Transcription
Let's start with narcissism and lying. It's an important issue for individuals and for society. You have somebody who has narcissistic pathology and you find them saying things that don't seem to correspond to reality. The question about lying is if they believe what they're saying and in that case it wouldn't be a lie. It would be self-delusion. Or if they actually are aware that it's not true, but they're saying it anyway, in which case it would be a lie. And sometimes it's hard to tell.
So, looking at patients, I'll give you a couple examples. Woman comes in and I'm doing the evaluation and I get to the part of the history where I want to know what she does work-wise. So she says, you know, I have a position in a major corporation. But I asked her to let me know specifically what she did. And without naming it, she started describing her work. She said, "Well, I report to corporate headquarters every morning. I go to the office I share with my colleagues. We're given a list of potential clients. We call them to see if they're interested in our services." And it dawned on me, she was describing being a telemarketer. So I said, by the way, it was something I wish as a therapist I had not said. I said, 'Oh, you're a telemarketer.' And I'm sure in my tone there was a little bit of a disappointed sound because when she said she had a job with a major corporation, it was kind of inflated. So she got really angry at me and said that I didn't even know how to speak English properly.
So here we've got an example where I think to maintain her self-esteem, she had to convince herself that this quote corporate position was more than being a telemarketer and to just call it by its real name interfered with her sense of grandiosity. And I should have just left well enough alone and said, "That's very interesting," and proceeded to listen to her. So was that a lie? Was that a delusion? I think it's more the latter.
Another example is a man in his late 20s came to treatment actually, uh, at the behest of his parents and he did nothing with his life except play video games and smoke marijuana. But he had the idea that when it was time for him to work, he could just sail into whatever industry he wanted and have a partner position. So these are the kind of things that I don't think are outright lies, but I think they're ways the person kind of kids themself or deludes themself into having an image that doesn't correspond to the very impoverished, unproductive life that they're living.
Another example, young woman comes in four years out of college having done nothing with her life, no work, no meaningful activity supported by her dad. And as I'm doing the evaluation, I say, you know, most people at some point think about some kind of work, some kind of career. She looked at me like I was an idiot for even asking. And she said, "Well, of course I've thought about that. When it's time for me to get a job, I'm gonna become the head of a major movie studio in Hollywood." Now, we all know you don't just walk in and become a head of a major movie studio. Was it a lie? Was it deluding herself? Probably the latter.
So these are patients where they seem to need to give themselves a version that's not true, but that they don't knowingly profess as an untruth. They talk themselves into it, sort of. Occasionally, these self-delusions are to the extent that we wonder if the person is psychotic, that they've kind of lost touch with reality in a more general way. And the difference is if the what seems delusional is only limited to their self-narrative, but if in interactions with other people in the world they seem more or less appropriate. But the situation is such that their interactions with the outside world are almost always going to be superficial. Because if you get close to somebody, you know, you begin to befriend somebody and you say to them, uh, you know, "I'm not working now, but I'm going to be the head of a major movie studio." And they say, "Oh, well, have you done film studies?" As soon as the other person begins to ask what are perfectly appropriate questions that challenge your narrative, you, the narcissistic person, is going to say, "Oh, well, I don't need this. I don't need that. That's very aggressive. Why should I tolerate this aggression?" I may have said it before, but for the narcissist, reality is an aggression.
But let's talk about beyond the clinical setting. And the best example, for better or worse, is uh some of what we heard in the news when Donald Trump was elected, starting with the inauguration and Sean Spicer announces that it's the biggest crowd that ever attended a presidential inauguration. And Trump kept repeating this. Now, here's where I don't know because I'm not in direct contact. The person's not in my office. To this day, I I wonder [snorts] did Trump truly think it was the largest crowd ever, which is a possibility. In that case, it would be a self-delusion. Or was he fully aware that it was not the biggest audience, but he was just outright lying because he thought it would serve his purposes? So we have to distinguish between the kind of self-deluding falsehood somebody tells himself or herself to maintain self-esteem and the kind of outright lie where the person knows it's not true, but they're trying to achieve some purpose. In that case, there's an antisocial part which is not necessarily present in the other cases. I mentioned the uh deliberate deceit for a clear goal, which would be, you know, to [snorts] be more popular and get more support from the public.
Is it thus the case that someone sort of in a narcissistic psychopathology is generally going to be self-deluding so that they feel okay and not intentionally lying to someone, or can they also still lie to get their goals met? It it could be both, but the kind of person who seeks psychotherapy generally is more the former, and they're suffering. Why do they have to delude themselves? Because they feel worthless. And it's really sad. We have to talk about what gives a person a sense of value. And it sounds a little corny and sentimental, but it's essentially the feeling that somebody's lovable. And a lot of people grow up without that feeling. There are all kinds of contributing factors to that. But if you're going through life and you don't feel there's anything lovable about you that people will appreciate you just as a human being, then you have to come up with some kind of special story or narrative that gives you value.
That's where we as therapists have to be very tactful. That's why it was wrong of me as a therapist to say to the woman, "Oh, I guess you're describing being a telemarketer," because that kind of burst her bubble, so to speak. She had managed to convince herself that the telemarketer job was sort of an important corporate position, and I should have respected that until we were able in therapy to access the inner doubts she had about herself to bring them more to the surface and explore them together. So she could move beyond her doubts to a little bit more of a secure feeling about herself, and then she could let go of the grandiose and not accurate or somewhat delusional narrative.
We were also taught, and then I personally started thinking about it, um, that when you begin to interface with the steps necessary to move toward a goal, inherently they're going to be hard, and that feels not good. And so part of moving toward a goal is tolerating the discomfort, sense of inadequacy, all of these not-great feelings that emerge when you're pushing yourself.
No, very good point. And I would like to say in relation to this that in TFP, which is a psychoanalytically based psychotherapy, we differ from traditional psychoanalytic work because of our focus on what's going on in the patient's external life, and we have as a condition of treatment the need to be involved in some kind of productive, structured activity outside of the therapy session. So, for instance, the guy who was smoking pot all day, I wouldn't have taken him into therapy without an agreement that he would, in the next couple of months as we began therapy, find some kind of employment, even if it's a volunteer job. Why do we do that? We do that because we know that this encounter with reality is going to provoke, elicit, activate the kind of anxieties you were describing. But then the person can come back to their therapy sessions, talk about how they're experiencing the job or the class they're taking, and then we can explore it.
And here's where it gets interesting because what we find is that elements of the patient's mind get externalized into the setting they're in. So, to give you an example, a patient of mine who was extremely self-critical and unable to build a life because of that. Her first activity was to start taking a college course. So she would come back to sessions and say, "I can't go there. You know, I sit in the seminar room and I just know if I open my mouth and make a comment, I just know that everybody's going to think it's stupid and be critical. Whether or not they say anything, you know, they'll all write me off as stupid." And as her description of the class continued, it turned out that this person in the group said the most idiotic thing you could have ever imagined, and that person in the group shouldn't be there because what right do they have being in the class if they can't even follow the material. So I could say, you know, "It's kind of interesting. We really don't know what the others are thinking, but we do know what you're thinking. And it's kind of critical and dismissing of all these people, but you seem to not be so aware of that. So the only person we really know is [snorts] dismissing of others is you."