September 20, 2025 • 29 mins
In this episode of The CultureHug Podcast, we take a calm and compassionate look at Narcissistic Personality Disorder (NPD) and narcissistic traits—without adding more anger or blame. Together, we’ll explore what these terms really mean, how they impact relationships, and why it’s important to protect your own emotional well-being when dealing with someone who shows these traits.
We’ll also talk about what a therapy roadmap might look like for someone with NPD, why the process takes years, and why patience and consistency are essential for real change. At the same time, we’ll face one of the hardest truths: you can’t love someone into changing. Change has to come from within, and it often requires professional support and long-term effort.
This episode is designed to bring understanding, not judgment. Whether you’re learning how to set boundaries, wondering if people with NPD can get better, or simply trying to make sense of your own experiences, this conversation offers clarity, compassion, and hope without false promises.
Resources:
We’ll also talk about what a therapy roadmap might look like for someone with NPD, why the process takes years, and why patience and consistency are essential for real change. At the same time, we’ll face one of the hardest truths: you can’t love someone into changing. Change has to come from within, and it often requires professional support and long-term effort.
This episode is designed to bring understanding, not judgment. Whether you’re learning how to set boundaries, wondering if people with NPD can get better, or simply trying to make sense of your own experiences, this conversation offers clarity, compassion, and hope without false promises.
Resources:
- Baskin-Sommers, A., Krusemark, E., & Ronningstam, E. (2014). Empathy in narcissistic personality disorder: From clinical and empirical perspectives. Personality Disorders: Theory, Research, and Treatment, 5(3), 323–333. https://doi.org/10.1037/per0000061
- Burgo, J. (2012, November 17). Narcissism and other defenses against shame. Psychology Today. https://www.psychologytoday.com/us/blog/shame/201211/narcissism-and-other-defenses-against-shame
- Choi-Kain, L. W., Simonsen, S., & Euler, S. (2022). A mentalizing approach for narcissistic personality disorder: Moving from “me-mode” to “we-mode.” American Journal of Psychotherapy, 75(2), 38–43. https://doi.org/10.1176/appi.psychotherapy.20210017
- DeWitt, H. (2025, June 20). Narcissistic tendencies vs. NPD: Key differences explained. Thriveworks Counseling. https://thriveworks.com/help-with/narcissism/narcissistic-tendencies-vs-npd/
- Grand Rising Staff. (2025, May 9). Recognizing splitting behavior. Grand Rising Behavioral Health. https://grandrisinghealth.com/recognizing-splitting-behavior/
- Greenberg, E. (2019, August 3). 10 stages in the treatment of narcissistic disorders. Psychology Today. https://www.psychologytoday.com/us/blog/theory-knowledge/201908/10-stages-in-the-treatment-of-narcissistic-disorders
- Grouport Therapy. (n.d.). How to stop being a narcissist: A guide to personal growth and self-awareness. https://www.grouporttherapy.com/blog/how-to-stop-being-a-narcissist
- Lebow, H. I. (2022, September 13). Narcissism vs. narcissistic personality disorder: Telling them apart. Psych Central. https://psychcentral.com/disorders/narcissism-vs-npd
- Mayo Clinic Staff. (2023, April 6). Narcissistic personality disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662
- Mayfield, E. (2020, December 16). Splitting in the narcissist | Is splitting a defense mechanism? Mindset Therapy. https://www.mindsettherapyonline.com/post/splitting-in-the-narcissist-is-splitting-a-defense-mechanism
- American Psychiatric Association. (2024, January 30). What is narcissistic personality disorder? Psychiatry.org. https://www.psychiatry.org/patients-families/narcissistic-personality-disorder/what-is-narcissistic-personality-disorder
- Villines, Z. (2025, September 8). Ca
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
In the quiet place, sha words on food like whispers
in the to who we start, Welcome to the Culture
(00:21):
Hook podcast, your space to learn and learn and grow,
one hug and one episode at a time.
Speaker 2 (00:27):
Today we're tackling a word you hear everywhere. Narcissis. Oh.
Speaker 1 (00:31):
Absolutely, It's thrown around constantly.
Speaker 2 (00:33):
Right like describing anyone difficult basically an X A boss,
someone just really self absorbed, exactly.
Speaker 1 (00:41):
And that's precisely why we need to, you know, dive deeper,
because when you actually look at the clinical sources, the
psych reviews, therapy models, the diagnostic manuals, the picture is well,
it's a lot more specific and often honestly rooted in
a lot of pain.
Speaker 2 (00:56):
Yeah, moving past the pop culture label, that's really our
goal here today. We've got a stack of material and
we want to unpack the difference between just you know,
having some narcissistic traits versus the actual clinical condition narcissistic
personality disorder or NPD. We're going to look at the
shame underneath it all, the real impact on relationships, and
this is important, the path towards change, because there is
(01:19):
one even though it's.
Speaker 1 (01:20):
Tough, it's really tough, and this deep dive. It's for
you listening. Maybe you know someone struggling with these patterns,
or maybe just maybe you see some of these defenses
in yourself.
Speaker 2 (01:28):
Before we even get started, though, there's something we need
to address head on, right, something you see all over
the internet.
Speaker 1 (01:34):
Yes, this idea, this pervasive claim that NPD is totally.
Speaker 2 (01:41):
Untreatable, that it's basically a life sentence.
Speaker 1 (01:43):
Precisely, you find so many websites, and frankly, a lot
of them aren't based on solid clinical grounds, saying people
with NPD are just inherently manipulative, they can't change, they'll
fool every therapist.
Speaker 2 (01:54):
But the actual clinical evidence, the stuff we're looking at today,
it says something very different.
Speaker 1 (01:59):
It really does. Its strongly refutes that idea. Look saying
NPD is untreatable. It's often coming from a place of
deep frustration, maybe even fear, but it's fundamentally a myth. Okay,
change is possible. It's incredibly demanding. Yes, it takes a
long time, it's psychologically grueling, but the evidence shows improvement happens.
People diagnose with MPD can engage in self reflection, they
(02:21):
can grow, and they can develop genuine empathy over.
Speaker 2 (02:24):
Time, and we're definitely going to circle back to that later,
to the actual process involved.
Speaker 1 (02:28):
Absolutely will detail the whole roadmap.
Speaker 2 (02:30):
Okay, so first things first, let's define the spectrum. Because
obviously having some self interest is normal, right. You need
a healthy sense of self.
Speaker 1 (02:37):
You absolutely do. That's the starting point what some call
healthy narcissism. It's about having a good sense of self worth, confidence, ambition.
But and this is key, it's balanced, balanced with reciprocal relationships,
caring about others, what the source is called pro social behavior.
Your self focus isn't hurting anyone, right.
Speaker 2 (02:57):
You can be strong yourself but still see and respect
others as separate people exactly.
Speaker 1 (03:01):
Now, take a step down and you get narcissistic traits.
And honestly, most of us show these sometimes, like what.
Speaker 2 (03:08):
A moment of varrogance, bragging a bit too much, yeah.
Speaker 1 (03:11):
Or being selfish in a specific situation. The difference here
is it's usually temporary, it's less severe, and it doesn't
define every part of your life. Someone might be say,
really self focused and maybe a bit exploitative at work,
but still be genuinely kind and empathetic with their kids
or their close friends. You know.
Speaker 2 (03:29):
Okay, so it's situational, not pervasive. But then there's the
clinical line narcissistic personality disorder. What makes it a disorder?
Speaker 1 (03:37):
It really comes down to pervasiveness and impairment NPD. According
to the DSM five tr that's the diagnostic manual, is
defined by this pervasive pattern, a pattern of grandiosity, needing
admiration constantly, and a real lack of empathy. And it's
not just a phase, no, it starts by early adulthood.
It shows up across many different context work relations, and
(04:00):
ship's identity, and it has to cause significant problems, either
major functional impairment in their life or real subjective distress.
It's rigid, it's maladaptive. It's not just a few bad habits.
Speaker 2 (04:10):
Okay, that distinction is critical. The DSM lists nine specific symptoms,
and you need at least five for a diagnosis. Can
we maybe touch on a few of the big ones
that really define this pattern?
Speaker 1 (04:19):
Sure, let's highlight some key ones. First, there's grandiosity, just
this inflated sense of self importance, expecting to be seen
as superior, even without the achievements to back it up. Okay,
the number two being preoccupied with fantasies, constant fantasies of
unlimited success, power, brilliance, perfect.
Speaker 2 (04:36):
Love, living in a fantasy world almost in a way.
Speaker 1 (04:39):
Yes. Third, this belief in being special, that they're unique,
only understood by other high status people. Fourth, the need
for excessive admiration. This is like they're fuel. They need
that constant praise to keep their self esteem afloat, which
is often quite fragile underneath.
Speaker 2 (04:55):
That makes sense.
Speaker 1 (04:56):
Fifth, and this one causes so much trouble. A sense
of entitlement, unreasonable expectations, expecting special treatment, expecting people to
just comply, believing the rules don't apply to them.
Speaker 2 (05:08):
Yeah, I can see how that would wreck relationships definitely.
Speaker 1 (05:12):
Sixth is exploiting others, using people to get what they want,
often without remorse. Seventh, the lack of empathy difficulty recognizing
or identifying with other's feelings will impact that one more, okay.
Eighth envy, either being envious of others or believing others
are envious of them. And finally, ninth, just plain arrogance,
(05:32):
condescending attitudes, haughtiness.
Speaker 2 (05:34):
Wow. Yeah, looking at that list, especially entitlement, exploitation, lack
of empathy, you can see why it's so damaging interpersonally.
If you always expect special treatment and live in fantasies,
reality must be a constant disappointment.
Speaker 1 (05:48):
And a source of conflict. It's also worth remembering, even
though we hear narcissists all the time, actual NPD is
fairly rare. Estimates are around what two percent of the
US population.
Speaker 2 (05:59):
So most people people showing these behaviors have traits, not
the full disorder, but those traits can still cause real.
Speaker 1 (06:05):
Harm, immense harm.
Speaker 2 (06:06):
Yes, now you mentioned earlier that NPD isn't monolithic. The
sources talk about two main types or phenotypes, right, and
they look really different on the outside, grandiose and vulnerable.
Speaker 1 (06:18):
Understanding this difference is crucial. The grandiose narcissists, often called
the overt type, is kind of the classic picture obvious arrogance, entitlement,
maybe exploitative, often a dismissing attachment style, like they don't
need connection.
Speaker 2 (06:30):
It might even seem really successful, like the powerful CEO
type exactly.
Speaker 1 (06:34):
They can sometimes seem high functioning. They might even use
their lack of empathy strategically, take big risks, focus intensely
without guilt about consequences.
Speaker 2 (06:42):
They project strength, okay, and the opposite is the vulnerable
narcissist the covert.
Speaker 1 (06:47):
Type, Yes, and this is where the internal struggle is
much more visible or at least palpable. Vulnerable narcissism is
marked by this fragile self image, deep shame, lots of
self criticism. They tend to have anxious or fearful attachment styles.
Speaker 2 (07:02):
So instead of puffing up, they might withdraw when challenged.
Speaker 1 (07:05):
Often, yes, they struggle immensely with negative feedback or failure.
It triggers intense anxiety, depression, shame. The research actually shows
a strong link between vulnerable narcissism and difficulties regulating emotions.
Speaker 2 (07:18):
Huh. So the grandiose top shuts for admiration to feel good,
while the vulnerable type is sort of silently tormented, desperate
for validation but terrified of being seen as flawed.
Speaker 1 (07:28):
That's a great way to put it. Both are essentially
running from the same core pain, that sense of inadequacy,
but they use opposite strategies on the outside.
Speaker 2 (07:35):
And that core pain, that shame. That's what we need
to look at next, right, the whole inner world and
the defenses built around.
Speaker 1 (07:43):
It, precisely because narcissism at its heart is a defense mechanism.
Speaker 2 (07:48):
Okay, so let's talk about that. When we say it's
a defense, we mean the grandiosity, the entitlement. It's all
a kind of psychological shield exactly.
Speaker 1 (07:56):
The sources are really clear on this. Deep down, underneath
the narcissistic presentation, there's often profound inadequacy insecurity, what's called
core shame.
Speaker 2 (08:06):
So the desperate need for external admiration is what a
way to drown out that inner feeling of being damaged
or flawed.
Speaker 1 (08:13):
It's an attempt to deny it, to flee from it.
One source calls this the narcissistic flight, this constant chase
for validation, success, status, anything to avoid facing that internal wound.
Speaker 2 (08:23):
Okay, so flight is the main strategy. But what other
defenses kick in to keep that shame buried besides just
looking impressive?
Speaker 1 (08:30):
Two big ones stand out in the literature aful working
alongside that flight blaming or indignant rage and contempt.
Speaker 2 (08:36):
Let's start with blaming an indignant rage. How does blaming
someone else actually help them feel better?
Speaker 1 (08:41):
Well, think about it. If someone with these patterns makes
a mistake, say at work, or forget something important for
their family, facing that directly means facing their own flaw,
their inadequacy.
Speaker 2 (08:53):
That triggers the shame, which feels unbearable.
Speaker 1 (08:56):
Right So instead, they might instantly shift focus. They might
obsessively replay the situation, but only focusing on how someone
else messed up, how a colleague sabotaged them, or how
their partner didn't remind them properly.
Speaker 2 (09:10):
Ah, so they build a case against the other person exactly.
Speaker 1 (09:13):
They become righteously indignant. They generate this storm of blame
directed outward. It shifts the focus from I messed up,
I feel ashamed, to I'm the victim.
Speaker 2 (09:22):
Of your failure, and that makes them feel superior again.
Speaker 1 (09:25):
Temporarily, Yes, it provides temporary relief from their own inner critic.
The sources even suggest that how harsh someone is outwardly
often mirrors how hearts their own internal voices. Blaming others'
silences that inner voice.
Speaker 2 (09:37):
For a moment that makes a disturbing kind of sense.
And the other defense is contempt. How does that work?
Speaker 1 (09:42):
Contempt is more of a posture, a posture of superiority.
It's about looking down on others to feel better about oneself.
It can be subtle, A condescending tone, an eye roll,
may be intellectual put downs.
Speaker 2 (09:55):
And how does that defend against shame?
Speaker 1 (09:57):
It often involves projection. Take the parts of themselves they
find intolerable, the weakness that damage, the shame, and unconsciously
project it onto someone else. Then they treat that person
with contempt.
Speaker 2 (10:10):
So it's like saying, I can't stand this feeling in me,
so I'll pretend you have it, and then I can
despise you for it.
Speaker 1 (10:15):
That's a perfect way to describe it. One fascinating case
study mentioned a therapist whose highly contemptuous client kept dreaming
about the therapists appearing as degraded figures, homeless, ragged. The
client was projecting their own unbearable shame onto the therapist
and then acting superior in sessions to maintain the defense.
Speaker 2 (10:33):
Wow, okay, now let's bring in splitting. This sounds crucial
for maintaining that fragile sense of self. What exactly is splitting?
Speaker 1 (10:41):
Splitting is considered a primitive defense mechanism. It develops early on. Basically,
it's an inability to handle complexity or ambiguity. Reality gets
simplified into extremes all good or all bad, black or white.
Speaker 2 (10:54):
The all or nothing thinking.
Speaker 1 (10:56):
Exactly and the sources often link this back to early
childhood experiences, specifically a failure to develop what's called whole
object relations.
Speaker 2 (11:04):
Right, we should probably explain that term. What does whole
object relations mean?
Speaker 1 (11:07):
It's the psychological capacity to see yourself and others in
an integrated, realistic way as complex people with both good
and bad qualities. Usually this develops when a baby has
reasonably consistent, good enough caregiving.
Speaker 2 (11:21):
So the baby learns that mom is still mom, still
fundamentally good, even when she's frustrating.
Speaker 1 (11:27):
Sometimes precisely, the good mom who feeds in comforts and
the bad mom who delays gratification or isn't perfectly attuned
get integrated into one all real person. But if caregiving
is chaotic, traumatic, maybe highly critical, alternating with idealizing.
Speaker 2 (11:43):
Then the child can't put those pieces together right.
Speaker 1 (11:46):
It's too overwhelming, So they keep the perception separate the
all good parent they need to survive and the all
bad parent who represents all the pain and criticism. And
this pattern carries into adulthood.
Speaker 2 (11:59):
Leading to that class cycle and relationships intense idealization followed
by sudden, harsh devaluation.
Speaker 1 (12:06):
Exactly, a new partner is put on a pedestal, perfect, flawless,
the answer to everything. All good, but the moment that
partner inevitably disappoints them shows a normal human flaw or
doesn't meet an impossible need. Bam, the splitting mechanism flips, and.
Speaker 2 (12:21):
Suddenly they're all bad, toxic, evil, the enemy.
Speaker 1 (12:25):
Correct, there's no middle ground. That's why you often hear
extreme language. You always do this, you never care, creates
massive instability.
Speaker 2 (12:31):
Okay, that explains a lot about the relationship turbulence. Now,
empathy lack of empathy is central to MPD, But you
said it's more nuanced than just not having it.
Speaker 1 (12:39):
Yes, the nuance is really important here. The sources describe
two main kinds of empathy failure. First, there's motivation based disengagement,
meaning the person can understand how someone else feels cognitively,
they have the capacity, but they choose not to engage
that empathy because it doesn't benefit them or it gets
in the way of their own goals.
Speaker 2 (12:57):
Ah like the example of.
Speaker 1 (12:58):
Mister H exactly. Mister H was great at mediating conflicts
at work and made him look good, feel competent. He
could turn on the empathy when it served him, but
when his wife was sick or his parents needed help.
He was indifferent, even annoyed. Their needs were a burden.
They didn't feed his need for admiration. He could switch
it on and off.
Speaker 2 (13:17):
Okay, So it's selective empathy based on self interest. What's
the other kind, deficit based disengagement?
Speaker 1 (13:23):
This is different. It's often linked more to the vulnerable type. Here,
the person genuinely struggles to tolerate or process strong emotions
from others. Grief, fear, intense worry. Hearing about it or
seeing it literally overwhelms them.
Speaker 2 (13:38):
So it triggers their own internal chaos, their own shame precisely.
Speaker 1 (13:42):
It's not calculated in difference. It's more like emotional flooding.
They can't handle the input.
Speaker 2 (13:47):
Mermous T the one who got angry when coworkers shared trauma.
Speaker 1 (13:50):
Yes, she found their stories spouse losing a job, child's
illness unbearably painful. Her reaction was anger, trying to shut
them down because their pain activated her own deep seated
distress and shame, which then made her feel even more
ashamed about reacting angrily. It's a genuine inability to cope
with the other person's emotional state.
Speaker 2 (14:12):
Understanding those two different empathy issues. Wow, it really sheds
light on why relationships with someone with NPD are often
so fraught with conflict and instability.
Speaker 1 (14:21):
Absolutely because that core pattern of exploitation using others to
regulate their own self worth really takes a toll.
Speaker 2 (14:28):
Yeah, the impact must be huge. The needs of partners, kids,
family members consistently take a back.
Speaker 1 (14:33):
Seat existently, and it shows up in so many ways.
Misusing family money, maybe, neglect, infidelity, patterns of emotional abuse
where the partner is constantly criticized, confused, made to feel inadequate.
Speaker 2 (14:44):
And often the relationship starts in a very specific way
with this tactic called love bombing.
Speaker 1 (14:49):
Ah, yes, love bombing very strategic. It's this intense, rapid
fire campaign of affection at the very beginning, like.
Speaker 2 (14:56):
What over the top complements, constant.
Speaker 1 (14:59):
Attention, exactly, grand gestures, expensive gifts, maybe talk of destiny,
soulmates being meant for each other, all happening very very quickly.
The goal is to forge this incredibly intense connection and
commitment almost immediately.
Speaker 2 (15:14):
Why what does that achieve for the person doing it?
Speaker 1 (15:17):
It creates a powerful setup for later when the devaluation
or exploitation inevitably starts. The partner is already deeply invested.
They're confused. They keep thinking back to that amazing, perfect beginning, right.
Speaker 2 (15:30):
Trying to reconcile the two versions of the person exactly.
Speaker 1 (15:33):
It makes it so much harder to see the reality
of the abuse and to actually leave. It creates cognitive dissonance.
Speaker 2 (15:38):
And they don't just take anyone, do they. The sources
say they often target certain types of people.
Speaker 1 (15:43):
That's often true. They might gravitate towards people who are
seen as maybe too nice or highly empathetic. Sometimes people
with codependent traits who tend to prioritize others needs and
emotional stability over their own. People who might struggle to
hold onto their own sense of self or boundaries within
a relationship.
Speaker 2 (15:59):
Which leads us to a really difficult but crucial point,
the limits of love. In this dynamic, So many partners
hope their love and patience will somehow fix the person, and.
Speaker 1 (16:12):
This is such a painful and frankly dangerous visconception. The
clinical consensus is crystal clear, another person's love cannot change
someone with MPD.
Speaker 2 (16:22):
Change has to come from within them.
Speaker 1 (16:23):
Absolutely. It requires their own internal motivation, their commitment and
undertaking that incredibly difficult therapeutic work we mentioned. Staying in
an abusive situation hoping your love will be the cure,
or clinging to the promise of change. It's not safe.
It just keeps the cycle going.
Speaker 2 (16:39):
So for someone listening who is dealing with these difficult
patterns in a loved one, what practical advice do the
sources offer? How can you protect yourself well?
Speaker 1 (16:48):
First and foremost, get support for yourself. Therapy is support group,
maybe even a domestic violence resource. If things have escalated
to abuse, you need your own validation, your own resilience.
Speaker 2 (16:57):
Okay, build your own support system. What about direct and.
Speaker 1 (17:00):
Communication needs to shift? Keep it very clear, concise and calm.
Avoid getting drawn into big emotional arguments. Stick to facts
and observable behaviors like we you yelled, I fell scared,
not you're always attacking me.
Speaker 2 (17:15):
Less accusation, more I feel statements based on specific actions exactly.
Speaker 1 (17:21):
Don't get bogged down debating the past or fairness. And
then there are boundaries. They have to be firm, really firm.
Speaker 2 (17:27):
How do you make them stick?
Speaker 1 (17:28):
You need to decide in advance what the consequence will
be if the boundaries crossed. And then this is the
hard part. You absolutely must follow through consistently. People with
MPD often test boundaries relentlessly because of that entitlement piece.
They need to experience clear, predictable consequences.
Speaker 2 (17:44):
Okay, firm consistent boundaries with clear consequences. What else?
Speaker 1 (17:49):
Remember your goal isn't to fix them or argue them
into insight. Your main emotional defense is staying calm. If
you react with intense anger or tears, you're often giving
them the emotion reaction they can use to manipulate the
situation or shift blame back onto you.
Speaker 2 (18:04):
So staying calm disrupts their usual pattern.
Speaker 1 (18:06):
It can it forces them potentially to sit with the
consequences of their own behavior without you getting sucked into
their emotional storm. You're protecting your own emotional well being.
Speaker 2 (18:18):
All right. This brings us back to the possibility of change.
We said it's a myth that MPD is untreatable. What's
the actual evidence that growth can happen.
Speaker 1 (18:28):
Well, there are longitudinal studies which are really valuable. For instance,
one study followed patients with NPD who committed to intensive
psychotherapy after about two and a half to five years.
Speaker 2 (18:38):
It's a long time.
Speaker 1 (18:39):
It is, but significantly, all the patients who finished the
study no longer met the full criteria for NPD. They
showed real improvements in their lives, holding down jobs, having
more stable reciprocal relationships.
Speaker 2 (18:50):
Wow. Okay, so five years to potentially move out of
the diagnostic category. That's hopeful, but it also really underscores
the level of commitment needed.
Speaker 1 (19:00):
This isn't about a few months of therapy. We're often
talking about five, ten, maybe even more years for really
deep fundamental change. You're not just treating a symptom like anxiety.
You're essentially trying to rebuild a psychological foundation built on
defending against shame.
Speaker 2 (19:17):
So if change is possible, why does it have such
a reputation for being difficult? Why do so many people
with NPD drop out of therapy early?
Speaker 1 (19:25):
Huge barriers? For one, many don't even come to therapy
for narcissism. They come because they're anxious or depressed, or
their partner gave them an ultimatum.
Speaker 2 (19:33):
So they're treating a symptom, not the root cause.
Speaker 1 (19:36):
Right, and once that immediate pressure is off or the
bad feeling eases up a bit, they might just leave. Plus,
the core of the therapy self reflection is the very
thing the entire narcissistic structure is designed to.
Speaker 2 (19:47):
Avoid facing the flaws, the vulnerability. It feels like a
direct attack, a narcissistic injury exactly.
Speaker 1 (19:54):
It can feel intensely humiliating, so they might react with denial, anger, blaming.
They're therapists, devaluing the whole process. They often quit. It
takes a very skill therapist who understands these dynamics, who
can handle being idealized one week and devalue the next
without taking it personally.
Speaker 2 (20:11):
So, assuming someone does stick with it, what's the ultimate
goal of therapy, what's the big shift they're working towards.
Speaker 1 (20:18):
It's fundamentally about perspective, moving from what some call ME mode,
that self centered view where the world revolves around validating them,
towards a more balanced relational we mode, meaning meaning learning
to accept responsibility, tolerate criticism or failure without falling apart,
develop more stable self esteem that isn't just based on grandiosity,
(20:38):
and understanding and managing their feelings in a healthier way.
Speaker 2 (20:41):
And what kinds of therapy are actually effective for this
deep work?
Speaker 1 (20:44):
Talk therapy is central and there are specific types often
used for personality disorders like MPD. Transference focused therapy TFP
is one, Mentalization based treatment MBT is another, and schem
of therapy is also common.
Speaker 2 (20:57):
Can you briefly explain TFP and MBT how do they
tackle these deep patterns?
Speaker 1 (21:02):
Sure? Both TFP and MBT really focus on what's happening
in the therapy room right then and there between the
client and the.
Speaker 2 (21:09):
Therapist, using the relationship itself as the tool.
Speaker 1 (21:12):
Exactly the client will inevitably start to relate to the
therapist in those old split ways, idealizing them one minute,
devaluing them the next. TFP and MBT helped the clients
slow down and examine those reactions as they.
Speaker 2 (21:25):
Happen, making them aware of the pattern in real time.
Speaker 1 (21:28):
Yes, and helping them mentalize, which means understanding their own
internal state and recognizing that the therapist's mind and experience are
separate and different from their own projection. It helps them
gradually integrate those split all good and all bad views
into a more realistic whole. The therapy relationship becomes a
safe place to practice reality testing, something that might have
(21:49):
been missing earlier in life.
Speaker 2 (21:50):
That makes a lot of sense to really grasp the
depth of this. Let's walk through the ten stages of
therapy that the sources outline. It's not strictly linear, but
it shows the journey.
Speaker 1 (22:00):
Roadmap is really eliminating, and it's worth noting. People who
start with maybe higher functioning or more capacity for self
reflection tend to progress further through these stages.
Speaker 2 (22:10):
Okay. Stage one symptom relief or appeasement.
Speaker 1 (22:12):
This is often the entry point they come in because
something feels bad anxiety, depression, or someone else is making
them go Like a partner, the motivation is purely external,
stop the pain or please the other person. A lot
of people with narcissistic issues unfortunately drop out right here.
Speaker 2 (22:29):
If they stay, they move to Stage two avoid future pain.
Speaker 1 (22:33):
Yeah. Here they start to get enough insight to see
what triggers their distress, what situations, what people lead to
bad feelings or negative consequences. Yeah, it's still very self focused,
how do I avoid feeling bad? But they're starting to
strategize based on understanding cause and effect in the world
around them.
Speaker 2 (22:49):
Then Stage three identify coping mechanisms.
Speaker 1 (22:52):
Now the therapist helps them gently explore their go to defenses,
the blaming, the contempt, the need for admiration. You might
start connecting these patterns back to childhood, seeing how these
strategies maybe help them survive back then. This stage can
sometimes be a bit less threatening because it feels more
analytical looking at the past.
Speaker 2 (23:11):
Identifying the patterns is one thing, but changing them that
sounds like the really hard part. What happens in stage four.
Speaker 1 (23:18):
Stage four is tough because you can't just remove a
defense mechanism, even a harmful one, without replacing it. It's
like taking away crutches before someone can walk right. So
stage four create new coping mechanisms. This is active work.
The client has to consciously try out new healthier ways
to get their needs met, maybe learning to ask for
help instead of demanding, or tolerating frustration instead of raging.
(23:42):
It takes huge effort, lots of repetition and feeling vulnerable
trying new things.
Speaker 2 (23:47):
And that repetition leads into the next stage.
Speaker 1 (23:49):
Yes, stage five, form new habits. Those old narcissistic reactions
are like deeply worn paths in the brain. Therapy here
involves actively inhibiting the automatic urge to use the old
defense and consciously effortfully substituting the new healthier behavior. They
practiced in stage four. This has to happen over and
(24:09):
over again in real life until the new pattern becomes
more automatic, like reprogramming software.
Speaker 2 (24:15):
It sounds like a massive rewiring job. But notice even
at stage five it still seems very focused on their
internal management. When do other people really start to factor in?
Speaker 1 (24:24):
That's the big shift in stage six impact on other people,
And interestingly, this usually only clicks after they've had some
successful Stage five forming those new coping habits. Why because
actually managing their behavior better gives them a source of
genuine earned.
Speaker 2 (24:38):
Pride, which reduces the need for the false pride of grandiosity.
Speaker 1 (24:42):
Exactly, with less need for those defenses, they can start
to tolerate the idea that considering others might actually benefit them.
The initial motivation might still be self referential, like, hey,
if I'm nicer to my partner, my home life is
calmer and I feel better. It's recognizing reciprocal benefit, but
maybe not full emotional empathy yet.
Speaker 2 (25:01):
Okay, and the work deepens further in stage seven focus
on childhood pain.
Speaker 1 (25:06):
Right, life is maybe a bit calmer. The new habits
offer some stability, The defenses aren't needed quite as desperately now,
It becomes safer to actually revisit and process the original wounds,
the trauma, the neglect, the criticism from childhood. This is
where they can develop real self empathy for the child they.
Speaker 2 (25:24):
Were, and that helps build a more stable sense of self.
Speaker 1 (25:27):
Yes, it's crucial for forming an integrated self image, seeing
oneself as a whole person with strengths and weaknesses, getting
closer to that whole object relations.
Speaker 2 (25:34):
We talked about, which then allows for probably the most
profound internal shift in stage eight, update the inner voice.
Speaker 1 (25:40):
This tackles the blueprint. Remember we said outer harshness often
reflects inner harshness. Stage eight is about becoming aware of
that critical, often punitive inner voice internalized from childhood. Many people,
as the sources say, are kind of running their adult
lives based on the programming of a scared kit.
Speaker 2 (25:58):
How do you actually change that audi inner.
Speaker 1 (26:00):
Critic It takes intense conscious effort noticing the voice You're stupid,
you'll fail, and then challenging it. Is it fair, is
it true? Is it helpful? They practice actively interrupting it,
maybe mentally saying stop, that's the old voice not accurate anymore,
and then consciously replacing it with a kinder, more realistic,
or at least neutral self talk. This is vital because
(26:23):
so much outward blaming is just that inner critic being
turned outwards for relief.
Speaker 2 (26:26):
Okay, so as the inner world becomes safer and less critical,
that presumably opens up space for stage nine empathy for
other people.
Speaker 1 (26:33):
Yes, this is where genuine emotional empathy, spontaneously feeling with
another person often starts to emerge more consistently. It might
first appear for someone who feels safe, maybe someone whose
vulnerability mirrors their own past pain, or someone in a story.
Then gradually, carefully this capacity can be expanded to include
people closer to them.
Speaker 2 (26:53):
Leading finally, after all this work to stage ten authenticity.
Speaker 1 (26:58):
This is the goal. Long trusting relationship with the therapist
itself is hugely healing. They've shown their bad side, their
vulnerable side, and the therapist didn't abandon or attack them. The
reliance on the old false self, the narcissistic defenses, starts
to fade. They can risk being more spontaneous, more genuine,
maybe even more joyful with others. It's the emergence of
a true integrated self.
Speaker 2 (27:20):
Wow. That ten stage journey really highlights that change. Isn't
a quick fix. It's like a fundamental process of reparenting oneself,
rewiring those deep patterns. It takes incredible courage to face
that core shame.
Speaker 1 (27:31):
It truly does so. Just to pull things together, we
really hammered home the difference between just having some narcissistic traits,
which is common, and the actual disorder INPD, which is
more pervasive and impairing.
Speaker 2 (27:44):
Right and emphasizing that narcissism at its root is often
a defense, a way to cope with deep feelings of
shame or inadequacy.
Speaker 1 (27:53):
We looked under the hood at those defenses, splitting into
black and white, the blaming, the contempt, and the complexities
around empathy. Some times it's a choice not to engage,
other times it's a genuine inability to tolerate other's emotions.
Speaker 2 (28:05):
And for listeners dealing with these patterns and relationships, we
talked about practical steps, clear communication, firm boundaries, and the
hard truth that you can't love someone into changing.
Speaker 1 (28:16):
But crucially we also focus on the possibility of growth.
Treatment is possible, even though it's long and difficult. That
ten stage roadmap shows a path from defensiveness towards eventually
real authenticity and empathy.
Speaker 2 (28:29):
So the final message for you listening, we hope, is
one of balanced compassion. Awareness really is key for healthier relationships,
whether you're navigating this with a loved one or maybe
seeing some reflections in the mirror.
Speaker 1 (28:41):
It's about having compassion for the underlying pain that often
drives these defenses, both in others and potentially in yourself,
while still being clear eyed about the impact of the
behaviors self.
Speaker 2 (28:52):
Compassion and compassion for others, informed by understanding exactly.
Speaker 1 (28:57):
And maybe one final thought to leave you with, connecting
back to that your voice from stage eight, pay attention
to how harshly people talk about others. Often the level
of criticism or judgment they direct outwards is a pretty
good clue to how harsh their own inner critic is.
Speaker 2 (29:12):
That outward blame is really just a reflection of an
inner battle seeking a moment's piece.
Speaker 1 (29:17):
Often yes, So perhaps observe that dynamic in yourself and
others with a little more nuance, a bit more understanding.
Speaker 2 (29:24):
A powerful thought to end on, thank you for joining us,
we hope this exploration offers some valuable perspective and tools
for understanding
Speaker 1 (29:41):
Who we start
In the quiet place, sha words on food like whispers
in the to who we start, Welcome to the Culture
(00:21):
Hook podcast, your space to learn and learn and grow,
one hug and one episode at a time.
Speaker 2 (00:27):
Today we're tackling a word you hear everywhere. Narcissis. Oh.
Speaker 1 (00:31):
Absolutely, It's thrown around constantly.
Speaker 2 (00:33):
Right like describing anyone difficult basically an X A boss,
someone just really self absorbed, exactly.
Speaker 1 (00:41):
And that's precisely why we need to, you know, dive deeper,
because when you actually look at the clinical sources, the
psych reviews, therapy models, the diagnostic manuals, the picture is well,
it's a lot more specific and often honestly rooted in
a lot of pain.
Speaker 2 (00:56):
Yeah, moving past the pop culture label, that's really our
goal here today. We've got a stack of material and
we want to unpack the difference between just you know,
having some narcissistic traits versus the actual clinical condition narcissistic
personality disorder or NPD. We're going to look at the
shame underneath it all, the real impact on relationships, and
this is important, the path towards change, because there is
(01:19):
one even though it's.
Speaker 1 (01:20):
Tough, it's really tough, and this deep dive. It's for
you listening. Maybe you know someone struggling with these patterns,
or maybe just maybe you see some of these defenses
in yourself.
Speaker 2 (01:28):
Before we even get started, though, there's something we need
to address head on, right, something you see all over
the internet.
Speaker 1 (01:34):
Yes, this idea, this pervasive claim that NPD is totally.
Speaker 2 (01:41):
Untreatable, that it's basically a life sentence.
Speaker 1 (01:43):
Precisely, you find so many websites, and frankly, a lot
of them aren't based on solid clinical grounds, saying people
with NPD are just inherently manipulative, they can't change, they'll
fool every therapist.
Speaker 2 (01:54):
But the actual clinical evidence, the stuff we're looking at today,
it says something very different.
Speaker 1 (01:59):
It really does. Its strongly refutes that idea. Look saying
NPD is untreatable. It's often coming from a place of
deep frustration, maybe even fear, but it's fundamentally a myth. Okay,
change is possible. It's incredibly demanding. Yes, it takes a
long time, it's psychologically grueling, but the evidence shows improvement happens.
People diagnose with MPD can engage in self reflection, they
(02:21):
can grow, and they can develop genuine empathy over.
Speaker 2 (02:24):
Time, and we're definitely going to circle back to that later,
to the actual process involved.
Speaker 1 (02:28):
Absolutely will detail the whole roadmap.
Speaker 2 (02:30):
Okay, so first things first, let's define the spectrum. Because
obviously having some self interest is normal, right. You need
a healthy sense of self.
Speaker 1 (02:37):
You absolutely do. That's the starting point what some call
healthy narcissism. It's about having a good sense of self worth, confidence, ambition.
But and this is key, it's balanced, balanced with reciprocal relationships,
caring about others, what the source is called pro social behavior.
Your self focus isn't hurting anyone, right.
Speaker 2 (02:57):
You can be strong yourself but still see and respect
others as separate people exactly.
Speaker 1 (03:01):
Now, take a step down and you get narcissistic traits.
And honestly, most of us show these sometimes, like what.
Speaker 2 (03:08):
A moment of varrogance, bragging a bit too much, yeah.
Speaker 1 (03:11):
Or being selfish in a specific situation. The difference here
is it's usually temporary, it's less severe, and it doesn't
define every part of your life. Someone might be say,
really self focused and maybe a bit exploitative at work,
but still be genuinely kind and empathetic with their kids
or their close friends. You know.
Speaker 2 (03:29):
Okay, so it's situational, not pervasive. But then there's the
clinical line narcissistic personality disorder. What makes it a disorder?
Speaker 1 (03:37):
It really comes down to pervasiveness and impairment NPD. According
to the DSM five tr that's the diagnostic manual, is
defined by this pervasive pattern, a pattern of grandiosity, needing
admiration constantly, and a real lack of empathy. And it's
not just a phase, no, it starts by early adulthood.
It shows up across many different context work relations, and
(04:00):
ship's identity, and it has to cause significant problems, either
major functional impairment in their life or real subjective distress.
It's rigid, it's maladaptive. It's not just a few bad habits.
Speaker 2 (04:10):
Okay, that distinction is critical. The DSM lists nine specific symptoms,
and you need at least five for a diagnosis. Can
we maybe touch on a few of the big ones
that really define this pattern?
Speaker 1 (04:19):
Sure, let's highlight some key ones. First, there's grandiosity, just
this inflated sense of self importance, expecting to be seen
as superior, even without the achievements to back it up. Okay,
the number two being preoccupied with fantasies, constant fantasies of
unlimited success, power, brilliance, perfect.
Speaker 2 (04:36):
Love, living in a fantasy world almost in a way.
Speaker 1 (04:39):
Yes. Third, this belief in being special, that they're unique,
only understood by other high status people. Fourth, the need
for excessive admiration. This is like they're fuel. They need
that constant praise to keep their self esteem afloat, which
is often quite fragile underneath.
Speaker 2 (04:55):
That makes sense.
Speaker 1 (04:56):
Fifth, and this one causes so much trouble. A sense
of entitlement, unreasonable expectations, expecting special treatment, expecting people to
just comply, believing the rules don't apply to them.
Speaker 2 (05:08):
Yeah, I can see how that would wreck relationships definitely.
Speaker 1 (05:12):
Sixth is exploiting others, using people to get what they want,
often without remorse. Seventh, the lack of empathy difficulty recognizing
or identifying with other's feelings will impact that one more, okay.
Eighth envy, either being envious of others or believing others
are envious of them. And finally, ninth, just plain arrogance,
(05:32):
condescending attitudes, haughtiness.
Speaker 2 (05:34):
Wow. Yeah, looking at that list, especially entitlement, exploitation, lack
of empathy, you can see why it's so damaging interpersonally.
If you always expect special treatment and live in fantasies,
reality must be a constant disappointment.
Speaker 1 (05:48):
And a source of conflict. It's also worth remembering, even
though we hear narcissists all the time, actual NPD is
fairly rare. Estimates are around what two percent of the
US population.
Speaker 2 (05:59):
So most people people showing these behaviors have traits, not
the full disorder, but those traits can still cause real.
Speaker 1 (06:05):
Harm, immense harm.
Speaker 2 (06:06):
Yes, now you mentioned earlier that NPD isn't monolithic. The
sources talk about two main types or phenotypes, right, and
they look really different on the outside, grandiose and vulnerable.
Speaker 1 (06:18):
Understanding this difference is crucial. The grandiose narcissists, often called
the overt type, is kind of the classic picture obvious arrogance, entitlement,
maybe exploitative, often a dismissing attachment style, like they don't
need connection.
Speaker 2 (06:30):
It might even seem really successful, like the powerful CEO
type exactly.
Speaker 1 (06:34):
They can sometimes seem high functioning. They might even use
their lack of empathy strategically, take big risks, focus intensely
without guilt about consequences.
Speaker 2 (06:42):
They project strength, okay, and the opposite is the vulnerable
narcissist the covert.
Speaker 1 (06:47):
Type, Yes, and this is where the internal struggle is
much more visible or at least palpable. Vulnerable narcissism is
marked by this fragile self image, deep shame, lots of
self criticism. They tend to have anxious or fearful attachment styles.
Speaker 2 (07:02):
So instead of puffing up, they might withdraw when challenged.
Speaker 1 (07:05):
Often, yes, they struggle immensely with negative feedback or failure.
It triggers intense anxiety, depression, shame. The research actually shows
a strong link between vulnerable narcissism and difficulties regulating emotions.
Speaker 2 (07:18):
Huh. So the grandiose top shuts for admiration to feel good,
while the vulnerable type is sort of silently tormented, desperate
for validation but terrified of being seen as flawed.
Speaker 1 (07:28):
That's a great way to put it. Both are essentially
running from the same core pain, that sense of inadequacy,
but they use opposite strategies on the outside.
Speaker 2 (07:35):
And that core pain, that shame. That's what we need
to look at next, right, the whole inner world and
the defenses built around.
Speaker 1 (07:43):
It, precisely because narcissism at its heart is a defense mechanism.
Speaker 2 (07:48):
Okay, so let's talk about that. When we say it's
a defense, we mean the grandiosity, the entitlement. It's all
a kind of psychological shield exactly.
Speaker 1 (07:56):
The sources are really clear on this. Deep down, underneath
the narcissistic presentation, there's often profound inadequacy insecurity, what's called
core shame.
Speaker 2 (08:06):
So the desperate need for external admiration is what a
way to drown out that inner feeling of being damaged
or flawed.
Speaker 1 (08:13):
It's an attempt to deny it, to flee from it.
One source calls this the narcissistic flight, this constant chase
for validation, success, status, anything to avoid facing that internal wound.
Speaker 2 (08:23):
Okay, so flight is the main strategy. But what other
defenses kick in to keep that shame buried besides just
looking impressive?
Speaker 1 (08:30):
Two big ones stand out in the literature aful working
alongside that flight blaming or indignant rage and contempt.
Speaker 2 (08:36):
Let's start with blaming an indignant rage. How does blaming
someone else actually help them feel better?
Speaker 1 (08:41):
Well, think about it. If someone with these patterns makes
a mistake, say at work, or forget something important for
their family, facing that directly means facing their own flaw,
their inadequacy.
Speaker 2 (08:53):
That triggers the shame, which feels unbearable.
Speaker 1 (08:56):
Right So instead, they might instantly shift focus. They might
obsessively replay the situation, but only focusing on how someone
else messed up, how a colleague sabotaged them, or how
their partner didn't remind them properly.
Speaker 2 (09:10):
Ah, so they build a case against the other person exactly.
Speaker 1 (09:13):
They become righteously indignant. They generate this storm of blame
directed outward. It shifts the focus from I messed up,
I feel ashamed, to I'm the victim.
Speaker 2 (09:22):
Of your failure, and that makes them feel superior again.
Speaker 1 (09:25):
Temporarily, Yes, it provides temporary relief from their own inner critic.
The sources even suggest that how harsh someone is outwardly
often mirrors how hearts their own internal voices. Blaming others'
silences that inner voice.
Speaker 2 (09:37):
For a moment that makes a disturbing kind of sense.
And the other defense is contempt. How does that work?
Speaker 1 (09:42):
Contempt is more of a posture, a posture of superiority.
It's about looking down on others to feel better about oneself.
It can be subtle, A condescending tone, an eye roll,
may be intellectual put downs.
Speaker 2 (09:55):
And how does that defend against shame?
Speaker 1 (09:57):
It often involves projection. Take the parts of themselves they
find intolerable, the weakness that damage, the shame, and unconsciously
project it onto someone else. Then they treat that person
with contempt.
Speaker 2 (10:10):
So it's like saying, I can't stand this feeling in me,
so I'll pretend you have it, and then I can
despise you for it.
Speaker 1 (10:15):
That's a perfect way to describe it. One fascinating case
study mentioned a therapist whose highly contemptuous client kept dreaming
about the therapists appearing as degraded figures, homeless, ragged. The
client was projecting their own unbearable shame onto the therapist
and then acting superior in sessions to maintain the defense.
Speaker 2 (10:33):
Wow, okay, now let's bring in splitting. This sounds crucial
for maintaining that fragile sense of self. What exactly is splitting?
Speaker 1 (10:41):
Splitting is considered a primitive defense mechanism. It develops early on. Basically,
it's an inability to handle complexity or ambiguity. Reality gets
simplified into extremes all good or all bad, black or white.
Speaker 2 (10:54):
The all or nothing thinking.
Speaker 1 (10:56):
Exactly and the sources often link this back to early
childhood experiences, specifically a failure to develop what's called whole
object relations.
Speaker 2 (11:04):
Right, we should probably explain that term. What does whole
object relations mean?
Speaker 1 (11:07):
It's the psychological capacity to see yourself and others in
an integrated, realistic way as complex people with both good
and bad qualities. Usually this develops when a baby has
reasonably consistent, good enough caregiving.
Speaker 2 (11:21):
So the baby learns that mom is still mom, still
fundamentally good, even when she's frustrating.
Speaker 1 (11:27):
Sometimes precisely, the good mom who feeds in comforts and
the bad mom who delays gratification or isn't perfectly attuned
get integrated into one all real person. But if caregiving
is chaotic, traumatic, maybe highly critical, alternating with idealizing.
Speaker 2 (11:43):
Then the child can't put those pieces together right.
Speaker 1 (11:46):
It's too overwhelming, So they keep the perception separate the
all good parent they need to survive and the all
bad parent who represents all the pain and criticism. And
this pattern carries into adulthood.
Speaker 2 (11:59):
Leading to that class cycle and relationships intense idealization followed
by sudden, harsh devaluation.
Speaker 1 (12:06):
Exactly, a new partner is put on a pedestal, perfect, flawless,
the answer to everything. All good, but the moment that
partner inevitably disappoints them shows a normal human flaw or
doesn't meet an impossible need. Bam, the splitting mechanism flips, and.
Speaker 2 (12:21):
Suddenly they're all bad, toxic, evil, the enemy.
Speaker 1 (12:25):
Correct, there's no middle ground. That's why you often hear
extreme language. You always do this, you never care, creates
massive instability.
Speaker 2 (12:31):
Okay, that explains a lot about the relationship turbulence. Now,
empathy lack of empathy is central to MPD, But you
said it's more nuanced than just not having it.
Speaker 1 (12:39):
Yes, the nuance is really important here. The sources describe
two main kinds of empathy failure. First, there's motivation based disengagement,
meaning the person can understand how someone else feels cognitively,
they have the capacity, but they choose not to engage
that empathy because it doesn't benefit them or it gets
in the way of their own goals.
Speaker 2 (12:57):
Ah like the example of.
Speaker 1 (12:58):
Mister H exactly. Mister H was great at mediating conflicts
at work and made him look good, feel competent. He
could turn on the empathy when it served him, but
when his wife was sick or his parents needed help.
He was indifferent, even annoyed. Their needs were a burden.
They didn't feed his need for admiration. He could switch
it on and off.
Speaker 2 (13:17):
Okay, So it's selective empathy based on self interest. What's
the other kind, deficit based disengagement?
Speaker 1 (13:23):
This is different. It's often linked more to the vulnerable type. Here,
the person genuinely struggles to tolerate or process strong emotions
from others. Grief, fear, intense worry. Hearing about it or
seeing it literally overwhelms them.
Speaker 2 (13:38):
So it triggers their own internal chaos, their own shame precisely.
Speaker 1 (13:42):
It's not calculated in difference. It's more like emotional flooding.
They can't handle the input.
Speaker 2 (13:47):
Mermous T the one who got angry when coworkers shared trauma.
Speaker 1 (13:50):
Yes, she found their stories spouse losing a job, child's
illness unbearably painful. Her reaction was anger, trying to shut
them down because their pain activated her own deep seated
distress and shame, which then made her feel even more
ashamed about reacting angrily. It's a genuine inability to cope
with the other person's emotional state.
Speaker 2 (14:12):
Understanding those two different empathy issues. Wow, it really sheds
light on why relationships with someone with NPD are often
so fraught with conflict and instability.
Speaker 1 (14:21):
Absolutely because that core pattern of exploitation using others to
regulate their own self worth really takes a toll.
Speaker 2 (14:28):
Yeah, the impact must be huge. The needs of partners, kids,
family members consistently take a back.
Speaker 1 (14:33):
Seat existently, and it shows up in so many ways.
Misusing family money, maybe, neglect, infidelity, patterns of emotional abuse
where the partner is constantly criticized, confused, made to feel inadequate.
Speaker 2 (14:44):
And often the relationship starts in a very specific way
with this tactic called love bombing.
Speaker 1 (14:49):
Ah, yes, love bombing very strategic. It's this intense, rapid
fire campaign of affection at the very beginning, like.
Speaker 2 (14:56):
What over the top complements, constant.
Speaker 1 (14:59):
Attention, exactly, grand gestures, expensive gifts, maybe talk of destiny,
soulmates being meant for each other, all happening very very quickly.
The goal is to forge this incredibly intense connection and
commitment almost immediately.
Speaker 2 (15:14):
Why what does that achieve for the person doing it?
Speaker 1 (15:17):
It creates a powerful setup for later when the devaluation
or exploitation inevitably starts. The partner is already deeply invested.
They're confused. They keep thinking back to that amazing, perfect beginning, right.
Speaker 2 (15:30):
Trying to reconcile the two versions of the person exactly.
Speaker 1 (15:33):
It makes it so much harder to see the reality
of the abuse and to actually leave. It creates cognitive dissonance.
Speaker 2 (15:38):
And they don't just take anyone, do they. The sources
say they often target certain types of people.
Speaker 1 (15:43):
That's often true. They might gravitate towards people who are
seen as maybe too nice or highly empathetic. Sometimes people
with codependent traits who tend to prioritize others needs and
emotional stability over their own. People who might struggle to
hold onto their own sense of self or boundaries within
a relationship.
Speaker 2 (15:59):
Which leads us to a really difficult but crucial point,
the limits of love. In this dynamic, So many partners
hope their love and patience will somehow fix the person, and.
Speaker 1 (16:12):
This is such a painful and frankly dangerous visconception. The
clinical consensus is crystal clear, another person's love cannot change
someone with MPD.
Speaker 2 (16:22):
Change has to come from within them.
Speaker 1 (16:23):
Absolutely. It requires their own internal motivation, their commitment and
undertaking that incredibly difficult therapeutic work we mentioned. Staying in
an abusive situation hoping your love will be the cure,
or clinging to the promise of change. It's not safe.
It just keeps the cycle going.
Speaker 2 (16:39):
So for someone listening who is dealing with these difficult
patterns in a loved one, what practical advice do the
sources offer? How can you protect yourself well?
Speaker 1 (16:48):
First and foremost, get support for yourself. Therapy is support group,
maybe even a domestic violence resource. If things have escalated
to abuse, you need your own validation, your own resilience.
Speaker 2 (16:57):
Okay, build your own support system. What about direct and.
Speaker 1 (17:00):
Communication needs to shift? Keep it very clear, concise and calm.
Avoid getting drawn into big emotional arguments. Stick to facts
and observable behaviors like we you yelled, I fell scared,
not you're always attacking me.
Speaker 2 (17:15):
Less accusation, more I feel statements based on specific actions exactly.
Speaker 1 (17:21):
Don't get bogged down debating the past or fairness. And
then there are boundaries. They have to be firm, really firm.
Speaker 2 (17:27):
How do you make them stick?
Speaker 1 (17:28):
You need to decide in advance what the consequence will
be if the boundaries crossed. And then this is the
hard part. You absolutely must follow through consistently. People with
MPD often test boundaries relentlessly because of that entitlement piece.
They need to experience clear, predictable consequences.
Speaker 2 (17:44):
Okay, firm consistent boundaries with clear consequences. What else?
Speaker 1 (17:49):
Remember your goal isn't to fix them or argue them
into insight. Your main emotional defense is staying calm. If
you react with intense anger or tears, you're often giving
them the emotion reaction they can use to manipulate the
situation or shift blame back onto you.
Speaker 2 (18:04):
So staying calm disrupts their usual pattern.
Speaker 1 (18:06):
It can it forces them potentially to sit with the
consequences of their own behavior without you getting sucked into
their emotional storm. You're protecting your own emotional well being.
Speaker 2 (18:18):
All right. This brings us back to the possibility of change.
We said it's a myth that MPD is untreatable. What's
the actual evidence that growth can happen.
Speaker 1 (18:28):
Well, there are longitudinal studies which are really valuable. For instance,
one study followed patients with NPD who committed to intensive
psychotherapy after about two and a half to five years.
Speaker 2 (18:38):
It's a long time.
Speaker 1 (18:39):
It is, but significantly, all the patients who finished the
study no longer met the full criteria for NPD. They
showed real improvements in their lives, holding down jobs, having
more stable reciprocal relationships.
Speaker 2 (18:50):
Wow. Okay, so five years to potentially move out of
the diagnostic category. That's hopeful, but it also really underscores
the level of commitment needed.
Speaker 1 (19:00):
This isn't about a few months of therapy. We're often
talking about five, ten, maybe even more years for really
deep fundamental change. You're not just treating a symptom like anxiety.
You're essentially trying to rebuild a psychological foundation built on
defending against shame.
Speaker 2 (19:17):
So if change is possible, why does it have such
a reputation for being difficult? Why do so many people
with NPD drop out of therapy early?
Speaker 1 (19:25):
Huge barriers? For one, many don't even come to therapy
for narcissism. They come because they're anxious or depressed, or
their partner gave them an ultimatum.
Speaker 2 (19:33):
So they're treating a symptom, not the root cause.
Speaker 1 (19:36):
Right, and once that immediate pressure is off or the
bad feeling eases up a bit, they might just leave. Plus,
the core of the therapy self reflection is the very
thing the entire narcissistic structure is designed to.
Speaker 2 (19:47):
Avoid facing the flaws, the vulnerability. It feels like a
direct attack, a narcissistic injury exactly.
Speaker 1 (19:54):
It can feel intensely humiliating, so they might react with denial, anger, blaming.
They're therapists, devaluing the whole process. They often quit. It
takes a very skill therapist who understands these dynamics, who
can handle being idealized one week and devalue the next
without taking it personally.
Speaker 2 (20:11):
So, assuming someone does stick with it, what's the ultimate
goal of therapy, what's the big shift they're working towards.
Speaker 1 (20:18):
It's fundamentally about perspective, moving from what some call ME mode,
that self centered view where the world revolves around validating them,
towards a more balanced relational we mode, meaning meaning learning
to accept responsibility, tolerate criticism or failure without falling apart,
develop more stable self esteem that isn't just based on grandiosity,
(20:38):
and understanding and managing their feelings in a healthier way.
Speaker 2 (20:41):
And what kinds of therapy are actually effective for this
deep work?
Speaker 1 (20:44):
Talk therapy is central and there are specific types often
used for personality disorders like MPD. Transference focused therapy TFP
is one, Mentalization based treatment MBT is another, and schem
of therapy is also common.
Speaker 2 (20:57):
Can you briefly explain TFP and MBT how do they
tackle these deep patterns?
Speaker 1 (21:02):
Sure? Both TFP and MBT really focus on what's happening
in the therapy room right then and there between the
client and the.
Speaker 2 (21:09):
Therapist, using the relationship itself as the tool.
Speaker 1 (21:12):
Exactly the client will inevitably start to relate to the
therapist in those old split ways, idealizing them one minute,
devaluing them the next. TFP and MBT helped the clients
slow down and examine those reactions as they.
Speaker 2 (21:25):
Happen, making them aware of the pattern in real time.
Speaker 1 (21:28):
Yes, and helping them mentalize, which means understanding their own
internal state and recognizing that the therapist's mind and experience are
separate and different from their own projection. It helps them
gradually integrate those split all good and all bad views
into a more realistic whole. The therapy relationship becomes a
safe place to practice reality testing, something that might have
(21:49):
been missing earlier in life.
Speaker 2 (21:50):
That makes a lot of sense to really grasp the
depth of this. Let's walk through the ten stages of
therapy that the sources outline. It's not strictly linear, but
it shows the journey.
Speaker 1 (22:00):
Roadmap is really eliminating, and it's worth noting. People who
start with maybe higher functioning or more capacity for self
reflection tend to progress further through these stages.
Speaker 2 (22:10):
Okay. Stage one symptom relief or appeasement.
Speaker 1 (22:12):
This is often the entry point they come in because
something feels bad anxiety, depression, or someone else is making
them go Like a partner, the motivation is purely external,
stop the pain or please the other person. A lot
of people with narcissistic issues unfortunately drop out right here.
Speaker 2 (22:29):
If they stay, they move to Stage two avoid future pain.
Speaker 1 (22:33):
Yeah. Here they start to get enough insight to see
what triggers their distress, what situations, what people lead to
bad feelings or negative consequences. Yeah, it's still very self focused,
how do I avoid feeling bad? But they're starting to
strategize based on understanding cause and effect in the world
around them.
Speaker 2 (22:49):
Then Stage three identify coping mechanisms.
Speaker 1 (22:52):
Now the therapist helps them gently explore their go to defenses,
the blaming, the contempt, the need for admiration. You might
start connecting these patterns back to childhood, seeing how these
strategies maybe help them survive back then. This stage can
sometimes be a bit less threatening because it feels more
analytical looking at the past.
Speaker 2 (23:11):
Identifying the patterns is one thing, but changing them that
sounds like the really hard part. What happens in stage four.
Speaker 1 (23:18):
Stage four is tough because you can't just remove a
defense mechanism, even a harmful one, without replacing it. It's
like taking away crutches before someone can walk right. So
stage four create new coping mechanisms. This is active work.
The client has to consciously try out new healthier ways
to get their needs met, maybe learning to ask for
help instead of demanding, or tolerating frustration instead of raging.
(23:42):
It takes huge effort, lots of repetition and feeling vulnerable
trying new things.
Speaker 2 (23:47):
And that repetition leads into the next stage.
Speaker 1 (23:49):
Yes, stage five, form new habits. Those old narcissistic reactions
are like deeply worn paths in the brain. Therapy here
involves actively inhibiting the automatic urge to use the old
defense and consciously effortfully substituting the new healthier behavior. They
practiced in stage four. This has to happen over and
(24:09):
over again in real life until the new pattern becomes
more automatic, like reprogramming software.
Speaker 2 (24:15):
It sounds like a massive rewiring job. But notice even
at stage five it still seems very focused on their
internal management. When do other people really start to factor in?
Speaker 1 (24:24):
That's the big shift in stage six impact on other people,
And interestingly, this usually only clicks after they've had some
successful Stage five forming those new coping habits. Why because
actually managing their behavior better gives them a source of
genuine earned.
Speaker 2 (24:38):
Pride, which reduces the need for the false pride of grandiosity.
Speaker 1 (24:42):
Exactly, with less need for those defenses, they can start
to tolerate the idea that considering others might actually benefit them.
The initial motivation might still be self referential, like, hey,
if I'm nicer to my partner, my home life is
calmer and I feel better. It's recognizing reciprocal benefit, but
maybe not full emotional empathy yet.
Speaker 2 (25:01):
Okay, and the work deepens further in stage seven focus
on childhood pain.
Speaker 1 (25:06):
Right, life is maybe a bit calmer. The new habits
offer some stability, The defenses aren't needed quite as desperately now,
It becomes safer to actually revisit and process the original wounds,
the trauma, the neglect, the criticism from childhood. This is
where they can develop real self empathy for the child they.
Speaker 2 (25:24):
Were, and that helps build a more stable sense of self.
Speaker 1 (25:27):
Yes, it's crucial for forming an integrated self image, seeing
oneself as a whole person with strengths and weaknesses, getting
closer to that whole object relations.
Speaker 2 (25:34):
We talked about, which then allows for probably the most
profound internal shift in stage eight, update the inner voice.
Speaker 1 (25:40):
This tackles the blueprint. Remember we said outer harshness often
reflects inner harshness. Stage eight is about becoming aware of
that critical, often punitive inner voice internalized from childhood. Many people,
as the sources say, are kind of running their adult
lives based on the programming of a scared kit.
Speaker 2 (25:58):
How do you actually change that audi inner.
Speaker 1 (26:00):
Critic It takes intense conscious effort noticing the voice You're stupid,
you'll fail, and then challenging it. Is it fair, is
it true? Is it helpful? They practice actively interrupting it,
maybe mentally saying stop, that's the old voice not accurate anymore,
and then consciously replacing it with a kinder, more realistic,
or at least neutral self talk. This is vital because
(26:23):
so much outward blaming is just that inner critic being
turned outwards for relief.
Speaker 2 (26:26):
Okay, so as the inner world becomes safer and less critical,
that presumably opens up space for stage nine empathy for
other people.
Speaker 1 (26:33):
Yes, this is where genuine emotional empathy, spontaneously feeling with
another person often starts to emerge more consistently. It might
first appear for someone who feels safe, maybe someone whose
vulnerability mirrors their own past pain, or someone in a story.
Then gradually, carefully this capacity can be expanded to include
people closer to them.
Speaker 2 (26:53):
Leading finally, after all this work to stage ten authenticity.
Speaker 1 (26:58):
This is the goal. Long trusting relationship with the therapist
itself is hugely healing. They've shown their bad side, their
vulnerable side, and the therapist didn't abandon or attack them. The
reliance on the old false self, the narcissistic defenses, starts
to fade. They can risk being more spontaneous, more genuine,
maybe even more joyful with others. It's the emergence of
a true integrated self.
Speaker 2 (27:20):
Wow. That ten stage journey really highlights that change. Isn't
a quick fix. It's like a fundamental process of reparenting oneself,
rewiring those deep patterns. It takes incredible courage to face
that core shame.
Speaker 1 (27:31):
It truly does so. Just to pull things together, we
really hammered home the difference between just having some narcissistic traits,
which is common, and the actual disorder INPD, which is
more pervasive and impairing.
Speaker 2 (27:44):
Right and emphasizing that narcissism at its root is often
a defense, a way to cope with deep feelings of
shame or inadequacy.
Speaker 1 (27:53):
We looked under the hood at those defenses, splitting into
black and white, the blaming, the contempt, and the complexities
around empathy. Some times it's a choice not to engage,
other times it's a genuine inability to tolerate other's emotions.
Speaker 2 (28:05):
And for listeners dealing with these patterns and relationships, we
talked about practical steps, clear communication, firm boundaries, and the
hard truth that you can't love someone into changing.
Speaker 1 (28:16):
But crucially we also focus on the possibility of growth.
Treatment is possible, even though it's long and difficult. That
ten stage roadmap shows a path from defensiveness towards eventually
real authenticity and empathy.
Speaker 2 (28:29):
So the final message for you listening, we hope, is
one of balanced compassion. Awareness really is key for healthier relationships,
whether you're navigating this with a loved one or maybe
seeing some reflections in the mirror.
Speaker 1 (28:41):
It's about having compassion for the underlying pain that often
drives these defenses, both in others and potentially in yourself,
while still being clear eyed about the impact of the
behaviors self.
Speaker 2 (28:52):
Compassion and compassion for others, informed by understanding exactly.
Speaker 1 (28:57):
And maybe one final thought to leave you with, connecting
back to that your voice from stage eight, pay attention
to how harshly people talk about others. Often the level
of criticism or judgment they direct outwards is a pretty
good clue to how harsh their own inner critic is.
Speaker 2 (29:12):
That outward blame is really just a reflection of an
inner battle seeking a moment's piece.
Speaker 1 (29:17):
Often yes, So perhaps observe that dynamic in yourself and
others with a little more nuance, a bit more understanding.
Speaker 2 (29:24):
A powerful thought to end on, thank you for joining us,
we hope this exploration offers some valuable perspective and tools
for understanding
Speaker 1 (29:41):
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