"At the core of all narcissistically-driven over-compensations is an underlying feeling of shame."

 

OUR APPROACH

The term narcissism has come into vogue in the popular press, of late, and it is generally used as a term of derision to describe individuals who had once achieved some degree of fame, fortune, or power, only to be exposed for an indiscretion that ruined their career or tarnished their reputation. Hero, leader, athlete, politician – far too many to mention, end up suffering a fall from grace, and one of the ways popular media finds to explain these repeated falls from grace is to label the individual as narcissistic. 


The general public has come to identify the narcissist as someone who is grandiose, self-absorbed, so self-serving, and entitled, that they don’t believe that “the rules should apply to them”. Although this is partially an accurate description of some narcissistic traits, from a clinical vantage point, what comprises the constellation of narcissistic dynamics is far more complex. 


To begin, the posture of confidence exhibited by many narcissistically-driven individuals can best be understood as just that, posturing.  Even though some individuals actually come to believe that the constructed version of the self is true, somewhere underneath the surface lies a secret fear that they are a fraud and will eventually be exposed. 


Most narcissistically-driven behaviors and beliefs originate in childhood, created in an attempt to compensate for or distance from deep-seated feelings of inadequacy or uncertainty. But as is the case with all compensatory solutions used as an attempt to feel better or more confident, the compensatory postures are unsustainable over time. 


Invariably, any defensive mechanism requires more and more effort to maintain over the life span. This is because the source of the pain is not yet understood or metabolized. Failed ambitions, the aging process, life’s disappointments and losses often result in a patient’s increased rigidity in attitudes and beliefs. In the treatment of narcissism, one of the central tasks for the therapist is to find ways to dismantle tightly woven defenses that mask feelings of underlying shame. 


The intensity and scope of narcissistic injury and the underlying shame that accompanies said injuries, are often relative to the quality of the parent-child bond. Drawing upon constructs from attachment theory, we are able to determine whether relational attachments were secure, insecure, or disorganized. All insecure attachments are traumatic. Whether the childhood environment was abusive, or the parental figures were detached, cold, neglectful, or the child had to endure an anxious, hovering parent who pushed the child to live up to someone else’s standards, all children quickly learn to adapt and compensate in order to maintain connection. Unfortunately, the cost of this compensation to maintain relational connection is often at the expense of healthy development. 


At the core of all narcissistically-driven over-compensations is an underlying feeling of shame. No one is immune to being activated by shame, although shame triggers vary in intensity and scope from individual to individual. 


Because none of us escapes the tumbles and traumas of childhood completely unscathed, all of us suffer from some degree of narcissistic injury to our sense of self. Depending on degree or severity, each of us may recognize some trace of defensive adaptation that we have used at some point in our lives.


Understanding the continuum of narcissistic injury is helpful in that it allows us to maintain a posture of compassion and hopefulness – compassion because its important to remind ourselves that we all have struggled with some degree of injury to our developing sense of self at some point in our lives, and hopeful because character organization is something that is mutable, not fixed. 


The underpinnings of our approach are as follows:


  1. The term narcissistic injury is defined not as a set of DSM or ICD-10 diagnostic symptoms. Rather, it is seen as a formidable residue of characterological damage that is active (or activated) in the present moment.

  2. The concept of narcissistic injury is understood on a continuum, where degrees of injury correlate to levels of fragility and vulnerability, all of which interfere with spontaneity, resilience, and authentic self-emergence.

  3. The treatment of narcissistic injury involves the here-and-now unpacking of the complex construction of narcissistic defenses, in particular its characterological residue.

  4. Narcissistic injury is not created in a vacuum but is based on early (or later) failures of attachment. Narcissistic compensations are attempts to maintain precarious attachments, as well as to bolster a fragile sense of self.

  5. Our aim throughout the treatment process is to neutralize painful feelings of shame by creating a therapeutic healing environment based on a secure attachment to the therapist. 


We have developed an assessment and treatment model that can be universally applied across training and treatment disciplines. This model is aimed at improving listening, tracking, and intervening from a relational perspective that is anchored in attachment theory in the service of understanding struggles related to narcissistic injury.