Narcissism

In this week's episode of Therapy Natters, Richard and Fiona dive deep into the topic of narcissism, specifically Narcissistic Personality Disorder, to distinguish between that and simply high self-esteem and assertiveness.

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Transcript

Richard: 0:09

Ring a ling a ding dong ding, everybody! It's time for another Therapy Natters again! The podcast where myself, Richard Nicholls, and fellow psychotherapist Fiona Biddle do our very best to give you some insight into the human condition and why we feel so rubbish sometimes, whether there's all the pressure of Christmas or not. Ho ho ho! Merry Christmas, by the way, Fiona. That, that, that was funny. Your little face then when I did that.

Fiona: 0:37

Merry Christmas, Richard. Yes, those who are regular listeners will know that I quite often, get the giggles with Richard's introductions. This, I think, is the first time when I've got the giggles before he's even started to speak because I knew something was coming by the, by the expression on his face. But yes, so I was already, already laughing. Oh dear.

Richard: 1:01

Well, it's once a year. I've got to pull out my inner child once a year.

Fiona: 1:06

Does your inner child ever go away? it doesn't ever go away, but that's, that's, why we love you. It's fine.

Richard: 1:13

Yeah, I was, I was 48 a couple of weeks ago. It was my birthday, but I do believe that my physical age is in Fahrenheit and the rest of me is in Celsius. Because that kind of makes me about nine. But there's always a part of us that we have to embrace and take out from time to time and show the world, isn't there? And that's okay.

Fiona: 1:38

Time and a

Richard: 1:39

Apart from when it's not okay. Yeah.

Fiona: 1:41

We talked about the parent adult child model a while ago, didn't we? And that was about, you know, being in the right mode at the right time. And that applies to all dimensions, of us as humans. I mean, there are tendencies that we should never act upon. But still we can recognize that it's perfectly normal to have every aspect of being a human. And also being an animal, because we are animals.

Richard: 2:09

Just dancing animals, basically. Which reminds me of a question that we had submitted in via my website. I don't know whose turn it is to read it out, we've not read out a question for a long time.

Fiona: 2:23

You read it, because otherwise I haven't got it, so.

Richard: 2:26

All right, this is from Abbey from Essex and Abbey says, I've had some very difficult relationships with men over the last 10 years. I'm 28 now and I've been seeing a counsellor for a year now, which has definitely helped me move on from them and start dating again. But I'm finding it hard to not see red flags in every man though. I understand that I'm just being triggered, but I'm struggling to see high self esteem or assertiveness. And instead, I see narcissism. But is there even a difference? Is narcissism just very high self esteem anyway? I'd be interested in your take. Thank you. Well, Abby, I'm very interested in my take too. I've been giving this some thought over the, throughout the morning to, uh, what, what we're gonna say. And I've got some ideas, I must admit, because I see narcissism in myself. But as a therapist who's been in therapy for so long, I'm quite comfortable with it. I can notice that and go, ah, I see what I'm doing there. Because the narcissist in me likes being the centre of attention, and there's a slight feeling of envy when somebody else is the centre of attention. Whereas somebody with great high self esteem, they don't mind if they're not the centre of attention. It's okay for somebody else to be the center of attention. It doesn't, it's no influence on them. Whereas somebody with narcissistic traits, it is. Now, as a therapist, I can see that in myself and shine a spotlight on it, so I'm more aware of it than most people. That's why my narcissism is quite low down on the spectrum. It really, really is. Despite what my friends would think. But somebody on the extremes would find that really hard.

Fiona: 4:15

What you've just said then about a spectrum is, is to me, absolutely crucial. Another thing that you said was absolutely crucial is, not sure what my friends would say or words to that effect. With this, like so many other things, we've got the objective and subjective views, so other people's views and our own views, and seeing this on a continuum, as Abbie has highlighted very eloquently, that it is a continuum of self confidence, and there is such a thing, according to the DSM 5, of Narcissistic Personality Disorder and regular listeners will know we've talked about disorders before. and that there are perhaps is time, time and a place when feeling of narcissism is an okay thing without it being disordered. We'll come back to both of those things about the spectrum and about the, Other people's views in a minute, but let's just give a definition of narcissistic personality disorder. This is from the Mayo Clinic. Narcissistic personality disorder is a mental health condition in which people have an unreasonably high sense of their own importance. They need and seek too much attention and want people to admire them. People with this disorder may lack the ability to understand or care about the feelings of others, but behind this mask of extreme confidence, they are not sure of their self worth and are easily upset by the slightest criticism. Now, There's some really important elements of that and I was emphasizing as I was saying it. Firstly, an unreasonably high sense of their own importance. So, there plenty of people in this world that in certain realms of life have a reasonably high sense of their own importance. I'll ask you in a minute, but I don't know who might have come into your mind, Richard, when when I said that. But, Barack Obama came into my mind.

Richard: 6:22

Oh wow!

Fiona: 6:23

I hope he has a reasonably high sense of his own importance. it's just, it's just the person who popped into my mind. It's not unreasonable.

Richard: 6:33

But there has been a president that came after him with an unreasonable one. Is that what you're saying?

Fiona: 6:38

No, no, I wasn't actually, because I hadn't gone to that point, but yes,

Richard: 6:42

Oh, I do.

Fiona: 6:43

place, good place to go to. Somebody who we, as the outsiders, perceive to have an unreasonably high sense of their own importance. Now, obviously we're talking about Donald Trump here and, you know, we have to remember, well, we don't have to, but perhaps we should, that he has had a lot of achievements in his life. You know, significant achievements, according to most people's standards. But he's gone, again, to most people's perception, certainly in the UK, he's gone beyond that and overblown his sense of importance.

Richard: 7:22

Mm.

Fiona: 7:23

So then the next bit is they need and seek too much attention. The too is critical because everybody needs and seeks attention. It's too much. Want people to admire them, well Everybody wants people to admire them. But it's the, it doesn't in that definition have a too in there, but I think it should.

Richard: 7:45

yeah, it's the difference between wanting it and needing it. Somebody with high self esteem might like the attention, but somebody with narcissistic personality disorder would need it, like oxygen. They couldn't exist without it, and then when they don't get it, they feel threatened, and it will make them angry.

Fiona: 8:04

Indeed. And so in this definition it just says want, but Mayo Clinic, you need to change it to need. Okay,

Richard: 8:11

needs to be a need, yeah.

Fiona: 8:13

and then people with this disorder may lack the ability to understand or care about the feelings of others and that's, to me, it, it feels like it's, it's just, it's just, it's a by product the need for the approval, the validation, overrides other people's needs. And this is where it becomes a disorder or a problem. it is really important, I feel, to be able to differentiate between, high self confidence, self efficacy, self esteem, and the narcissistic, disorder, which is a problem for the person who holds it. But also for their friends, family, colleagues, etc.

Richard: 9:03

What we tend to find is that people with a good healthy level of self esteem, that was modelled to them when they were learning how to be themselves. From the age of nought to five or seven or fifteen or whatever theory we want to look at as to when we stop learning and developing our personality. I don't think it ever stops, but those first seven years are really quite crucial. If those first seven years, using seven as just a figure, if it was taught to you that your voice deserved to be heard that you deserved to be listened to, then once you've then developed your theory of mind and you recognize that you're no more special than everybody else, you've got a nice level of self esteem. Whereas somebody who was maybe neglected or ignored, belittled, forgotten, even abused during those first seven years, they're going to have a different mindset. They're gonna have a feeling that their voice shouldn't be heard, that they're not worthy. And we go one of two ways when that happens. We either say, well, it's a bit like the, I'm okay, you're okay life positions. When somebody's had a neglectful childhood, there's often an I'm not okay point. And then we look at, well, what about them? Are they okay? And I'm not okay? Because in that case, it's me, that's the problem here. And it's me that needs to have negative feelings about. But if it's they're not okay, and I'm not okay, then that is quite a, painful place to live. And so we, in order to exist and not be anxious all the time, we develop defense mechanisms. And one of those is narcissism, to prop up our low self esteem and our feelings about self, because that's the difference between thinking about ourself and feeling about ourself. We can think that we deserve to be heard. But we might not feel that we deserve to be heard. And I think that's where narcissistic personality disorder becomes dominant in people. Where their defenses come up, and of course they know, aged seven, that they deserve to be heard because they're human. Well, why am I not being heard? Well, everybody else is a piece of crap, that's why. in order to succeed in this world, I have to be above them, because look how awful I was treated, and it's because of them, because they are bad. And they might act as if I'm okay, you're not okay, but actually deep down they're still living in the I'm not okay, you're not okay position. I hope that makes sense. There's a bit of a ramble there.

Fiona: 11:48

Well, it made sense to me. If anybody, if it doesn't, Google the life positions, I'm okay. You're okay. It's Cartesian logic. You've got the four combinations, and each one has, has its definition of how you are. So, you know, the ideal position is to believe that I'm okay, and you're okay, and everybody's okay.

Richard: 12:09

And, think somebody with, a good healthy level of self esteem feels, I'm okay, you're okay. And then when somebody else dominates, somebody else, Ah, here's the thing that we might see as a difference between somebody with a narcissistic personality disorder and somebody who has just got high self esteem. Somebody with high self esteem might be proud of somebody else for achieving something. They might look at somebody else's successes and be pleased and go, well done, and mean it, and feel it, I'm proud of them. Somebody with NPD, no, they, they, they can't do that, because that's evidence that that person might be in some way better than them and they can't have that.

Fiona: 12:51

again, I think it's important to recognise this is a continuum. To me, that would be the extreme end and I obviously haven't got a clue, but my feeling is there's probably not that many people who are at that extreme end, but that still a problem further along that continuum. So,

Richard: 13:13

Well, it's not impossible. I've seen case studies of, of people with NPD who have sabotaged their children's lives. Because their children have been doing well at something. I can't have my child doing well. And they've, they've ripped apart their work. it wouldn't get submitted.

Fiona: 13:29

not saying it doesn't happen, I'm just saying

Richard: 13:32

Yeah, it's rare.

Fiona: 13:33

need to just somebody who's listening to this. who might be thinking, oh crikey, oh crikey, that's describing me. That doesn't mean that it's that bad, necessarily. if you're listening and you're thinking that perhaps you're a little bit further along that continuum than you would like to be, and then you can work on it. Because if you work on the, underlying lack of self esteem, then the other will fall away. Going back to the idea of self confidence, I'll use myself as an example, because I can, and I know myself. I first started training as a therapist, I would say that I had reasonable self esteem and self confidence, but I had some experiences from school and just growing up experiences, where I did feel that what I had to say wasn't as worthy as what other people had to say, and that I wasn't as Good, just to use a generic term, as other people in, in various ways. and the therapy that I undertook in order to become a therapist really helped me work on those things, so that for example, last night I went to a pub quiz with the new team, so I didn't know anybody there, and there was part of me watching myself and thinking, God, you're coming over as rather confident, aren't you? You know, I was Joining it, pushing myself forward, answering questions, joking with the people, and thinking, this is, this is sort of not who I internally believe I am. But I am. But I still haven't quite caught up, even now, from, you know, that would not have been me as a teenager or young adult. I would have not got into that sort of place until I knew people. Those other people there, would have perceived me as a really self confident person. I was also brought up in the age, and it probably still exists in the sense of, you know, you don't blow your own trumpet. So being overconfident

Richard: 15:45

Is arrogant.

Fiona: 15:45

Oh gosh, that word, yes. Arrogant is, is such a, a bad thing to be.

Richard: 15:53

But if you've never been assertive, then assertiveness will feel like arrogance.

Fiona: 15:57

And it gets labelled as that

Richard: 15:59

yeah, it can, yeah, if nobody's used to it. If you've been hiding away your personality, hiding yourself away, and then people go to therapy and they sort of get a little bit better about themselves and they start speaking up. And they put their boundaries in place. To other people it might seem arrogant, it really will, but actually you're just behaving healthily and normally like everybody else. But somebody with narcissistic personality disorder watching that, they're not able to allow other people to have boundaries. Because the, the narcissist, using that word to mean somebody with a disorder, rather than just somebody who likes themselves, they have to control those boundaries.

Fiona: 16:36

So a narcissist will be putting people down and using words like arrogance to control others and to to

Richard: 16:46

Because that's, that's how they keep themselves high.

Fiona: 16:49

to to, yeah. To stop them being in a lot of ways, yeah. Keep them down.

Richard: 16:57

If the pain of somebody saying no to you is so great that you can't take it, that person who said no to you needs to be written out of your life. I'll take that to therapy. Because that's, painful. Because we should be able to hear people say, No, sorry, I can't do that. Or, no, sorry, I'm not prepared to do that. And for the therapists listening, because people with narcissistic personality disorder might be sent to therapy by their partners or by court, even. Or they might come from, yeah, they might come from anger management, that sort of thing. There can be a sign of it when the client is telling you when the appointment needs to be, rather than you saying, I have a 2. 30 appointment. Well, I can't make 2. 30, but I can do 2. 45. So can I do 2. 45 to 3. 45? Well no, I've got another client then, so we can have a 45 minute session, it's okay if you're late. But I want my full hour, and that's what time I'm gonna be there. That inability to, to be able to work within your boundaries, that's something to highlight, gently, with them. For the therapists out there.

Fiona: 18:10

There's something about controlling of other people's behavior to make the self feel better in all of that, isn't there?

Richard: 18:18

Yeah. And somebody with high self esteem does not need to do that. Because they like themselves already, enough. They know their worth. Whereas somebody with NPD acts as if they do, but deep down they really do not. And it's all those defences that they've been putting up that mask it. They might have years of therapy before they realise that actually deep down I hate myself. Because they've had so many years of pretending that they don't, so they believe it. It is kind of like a delusion. Narcissistic Personality Disorder. It is like living in a delusion. It really is.

Fiona: 18:56

which is why, as you just said. They might get sent. People with NPD rarely come for therapy unless it's for something very specific that's not about them. So it could be a behavior, an addiction, a relationship, but They do it with the expectation that they are okay and it's other people who need to change. So, you know, nobody phones up and says, I'm a narcissist, I need therapy.

Richard: 19:34

Because it means admitting that they need therapy, and that's so hard. I did see some statistics, rather oddly, that found that It was more likely that men were diagnosed with Narcissistic Personality Disorder and women with Borderline Personality Disorder. Even when the case studies that the psychiatrists have been shown, and this is in a study, so read all these case studies, what personality disorder is this? If the character in the story is a man, they get labelled with NPD. If it's a woman, they get labelled with Borderline more often than not. Women can be narcissists too, and men can have borderline too.

Fiona: 20:16

I think using the more up to date version of an emotionally unstable personality disorder probably is more helpful than borderline because never, what's borderline? On the border of what? Reminds me of a but

Richard: 20:35

be on the border of psychosis. Because the symptoms are the same.

Fiona: 20:38

Yes it's not a helpful term, but it makes sense if you say emotionally unstable and narcissistic. Stereotypically, one would be a female trait and one would be a male trait, but A lot of similarities, because underlying both is an I'm not okay.

Richard: 21:00

Yes, but with borderline it tends to be I'm not okay, you're okay. Oh, having said that, can really switch. Because somebody with emotionally unstable personality disorder, they might crave and be preoccupied with an attachment figure. They might be desperate for somebody's attention. But then, very quickly, can see that person as the enemy if they do something wrong, and cut them out of their life. So, maybe these two disorders are the same. A psychiatrist would probably say no. But, a lot of the symptoms are same.

Fiona: 21:35

they're labels that get stuck onto people and they're helpful, as we talked about very early on in this podcast series. Labels are helpful if they're helpful and they're not if they're it's a way of looking at something when we know that there's something that's not quite right. So you look behind the It's not quite right to find out what isn't right. then, hopefully, put it right. Because that's, as you said, the age of seven, seeing, you know, just a little child of seven who's not feeling that they are quite right. And I want to help that little seven year old that's still part of the adult that's sitting there in front of me. I want to help that seven year old feel okay. So doesn't really matter what the label that's been stuck on them is. But it might lead to that understanding that something's not quite right. I saw a clip from Jordan Peterson the other day. Now,

Richard: 22:39

I'm sorry.

Fiona: 22:40

well, yes, not everything he says is bonkers. There was this one thing which is still a little extreme. He was saying that a parent's job is To enable a child by the age of four or five to be socially, acceptable and desirable socially, so that that four or five year old could go into the classroom and people want to talk to them, want to play with them, because then they are set up for relationships of being positive. That I go in there, I'm received well, people want to play with me. The alternative is that that child gets used to going in and people don't want to play with them, don't want to be with them, and that sets them up for a lifetime of having other people looking at them with a, rejection on their faces. I saw a debate where he was debating pro Christianity, but he just completely redefined God. so, I mean, it's like saying, no, no, God isn't the thing that everybody believes in. But by my definition, I believe in God. I mean, I could say God is a phone. so I believe in God, because I've got this phone in my hand, and the phone is a God, so therefore I believe in it. So, I'm not, I'm not advocating, Jordan Peterson per se, but sometimes there are things that he says that are interesting.

Richard: 24:12

Yes, yeah, and that's often the problem that we find with people that are quite outspoken that cause problems. 90 percent of what they say is interesting and accurate and valuable information. And then if 10 percent is dangerous, we just assume that 100 percent of what they say is right. And so that includes the 10%. We find that with Andrew Tate. Don't know whether you know of Andrew Tate. Some of the things he said has been quite helpful and useful, but many of the things hasn't been. And how do children know the difference? When they're learning and they're looking up to people, they don't know what's, the healthy thing and what's the unhealthy thing. They're just soaking it all up.

Fiona: 24:50

and we could just say the same with religion. every religion I'm generalising, most religions. Let's say most religions, because I do not know about everyone, will have some good things them.

Richard: 25:01

yeah.

Fiona: 25:01

Yes, something 3000, I think, the last count, most religions will have some good stuff in it and some bad stuff. Let's move away from percentages, because I don't know if Jordan Peterson's 90%, I don't know what percentage Andrew Tate's at, I don't know what percentage Catholicism is at, or Islam, or anything. But there is a point within all of these things, where, there's some good, some not so good. and it takes mental strength to be able to listen to something and go, hmm, yeah, that bit, fine that bit, not so fine. But even then society criticizes. So Christianity gets criticized for people using it as a shopping list. I like that bit in that chapter of the Bible but I don't like that bit. So we'll wipe out those bits, so Leviticus for example, we wipe

Richard: 26:01

Very much,

Fiona: 26:02

but we'll keep those bits and then that becomes a criticism.

Richard: 26:07

Yeah.

Fiona: 26:08

have, you're not taking it all, so why, why'd you take any of it? But that's life, isn't it? That we have to, we have to cherry pick. that, that, that I would say a strength if you know that that's what you're doing.

Richard: 26:24

Yeah. And what I would say to Abby from Essex, thank you for writing in again, is the, the experiences that you had. Like, she, she, she actually did say in the email that she was, she's been seeing a counselor for a year now.'cause my, my first thought was, take all this to therapy. And she is, and, and for anybody listening in a similar position, this needs exploring because it's a lot of this is about the past influencing the present. Abbey's seeing red flags in people where there might not be red flags, but those red flags from the past were so triggering and painful that how could we not be frightened of those things happening again? If something creates pain, you put your hand in a fire, it burns. And then you see a fire, you go, I'm not putting my hand in that. That hurts. And if something looks a little bit like fire, but Okay, it looks like fire, but it's not hot. But it looks like it's hot. I'm still not going anywhere near that, just in case. That's, that's what she's experiencing.

Fiona: 27:22

Red flags is a, is an interesting, metaphor? Is it a metaphor? Anyway, it's an interesting thing. Again, it's seen as an all or nothing. Ooh, he said this, that's a red flag. It might be a pale pink flag. It's a sign of something to be explored. I mean, yes, there could be red flags, absolutely. There can be. Clearly, this is some You do not want to go there. And that could be a generic or it could be a very personal, specific thing. But a lot of the time it's going to be something to check out rather than immediately presume. And I think that's really what Abby is saying. She's recognising some of those red flags are things to explore rather than immediately jump on.

Richard: 28:15

Yeah, absolutely. Well, I hope that helps, Abbie, and anybody in a similar position. Do replay this episode, play it back a couple of times, get your head around it. It might be one that you replay. As with any of the other ones, I mean, these are going to sit on the internet for forever. I mean, even if, even if we take them down for some reason because it costs too much money to host them, and we're not doing this anymore because It's 100 years in the future. They'll just be sitting on some free site somewhere with adverts in the middle that we have no control over. Grrr. Which on my watch, I'm not doing and I want you to quote me on that that I'm not putting adverts for other people's stuff in the middle of our podcasts. That doesn't feel right to me. I'd rather advertise our own stuff, but we'll come to that next year. Hey, let's wrap up and wish everybody a Merry Christmas, because this is the last one before Christmas. Today's, when this comes out, it's Wednesday, and Christmas Day Is it Monday? Monday, it? Yes.

Fiona: 29:15

Still nearly two weeks away.

Richard: 29:18

It is for us, yeah, because 15th we're recording. It doesn't matter, little insight into what we do with our clients. Today's Friday the 15th of December, but, yeah, I've got tinsel everywhere. It's Christmas. Right, I need to go and buy my wife a Christmas present, because I've left it too late. It's alright, she doesn't listen. And I don't need her to, because I'm not that far up the scale of narcissism. And my wife has boundaries, and I can accept those.

Fiona: 29:52

you have your validation anyway, so you don't need it a fake way.

Richard: 29:57

Oh, absolutely. Quite right, quite right. Well, let's love them and leave them for another week.

Fiona: 30:03

Yes, happy Christmas

Richard: 30:04

Christmas, everybody! You know where we are if you want anything. We'll speak to you next week in the weird week that's in between Christmas and New Year and no one knows what day it is. Well,

Fiona: 30:15

Yes.

Richard: 30:16

well, it's going to be Wednesday. That'll help you. Speak to you next time. Bye, everybody.