Saturday, February 03, 2007

Treating NPD?

From the treatment guidelines in Narcissistic Ppersonality Disorder in Psychology Today

Therapists can actually use the narcissistic features of their patients to engage and assess them. To avoid angering the patient, it's important to work with, rather than belittle, the narcissistic ego. A therapist should, for example, address a patient's heightened self-importance and desire for control by saying such things as "Because you are obviously such an intelligent and sensitive person, I'm sure that, working together, we can get you past your current difficulties."

Hold the phone. This treatment guideline advises the therapist to lie to the patient, to flatter the patient = to manipulate the patient. Frankly, I don't blame the patient then (who is much better at manipulating people) for turning the trick and manipulating the therapist.

Nobody likes to be manipulated. How arrogant to think the patient doesn't know he or she is being patronizingly manipulated. Some way to establish trust. Some way to battle the delusions. Now Magical Thinking is no longer required to maintain them: it has help in the therapist's own support of these delusions.

Narcissistic personality traits can also be used to provide motivation for therapy. The patient may be induced to change negative behaviors: a better appearance, improved career prospects, or romantic and sexual conquests can been viewed as a reward for recovery.

"Conquests"?

Read the rest. throughout it seems to recommend nothing but drying out a drunk narcissist and teaching him or her new ways to achieve the same old ends - ways that seem more normal and therefore are just more stealthy - without ever addressing the pathology of the underlying disorder.

I am begining to see clearer and clearer why evidence increasingly indicates that treatment, if anything, makes predators more dangerous.
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10 Comments:

At 9:40 AM, Anonymous Anonymous said...

When the N is my life went to a therapist, she came out of the very brief (2 sessions) therapy more aggressive than she went in. My own therapist told me that most counselors choose not to deal with N's and send the client away the moment they suspect they have one in the office. I think they pull this off by making the N. feel there isn't anything wrong with them. Or perhaps the N. is lying about what was said in the sessions.

She seemed to use all of the therapy time to decide what was wrong with everyone else in her life. Of course there was nothing wrong with her. After the aborted therapy she came at the family with all sorts of diagnoses about our mental illnesses. She even told us what drugs she thought we should be on. She went so far as to say that the Dr. that she saw agreed with her about it.

In my own conversations with my N. (while we were still talking) I found that she had the strange ability to hear every compliment that I paid her but didn't hear any of my concerns or negative comments comments about her behavior. I believe that the N. will grab ahold of the flattering remarks of a therapist (or anyone) and use them to feel even more superior and invincible.

I agree with you. Therapy makes the predator a better predator. It helps them to camouflage their true selves even better. They use the "therapy" to make a better sheep costume.

-Anonymous

 
At 10:02 AM, Anonymous Anonymous said...

My ex N loved to tell the tale that the one time he went to therapy, the therapist said there was nothing wrong with him and he should actually be the therapist.

Now I hope the therapist was just playing up to his N. but who knows? Either way the ex didnt get it and is still hopelessly disordered, I presume.

No contact is the only way for me.

 
At 10:11 AM, Blogger Kathy said...

I have read and heard things that correlate with what you say. And I love the way you put it in the last paragraph, because you make point so clear: it helps this predator "make a better sheep costume." That's probably the main factor about therapy that makes them more dangerous.

Plus, since conventional wisdom is to NOT break down the delusions of grandeur, but to "work with" the grandiosity, it stands to reason that they are just making the N feel more justified and therefore more aggressive.

I wonder how often that happens - that the N and the therapist discuss what's wrong with the family, not the N.

 
At 9:23 AM, Anonymous Anonymous said...

i think people outside this arena would say me and my H need at least counseling if not therapy. But I am increasingly opposed to the idea after all the reading i'm doing.Depending on my state of mind, it can get pretty lonely being the only one who really gets what i'm understanding.They are the way they are. We can't change them into something else.Of all the places we may be able to influence and appear to change people and affect them (and to some degree control them) this is one time when we just can't.I think our culture trains us reject the idea that we can't fix and cure everything we don't like. We could use better training in dealing with grief and disappointment.Hey maybe i'll make my million off of grief counseling?!!! jt

 
At 9:30 AM, Anonymous Anonymous said...

i looked up "blame" yesterday. It was a little enlightening. I realized that yes, I can blame my H for our problems more accurately that he killed off my love for him. And yes, a lot of things ARE his fault. But you know what? I only felt better for a little while. It was nice to feel validated. It felt good to know "hey- I was right!" for a liile while. But it doesn't change anything. On the outside. I have to change me. On the inside. On how I'm going to think and act. Not in relation to the N, not inspite of or because of the N, but just because I am alive. Period. jt

 
At 10:51 AM, Anonymous Anonymous said...

I also have experience with an N whose behavior became more aggressive and hurtful after he started therapy. I also tried joint therapy with the N, which was a huge, painful mistake, except for the fact that my eyes were truly opened about the manipulation he was capable of. That was one of the big clues that eventually led me to get out of the marriage.

 
At 10:34 PM, Anonymous Anonymous said...

I think it is probably more helpful for the family members of a narcissist to get counseling and to strategize ways to cope with the narcissist as well as recover from the damage that they do to your spirit. Therapy only helps those who want to be helped and narcissists seldom want to change.

 
At 10:40 AM, Blogger joanne said...

I have discovered after 7 years(4 on; 3 off; now 2 mo. on again) of being in a 'recovery' relationship (both the N and I are recovering addicts), that the 12 step program has the potential to do what was mentioned earlier...make the sheep costume more effective. He has learned how to 'use the steps' to manipulate his circumstances to place all responsibility on me. There is no capability to work on a relationship with this person. He is incapable of seeing a situation as a problem-solving issus; only as an option of winner vs. loser. This translates into him doing whatever it takes to be the 'winner'; it is me who must be 'sacrificed' for his win at all times. The relationship does not exist in his mind. I also relate to the person who offered how pointless it is for us to be aware of the pathology without making changes to remove ourselves. Who is the sicker...!!?? I am still struggling to accept that I let him back in after 3 years and now have to do the whole removal process and heartbreak all over again. This will truly be the last time I volunteer for this misery. And I will 'keep coming back' (to meetings) to remind myself of that...!

 
At 4:05 PM, Anonymous Anonymous said...

All these comments just make me so sad for all of you affected by the Ns in your lives. I have kept a very distant and cool relationship w/my N sister for a number years.

Recently, an acquaintance of hers, who she had been telling anyone and everyone for the past 2 yrs was her hot-n-heavy boyfriend (it sure would have been news to him - they went out for dinner exactly TWICE in this 2-yr period) announced his engagement. This threw my sis into a full fledged depression. On the heels of that, she is scheduled to undergo a breast lumpectomy. Since she basically has no friends, she asked me to stay w/her for a couple of days (actually, she lied and said "the doctor said I need a family member w/me" but I recognized it for what it was - doesn't really bother me.) I do resent the time it takes away from my wife and kids but, nutbag that she is, she's still lonely and in pain.

In any event, she has entered therapy which I do not believe has been effective. Mostly because she is telling the T how this guy "dumped" her after this long-lasting affair. I guess that echos what you've all written here re interaction with counselors.

But now my question: WHAT CAN BE DONE FOR THESE FOLKS? I'm sure my sister doesn't want to be this miserable, unhappy, lie-fabricator. Her life clearly greatly suffers from her actions. My thought is to say "look, you have some very deep-rooted problems. One of the ways this comes out is that you lie about just about any and everything you talk about - including your fantasy boyfriend. You need to go to the shrink and tell her that you have been unable to keep from lying YOUR WHOLE LIFE. In the absence of your ability to do this, you cannot have any more contact w/me or my family. You cannot be part of our lives and we can't be part of yours.....your call."

I suppose this is really one of the 12-steps...admitting the problem. Lots of what I've read suggests N's are unable to do that. But what if.....? I've been contemplating this step for some time.

 
At 7:11 PM, Anonymous Anonymous said...

In response to the last poster:
"But now my question: WHAT CAN BE DONE FOR THESE FOLKS? I'm sure my sister doesn't want to be this miserable, unhappy, lie-fabricator. Her life clearly greatly suffers from her actions. My thought is to say "look, you have some very deep-rooted problems. One of the ways this comes out is that you lie about just about any and everything you talk about - including your fantasy boyfriend. You need to go to the shrink and tell her that you have been unable to keep from lying YOUR WHOLE LIFE. In the absence of your ability to do this, you cannot have any more contact w/me or my family. You cannot be part of our lives and we can't be part of yours.....your call."


I did this exact thing- almost word for word with my parents 24 years ago. They were unable to comply-so I severed every possible tie, including relatives I loved and wished to remain in contact with - to ensure my complete and total separation.

After 18 years, I began a very slow process of reconciliation. It took 5 years of minimal contact.

I can say in their case, yes, they truly have changed to some degree.

The relationship as it stands is not that of a "child" with it's parents...it is very distant with high boundaries on my end. I treated them with the cordiality one might treat a stranger at first and it has grown a bit from there BUT...it will NEVER be a formal parent/child relationship. My expectations of them are extremely minimal and in that, I have been able to be pleasantly surprised by some of their growth. This is NOT the case usually. My ex-P husband's mother is a 75 yr old malignant N all of her life and at 70 (last I saw her) she was more destructive and horrific than ever.

My parents, while somewhat changed and to be honest, far more acceptable as human entities, to this day will NEVER be able to take responsibility (honest, truthful) for what they were and did in the past. And the ex-P mother-will never in this lifetime even achieve that much.

 

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