Narcissism - Treatment Modalities and Therapies - Part II

Written by Sam Vaknin

Continued from page 1

Confrontingrepparttar 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 ofrepparttar 126195 narcissist's persecutory delusions, bred by his humiliation inrepparttar 126196 therapeutic setting.

Successes have been reported by applying 12-step techniques (as modified for patients suffering fromrepparttar 126197 Antisocial Personality Disorder), and with treatment modalities as diverse as NLP (Neurolinguistic Programming), Schema Therapy, and EMDR (Eye Movement Desensitization).

But, whateverrepparttar 126198 type of talk therapy,repparttar 126199 narcissist devaluesrepparttar 126200 therapist. His internal dialogue is: "I know best, I know it all,repparttar 126201 therapist is less intelligent than I, I can't affordrepparttar 126202 top level therapists who arerepparttar 126203 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 userepparttar 126204 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 inrepparttar 126205 first three sessions ofrepparttar 126206 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 "underrepparttar 126207 influence" of "mind altering" drugs prescribed to them by others.

Additionally, many of them believe that medication isrepparttar 126208 "great equaliser" – it will make them lose their uniqueness, superiority and so on. That is unless they can convincingly presentrepparttar 126209 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 thatrepparttar 126210 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 inrepparttar 126211 physical world, change is brought about only through incredible powers of torsion and breakage. Only whenrepparttar 126212 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

The Myth of Mental Illness - Part II

Written by Sam Vaknin

Continued from page 1

Mental health professionals prefer to talk about an impairment of a "person's perception or understanding of reality". They hold a "guilty but mentally ill" verdict to be contradiction in terms. All "mentally-ill" people operate within a (usually coherent) worldview, with consistent internal logic, and rules of right and wrong (ethics). Yet, these rarely conform torepparttar way most people perceiverepparttar 126194 world. The mentally-ill, therefore, cannot be guilty because s/he has a tenuous grasp on reality.

Yet, experience teaches us that a criminal maybe mentally ill even as s/he maintains a perfect reality test and thus is held criminally responsible (Jeffrey Dahmer comes to mind). The "perception and understanding of reality", in other words, can and does co-exist even withrepparttar 126195 severest forms of mental illness.

This makes it even more difficult to comprehend what is meant by "mental disease". If some mentally ill maintain a grasp on reality, know right from wrong, can anticipaterepparttar 126196 outcomes of their actions, are not subject to irresistible impulses (the official position ofrepparttar 126197 American Psychiatric Association) - in what way do they differ from us, "normal" folks?

This is whyrepparttar 126198 insanity defense often sits ill with mental health pathologies deemed socially "acceptable" and "normal" - such as religion or love.

Considerrepparttar 126199 following case:

A mother bashesrepparttar 126200 skulls of her three sons. Two of them die. She claims to have acted on instructions she had received from God. She is found not guilty by reason of insanity. The jury determined that she "did not know right from wrong duringrepparttar 126201 killings."

But why exactly was she judged insane?

Her belief inrepparttar 126202 existence of God - a being with inordinate and inhuman attributes - may be irrational.

But it does not constitute insanity inrepparttar 126203 strictest sense because it conforms to social and cultural creeds and codes of conduct in her milieu. Billions of people faithfully subscribe torepparttar 126204 same ideas, adhere torepparttar 126205 same transcendental rules, observerepparttar 126206 same mystical rituals, and claim to go throughrepparttar 126207 same experiences. This shared psychosis is so widespread that it can no longer be deemed pathological, statistically speaking.

She claimed that God has spoken to her.

As do numerous other people. Behavior that is considered psychotic (paranoid-schizophrenic) in other contexts is lauded and admired in religious circles. Hearing voices and seeing visions - auditory and visual delusions - are considered rank manifestations of righteousness and sanctity.

Perhaps it wasrepparttar 126208 content of her hallucinations that proved her insane?

She claimed that God had instructed her to kill her boys. Surely, God would not ordain such evil?

Alas,repparttar 126209 Old and New Testaments both contain examples of God's appetite for human sacrifice. Abraham was ordered by God to sacrifice Isaac, his beloved son (though this savage command was rescinded atrepparttar 126210 last moment). Jesus,repparttar 126211 son of God himself, was crucified to atone forrepparttar 126212 sins of humanity.

A divine injunction to slay one's offspring would sit well withrepparttar 126213 Holy Scriptures andrepparttar 126214 Apocrypha as well as with millennia-old Judeo-Christian traditions of martyrdom and sacrifice.

Her actions were wrong and incommensurate with both human and divine (or natural) laws.

Yes, but they were perfectly in accord with a literal interpretation of certain divinely-inspired texts, millennial scriptures, apocalyptic thought systems, and fundamentalist religious ideologies (such asrepparttar 126215 ones espousingrepparttar 126216 imminence of "rupture"). Unless one declares these doctrines and writings insane, her actions are not.

we are forced torepparttar 126217 conclusion thatrepparttar 126218 murderous mother is perfectly sane. Her frame of reference is different to ours. Hence, her definitions of right and wrong are idiosyncratic. To her, killing her babies wasrepparttar 126219 right thing to do and in conformity with valued teachings and her own epiphany. Her grasp of reality -repparttar 126220 immediate and later consequences of her actions - was never impaired.

It would seem that sanity and insanity are relative terms, dependent on frames of cultural and social reference, and statistically defined. There isn't - and, in principle, can never emerge - an "objective", medical, scientific test to determine mental health or disease unequivocally.

VIII. Adaptation and Insanity - (correspondence with Paul Shirley, MSW)

"Normal" people adapt to their environment - both human and natural.

"Abnormal" ones try to adapt their environment - both human and natural - to their idiosyncratic needs/profile.

If they succeed, their environment, both human (society) and natural is pathologized.

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

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