Transcription
So you know there's over 50 labels for narcissism, and not to go into the research, but you can, I'll cram in as much as I can. I mean, these are both empirical studies that look at traits of people who are high on narcissism. So, and they're also clinical investigations. So there's a rise in narcissism generally in our society, and that is a social trend. I think that's very different with the rise in narcissistic personality disorders per se, which are also growing, but not commensurate with narcissistic traits in the society as a whole.
There's been a tremendous amount of attention about this on the part of, interestingly enough, mostly social psychologists. So they've looked at trends in parenting, overly permissive, praising the child not commensurate with their actual accomplishments, you know, too much emphasis on self-esteem in the schools, and the absence of, you know, real productivity in kids. Um, so it's sort of an empty praise of kids, and that has been associated with the rise in narcissistic traits.
So you probably know that there are these studies that, uh, I think it's Miller and Twenge have done, and they've written a couple of books. One's called "The Me Generation," another one is called "The Narcissism Epidemic." They have looked at narcissistic traits, the tendency to be grandiose, to feel special, to feel entitled, to exploit others, uh, to be envious of others. They've looked at the rise of narcissistic traits in college students, and they actually found that from 1980 to the present, really very significant rise in the average college student's, uh, reporting of narcissistic traits. In fact, so the average college student reports narcissistic traits commensurate with celebrities. Everyone's the star of their own show.
So certainly these kinds of things, the rise of social media, I think the, the hegemony of the media, the init, the ability to present oneself and create an image, fail, right? That really isn't reflective of the true core self. There's so many aspects of contemporary life, and this goes, you know, the whole notion of modernity, for example, the idea of an insular self that is valued above family bonds and community. So, you know, it fosters individualism. I mean, social mobility breaks down family ties, community ties. I mean, there's so many aspects of contemporary life that actually foster narcissistic traits. This has been written about extensively by Christopher Lasch in his book "The Culture of Narcissism," which I think has really never been quite surpassed.
At the same time, I think we have to look at the other side of that, which is the amplification of the self, the opportunity to develop multiple aspects of the self, which is unprecedented in human history. So the rise of narcissistic traits has a downside, but it also has a self-expanding, developing side. So I don't, I see it as problematic, but, but it has another expansive side in which people actually get to develop themselves and to experience themselves in myriad ways that they've never been able to before in human history.
I have a theory about narcissistic pathology that goes all the way back to infancy. There's tons of infant research, as you know, that's very relevant to psychoanalytic theory and treatment. This is a theory I've pieced together on my own using parts of infant research, clinical observation, and theory from, you know, psychoanalysts like, particularly Simmington. He has a theory which I actually endorse, which is that narcissistic pathology comes out of parents who are who use the child as an extension of the self, who are cold and over controlling and over involved. There's different variants of it, but the elements of it are treating the child as though they're an extension of the self and really delegate the child to aggrandize the parent and fulfill the parents' ambitions and enhance the parents' narcissism, but in the context of being cold and controlling and exploitative of the child as well.
The child at some point turns away from the parent and begin becomes precociously self-sufficient, precociously internalized. And I idealize vision of that parent, that internalized view of the parent, then becomes, um, merged within with the real self. So there's a, you know, what we call the grandiose self, which is the real self, the ideal self, and the ideal other, all combined to form a grandiose self-structure. You know, children who are destined to become narcissistic also have a hand in this, and they actually turn away from the parent and they titrate their dependency on the parent, usually because they've been disappointed in the parent, and they form a kind of premature self-sufficiency and capacity to regulate the self and rely on the self. At the same time, they're taking idealized aspects of the parents right into the self. So they often admire these parents and they take those admired aspects of the parent into the self, and that becomes the core of the self, the idealized view of the parents, the real self, and then what we call the ego ideal. We all have a vision of, you know, what we aspire to, and that creates a core grandiose self.
So they never go through a realistic view of the parent. That's right. They don't develop. Very hard for them to see the parents as real people. They either idealize them or devalue them, and they take the idealized aspects of the parents into the self prematurely to protect them from the disappointment and the anger they feel towards certain, you know, pathogenic behaviors on the part of the parent. The child has some responsibility for this and some agency. I think not responsibility, the child has some agency in the turning away and forming the narcissistic core. You know, it's a diminishing of omnipotence if development goes well, but if it doesn't, the omnipotence persists, and it persists into the rapprochement phase. So rapprochement is around age one, and that's the phase of the love affair with the world and the feeling of omnipotence and so on and so forth. And the mother, to some extent, participates in that in the child's sense of invulnerability and celebrates, you know, how the baby gets up to walk, everybody goes crazy and claps and cheers, and the baby, I mean, you can see it right there on their faces, they look so thrilled with themselves. And rapprochement has to do with their understanding that they're not omnipotent, and so therefore they run back to the mother out of fear of aloneness and fear of separation. Then they're, you know, back and forth, and that's what rapprochement is, alternations between clinging to the mother in a very regressive way and then going off to explore.
I think narcissistic pathology really has to do with what happens at the end of rapprochement when the child begins to internalize the parents as stable, consistent, you know, what we call object constancy, constant objects internally. So they don't need the parent in reality as much as they do. They have an internalized image of the parent that enables them to tolerate separation and tolerate aloneness. Well, I think what happens with narcissistic disorders is that happens prematurely because the parent has disappointed in some way or not been there to really support them in reality. So they internalize an idealized view of the parent, and that becomes part of their self-structure, and that combines with an idealized view of the self, and that blends with the real self to create a grandiose self. So it's something that, in my mind, happens on the way to object constancy. So true object constancy is never quite achieved.
So in the normal process, the parents, you know, are there for refueling. They're there to help the child tolerate the, the loss of narcissistic omnipotence, right, that they have earlier in their childhood. And, you know, there's lots of different theories with how that happens, but I think to me, the most compelling one comes out of the idea of mother and baby or child participate in creating a transitional sphere. So the transitional sphere is where the child can use a combination of fantasy and reality. So that the child can play with the mother in games where they sort of play out their feeling of omnipotence, powerfulness, and mother plays along with it. And then through play, it gets gradually transformed into something that is both, it's another kind of internalization. The baby's able to take parts of the mother and her regulating function into them and, and to make these kinds of games, what we call, what would it call, transitional phenomena, is sort of part of their own creativity. So there are, there's the illusions of omnipotence get channeled into creative, you know, pursuits, and that keeps going on through adulthood. You know, in order to be creative, one has to tolerate being alone, one has to also draw on the internal reservoirs one has from interactions with others, as well as have a solid sense of self. So it, when development goes well enough, you know, on the way to object constancy, the child internalizes stable, consistent, with a view of the parent as stable, consistent, nurturing, and a combination of positive and negative aspects.
So, as I said, there's, there's research that really does show, um, evidence of narcissistic traits in children from the age of six to six on. There's a scale actually called the Childhood Narcissism Scale, and those kids who are high on that scale tend to be quite aggressive. They're the bullies in the group. They show evidence of a grandiose self. They think they should come first. They're entitled to, you know, special treatment. They have certain kinds of behaviors. The kids who don't try in school because they, they just can't be bothered or they are afraid to fail, and often they try to make themselves the teacher's pet and ingratiate themselves with teachers. So there's all kinds of behaviors that are observable along the way. Um, when you get to adolescence, it's much clearer. The boys tend to be more grandiose, and those characteristics become kind of ego-syntonic, and they're not distressed about it. The girls show more vulnerable narcissistic presentation, which means they're rejection sensitive, they're shame-prone, and, and they have poor self-esteem. So it starts breaking down along gender lines, at least in a couple of studies in adolescence, which I think is very, very interesting.
The scales for kids focus more on the grandiosity, and this is a big debate in the literature, as you know, because the question is, are there prototypes of narcissism that are separate from each other, or is there actually really vulnerable and grandiose manifestations of the disorder that all people who have narcissistic pathology are going to have? I'm much more in the latter. I believe in the latter, much more. I think wherever you have grandiosity, you have a covert vulnerability, and if you have vulnerability and shame-proneness and rejection sensitivity on the surface, and a sense of being special in one's suffering, there are usually covert grandiose fantasies. But I think when you're doing research, people want to separate out traits and identify traits, and so they don't see the whole picture.
When we treat people, either, you know, in psychodynamic psychotherapy or psychoanalysis over a long period of time, you see the emergence of both sides of the narcissistic pathology. People may start out very thick-skinned and grandiose, but if they really engage in the treatment process over time, you're going to see the vulnerability emerging. I mean, it's not always obvious that those individuals have narcissistic pathology as their primary difficulty. They often come in feeling very depressed, presenting as very self-defeating, and those kind of patients are actually, in certain ways, harder to treat than the more overt grandiose narcissists. You feel like you're being the sadistic one, you're cast in the role of being the person who's not empathizing with them. But what I have found over time is that empathy only goes so far with these patients because there is a sadomasochistic drama going on internally that they really have to come to grips with, and their aggression is often hidden, and their aggression actually comes out in trying to control people through this kind of a narrative of special suffering.
You know, there's a whole range of analysts who, I mean, the primary one is Rosenfeld, who's a clinician analyst, and he identified a thick-skin prototype and a thin-skinned, and he believed these were actually two quite separate types. And then there was a lot of research. It all boils down to a grandiose and vulnerable, what I think of as presentation or mental states that oscillate. So somebody who's incredibly thick-skinned and grandiose may present that way for a very long time, but over time, you can actually see the vulnerable aspect emerge. You pay really minute attention to both the verbal and the non-verbal cues that you're getting from your patient, affects that fleetingly cross their expression, turning gaze away, the moments when they do that, um, voice tone, as well as it's in the music with these patients as much as it is in the words, because they're often quite intelligent, prolific, often they've had lots of therapy, they can talk the talk. But spontaneous free association, when they really let things flow spontaneously and risk the therapist really understanding what's going on in an intersubjective way, is much more difficult for them. They come with sort of canned narratives, we call it the grandiose narrative. So, and you're expected to accept the grandiose narrative, that's their version of what happened. Any attempt to break into that, I've had patients say to me, well, wait, I, I told you, I want to finish telling you this, and then you can say something. It's a very, there's an attempt to rigidly control what's going on in the session, and sometimes you have to go with that. Other times, you know, you have to point out that that's a pattern, you see it as a pattern, and what is it about? So there are these resistances that take place in the, in the verbal communication, and so the action really is in the non-verbal with these patients, um, and the affect that's being expressed in the room.
So that's one way you address it. You know, different patients have more or less degrees of treatability, and one of the things you have to understand is some of these patients really are only going to improve so much in their functioning. If you can help them understand what are the costs and consequences of clinging to their grandiosity and their narcissistic illusions, and so they function better in the world. That's sometimes all you can hope for. But the kind of therapy I do, which is transference-focused psychotherapy, which is a very intensive twice-a-week type of treatment, where we really, we work on what we call, what is the dominant object relation there in the room at that moment? So the typical one for narcissistic personality disorder would be the grandiose and the devalued object. Therapists tend to be devalued, and some therapists are never able to get beyond that. Soon as you have to sit with the devaluation for a very, very long time before you can actually get to the core of it. And sometimes you have to use what we call interpreting the projection. Well, today you're seeing me as the most incompetent therapist who could never really understand you, and that must be very painful to feel so isolated. It has to do with being able to eventually get around to saying there's an incompetent presence in this room, and there's a grandiose omnipotent presence, and sometimes I am the grandiose omnipotent one, and you're the incompetent one, and sometimes I'm the incompetent one, and you're the grandiose omnipotent one, to get the person to realize that that's a relationship that's part of their own self-structure, and they're going to take that constellation wherever they go. And they're going to usually tend to devalue people in order to build up their own grandiosity, but not always. They can feel threatened, they can feel criticized, and then they can have a sudden reversal, a plunge into exquisite vulnerability. Usually that leads them to attack. So people don't see how vulnerable and how painful those states of vulnerability are, and how much the grandiose itself is kind of a brittle shell that protects people. They crawl back into it over and over again in the, in the therapy. But the goal of our therapy, as I, or the goal, I think of treatment of these patients, is to get them to understand all the different components that go into the narcissistic disorder, the feelings of grandiosity, the exquisite vulnerability, and as they come up in the transference relationship, and that's why I think the therapy is actually effective. But when you make an interpretation, you have to know that it can precipitate a shame reaction because it's the tremendous fear of exposure, of judgment, of criticism. Why is that? Because when you have an identification with ideal parental figures, let's call it that way internally, there's always the tendency to criticize the self because ideal objects demand, ideal figures demand ideal children, right? So the child feels they can never live up to those expectations, so they're chronically feeling shame, they're chronically feeling criticized, and that becomes an internal process, right? And it gets externalized in the therapy.