I. I can't afford the top level therapist who are the only ones qualified to treat me as my equals, needless to say. I'm actually as good a therapist as my therapist. I'm as good as a therapist.

Another thread of internal dialogue, he, my therapist, should be my colleague. In certain respect, it is he who should accept my professional authority. He should learn from me. Why would he be my friend? After all, I can use the lingo, the psychobabble, as even better than he does. It's us, him and me, against a hostile and ignorant world.

This way, the narcissist creates a shared psychosis between him and the psychotherapist, as though they are both in one boat fighting the whole world.

The inner dialogue continues.

Narcissist says to himself, just who does he think he is asking me all these questions? What are his professional credentials to start with? I'm a success. And he is a nobody therapist in a dingy office. He is trying to negate my uniqueness. He is trying to reduce me to his level. He is an authority figure. I hate him and I will show him. I will humiliate him. I will prove him ignorant. I will have his license revoked.

Freud called this transference.

Actually, the narcissist says to himself, my therapist is pitiable, a zero, a failure, otherwise he wouldn't be doing what he is doing.

And these self-delusions and fantastic grandiosity are really the narcissist's defenses and resistance to treatment.

This abusive internal exchange becomes more of a vituperative and pejorative as therapy progresses.

The narcissist distances himself from these painful emotions by generalizing and analyzing them, by slicing his life and hurt into neat packages of what he thinks are professional insights, which he condescendingly, patronizingly and kindly provides his therapist with.

The narcissist has a dilapidated and dysfunctional true self overtaken and suppressed by a false self.

In therapy, the general idea is to create the conditions for the true self to resume its growth, safety, predictability, justice, love, and acceptance, what we call a holding environment.

But to achieve this ambience, the therapist tries to establish a mirroring, a re-parenting environment.

Therapy is supposed to provide these conditions of nurturance and guidance through transference, cognitive relabeling, or other methods.

The narcissist must learn that his past experiences are not laws of nature, that not all adults are abusive, that relationships can be nurturing and supportive.

Most therapists try to co-opt the narcissist's inflated ego, his false self, and his defenses. They complement the narcissist, challenging him to prove his omnipotence by overcoming his own disorder. They appeal to his quest for perfection, brilliance and eternal love and to his paranoid tendencies in an attempt to get rid of counterproductive, self-defeating and dysfunctional behavior patterns. Some therapists try to stroke the narcissist's grandiosity and ego.

By doing so, they hope to modify or counter cognitive deficits, thinking errors, and the narcissist's victim stance martyrdom. They contract with the narcissist to alter his conduct.

Psychiatrists tend to medicalize the disorder by attributing it to genetic or biochemical causes.

Narcissists like this approach, as it absolves them from responsibility for their actions. Not my fault, it's my genes, it's not my fault, it's the biochemistry of my brain, says the narcissist.

Therapists with unresolved issues and narcissistic defenses of their own sometimes feel compelled to confront the narcissist head-on and to engage in power plays and power politics. For instance, by instituting disciplinary measures, they compete with the narcissist, these narcissistic therapists. So they compete with their patients and they try to establish their superiority.

They say, I am clever than you are, I have more knowledge, my will should prevail, and so on.

This form of immaturity is decidedly unhelpful and could lead to rage attacks and a deepening of the narcissist's persecutory delusions.

These delusions are bred, to start with, by his humiliation. And if this humiliation in early childhood is reenacted in the therapeutic settings, all narcissistic defenses erupt.

Narcissists generally are averse to being medicated, as this amounts to an admission that something has been wrong and needs fixing.

They also hate to lose control. They are control freaks and they hate to be under the influence of mind-altering drugs prescribed to them by others.

Many narcissists believe that medication is the great equalizer. It will make them lose their uniqueness, superiority, and astounding mind. That is unless they can convincingly present the act of taking their medicine as heroism, a daring enterprise of self-exploration, part of a breakthrough clinical trial, and so on and so forth.

Narcissists often claim that the medicine affects them differently than it does other people, or that they have discovered a new exciting way of using the medicine, or that they are part of someone's, usually themselves, learning curve, part of a new approach to dosage, part of a new cocktail which holds great promise, etc.

Narcissists must dramatize their lives, they are drama queens, to feel worthy and special, out-neal, out-unique. Either be special or don't be at all. Narcissists are drama queens and their life is one big theater show.

Very much like in the physical world, change is brought about only through incredible powers of torsion and wreckage. Only when the narcissist's elasticity gives way, only when he is wounded by his own intransigence, only then is their only hope.

It takes nothing less than a real crisis.

And we at Bordeaux are not enough.

If you enjoyed this article, you might like the following:

Raging Narcissist: Merely Pissed-off?

Narcissistic rage is a phenomenon that occurs when a narcissist is frustrated in their pursuit of narcissistic supply, causing narcissistic injury. The narcissist then projects a bad object onto the source of their frustration and rages against a perceived evil entity that has injured and frustrated them. Narcissistic rage is not the same as normal anger and has two forms: explosive and pernicious or passive-aggressive. People with personality disorders are in a constant state of anger, which is effectively suppressed most of the time, and they are afraid to show that they are angry to meaningful others because they are afraid to lose them.


Old-age Narcissist

Narcissists age without grace, unable to accept their fallibility and mortality. They suffer from mental progeria, aging prematurely and finding themselves in a time warp. The longer they live, the more average they become, and the wider the gulf between their pretensions and accomplishments. Few narcissists save for rainy days, and those who succeed in their vocation end up bitterly alone, having squandered the love of family, offspring, and mates.


Narcissist's Constant Midlife Crisis

The midlife crisis is a much-discussed but little understood phenomenon. There is no link between physiological and hormonal developments and the mythical midlife crisis. The narcissist is best equipped to tackle this problem as they suffer from mental progeria and are in a constant mid-life crisis. The narcissist's personality is rigid, but their life is not. It is changeable, mutable, and tumultuous. The narcissist does not go through a midlife crisis because they are forever the child, forever dreaming and fantasizing, forever enamored with themselves.


How Narcissist Is Mortified

Narcissistic behavior can be modified through treatment, but pathological narcissism is unchangeable. Narcissists have empathic aphantasia, meaning they cannot visualize other people in an empathic way. The misinformation effect is a bigger problem for narcissists than for normal people because they have severe problems with their memory and are dissociative. The longer the delay between the presentation of the original event and the post-event information, the more likely it is that individuals will incorporate the misinformation into the new memory.


Narcissist's Pathological Space: His Kingdom

The pathological narcissistic space is a geographical area, group of people, or an abstract field of knowledge in which the narcissistic pathology reaches its full expression and effectiveness. It is a territorially expanded false self that is achieved via sources of narcissistic supply. The existence of the pathological narcissistic space is independent of the existence of sources of narcissistic supply. The pathological narcissistic space constantly consumes and drains narcissistic supply, and it generates negative narcissistic accumulation.


Self-Aware Narcissist: Still a Narcissist

Narcissism is pervasive and defines the narcissist's waking moments, infiltrating and permeating their dreams. Narcissists only admit to a problem when they are abandoned, destitute, and devastated. Narcissistic behaviors can be modified using talk therapy and pinpointed medication conditioning, but there is a huge difference between behavior modification and a permanent alteration of a psychodynamic landscape. Narcissism may improve with age, but it is rare.


Narcissists Fear Therapy

Narcissists cannot cure themselves, and gaining insight into the disorder is not the same as healing. The best way for a narcissist to help themselves is by resorting to a mental health professional, but even then, the prognosis is dim. The therapeutic situation implies a superior/inferior relationship, which is difficult for the narcissist to accept. The narcissist must shed his false self and face the world naked, defenseless, and to his mind pitiful.


How To Get Your Narcissist to Therapy ("Granny Fanny Cris" Method)

The text discusses how to get a narcissist to attend therapy, emphasizing the importance of not directly confronting the narcissist's grandiosity and instead using strategies such as co-opting their grandiosity, appealing to their self-conception, and leveraging crises to motivate them to seek therapy. It also highlights the challenges of therapy with narcissists, including their resistance and the need for therapists to collaborate with their grandiosity and fantasy defenses. The text also addresses the different types of crises that may drive a narcissist to therapy, such as ultimatums, mental disorders, and suicidality.


Depressive Narcissist

Pathological narcissism is often considered a form of depressive illness, with the life of a typical narcissist punctuated with recurrent bouts of dysphoria, sadness, hopelessness, anhedonia, loss of the ability to feel pleasure, and clinical forms of depression. Narcissists react with depression not only to life crises but to fluctuations in narcissistic supply and to the internal dynamics that these fluctuations generate. There are several types of dysphoria and depression in pathological narcissism, including loss-induced dysphoria, deficiency-induced dysphoria, self-worth dysregulation dysphoria, grandiosity gap dysphoria, and self-punishing dysphoria. Many narcissists end up delusional, schizoid, or paranoid to avoid agonizing and knowing depression.


Narcissist: Why Self-help?

Narcissists can take steps to cope with their disorder before deciding whether to attend therapy. The first step is self-awareness, which involves admitting that something is wrong and accepting responsibility for their role in their misfortune. The second step is confronting a more realistic view of themselves, which can be achieved by people who care about the narcissist confronting them with the truth about themselves and their life. The third step is committing to a regime of therapy, which involves adopting a humble frame of mind and being constructively and productively active in their own therapy. However, few narcissists see why they should embark on this massive quest.

Transcripts Copyright © Sam Vaknin 2010-2023, under license to William DeGraaf
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