In this episode I explore the concept of narcissistic deflation and its potential misdiagnosis as depression. I highlight the importance of detecting and properly treating narcissistic deflation, which often goes unnoticed without the expertise of a trained professional in personality disorders. Shame states are identified as a key factor in this phenomenon, with examples provided to illustrate their impact on individuals. The connection between excitement, disappointment, and shame is explored, emphasizing the role of misattunement in triggering shame. I discuss the importance of regulating shame and developing self-regulation skills to prevent narcissistic injury.  Finally, I offer a treatment approach focused on long-lasting change and “robust” self-regulation, and provide further resources and support for those struggling with these issues.

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Dr. Anthony Mazzella is a psychoanalyst and psychodynamic psychotherapist specializing in narcissism, personality disorders, and relational dynamics.