Narcissism - Treatment Modalities and Therapies - Part I

Written by Sam Vaknin


Question:

Isrepparttar Narcissistic Personality Disorder (NPD) more amenable to Cognitive-Behavioural therapies or to Psychodynamic/Psychoanalytic ones?

Answer:

Narcissism pervadesrepparttar 126201 entire personality. It is all-pervasive. Being a narcissist is akin to being an alcoholic but much more so. Alcoholism is an impulsive behaviour. Narcissists exhibit dozens of similarly reckless behaviours, some of them uncontrollable (like their rage,repparttar 126202 outcome of their wounded grandiosity). Narcissism is not a vocation. Narcissism resembles depression or other disorders and cannot be changed at will.

Adult pathological narcissism is no more "curable" thanrepparttar 126203 entirety of one's personality is disposable. The patient is a narcissist. Narcissism is more akin torepparttar 126204 colour of one's skin rather than to one's choice of subjects atrepparttar 126205 university.

Moreover,repparttar 126206 Narcissistic Personality Disorder (NPD) is frequently diagnosed with other, even more intractable personality disorders, mental illnesses, and substance abuse.

Cognitive-Behavioral Therapies (CBTs)

The CBTs postulate that insight even if merely verbal and intellectual is sufficient to induce an emotional outcome. Verbal cues, analyses of mantras we keep repeating ("I am ugly", "I am afraid no one would like to be with me"),repparttar 126207 itemizing of our inner dialogues and narratives and of our repeated behavioural patterns (learned behaviours) coupled with positive (and, rarely, negative) reinforcements are used to induce a cumulative emotional effect tantamount to healing.

Psychodynamic theories rejectrepparttar 126208 notion that cognition can influence emotion. Healing requires access to andrepparttar 126209 study of much deeper strata by both patient and therapist. The very exposure of these strata torepparttar 126210 therapeutic is considered sufficient to induce a dynamic of healing.

The therapist's role is either to interpretrepparttar 126211 material revealed torepparttar 126212 patient (psychoanalysis) by allowingrepparttar 126213 patient to transfer past experience and superimpose it onrepparttar 126214 therapist or to provide a safe emotional and holding environment conducive to changes inrepparttar 126215 patient.

The sad fact is that no known therapy is effective with narcissism itself, though a few therapies are reasonably successful as far as coping with some of its effects goes (behavioural modification).

Dynamic Psychotherapy Or Psychodynamic Therapy, Psychoanalytic Psychotherapy

This is not psychoanalysis. It is an intensive psychotherapy based on psychoanalytic theory withoutrepparttar 126216 (very important) element of free association. This is not to say that free association is not used in these therapies only that it is not a pillar ofrepparttar 126217 technique. Dynamic therapies are usually applied to patients not considered "suitable" for psychoanalysis (such as those suffering from personality disorders, exceptrepparttar 126218 Avoidant PD).

Typically, different modes of interpretation are employed and other techniques borrowed from other treatments modalities. Butrepparttar 126219 material interpreted is not necessarilyrepparttar 126220 result of free association or dreams andrepparttar 126221 psychotherapist is a lot more active thanrepparttar 126222 psychoanalyst.

Psychodynamic therapies are open-ended. Atrepparttar 126223 commencement ofrepparttar 126224 therapy,repparttar 126225 therapist (analyst) makes an agreement (a "pact" or "alliance") withrepparttar 126226 analysand (patient or client). The pact says thatrepparttar 126227 patient undertakes to explore his problems for as long as may be needed. This is supposed to makerepparttar 126228 therapeutic environment much more relaxed becauserepparttar 126229 patient knows thatrepparttar 126230 analyst is at his/her disposal no matter how many meetings would be required in order to broach painful subject matter.

Narcissism, Substance Abuse, and Reckless Behaviours

Written by Sam Vaknin


Pathological narcissism is an addiction to Narcissistic Supply,repparttar narcissist's drug of choice. It is, therefore, not surprising that other addictive and reckless behaviours workaholism, alcoholism, drug abuse, pathological gambling, compulsory shopping, or reckless driving piggyback on this primary dependence.

The narcissist like other types of addicts derives pleasure from these exploits. But they also sustain and enhance his grandiose fantasies as "unique", "superior", "entitled", and "chosen". They place him aboverepparttar 126200 laws and pressures ofrepparttar 126201 mundane and away fromrepparttar 126202 humiliating and sobering demands of reality. They render himrepparttar 126203 centre of attention but also place him in "splendid isolation" fromrepparttar 126204 madding and inferior crowd.

Such compulsory and wild pursuits provide a psychological exoskeleton. They are a substitute to quotidian existence. They affordrepparttar 126205 narcissist with an agenda, with timetables, goals, and faux achievements. The narcissist repparttar 126206 adrenaline junkie feels that he is in control, alert, excited, and vital. He does not regard his condition as dependence. The narcissist firmly believes that he is in charge of his addiction, that he can quit at will and on short notice.

The narcissist denies his cravings for fear of "losing face" and subvertingrepparttar 126207 flawless, perfect, immaculate, and omnipotent image he projects. When caught red handed,repparttar 126208 narcissist underestimates, rationalises, or intellectualises his addictive and reckless behaviours converting them into an integral part of his grandiose and fantastic False Self.

Thus, a drug abusing narcissist may claim to be conducting first hand research forrepparttar 126209 benefit of humanity or that his substance abuse results in enhanced creativity and productivity. The dependence of some narcissists becomes a way of life: busy corporate executives, race car drivers, or professional gamblers come to mind.

The narcissist's addictive behaviours take his mind off his inherent limitations, inevitable failures, painful and much-feared rejections, andrepparttar 126210 Grandiosity Gap repparttar 126211 abyss betweenrepparttar 126212 image he projects (the False Self) andrepparttar 126213 injurious truth. They relieve his anxiety and resolverepparttar 126214 tension between his unrealistic expectations and inflated self-image and his incommensurate achievements, position, status, recognition, intelligence, wealth, and physique.

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