Heal NPD

In this episode, Dr. Ettensohn discusses the emptiness that individuals with pathological narcissism and NPD often experience using the concept of ‘Self as Object.’ 

Individuals with pathological narcissism and NPD often report having been treated as an object for someone else’s gratification in childhood. This early exploitation can cause profound disconnect from emotional authenticity, because it necessitates the development of false self adaptations to protect against overwhelming shame, envy, and rage. 

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In this episode, Dr. Ettensohn discusses the relationship between social anxiety and pathological narcissism and NPD, focusing on underlying fears of shame and humiliation, loss of self, and the legacy of relational trauma. 

Sartre, J.P. (1964). Nausea. New Directions Publishing Corp. 

In this episode, Dr. Ettensohn clarifies the concept of Malignant Narcissism, drawing on the model developed by theorist Otto Kernberg. Common misconceptions are dispelled. Object Relations Theory is used to discuss the origins of both NPD and Malignant Narcissism, highlighting developmental differences between each disorder.

Two meaning of malignant narcissism are discussed:

1. Malignant narcissism is a combination of narcissistic personality, antisocial traits, ego-syntonic sadism, and paranoid thinking that represents its own personality constellation distinct from Narcissistic Personality Disorder.

2. Malignant narcissism represents a phase or episode of narcissistic pathology in which repressed or split-off identifications with sadistic objects rise to the surface and become enacted in relationships. This is often due to loosening of grandiose defenses in psychotherapy.

Link to Episode discussing Borderline Personality Organization referenced in the video: https://youtu.be/ZZP6gAm5L6c

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References:

Ettensohn, M.D. (2011). The relational roots of narcissism: Exploring relationships between attachment style, acceptance by parents and peers, and measures of grandiose and vulnerable narcissism. (Doctoral dissertation).

Goldner-Vukov, M., & Moore, L. J. (2010). Malignant narcissism: From fairy tales to harsh reality. Psychiatria Danubina, 22(3), 392-405.

Kernberg, O. F. (1970). Factors in the psychoanalytic treatment of narcissistic personalities. Journal of the American Psychoanalytic Association, 18, 51-85.

Kernberg O.F. (1984). Severe Personality Disorders. New Haven, CT: Yale University Press

In this episode, Dr. Ettensohn discusses the topic of integration. Pathological narcissism is a disorder in which different parts of the self are not well-integrated, creating large disparities and discontinuities in identity, self-image, and perception of others. This phenomenon is sometimes called "splitting," and is thought to be partly due to chronic relational trauma and neglect in early childhood. Dr. Ettensohn explains how this occurs and provides suggestions for beginning to approach life more wholistically. 

In this episode, Dr. Ettensohn discusses the importance of recognizing the resiliency of those who struggle with NPD and pathological narcissism. Each person's psychology is a story of survival. In our focus on deficits and pathologies, we often overlook the strength of the individual and the sometimes surprising and ingenious ways that they have found to survive. 

References:

Rogers, C. (1980). A way of being. Houghton Mifflin.

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In this episode, Dr. Ettensohn addresses common questions about therapy for NPD, discussing the current lack of competent therapists, where to find therapists who understand narcissism, and why it isn't effective to treat NPD on your own. 

References: 

Blagys, M.D., & Hilsenroth, M.J. (2000). Distincitve activities of short-term psychodynamic-interpersonal psychotherapy: A review of the comparative psychotherapy process literature. Clinical Psychology: Science and Practice, 7, 167-188.

Johnson, S. M. (1987). Humanizing the narcissistic style. New York: W.W. Norton & Co.

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109

Ulberg, R., & Hanne-Sofie, JD. (2018). Empirical support for the psychoanalytic concepts. The Lancet Psychiatry, 5(7), 543-544

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Dr. Ettensohn discusses the protective false self, highlighting its origins in childhood relational trauma and its role in maintaining narcissistic grandiosity. He also discusses important related issues including the role of grief in reconnecting with authentic self experience.

References: 

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Narcissistic individuals are often hypersensitive to feeling criticized, rejected, or humiliated. In this episode, Dr. Ettensohn traces the roots of interpersonal hypersensitivity in narcissism, giving special focus to a particular constellation of relational trauma thought to contribute to NPD. In addressing these issues, he discusses the here-and-now strategy of pairing self-compassion with personal responsibility. 

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References:

Ettensohn, M. D. (2013). The relational roots of narcissism: Exploring relationships between attachment style, acceptance by parents and peers, and measures of grandiose and vulnerable narcissism. Dissertation Abstracts International: Section B: The Sciences and Engineering, 73(10-B(E)).

Acceptance is one of the most powerful tools in healing and recovery from almost any mental illness. In this episode, Dr. Ettensohn discusses what acceptance means, why it is so important, and how it applies to healing from pathological narcissism and NPD. This episode also includes instructions for practicing acceptance in the form of mindfulness meditation.

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Dr. Ettensohn discusses the differences and similarities between vulnerable narcissism and Borderline Personality Disorder (BPD). 

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