Can the Narcissist Help Himself?

In the book describing the fabulous tales of Baron Munchhausen, there is a story about how the legendary nobleman succeeded to pull himself out of a quicksand marsh – by his own hair. Such a miracle is not likely to recur. Narcissists cannot cure themselves any more than other mental patients do.

Pathological narcissism (the Narcissistic Personality Disorder - NPD) is not merely an aberrant thought process which can be controlled cognitively. It is an all-pervasive emotional, cognitive, and behavioural impairment. Thus, gaining insight into the disorder is not tantamount to healing.

It is not a question of determination or resilience. It is not a function of the time invested by the narcissist, the effort expended by him, the lengths to which he is willing to go, the depth of his commitment and his professional knowledge. All these are very important precursors and good predictors of the success of an eventual therapy. However, they are no substitute for one.

The best – really, the only way – a narcissist can help himself is by resorting to a mental health professional. Even then, sadly, the prognosis (the healing prospects) are dim. It seems that only time can bring on a limited remission (or, at times, aggravation of the condition).

Therapy can tackle the more pernicious aspects of this disorder. It can help the patient adapt to his condition, accept it and learn to conduct a more functional life. Learning to live with one's disorder – is a great achievement and the narcissist should be happy that even this modicum of success is, in principle, possible.

But just to get the narcissist to see a therapist is difficult. The therapeutic situation implies a superior-inferior relationship. The therapist is supposed to help him – and, to the narcissist, this means that he is not as omnipotent as he imagines himself to be. The therapist is supposed to know more (in his field) than the narcissist – a presumption which seems to undermine the second pillar of narcissism, that of omniscience.

Going to a therapy (of whatever nature) implies both imperfection (something is wrong) and need (read: weakness, inferiority). The therapeutic setting (the client visits the therapist, has to be punctual and to pay for the service) – implies subservience. The process itself is also threatening: it involves transformation, losing one's identity (read: uniqueness), one's long cultivated defences.

The narcissist must shed his False Self and face the world naked, defenceless, and (to his mind) pitiful. He is inadequately equipped to deal with his old hurts, traumas and unresolved conflicts. His True Self is infantile, mentally immature, frozen, incapable of confronting the almighty Superego (the narcissist's inner, chastising, voices). The narcissist knows this – and recoils. Therapy demands of him to finally place full, unmitigated, trust in another human being.

Moreover, the transaction implicitly offered to him is the most unappealing imaginable. He is to give up decades of emotional investment in an elaborate, adaptive and, mostly, functioning, mental hyper structure. In return, he stands to become "normal" – an anathema to a narcissist. Being normal, to him, means, being average, not unique, non-existent. Why should the narcissist commit himself to such a move when it doesn't even guarantee him happiness (he sees many unhappy "normal" people around)?

But is there anything the narcissist can do by himself, "in the meantime", until he reaches a final decision whether to attend therapy or not?

The first step involves self-awareness. The narcissist often notices that something is wrong with him and with his life – but he never own up to his role and responsibility in his misfortune and discomfort. He prefers to come up with elaborate rationalizations as to why that which is wrong with him – is really quite OK!

Cognitive dissonance, rationalisation or intellectualisation are the narcissist's allies in insulating him from reality. The narcissist consistently convinces himself that everyone else is wrong, deficient, lacking, and incapable (alloplastic defences and outside locus of control). He tells himself that he is exceptional and made to suffer for it – not that he is in the wrong. On the contrary, history will surely prove him right as it has done so many other towering figures.

This is the first and, by far, the most critical step on the way to coping with the disorder: will the narcissist admit, be forced, or convinced to concede that he is absolutely and unconditionally wrong, that something is very amiss in his life, that he is in need of urgent, professional, help and that, in the absence of such help, things will only get worse? Having crossed this Rubicon, the narcissist is more open and amenable to constructive suggestions and assistance.

The second important leap forward is when the narcissist begins to confront a more REALISTIC version of himself. A good friend, a spouse, a therapist, a parent, or a combination of these people can decide not to collaborate with the narcissist's confabulations anymore, to stop fearing the narcissist and not to acquiesce in his folly any longer.

When they confront the narcissist with the truth about himself, they help demolish the grandiose phantom that "runs" the narcissist. They no longer succumb to his whims or accord him a special treatment. They reprimand him when needed. They disagree with him and show him why and where he is mistaken. In short: they deprive him of many of his sources of Narcissistic Supply. They refuse to take part in the elaborate game that is the narcissist. They rebel.

The third Do It Yourself element involves the decision to commit to a regime of therapy. This is a tough one. The narcissist must not decide to embark on therapy only because he is (currently) feeling bad (mostly, due to a life crisis), or because he is subjected to pressure by family or peers, or because he wants to get rid of a few disturbing issues while preserving the awesome totality.

His attitude towards the therapist must not be judgemental, cynical, critical, disparaging, competitive, or superior. He must not view the therapy as a contest or a tou
ament. There are many winners in therapy – but only one loser if it fails. He must decide not to try to co-opt the therapist, not to threaten him, or humiliate him.

In short: he must adopt a humble frame of mind, open to the new experience of encountering one's self. Finally, he must resolve to be constructively and productively active in his own therapy, to assist the therapist without condescending, to provide information without distorting, to try to change without consciously resisting.

The end of therapy is really only the beginning of a new, more vulnerable life. This terrifies the narcissist. He knows that maybe he can get better, but he can rarely get well ("heal"). The reason is the narcissist's enormous life-long, irreplaceable and indispensable emotional investment in his disorder.

The narcissist's disorder serves two critical functions, which together maintain the precariously balanced house of cards that is his personality. His disorder endows the narcissist with a sense of uniqueness, of "being special" – and it provides him with a rational explanation of his behaviour (an "alibi").

Most narcissists reject the notion or diagnosis that they are mentally disturbed. Absent powers of introspection and a total lack of self-awareness are part and parcel of the disorder. Pathological narcissism is founded on alloplastic defences – the firm conviction that the world or others are to blame for one's behaviour.

The narcissist simply "knows" that his closest, nearest and dearest should be held responsible for his reactions because they have triggered them. With such an entrenched state of mind, the narcissist is constitutionally incapable of admitting that something is wrong with HIM.

But that is not to say that the narcissist does not experience the pernicious outcomes of his disorder. He does. But he re-interprets this experience. He regards his dysfunctional behaviours – social, sexual, emotional, mental – as conclusive and irrefutable proof of his superiority, brilliance, distinction, prowess, might, or success.

Rudeness to others and bullying are reinterpreted as efficiency. Abusive behaviours are cast as educational. Sexual absence as proof of preoccupation with higher functions. His rage is always justified and a reaction to injustice or to being misunderstood by intellectual dwarves.

Thus, paradoxically, the disorder becomes an integral and inseparable part of the narcissist's inflated self-esteem and vacuous grandiose fantasies.

His False Self (the pivot of his pathological narcissism) is a self-reinforcing mechanism. The narcissist believes that he is unique BECAUSE he has a False Self. His False Self IS the centre of his "specialness". Any therapeutic "attack" on the integrity and functioning of the False Self constitutes a threat to the narcissist's ability to regulate his wildly fluctuating sense of self-worth and an effort to "reduce" him to other people's mundane and mediocre existence.

The few narcissists that are willing to admit that something is terribly wrong with them, displace their alloplastic defences. Instead of blaming the world, other people, or circumstances beyond their control – they now blame their "disease". Their disorder becomes a catch-all, universal explanation for everything that is wrong in their lives and every derided, indefensible and inexcusable behaviour. Their narcissism becomes a "licence to kill", a liberating force which sets them outside and above human rules and codes of conduct. Such freedom is so intoxicating and empowering that it is difficult to give up.

The narcissist is emotionally attached to only one thing: his disorder. The narcissist loves his disorder, desires it passionately, cultivates it tenderly, is proud of its "achievements" (and in my case, I make a living off it). His emotions are misdirected. Where normal people love others and empathise with them, the narcissist loves his False Self and identifies with it to the exclusion of all else – including his True Self.