Background

Passive-Aggressive (Negativisitic) Patient Therapy Notes

Uploaded 3/9/2011, approx. 3 minute read

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

The negativistic, passive-aggressive personality disorder is not a formal diagnosis in the psychiatric community. It appears in Appendix B of the Diagnostic and Statistical Manual 4, an appendix titled Criteria Sets and Access provided for further study.

Despite this fact, passive-aggressive or negativistic personality disorder is widely diagnosed by many health practitioners and also treated.

So here is the simulation of a first therapy session with Mike, a male 52 years old diagnosed with negativistic or passive-aggressive personality disorder by his therapist.

Mike is attending therapy at the request of his wife. She complains that he is emotionally absent and aloof.

Mike shrugs, we used to have a great marriage, but good things don't last. You can't sustain the same levels of passion and interest throughout the relationship. Isn't his family worth the effort as a therapist?

Another shrug. He doesn't pay to be a good husband or a good father. Look what my loving wife did to me.

In any case, at my age, the future is behind me. Carpe diem is my motto.

The therapist tries to probe. Does Mike consider his wife's demands to be unreasonable? And Mike flairs. With all due respect, that's between me and my spouse.

Then why is he wasting his time in the therapist? I didn't ask to be here, protest Mike. Did he prepare a list of things he would like to see improved in his family life?

He forgot. Can he compile it for the next meeting? Only if nothing more urgent pops up.

It would be difficult to continue to work together if he doesn't keep his promises, says the therapist.

Mike understands, and he will see what he can do about it.

But he says it without great conviction.

The problem is, Mike says, that he regards psychotherapy as a form of conartistry.

Psychotherapists, he says, are snake oil salesmen. Later-day witch doctors.

Only far less efficient.

He hates to feel cheated or deceived. Does he often feel cheated or deceived as a therapist?

Mike laughs dismissively. He is too clever for run-of-the-mill crooks. He is often underestimated by them. He always has the upper hand.

Do other people besides crooks underestimate him?

He admits to being unappreciated and underpaid at work. It bothers him.

He believes that he deserves more than that.

Obsequious intellectual midgets rise to the top in every organization, Mike observes, with virulent envy and rage.

How does he cope with this discrepancy between the way he perceives himself and the way others evidently evaluate him?

Mike says he ignores the fools. How can one ignore one's co-workers and one's superiors?

Mike simply doesn't talk to them. He says, in other words, does he sulk?

Mike refuses to answer. His rage, barely suppressed, rises to the surface.

Finally, after some additional pressure, Mike admits that he does sulk but not always.

He sometimes tries to enlighten and educate people he deems worthy of his efforts. He often gets him into arguments.

And he has acquired the reputation as a cantankerous curmudgeon, but he doesn't care.

Is he impatient or is he an irritable, irascible person? What do you think, Mike counters?

During this session, did I ever lose my cool? Frequently, says the therapist, Mike half rises from his chair, then thinks better of it and settles down.

Do your things, he says solemnly and contemptuously. Let's get it over with.

This has been the simulated first therapy session with Mike, a passive-aggressive male, 52 years old.

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

Narcissists and Negativistic (Passive-Aggressive) Personality Disorder

The negativistic, passive-aggressive personality disorder is not yet recognized by the committee that is cobbling together the diagnostic and statistical manual. People diagnosed with a negativistic passive-aggressive personality disorder resemble narcissists in some important respects. Despite the obstructive role they play, passive-aggressives feel unappreciated, underpaid, cheated, discriminated against, and misunderstood. Passive-aggressives may be sullen, irritable, impatient, argumentative, cynical, skeptical, and contrarian.


Mortification in Borderline Women, Narcissistic Men: Let Me Go, Give Me Life

Professor Sam Vaknin discusses mortification in borderline women and how it differs from mortification in narcissistic men. Both narcissists and borderlines have a false self, but the functions of the false self differ between the two. In narcissists, the false self serves as a decoy and a manipulative tool, while in borderlines, the false self functions as a host personality, moderating and switching between self-states. Mortification in borderlines is self-inflicted and serves as a way to feel alive, create drama, and experience transformation. When mortified, borderlines either disappear through dissociation or make others disappear through psychopathic behavior. In contrast, narcissists seek mortification to temporarily get rid of their false self and feel liberated.


Narcissist's Victim: NO CONTACT Rules

Professor Sam Vaknin advises victims of narcissism and psychopathy to maintain as much contact with their abuser as the courts, counselors, evaluators, mediators, guardians, or law enforcement officials mandate. However, with the exception of this minimum mandated by the courts, decline any and all gratuitous contact with the narcissist or psychopath. Avoiding contact with the abuser is a form of setting boundaries, and setting boundaries is a form of healing. Be firm, be resolute, but be polite and civil.


Mourning Yourself After Narcissistic Abuse

Professor Sam Vaknin discusses the concept of prolonged grief disorder (PGD), previously known as complicated grief, which is characterized by an inability to move on from a loss. He explains that grief can become a central organizing principle in a person's life, leading to a constricted existence and an inability to enjoy life. Vaknin suggests that everyone experiences prolonged grief at some point, and it is considered pathological if it lasts longer than a year. He also delves into the relationship between narcissists and their victims, describing how narcissists can induce a state of prolonged grief in their victims by offering a simulation of unconditional love and then withdrawing it, leaving the victim feeling abandoned and mourning the loss of the relationship, which was never real to begin with. Vaknin emphasizes the importance of separating from the narcissist both physically and mentally to break the symbiotic relationship and begin the process of healing and individuation.


Narcissists: Difficult and Hateful Patients

Patients with personality disorders often evoke dislike or hatred in their physicians, with the narcissistic patient being the worst. They insist they are equal to the psychotherapist in knowledge, experience, or social status, and resist psychotherapy. Management of personality disorders consists largely of helping the person find a way of life that conflicts less with their character, and aims should be modest. Healthcare professionals who treat patients with personality disorders may experience resentment, alienation, and burnout.


So, Is My Narcissist a Covert Narcissist? Nonsense vs. Scholarship

Covert narcissists are individuals who suffer from an in-depth sense of inferiority, have a marked propensity towards feeling ashamed, and are shy and fragile. They are unable to genuinely depend on others or trust them, suffer from chronic envy of others, and have a lack of regard for generational boundaries. Covert narcissists are not goal-orientated, have shallow vocational commitment, and are forgetful of details, especially names. Inverted narcissists are a subspecies of covert narcissism and are self-centered, sensitive, vulnerable, and defensive, sometimes hostile and paranoid.


How 2 Types of Gaslighting Affect You

The video discusses gaslighting from both verbal and behavioral angles, emphasizing the distinction between narcissistic confabulation and psychopathic gaslighting. It also delves into the experiences of victims and the tactics used by perpetrators, highlighting the differences between narcissists and psychopaths in their approach to gaslighting. The video concludes by encouraging viewers to walk away from such toxic dynamics.


Passive Aggressive Or Covert Narcissist?

Covert narcissists and passive-aggressive individuals share some traits, but there are key differences between them. Covert narcissism involves hidden grandiosity, while passive aggression is about internalizing negative emotions and expressing them indirectly. Both can be emotionally invested in failure and have a negative impact on others. However, passive-aggressive individuals focus more on frustrating and undermining others, while covert narcissists are more invested in their own grandiosity.


Flat Attachment, Dreading Intimacy, and Defiant Promiscuity

Flat attachment is a type of attachment style where people are incapable of bonding or relatedness to others. They commodify people and treat them as replaceable objects. Flat attachment is common among narcissists and psychopaths. With the rise of dating apps and social pressures, people are becoming more atomized and isolated, leading to an increase in flat attachment.


CHILLING: Conman in Action, Scammer Pounces on Prey

The text is a first-person narrative of a conman who lures his victim into a shared psychosis, infiltrating his mind and converting him to the cause. The conman is in control and manipulates his victim's emotions, making him feel vulnerable and dependent on him. The victim is addicted to the conman's attention and affection, and the conman exploits this to extract information and money from him. The conman is devoid of conscience and sees his victim as nothing more than a means to an end.

Transcripts Copyright © Sam Vaknin 2010-2024, under license to William DeGraaf
Website Copyright © William DeGraaf 2022-2024
Get it on Google Play
Privacy policy