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Taming the Beast: Pathological Narcissism and the Quality of Life
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Part 1

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Many textbooks (and many patients) claim that the psychodynamic therapies when applied to personality disorders are ineffective.

Functional (cognitive, behavioral) treatments should be preferred in certain cases and regarding certain aspects of the disorder.

To a Narcissist, I would recommend a behavioral-cognitive-functional and less protracted type of therapy.

1. Know and accept thyself. This is what you are. You are highly intelligent. You are very inquisitive. You are a Narcissist. These are facts. Narcissism is an adaptive mechanism. It is dysfunctional - but it saves you from a LOT MORE dysfunction or even a-function. Make a list: what does it mean to be a Narcissist in your specific case? What are your typical behavior patterns? Which types of behavior are counterproductive, irritating, self-defeating or self-destructive? Which are productive, constructive and should be enhanced DESPITE their pathological origin?
2. Decide to suppress the first and to promote the latter. Construct lists of self-punishments, negative feedback and negative reinforcements. Impose them upon yourself when you exhibit one of the behaviors in the first list. Make a list of prizes, little indulgences, positive feedbacks and positive reinforcements. Use them to reward yourself when you display a behavior of the second kind.
3. Keep doing this with the express intent of conditioning yourself. Be objective, predictable and just in the administration of both punishments, and awards, positive reinforcements and feedback and negative ones. Learn to trust your "inner court". Constrain the sadistic, immature and ideal parts of your personality (known as "superego" in psychoanalytic parlance) by the application of a uniform codex, a set of immutable and invariably applied rules.
4. Once sufficiently conditioned, monitor yourself incessantly. Narcissism is sneaky and it possesses all your resources because it is you. It is intelligent because you are. Beware and never lose control. With time this onerous regime will become a second habit and supplant the Narcissistic (pathological) superstructure.

All the above can be amply summed by suggesting to you to become your own parent. This is what parents do and the process is called "education" or "socialization". If your particular path to the adoption of this course is a particular therapy - go ahead. As a metaphor, a narrative, no therapeutic approach is better or worse than any other.

Part 2

In the previous part we discussed the healing prospects of a Narcissist. Yet, how can a False Self be anything but false? How can anyone on a permanent diet of reflections ever see true objects? How can the Narcissist - whose essence is the devouring of meaningful others and their transformation into meaningless and other - ever love?

The answer is: discipline, decisiveness, clear targets, conditioning, and justice. The Narcissist is the product of unjust, capricious and cruel treatment. He is the finished product of a production line of self-recrimination, guilt and fear. He needs to take the antidote to counter the Narcissistic poison. Unfortunately, there is no drug I know of which can ameliorate pathological Narcissism. Confronting ones parents and childhood is a good idea if the Narcissist feels that he is ready for it. Can he take it? Can he cope with new truths, however painful? The Narcissist must be careful. This is playing with fire. But if he feels confident that there is nothing that can be revealed to him in such a confrontation that he cannot withstand - it is a good and wise move in the right direction. My advice to the Narcissist would then be: just dedicate a lot of time to rehearsing it and define well what is it exactly that you want to ask. Do not turn this into a monodrama, group dynamics or trial. Ask so that you shall be answered. Don't try to prove anything, to vindicate, to avenge, to take revenge, to win, to exculpate. Talk as you would with yourself. Do not try to sound professional, mature, intelligent, knowledgeable and distanced.

There is no "problem to solve" - just a condition to adjust yourself to. Think about it as diabetes.

Disorders - Narcissistic Personality Disorder