Productive Narcissist - Excerpts Part 11

Human relationships are dynamic. We must assess our friendships, partnerships, even marriages periodically. The past is insufficient to sustain a healthy, nourishing, supportive, caring, and compassionate relationship. It is a good pre-condition, perhaps a necessary one - but not a sufficient one. We must gain and regain our friendships on a daily basis. Human relationships are a constant test of allegiance and empathy.

8. Self-Confidence and Real Achievements

This is how we go about life: we find out what we excel at, we develop these talents and gifts, we show the results to people, we secure their appreciation, and this adds to our self confidence. We should be proud of our REAL achievements and qualities.

9. Communicating Emotions

Impressive "emotional intelligence" is typical of people who were hurt in the past. They are more attuned to the emotional needs of others. But there is a big difference between "being mean" and expressing emotions, even negative emotions. I think you should communicate your emotions. If you are angry you should say so and explain both what made you angry and how it can be avoided in the future. If you are jealous, you should express your jealousy in a constructive way. Suppressed emotions are bad. They are like an untreated infection. They poison you. They are likely to bring about short depressive episodes.

10. Possessive Jealousy

If you have a work of art at home - would you hide it behind a curtain and peak at it only secretly or would you share it with family and friends and maybe with the public?

If you have a friend and you can make her happy - would you still qualify as a friend if you prevented this happiness from her by withholding the knowledge necessary for its attainment?

And if all this were to involve an intercourse of the body as well as of the mind - should this technical detail derail your resolve to increase the welfare of others rather to decrease it through greed and envy?

11. Pessimism versus Realism in the Treatment of Narcissists

I personally opt for "realism" rather than "optimism" or "pessimism".

Here are some hard facts which I think could serve as an undisputed basis for discussion:

• There are gradations and shades of narcissism. Lacking grandiosity and possessing empathy are not minor variations. They are serious predictors of future dynamics. The prognosis is much better if they do exist.
• There are cases of spontaneous healing and of "short term NPD" (Gunderson and Roningstam, 1996).
• The prognosis for a classic NPD case (grandiosity, lack of empathy and all) is decidedly not good IF we are talking about LONG TERM and COMPLETE HEALING. Moreover, NPDs are intensely disliked by therapists.

BUT

• Side effects, associated disorders (such as OCD), and SOME aspects of NPD (certain behaviours, the dysphorias, the paranoiac dimensions, the outcomes of the sense of entitlement, the pathological lying) CAN be modified (using talk therapy and, depending on the problem, medication). We are not talking about SHORT term solutions - but there are partial solutions and they do have long term effects.
• The DSM is billing and administration oriented. It is intended to "tidy" up the psychiatrist's desk. The PDs are ill demarcated, they tend to intermingle and be cross referenced. The differential diagnoses are vaguely defined, to use a gentle understatement. There are some cultural biases and judgements (see the Schizotypal PD). The result is sizeable confusion and multiple diagnoses. NPD was introduced in 1980 (in the DSM III). There isn't enough research to substantiate one view or another. The DSM V might abolish it altogether within the framework of a cluster or a single "personality disorder" diagnosis. As it is, the difference between HPD and somatic NPD is, to my mind, rather blurred in the extreme cases. So, when we discuss the question: "can NPD be healed?" we need to realize than we don't know for sure what is NPD and what constitutes long term healing in the case of an NPD. There are those who seriously claim that NPD is a CULTURAL disorder with a massive societal determinant.

next: Excerpts from the Archives of the Narcissism List Part 12