Latest / The Dr. Psych Mom Show with clinical psychologist Dr. Samantha Rodman Whiten / Yes, Narcissists Can Change In Therapy

Transcript

Yes, Narcissists Can Change In Therapy · The Dr. Psych Mom Show with clinical psychologist Dr. Samantha Rodman Whiten

• 0:06
  Hi everybody, and welcome to the doctor psych mom show today.
• 0:10
  I am going to be talking about how yes narcissists can change
• 0:13
  in therapy and I've alluded to this a whole bunch or you know
• 0:17
  I've said it a couple times within other podcasts how
• 0:20
  narcissists are like now, what borderline personality disorder
• 0:25
  used to get treated like which was like a monster, you know
• 0:29
  that can never change and this is not accurate, you know?
• 0:33
  But I will talk about that as soon.
• 0:35
  Luna. As I talk about how you should
• 0:37
  subscribe because I have all sorts of great subscriber only
• 0:40
  episodes. And the most recent one, is what
• 0:44
  happens when you and your spouse have different expectations for
• 0:47
  the empty nester or retirement years.
• 0:51
  So let's move on to the topic at hand, which is narcissism.
• 0:56
  So, obviously the idea of narc abuse and all this stuff is,
• 1:00
  like, super big in the popular media and while narcissus as As
• 1:05
  I have a video out about this or only a very, very small percent
• 1:09
  of the population, a small. Some people think is a half a
• 1:12
  percent that does go up to like, 10% or something in clinical
• 1:17
  settings. It never goes up to the like
• 1:21
  half of the men in the world or something, which is like, what
• 1:25
  people act like and it's a, it's a small subset.
• 1:29
  Although of course it's like a larger subset in certain groups
• 1:32
  and interesting study, I read said it's 17 percent of medical
• 1:35
  Students, which is kind of funny because you also have to look at
• 1:38
  the criteria, like one of the criteria.
• 1:41
  The DSM criteria for narcissism is like, believes is special and
• 1:44
  should only associate with other kind of special people.
• 1:47
  Will, if you get into medical school, is hard to do, you know?
• 1:51
  So you really are in a real small group.
• 1:55
  So, yes they would meet criteria.
• 1:57
  Does that mean all doctors are narcissists?
• 1:59
  No, but but yeah, rates are higher in certain populations
• 2:04
  than in others. Just because a certain
• 2:07
  populations have basically an identity around being special.
• 2:11
  So if you're at very high levels in your career, then you know
• 2:17
  that there aren't a lot of people like you and, yeah, that
• 2:20
  does impact your personality another area.
• 2:23
  I work with people. A sex addiction and narcissism
• 2:26
  goes hand-in-hand with sex addiction, a lot and you can
• 2:29
  read an interesting book on sex and love and relationship
• 2:32
  addiction because these are all the people addictions.
• 2:34
  By the way, is When you love too much so you can look for that
• 2:38
  book on Amazon. If that's something you're
• 2:40
  struggling with, I'll probably do a podcast on it at some
• 2:42
  point. But anyway, narcissists, let's
• 2:46
  say that you are dealing with a dyed-in-the-wool narcissist and
• 2:49
  they meet all the DSM criteria for narcissism and they're just
• 2:53
  one of those people that everybody thinks they're
• 2:55
  extremely self-involved, and they always have been.
• 2:59
  So, what, what then are they beyond help as so much Allure
• 3:06
  media memes would have you believe?
• 3:08
  No, no there's no like there's no real there's no evidence for
• 3:16
  that at all. You know, the majority of people
• 3:20
  who come into counseling or struggling with maladaptive ways
• 3:24
  of viewing the world, if not 100% of people that come in to
• 3:27
  counsel it, you know. So they're maladaptive way of
• 3:31
  viewing. The world is that they are never
• 3:33
  the problem but It like so many people coming into counseling
• 3:39
  like that, you know, thinking that they aren't the problem and
• 3:42
  it's everybody else people with depression.
• 3:45
  Like the way that you the the theory of what depression really
• 3:50
  is is - this is called the cognitive Triad and cognitive
• 3:53
  therapy negative thoughts about self world and future.
• 3:58
  So yeah, like you definitely don't think that.
• 4:03
  Yeah, Okay. Negative thoughts about Self.
• 4:05
  But that doesn't mean you think you're the problem if frequently
• 4:08
  means like I think I'm so ugly and stupid that.
• 4:11
  That's why everybody's mean to me, but like you still get an
• 4:15
  everybody does X and like, I am a victim of it and that's in
• 4:20
  depression, you know, like everybody with depression that
• 4:23
  is like, 20% of of, at least women that I've struggled with
• 4:26
  depression. At some point.
• 4:27
  They're not all narcissists just because they believe that
• 4:29
  everybody is the problem in a certain sense, you know
• 4:34
  everybody's kind of Out to get me.
• 4:36
  That is a way that people feel when they're raised in very
• 4:39
  negative homes. Also a narcissist have that as
• 4:43
  well. They say things like, you know,
• 4:45
  it's not my fault that this person just, you know, won't do
• 4:49
  their job or it's not my fault that my wife just has a low sex
• 4:53
  drive or it's not my fault that my kids are just difficult, you
• 4:56
  know? But that's so endemic to just
• 4:59
  any unhappy person that's like a normal human way to view the
• 5:03
  world when you're in distress. Is this cognitive dissonance
• 5:06
  reduction of? It can't be me.
• 5:08
  That's a short-term coping strategy saying it must be
• 5:11
  everybody else, it's not me. And the idea of thinking that
• 5:14
  you're special like everybody thinks they're special in some
• 5:19
  way or another. Even the people that are super
• 5:21
  depressed that are like I am uniquely honestly, all ugly and
• 5:24
  stupid. They think they're special to
• 5:26
  was just in a bad way. So lots of people struggle with
• 5:30
  these like distorted worldviews and assuming that a distorted
• 5:34
  world, you can't. You worked on just because it
• 5:36
  fits into certain boxes of criteria for narcissistic
• 5:40
  personality disorder doesn't make any sense.
• 5:43
  Their maladaptive worldviews and they are workable and treatable
• 5:49
  with CBT or really any other sort of therapy in which
• 5:53
  somebody is working with a therapist with whom they have a
• 5:55
  strong Alliance and a therapist who has experience with this
• 5:59
  demographic, you know. There are so so many people that
• 6:04
  are not diagnosed with any Narcissism at all.
• 6:06
  They are working on something like addiction or depression, or
• 6:09
  relationship problems or anxiety and what happens like what's the
• 6:14
  major thing that's worked on cognitive flexibility and
• 6:17
  empathy? These are things that are worked
• 6:20
  on in therapy, constantly taking other people's perspectives,
• 6:24
  understanding that there's like a bigger world with other people
• 6:27
  that feel different things. This isn't something that like
• 6:29
  all other people, except narcissists are awesome.
• 6:32
  At I work with this with people's social.
• 6:35
  Heidi where I'm like, do you really think everybody's
• 6:37
  thinking about you? You know, like it's not a kind
• 6:39
  of narcissism where they think everybody's thinking, they're so
• 6:41
  awesome but they still overestimate how much other
• 6:44
  people think about them and have to kind of understand and really
• 6:48
  learn a different approach to thinking about things, you know
• 6:52
  where they say no. Most people aren't thinking
• 6:54
  about me at all, actually you know?
• 6:57
  And so the cognitive flexibility the ability to hold different
• 7:01
  perspectives in your head at the same time and understand that
• 7:03
  the way that you view things isn't however Nobody does that's
• 7:06
  a core tenet and skill. That is learned in all
• 7:11
  successful. Psychotherapy, I would argue
• 7:13
  increased empathy would be a consequence of any successful
• 7:18
  therapy. And so, then why could this not
• 7:21
  be done with people? Just once they hit a certain,
• 7:24
  like, level of self-absorption. There is no specific.
• 7:31
  There's no blood test for narcissism, there's no specific
• 7:33
  way. Everything is along a spectrum.
• 7:35
  Is what I'm trying to say. People used to think there was
• 7:37
  like, autism, and not autism, and now we know that there's an
• 7:40
  Autism Spectrum. There's also a depression
• 7:43
  Spectrum. So if you want to get a
• 7:45
  diagnosis of depression, you need to have X criteria from the
• 7:49
  DSM. But if you have x minus 1, does
• 7:51
  that mean that you don't also feel depressed?
• 7:54
  You just feel slightly less depressed.
• 7:57
  That's all, it's a spectrum of depression, there's a spectrum
• 8:00
  of narcissism. There's a spectrum of
• 8:02
  self-absorption, so there There's no specific thing that
• 8:06
  when you have like X criteria of narcissism, then you become no
• 8:11
  longer able to engage with therapy.
• 8:14
  And then you get put in a box of like, being a monster that
• 8:17
  somebody who is like completely devoid of any ability to ever
• 8:22
  grow and change that isn't real. And I talked a lot about how I
• 8:26
  used to work with children who have been sexually abused and
• 8:30
  this was on my internship and you know, children who have been
• 8:33
  sexually, abused turn into they turn into Two older children
• 8:37
  that sexually abused other children and then they turn into
• 8:40
  adolescents who tried to sexually abuse children and then
• 8:43
  they turn into adults who abuse children.
• 8:45
  Now, everybody understands it. As soon as it's a child that is
• 8:50
  just doing what they know that just got abused last week.
• 8:53
  And then turns around this week and abuses.
• 8:55
  Another child, everybody has empathy for that child and then
• 8:58
  all of a sudden, nobody has empathy anymore.
• 9:00
  The minute that they turn 18, this doesn't mean that you don't
• 9:05
  No that they definitely need treatment.
• 9:07
  And it doesn't mean that you allow them around your kids
• 9:10
  certainly or that they shouldn't be kept possibly even in prison
• 9:14
  if they can't deal with if they can't change.
• 9:19
  But plenty of people do plenty of those children do change.
• 9:22
  They really do. They go from being a child who
• 9:25
  abuses another child because they were abused as a child to
• 9:28
  being a little bit. Older of a child who does those
• 9:32
  behaviors those acting out. Behaviors less And then they may
• 9:36
  turn into a teen or an adult that never does them.
• 9:39
  If they're lucky enough to have any sort of treatment with a
• 9:43
  compassionate empathic provider, who is trained in these areas
• 9:47
  and who believes in them and has faith in them.
• 9:49
  So, even the child molester quote-unquote, who people really
• 9:54
  say as a quote monster? Can't you see that this along a
• 9:58
  spectrum to and why that would happen, you know?
• 10:02
  And so then sometimes people say, alright what about a
• 10:05
  Psychopath. I don't know enough about the
• 10:07
  current research on psychopathy to say whether this is somehow a
• 10:12
  distinct thing. But my gut would tell me that
• 10:15
  everything is along a spectrum. There's always a worse.
• 10:19
  Psychopath right? So then, isn't there a better
• 10:21
  psychopath? You know, isn't and sociopath
• 10:25
  sure there's people who are criminals for example but would
• 10:28
  never murder. Somebody, there's people who
• 10:30
  would murder somebody but it would not a woman or a child,
• 10:34
  you know, there's always These levels.
• 10:36
  So in order to understand better, like why you may be
• 10:41
  drawn to this idea that narcissist are uniquely bad, you
• 10:46
  got to look back at how you were raised.
• 10:48
  Were you raised with a victim perpetrator mentality?
• 10:52
  A black-and-white mentality. A good versus evil mentality,
• 10:57
  it's very easy when you were raised in that way, when you see
• 11:00
  a parent, always play the Martyr card or the victim card to say,
• 11:04
  oh no. Now I see that, my husband is a
• 11:07
  narcissist or my wife is a narcissist and therefore I am,
• 11:11
  definitely the victim and the Martyr, and they are definitely
• 11:14
  the quote bad guy. But in so many situations this
• 11:19
  can just easily be understood from a different perspective.
• 11:23
  If you took a different, if you took a couple minutes to do it.
• 11:26
  So like there's plenty of men who come in and they say my wife
• 11:29
  is so narcissistic and self-involved, you know, and
• 11:32
  they give me like 1 million different reasons why.
• 11:35
  But when the wife comes in, if they come in, you know, later
• 11:38
  for a couples counseling or they are, you know, it's just the
• 11:41
  beginning stages of couples counseling and I meet with each
• 11:43
  client individually, after the initial joint session, I meet
• 11:46
  with each person individually. So when the individual session,
• 11:49
  the person who's complaining about the narcissist seems to
• 11:52
  have all these you know Wonderful proofs of what they
• 11:56
  think and then you talk to the other person and it's just
• 11:58
  totally different. They're like, you know, every
• 12:01
  single thing that happened. They have their own perspective
• 12:04
  of Of course and then you start to see it's not so black and
• 12:07
  white. So yes narcissists can change
• 12:10
  and grow in therapy they can change by understanding that
• 12:14
  they struggle with certain self-absorbed schemas ways of
• 12:17
  viewing the world seeing where these came from frequently, they
• 12:21
  can be motivated Honestly by remembering a narcissistic
• 12:24
  parent and how that person made them feel and acknowledging that
• 12:28
  their spouse. And children may be starting to
• 12:30
  feel, or may have already said, they feel the same about them.
• 12:34
  They may at first. I mean, and I wrote about this
• 12:37
  in 2014 and an article about engaging Narcissus and couples
• 12:40
  counseling that's in Psych Central and I linked you to that
• 12:44
  but sometimes they're just doing it to be a good client at first
• 12:47
  because they like to achieve so much and when they start so it's
• 12:51
  like how a child would at first. Get good grades to make a parent
• 12:54
  happy. Then later there can be
• 12:56
  intrinsic motivation to get you no good grades and to succeed on
• 12:59
  their own, you know, and it's the same thing like somebody
• 13:02
  with narcissism as kind of a childlike.
• 13:05
  Lecture where they just want to be seen by everybody as good and
• 13:08
  bad. But that doesn't mean that they
• 13:09
  can't not not good or bad, just good but it doesn't mean that
• 13:13
  they can't change and grow. That doesn't mean that the
• 13:16
  extrinsic motivation of seeing how first the therapist and then
• 13:20
  their spouse and children respond differently to them if
• 13:23
  they act more empathic that can eventually turn into saying.
• 13:27
  Wow. I like being more empathic and
• 13:29
  that can lead to playing with acting in new ways when the
• 13:33
  therapist or the wife and kids. Aaron, you know, looking and try
• 13:37
  and get in other aspects of life and then just feeling good about
• 13:41
  doing it all adolescents, go through a stage called, you
• 13:45
  know, adolescent narcissism, which is developmentally normal.
• 13:48
  But most of them grow out of it, you know, and how did they grow
• 13:51
  out of it? Usually, they have a strong and
• 13:54
  loving family unit. That is kind of reinforcing
• 13:58
  their positive and loving actions, and not really
• 14:02
  reinforcing the ones that are self-involved.
• 14:05
  And, and if you do not have the benefit of having a strong and
• 14:09
  secure and supportive family unit as most narcissist don't,
• 14:13
  otherwise, they wouldn't have to develop that Persona, as a
• 14:15
  child, then the therapist can can be in loco parentis in that
• 14:22
  way. Can be instead of the secure
• 14:24
  family unit. The therapist can basically be
• 14:26
  the parent that reinforces the kind loving empathic behavior,
• 14:31
  and really does not reinforce the the The an empathic
• 14:36
  self-absorbed Behavior. So if you're interested in what
• 14:40
  I just said about how narcissists are created
• 14:43
  frequently, this is because a child was abused or neglected.
• 14:46
  Same as with borderline personality disorder, which is
• 14:49
  another cluster B personality disorder, they were abused or
• 14:52
  neglected and or they were overly parented and this kind of
• 14:57
  intrusive self-centered way where the parent was trying to
• 15:00
  get them to be a certain way, all the time for the parents own
• 15:04
  benefit. And so they develop this kind of
• 15:07
  false Persona. That's very adaptive and helpful
• 15:10
  in their family of origin where they are like a Superman / super
• 15:14
  woman that can protect themselves in a very insecure
• 15:19
  environment so they create this Persona.
• 15:23
  It works for them. It's it's something that is a
• 15:26
  source of self-protection and then they just keep on using it.
• 15:30
  You know. And this is like any sort of
• 15:32
  Personality Disorder these behaviors are learned.
• 15:35
  Turned in a setting where they are adaptive in your family of
• 15:38
  origin, but then you just keep using them forever because you
• 15:40
  don't know any other way of acting.
• 15:42
  And if enough bad things happen from acting narcissistic such as
• 15:46
  like, your wife's going to leave you or your kids aren't talking
• 15:48
  to you or what have you then? Yes, you can definitely with
• 15:52
  that motivation. Learn how to be different and
• 15:56
  for learning how to act different.
• 15:58
  I have plenty of podcasts on fake it till you make it, you
• 16:01
  know, then eventually you can say, wow, it actually feels good
• 16:04
  to be doing. Doing things that aren't just
• 16:06
  looking out for number one, it actually makes me feel like a
• 16:09
  better person and I like feeling like a better happier more, deep
• 16:14
  more, real more authentic individual, and I'm going to
• 16:17
  keep this going and keep this self-growth going.
• 16:20
  So certainly people with narcissistic traits and to meet
• 16:24
  criteria for narcissistic personality disorder, which
• 16:26
  again could only be one more criteria on that.
• 16:29
  A person who doesn't meet criteria.
• 16:31
  Certainly people who are just generally more, self-absorbed
• 16:34
  can change. Learn and grow and evolve in
• 16:37
  Psychotherapy. Just as we didn't used to think
• 16:40
  that people with borderline personality disorder could until
• 16:43
  the big wave of Marsha Linehan coming out with DBT and saying.
• 16:47
  Yes of course people cat, you know?
• 16:49
  And so if you have told yourself that your marriage is on is not
• 16:54
  treatable and not fixable because your partner is
• 16:59
  narcissistic traits or if you've told yourself that you cannot
• 17:02
  engage with a family member because they have narcissistic
• 17:04
  traits. AIDS or somebody at work or
• 17:06
  whatever. Sure.
• 17:07
  If it's a person where you don't have any strong feelings or skin
• 17:12
  in the game, then definitely use the gray rock method that I've
• 17:15
  talked about in other posts and podcasts.
• 17:17
  You know, like to get along with in-laws or your boss or
• 17:21
  something. But if this is, you know, your
• 17:23
  marriage and it's somebody that you love or you used to love
• 17:27
  then at, and you send something that's really holding you back
• 17:32
  from couples counseling. Is that you think, Everything
• 17:35
  that you've read on the internet, there would be no
• 17:37
  changing for this person. Why not try, you know, I mean,
• 17:42
  there are certainly people who are self-absorbed, can change
• 17:45
  and grow. And that's really all that you
• 17:47
  have to to think about as a mantra and if it turns out that
• 17:51
  the person does not change in Grote to your, you know, needs
• 17:55
  and does not turn into somebody that you could live with.
• 17:58
  There's like no harm, no foul and trying.
• 18:01
  And also, if you are the person who struggles with a narcissist,
• 18:05
  Awesome yourself. Listening to this your husband
• 18:07
  told by a partner, or your children, or whoever that you're
• 18:10
  very self-absorbed. You know, try to work on it.
• 18:14
  Obviously tried to go to therapy, a lot of those people.
• 18:17
  Only come into therapy when addiction gets out of hand or
• 18:21
  relationship problems, get out of hand or something like that.
• 18:25
  But you can get in before that as soon as the first person in
• 18:28
  your life thinks that you're self-centered, there's obviously
• 18:31
  something to discuss with a provider I'm Mean don't just
• 18:35
  like be ignoring that feedback that's like super valid feedback
• 18:40
  it's only going to get worse from there.
• 18:42
  Probably, you know, more and more people in your life are
• 18:45
  going to come out of the woodwork over the years and
• 18:47
  decades saying that you're fairly self-absorbed and you
• 18:50
  only think about yourself. So, if you've ever gotten that
• 18:53
  feedback, then Now's the Time, you know, to get into treatment,
• 18:57
  I've written a post, like, what about, when you're the
• 18:59
  narcissist, you know? And that's something to read,
• 19:01
  all right? Hopefully, this was useful and
• 19:04
  made you think about things? Even a little bit differently.
• 19:06
  Always my goal and I will talk to you soon.
• 19:08
  Bye bye.