Continued from page 1
Confronting narcissist head on and engaging in power politics ("I am cleverer", "My will should prevail", and so on) is decidedly unhelpful and could lead to rage attacks and a deepening of narcissist's persecutory delusions, bred by his humiliation in therapeutic setting.
Successes have been reported by applying 12-step techniques (as modified for patients suffering from Antisocial Personality Disorder), and with treatment modalities as diverse as NLP (Neurolinguistic Programming), Schema Therapy, and EMDR (Eye Movement Desensitization).
But, whatever type of talk therapy, narcissist devalues therapist. His internal dialogue is: "I know best, I know it all, therapist is less intelligent than I, I can't afford top level therapists who are only ones qualified to treat me (as my equals, needless to say), I am actually a therapist myself…"
A litany of self-delusion and fantastic grandiosity (really, defences and resistances) ensues: "He (my therapist) should be my colleague, in certain respects it is he who should accept my professional authority, why won't he be my friend, after all I can use lingo (psycho-babble) even better than he does? It's us (him and me) against a hostile and ignorant world (shared psychosis, follies-a-deux)…"
Then there is this internal dialog: "Just who does he think he is, asking me all these questions? What are his professional credentials? I am a success and he is a nobody therapist in a dingy office, he is trying to negate my uniqueness, he is an authority figure, I hate him, I will show him, I will humiliate him, prove him ignorant, have his licence revoked (transference). Actually, he is pitiable, a zero, a failure…"
And this is only in first three sessions of therapy. This abusive internal exchange becomes more vituperative and pejorative as therapy progresses.
Narcissists generally are averse to being medicated. Resorting to medicines is an implied admission that something is wrong. Narcissists are control freaks and hate to be "under influence" of "mind altering" drugs prescribed to them by others.
Additionally, many of them believe that medication is "great equaliser" – it will make them lose their uniqueness, superiority and so on. That is unless they can convincingly present act of taking their medicines as "heroism", a daring enterprise of self-exploration, part of a breakthrough clinical trial, and so on.
They often claim that medicine affects them differently than it does other people, or that they have discovered a new, exciting way of using it, 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"). Narcissists must dramatise their lives to feel worthy and special. Aut nihil aut unique – either be special or don't be at all. Narcissists are drama queens.
Very much like in physical world, change is brought about only through incredible powers of torsion and breakage. Only when narcissist's elasticity gives way, only when he is wounded by his own intransigence – only then is there hope.
It takes nothing less than a real crisis. Ennui is not enough.
Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .
Visit Sam's Web site at http://samvak.tripod.com