WEBVTT - Ask Dr. Ramani: How Do I Go to Therapy with a Narcissist? 0:00:00.240 --> 0:00:04.160 What happens when you take a narcissist to therapy. On 0:00:04.320 --> 0:00:08.000 this episode of Navigating Narcissism, I'm diving back into our 0:00:08.080 --> 0:00:13.800 DMS to answer your questions about your therapy dilemmas. So 0:00:14.480 --> 0:00:17.960 many of you have narcissistic people in your life that 0:00:18.000 --> 0:00:21.360 you love and that you want so badly for those 0:00:21.400 --> 0:00:26.520 relationships to get better. I know you sometimes wonder could 0:00:26.560 --> 0:00:30.280 I make this better if I just went to therapy 0:00:30.320 --> 0:00:36.440 with them. Now we're taking on the good, the bad, 0:00:36.680 --> 0:00:40.640 and the ugly of going into the room and sitting 0:00:40.720 --> 0:00:45.239 on the couch with a narcissist. Get Ready, Therapy with 0:00:45.360 --> 0:00:49.400 narcissists isn't for the faint of heart. This podcast should 0:00:49.440 --> 0:00:52.160 not be used as a substitute for medical or mental 0:00:52.159 --> 0:00:57.520 health advice. Individuals are advised to seek independent medical advice, counseling, 0:00:57.640 --> 0:01:01.840 and or therapy from a healthcare professional with respect to 0:01:01.960 --> 0:01:07.160 any medical condition, mental health issue, or health inquiry, including 0:01:07.280 --> 0:01:12.120 matters discussed on this podcast. The views and opinions expressed 0:01:12.280 --> 0:01:17.760 are solely those of the podcast author or individuals participating 0:01:18.040 --> 0:01:21.400 in the podcast, and do not represent the opinions of 0:01:21.480 --> 0:01:26.680 Red Table Talk Productions, iHeartMedia, or their employees. Our first 0:01:26.720 --> 0:01:31.560 question is from Roxanna. She writes, my narcissistic sister has 0:01:31.600 --> 0:01:34.959 been wreaking havoc on our lives for years? How do 0:01:35.040 --> 0:01:38.520 I tell her she needs therapy without her exploding on 0:01:38.640 --> 0:01:44.080 me and actually convince her to go? So Roxanna's question 0:01:44.280 --> 0:01:49.200 is a universal question for people who have narcissistic people 0:01:49.240 --> 0:01:51.960 in their lives, which is how can I get them 0:01:51.960 --> 0:01:54.120 to go to therapy? You know, there's a thing that 0:01:54.160 --> 0:01:58.080 people throw around, especially therapists who care about narcissism. It's 0:01:58.120 --> 0:02:03.200 that narcissism is the only kind of maladaptive personality style 0:02:03.280 --> 0:02:07.080 or mental health pattern where the people who have it 0:02:07.800 --> 0:02:10.760 push other people into therapy. And I really think that 0:02:10.760 --> 0:02:14.320 that captured sort of the paradox of narcissism. Everyone around 0:02:14.400 --> 0:02:17.280 them is going into therapy to cope with this. They 0:02:17.360 --> 0:02:20.440 aren't going into therapy, which means not only are we 0:02:20.520 --> 0:02:22.480 never going to see progress with them, but it also 0:02:22.520 --> 0:02:25.359 means therapists often don't know how to work with these clients. Right. 0:02:25.600 --> 0:02:28.600 The big anguish for so many people in these situations 0:02:28.639 --> 0:02:32.080 is could therapy maybe help a little? Could it maybe 0:02:32.120 --> 0:02:34.880 make them a little more accountable? And above all else, 0:02:35.520 --> 0:02:39.280 how do we even get them to consider going This 0:02:39.480 --> 0:02:42.200 is a dilemma, and so Roxanna kind of throws a 0:02:42.320 --> 0:02:44.880 double dilemma in here where she says, how do I 0:02:44.919 --> 0:02:47.840 tell her she needs therapy without her exploding on me? 0:02:48.440 --> 0:02:50.240 So to pick a lane, Roxanna, you can tell her 0:02:50.280 --> 0:02:52.720 she needs therapy, but the version of that with art 0:02:52.800 --> 0:02:56.440 or exploding not so likely. And then the cherry on 0:02:56.520 --> 0:03:01.160 top as it was, and convince her to gosation about 0:03:01.440 --> 0:03:06.600 asking someone narcissistic to go into therapy is more often 0:03:06.639 --> 0:03:11.120 than not going to be unsuccessful, and it could actually 0:03:11.120 --> 0:03:14.000 be quite upsetting for you because the odds are they're 0:03:14.040 --> 0:03:18.119 going to gaslight you. Oh really, really, who needs therapy here? Hmm? 0:03:18.480 --> 0:03:20.160 Maybe you should go in. Maybe you need to double 0:03:20.240 --> 0:03:22.680 up on the sessions you're already going to, or in fact, 0:03:23.040 --> 0:03:25.480 maybe your therapist is just a scammer, just taking your 0:03:25.480 --> 0:03:28.760 money because you seem as disturbed as you've always been. 0:03:28.800 --> 0:03:31.640 So by the time this conversation is done, you're thinking 0:03:31.680 --> 0:03:34.240 this wasn't worth it. I'm just not doing this. I'm 0:03:34.280 --> 0:03:37.160 not gonna put myself in this kind of harm's way 0:03:37.280 --> 0:03:39.240 just to try to convince someone to do something that 0:03:39.280 --> 0:03:41.400 would be good for them. So here's a couple of ways. 0:03:41.480 --> 0:03:45.280 Let's break this down. Number one, does therapy work with 0:03:45.400 --> 0:03:51.440 narcissistic people ish? And it's a weak ish because I 0:03:51.480 --> 0:03:54.280 have worked with a lot of narcissistic clients over the earth, 0:03:54.360 --> 0:03:56.600 and I have to say, learned a ton. You know, 0:03:56.600 --> 0:03:58.000 the only way you're going to learn how to box 0:03:58.080 --> 0:04:00.040 is to go fifteen rounds in the ring. What I 0:04:00.120 --> 0:04:03.560 learned is that the kinds of changes that therapy can 0:04:03.680 --> 0:04:07.920 enact with a narcissistic client tend to be very small, 0:04:08.640 --> 0:04:11.920 and they don't tend to be at enough of a 0:04:12.000 --> 0:04:17.360 consistent or big enough level for the people around them 0:04:17.720 --> 0:04:22.240 to notice the change. So the tricky piece with that 0:04:22.560 --> 0:04:25.559 is that people think that, well, you're telling me they're changing. 0:04:25.560 --> 0:04:27.479 They're changing in a way I can see them. But 0:04:27.560 --> 0:04:30.320 I'm not having dinner with them. I'm not going on 0:04:30.400 --> 0:04:34.880 vacation with them. I'm not having to cajole them to 0:04:34.920 --> 0:04:37.480 empty the dishwasher. None of that's not my problem with them. 0:04:37.480 --> 0:04:40.160 I have them for an hour, and in my work 0:04:40.160 --> 0:04:41.760 with them, I've got to tell you, it's the hardest 0:04:41.760 --> 0:04:44.640 clinical work I've ever done. I've been verbally abused, I've 0:04:44.640 --> 0:04:48.279 heard some really terrible things that I can't unhear. I 0:04:48.400 --> 0:04:51.320 have heard about them doing terrible things to people, saying 0:04:51.440 --> 0:04:54.080 terrible things to people. A lot of therapists would say, 0:04:54.080 --> 0:04:56.080 I would have fired that client, right, And that's what 0:04:56.160 --> 0:04:59.560 often happens with narcissistic clients. Either they're fired by their 0:04:59.600 --> 0:05:04.200 therapist or just when the therapist puts the pressure on 0:05:04.240 --> 0:05:07.760 them to really do some emotional accountability work, they get 0:05:07.839 --> 0:05:11.360 up and leave. So either way, they're dropping out of therapy. 0:05:11.360 --> 0:05:13.719 And in fact, there's data out there that shows that 0:05:14.000 --> 0:05:17.279 narcissistic people are probably somewhere between sixty to seventy percent 0:05:17.320 --> 0:05:19.560 more likely to drop out of therapy, so it's really 0:05:19.560 --> 0:05:23.200 hard to retain them in. And I have read cases 0:05:23.200 --> 0:05:26.160 of unicorns, but the reason I've read them is because 0:05:26.200 --> 0:05:29.480 they were so unique they got published. For the rest 0:05:29.520 --> 0:05:33.760 of us who are working with these clients, we're talking 0:05:33.920 --> 0:05:38.000 about baby steps. I've had narcissistic clients I've worked with 0:05:38.040 --> 0:05:41.200 who said to me, so, you're telling me that the 0:05:41.240 --> 0:05:43.600 only way this whole relationship thing is going to work 0:05:43.600 --> 0:05:46.039 out without my wife screaming at me all the time 0:05:46.120 --> 0:05:47.680 is if I have this empathy for her and have 0:05:47.720 --> 0:05:50.960 to listen to her stuff and like, yeah, sometimes I 0:05:50.960 --> 0:05:52.400 see women on the side when I travel and you're 0:05:52.440 --> 0:05:55.880 telling me I have to give that up too, And I'm like, well, 0:05:55.960 --> 0:05:58.159 I'm not telling you what to do, but yeah, that's 0:05:58.240 --> 0:06:01.800 kind of like empathy good. And interestingly, I've had some 0:06:01.880 --> 0:06:05.599 clients hear that to let me sleep on that, come 0:06:05.640 --> 0:06:08.400 back the next week and say nah, and they filed 0:06:08.440 --> 0:06:11.839 for divorce and broke up with the lover. Actually I 0:06:11.920 --> 0:06:14.680 put that in my wind column because I thought he 0:06:14.680 --> 0:06:16.680 heard this enough to say, well, I don't want to 0:06:16.760 --> 0:06:18.640 hurt these people, but I also do not want to 0:06:18.640 --> 0:06:20.440 listen to them anymore. And I don't want to deal 0:06:20.440 --> 0:06:22.039 with the nonsense. And if you're telling me that dealing 0:06:22.120 --> 0:06:24.200 with their nonsense is how you do a relationship, right, 0:06:24.279 --> 0:06:27.920 I'm out when to me because now those relationships, which 0:06:27.920 --> 0:06:34.080 weren't healthy were ended. I can't tell you how many Christmases, Thanksgivings, Birthdays, 0:06:34.200 --> 0:06:38.640 late nights I've had encroached upon by emergency emergency. It's 0:06:38.640 --> 0:06:43.520 an emergency. I remember Christmas when the emergency emergency said 0:06:43.560 --> 0:06:45.880 to my kids, put those presents on ice, I'll be 0:06:46.000 --> 0:06:49.560 right back. You know what the emergency was, A girlfriend 0:06:49.560 --> 0:06:52.280 wouldn't wear the new shoes that someone bought for them. 0:06:52.320 --> 0:06:54.799 I'm like, I'm out, no, no, no, no, and I'm seeing 0:06:54.800 --> 0:06:57.479 that in a tiny little sliver. Imagine what the people 0:06:58.040 --> 0:07:00.360 who are in relationships with them are going through. So 0:07:00.480 --> 0:07:03.840 the whole thing has meant to tell you that even 0:07:03.960 --> 0:07:07.600 if you're able to have this uncomfortable conversation about therapy, 0:07:08.279 --> 0:07:10.440 the kind of change that you may need for your 0:07:10.440 --> 0:07:14.320 relationship to move forward may not happen Number one. Number two, 0:07:15.120 --> 0:07:18.240 for therapy to make that kind of change could take 0:07:18.400 --> 0:07:22.920 years and years and years. Folks. We're talking tens, if 0:07:22.960 --> 0:07:25.920 not hundreds, of thousands of dollars worth of therapy. There 0:07:25.920 --> 0:07:28.000 are a no insurance company in the world that's going 0:07:28.040 --> 0:07:31.640 to pay for that much therapy. Okay. The other thing 0:07:31.680 --> 0:07:34.000 to keep in mind is that the mistake that a 0:07:34.040 --> 0:07:37.600 lot of folks make in narcissistic relationships is that they 0:07:37.640 --> 0:07:41.800 attempt to be the narcissistic person's therapist. It's part of 0:07:41.800 --> 0:07:44.040 the trauma bonding cycle that you want to be all 0:07:44.120 --> 0:07:46.840 things to people in toxic relationship. I'm going to be 0:07:46.880 --> 0:07:49.320 their friend, I'm going to be their sober coach. I'm 0:07:49.320 --> 0:07:50.920 going to be their therapist. I'm going to be the 0:07:50.920 --> 0:07:53.760 house cleaner. I'm going to be their sex partner. You 0:07:53.800 --> 0:07:56.400 can't do all of that as one person, and you 0:07:56.520 --> 0:08:00.000 certainly can't be their therapists. So that you're often listening 0:08:00.080 --> 0:08:02.720 and letting them offload so many of their problems on 0:08:02.760 --> 0:08:05.400 you that at some point if you sort of distance 0:08:05.480 --> 0:08:08.360 from that, that can actually help you. And if they 0:08:08.440 --> 0:08:11.440 keep talking about how much they're struggling with a specific problem, 0:08:11.640 --> 0:08:14.000 I can't believe this is happening. I can't believe that's happening. 0:08:14.080 --> 0:08:16.080 That might be your entry point. Say you know what, 0:08:16.240 --> 0:08:18.200 it sounds like you have a lot going on. They 0:08:18.240 --> 0:08:21.680 feel validated. It could really be helpful to talk to 0:08:21.720 --> 0:08:24.840 someone who's a professional. You're such an important person and 0:08:24.880 --> 0:08:27.840 you do such important things. It really seems like getting 0:08:27.840 --> 0:08:31.040 the help you need could be useful. Give them the validation, 0:08:31.720 --> 0:08:34.160 fluff them up a little bit, and then you might 0:08:34.160 --> 0:08:36.640 be able to say you need another important, educated person 0:08:36.679 --> 0:08:39.480 helping you. Is it a little manipulative? If it gets 0:08:39.480 --> 0:08:42.400 them in the door, it may be helpful. Even if 0:08:42.440 --> 0:08:45.839 a narcissistic person gets five, six, seven sessions, it can 0:08:45.960 --> 0:08:49.280 actually make a difference. But what you've got to do 0:08:49.760 --> 0:08:53.240 is make therapy palatable a little bit of a doctor 0:08:53.320 --> 0:08:56.960 Romedey moment here, Because I practice in Los Angeles. Having 0:08:57.000 --> 0:08:59.840 a therapist is a little bit like having a personal trainer, 0:09:00.200 --> 0:09:03.079 Like people talk about it in public here, like who's 0:09:03.120 --> 0:09:06.200 your shrink. It's not like a taboo topic that like 0:09:06.240 --> 0:09:08.640 it could be in other places, but in LA that's 0:09:08.640 --> 0:09:11.880 a thing that has actually been an asset for many 0:09:11.880 --> 0:09:14.360 of the narcissistic clients I have. They're like, whooh, I'm 0:09:14.360 --> 0:09:16.520 going to go see doctor narcissism. I bet I can 0:09:16.600 --> 0:09:19.679 break her. That's often been kind of their groove, and 0:09:19.720 --> 0:09:23.080 we've actually done some interesting work together because they didn't 0:09:23.080 --> 0:09:25.640 get under my skin. But it became a game. That's 0:09:25.640 --> 0:09:28.360 a very long way for saying, if you're going to 0:09:28.440 --> 0:09:32.480 suggest therapy to your sister, find that tiny little window 0:09:32.480 --> 0:09:36.800 of opportunity when she's talking about a specific problem. Tell 0:09:36.840 --> 0:09:39.960 her that her problem's really, really important and it really 0:09:40.000 --> 0:09:43.480 deserves the attention of somebody who's got training to do this, 0:09:44.120 --> 0:09:47.560 because she's an important person and needs that kind of support, 0:09:47.960 --> 0:09:50.240 and you might be able to play on her grandiosity, 0:09:50.760 --> 0:09:54.000 just a nudger in the door. In our next question here, 0:09:54.080 --> 0:09:58.479 Brianna asks why are so few therapists trained in recognizing 0:09:58.559 --> 0:10:02.319 narcissism and narcissistic g abuse. I've tried therapy with my 0:10:02.400 --> 0:10:06.280 narcissistic parents. It was horrible. Why isn't this more widely 0:10:06.360 --> 0:10:09.400 understood among therapists. Well, you know what, Brianna, I'm so 0:10:09.400 --> 0:10:11.560 glad you asked this question because it actually allows me 0:10:11.640 --> 0:10:14.280 to talk about my passion project, where I'm actually developing 0:10:14.320 --> 0:10:17.920 a thirty hour training program for therapists to work with 0:10:18.000 --> 0:10:21.880 narcissistic abuse, and am now lecturing actually all over the 0:10:21.920 --> 0:10:24.840 world for two therapists on how to learn about this. 0:10:25.520 --> 0:10:27.960 One thing I think everyone needs to understand is that 0:10:28.360 --> 0:10:32.400 we weren't taught this. Very rarely do graduate programs have 0:10:32.440 --> 0:10:36.920 an entire semester course on personality disorders, least of all, 0:10:36.920 --> 0:10:40.800 an entire course on narcissism and antagonistic personalities. They just 0:10:40.800 --> 0:10:44.240 don't exist. I've talked to ballrooms full of five hundred 0:10:44.240 --> 0:10:47.400 people and I'll say, raise your hand if you had 0:10:47.400 --> 0:10:51.160 a full semester course on personality disorders, five hands maybe, 0:10:51.240 --> 0:10:53.760 And they tend to be younger people speaking to a switch. 0:10:53.800 --> 0:10:56.080 And then I've talked to graduate students and said, yeah, 0:10:56.240 --> 0:10:58.440 we had a course on personality disorders. We learned about 0:10:58.480 --> 0:11:01.480 the biology personality disorder or something like that's important, but 0:11:01.520 --> 0:11:03.640 did you learn how to work with them clinically. No. 0:11:04.800 --> 0:11:09.440 This phenomenon of narcissistic abuse is very, very new, and 0:11:09.440 --> 0:11:12.200 there's a few of us like myself who've been working 0:11:12.280 --> 0:11:14.640 in this area for over a decade, and it's about 0:11:14.679 --> 0:11:17.360 that new, probably been around for about twenty twenty five years. 0:11:17.679 --> 0:11:23.760 My entire graduate career. Entire graduate career, not in my classrooms, 0:11:24.200 --> 0:11:28.839 my clinical training, my hospital training, the word narcissism didn't 0:11:28.840 --> 0:11:33.679 come up once, not once, And it wasn't until one 0:11:33.960 --> 0:11:37.640 series of meetings with a really gifted supervisor who taught 0:11:37.640 --> 0:11:40.200 me a little bit about these dynamics. Then the word 0:11:40.280 --> 0:11:45.800 did not come up again in my professional career until 0:11:45.840 --> 0:11:48.880 I was a professor at a university and then started 0:11:48.880 --> 0:11:52.400 my own program of research. So it is simply not 0:11:52.600 --> 0:11:55.200 talked about. And then what that means then is there's 0:11:55.240 --> 0:11:58.640 this big knowledge gap that many many clinicians out there 0:11:58.640 --> 0:12:01.400 are really trying to get the training in. So clinicians 0:12:01.440 --> 0:12:04.360 listening stay tuned that training program's coming out soon. But 0:12:04.600 --> 0:12:08.120 in the interim, couple of thoughts, try to find a 0:12:08.160 --> 0:12:12.960 therapist who's trauma informed at a minimum, trauma informed therapists 0:12:13.160 --> 0:12:18.440 will account for your history of interpersonal trauma and interpersonal 0:12:18.520 --> 0:12:21.520 issues in your relationships. That can make a big difference. 0:12:22.440 --> 0:12:25.280 Second is if you find a therapist who's well versed 0:12:25.320 --> 0:12:29.640 in domestic abuse, domestic violence, or intimate partner violence, those 0:12:29.720 --> 0:12:32.720 therapists will at least have some of the language of 0:12:32.760 --> 0:12:35.880 these kinds of manipulative relationships that have gas lighting and 0:12:36.080 --> 0:12:40.960 all of these other controlling dynamics present. But other than 0:12:41.000 --> 0:12:43.080 those kinds of things, if you can just find a 0:12:43.120 --> 0:12:45.720 therapist who can be present with you in the room, 0:12:46.320 --> 0:12:49.320 not doubt you, not put an agenda on you, you'll 0:12:49.360 --> 0:12:52.439 be fine. There's a lot of fantastic therapists out there, 0:12:52.520 --> 0:12:56.719 just empathic, really well trained people who will get it. 0:12:57.400 --> 0:13:01.000 And as with anything, whether it's a dentist, medical doctor, 0:13:01.200 --> 0:13:05.320 or therapist, if you don't feel comfortable, it's okay to 0:13:05.400 --> 0:13:08.320 find someone else. Not every therapist is a good fit 0:13:08.400 --> 0:13:11.880 for everyone. Take your time and find someone you like. 0:13:12.000 --> 0:13:14.800 The therapist that you don't like someone else loves, so 0:13:14.880 --> 0:13:18.160 everyone finds their place, but give yourself time and permission 0:13:18.200 --> 0:13:22.600 to do that. Next, Gina writes, my boyfriend and I 0:13:22.640 --> 0:13:25.520 have been in therapy together for three years, we've been 0:13:25.559 --> 0:13:28.880 focusing on his narcissism, but it seems like he's made 0:13:29.000 --> 0:13:32.640 no progress. I'm not expecting an overnight cure, but what 0:13:32.720 --> 0:13:35.400 are some realistic goals to have in couples therapy with 0:13:35.480 --> 0:13:39.160 a narcissist. Gina's question brings up two really interesting things 0:13:39.160 --> 0:13:42.520 to me. One thing that can happen, and I'm so 0:13:42.559 --> 0:13:45.520 glad Gina put the question like this, is that what 0:13:45.640 --> 0:13:47.880 we can see is that when a person goes into 0:13:47.920 --> 0:13:52.360 couple's therapy with a narcissist, something that can happen is 0:13:52.400 --> 0:13:55.840 that the couple's therapist will actually put a lot of 0:13:55.840 --> 0:13:58.400 their focus on the narcissistic person because they're the one 0:13:58.520 --> 0:14:02.880 engaging in more bad behaviors. It's an interesting play by 0:14:02.920 --> 0:14:06.960 the therapist which sometimes works and sometimes doesn't. Where it 0:14:07.040 --> 0:14:10.120 can work is that it's almost as though Gina's narcissistic 0:14:10.160 --> 0:14:14.240 boyfriend may not go to therapy on his own, but 0:14:14.400 --> 0:14:17.400 somehow he's showing up week after week with her. But 0:14:17.480 --> 0:14:20.360 she's saying though it doesn't feel like he's making much progress, 0:14:20.720 --> 0:14:24.080 and the struggle there is after three years, if no 0:14:24.160 --> 0:14:26.640 progress is being made, then this really probably is what 0:14:26.640 --> 0:14:30.160 we see with most narcissistic clients there is not likely 0:14:30.520 --> 0:14:34.560 to be significant movement in therapy. I mean, I know 0:14:34.600 --> 0:14:36.960 she's not expecting an overnight cure, but three years is 0:14:37.000 --> 0:14:40.520 a long time. So the bigger question, though Gina's asking, 0:14:40.640 --> 0:14:42.920 is what are the realistic goals to have. I'll tell 0:14:42.960 --> 0:14:45.600 you one thing that's not a realistic goal is that 0:14:45.800 --> 0:14:48.640 Gina's boyfriend is going to change significantly. That's just not 0:14:48.680 --> 0:14:51.440 on the table. But a lot of people, a lot 0:14:51.480 --> 0:14:54.120 of people go into couples or even family therapy with 0:14:54.160 --> 0:14:56.920 a narcissistic person, and I think the key to all 0:14:57.000 --> 0:15:01.120 therapy is that a person goes in there with realistic goals. 0:15:02.040 --> 0:15:07.120 So what needs to happen is that when you go 0:15:07.160 --> 0:15:11.160 into therapy, have very behavioral goals, because those are more 0:15:11.160 --> 0:15:14.760 observable and they're more measurable. One of the biggest challenges 0:15:14.760 --> 0:15:18.800 in a narcissistic relationship is that we always make assumptions 0:15:18.840 --> 0:15:22.160 about the intention of the narcissist. Are you trying to 0:15:22.240 --> 0:15:26.000 hurt me? Actually, no, they're not. Believe it or not. No, 0:15:26.040 --> 0:15:30.200 they're not. They're just not noticing you. They're not trying 0:15:30.240 --> 0:15:32.400 to do anything. You know, you just want me to 0:15:32.400 --> 0:15:36.200 be sad wrong again. They're not noticing you enough to 0:15:36.320 --> 0:15:39.680 care about that. So, because a lot of folks in 0:15:39.920 --> 0:15:43.760 couple's therapy with a narcissistic partner focus on the narcissistic 0:15:43.800 --> 0:15:48.640 person's intentions, you're going nowhere fast because we cannot change 0:15:49.000 --> 0:15:53.720 another person's intentions. We can't. The best we've got is 0:15:53.760 --> 0:15:57.600 a person's behavior, how a person shows up, whatever that 0:15:57.640 --> 0:16:02.200 looks like. And then you better figure out what's most 0:16:02.520 --> 0:16:07.440 important for you. Is it more participation in some household chores. 0:16:08.360 --> 0:16:11.600 Is it how they talk with your children, you know? 0:16:11.760 --> 0:16:14.000 Is it the use of certain forms of language, saying 0:16:14.000 --> 0:16:16.560 that I cannot have you use certain kinds of obscene 0:16:16.640 --> 0:16:19.680 language around the children. It has to be so clear. 0:16:20.200 --> 0:16:23.360 So the couple's therapy then becomes a place of accountability, 0:16:23.880 --> 0:16:26.240 so that there can be some of that backing and forthing, 0:16:26.320 --> 0:16:31.640 so that behavioral piece becomes really important. Another big goal 0:16:31.720 --> 0:16:36.840 that people want in couple's therapy is accountability, so therapy 0:16:36.920 --> 0:16:40.200 can be a place where the narcissistic person actually learns 0:16:40.640 --> 0:16:44.040 how to give an apology. Narcissistic people don't know how 0:16:44.080 --> 0:16:47.920 to apologize. The most common way that narcissistic people apologize 0:16:47.920 --> 0:16:51.880 they'll say, I'm sorry you feel that way. That's not 0:16:52.000 --> 0:16:56.320 an apology. That is an embarrassment, a little bit of 0:16:56.320 --> 0:16:59.280 a gas light, and it's definitely a manipulation, but it's 0:16:59.360 --> 0:17:03.400 not an apology. I'm sorry you feel that way. That's 0:17:03.440 --> 0:17:06.520 how I feel, So you're sorry for my m gaslight. 0:17:07.480 --> 0:17:12.920 An apology is i'm sorry. A real apology takes responsibility, 0:17:13.280 --> 0:17:18.680 I'm sorry I did something that hurts you, empathy, responsibility 0:17:19.080 --> 0:17:23.760 That practicing of how to issue an apology can actually 0:17:23.800 --> 0:17:26.840 be something you can work on in therapy because it 0:17:26.920 --> 0:17:29.919 is about how language is used. It's about the construction 0:17:30.359 --> 0:17:33.399 and the architecture of an apology. The other thing you 0:17:33.400 --> 0:17:35.520 want to hold out for as a goal in therapy 0:17:36.119 --> 0:17:39.280 is techniques that you can take out of the therapy 0:17:40.119 --> 0:17:43.680 and use, whether it's permission to step out of a 0:17:43.720 --> 0:17:47.320 difficult situation, some tool that the therapist gives you to 0:17:47.400 --> 0:17:50.240 kind of put the brakes on what's happening, things that 0:17:50.280 --> 0:17:54.640 you can use between sessions, and then using the couple's 0:17:54.720 --> 0:18:00.159 therapy as a place to feel seen, heard, and recognize. 0:18:00.240 --> 0:18:02.920 The one thing you never want is to walk out 0:18:02.920 --> 0:18:06.280 of couple's therapy feeling more confused than when you walked 0:18:06.320 --> 0:18:10.399 in the door. My conversation will continue after this break. 0:18:17.240 --> 0:18:19.959 So in this next questions sort of a general question 0:18:20.400 --> 0:18:25.280 that asks how do the different types of narcissism show 0:18:25.359 --> 0:18:29.920 up in couple's therapy? Such a good question. So I'm 0:18:29.920 --> 0:18:31.879 going to put on my teachy cap for a moment, 0:18:31.920 --> 0:18:34.120 because I think this is a real opportunity for us 0:18:34.560 --> 0:18:37.200 to just have a review of the general types of narcissism, 0:18:37.520 --> 0:18:39.399 but then connect to how that could show up in 0:18:39.440 --> 0:18:41.920 the therapy room. All right, so let's start at the top. 0:18:41.960 --> 0:18:45.600 The most common, the classic, the narcissistic type. We're all 0:18:45.680 --> 0:18:51.720 most familiar with, the grandiose narcissist, right, arrogant, pretentious, larger 0:18:51.720 --> 0:18:55.680 than life, extroverted, Aren't I great? Tell me more? Tell 0:18:55.680 --> 0:18:57.720 me how great I am? Let me pick up the check. 0:18:58.000 --> 0:19:01.159 Yeah ya, yay, okay, I was flirting with her, that 0:19:01.280 --> 0:19:05.159 kind of narcissist, right, grandiose narcissists when they show up 0:19:05.160 --> 0:19:06.960 in therapy, let me tell you one thing they're almost 0:19:07.000 --> 0:19:10.399 always going to do, and that's to really show up 0:19:10.440 --> 0:19:13.520 with tons of charisma and try to charm the hell 0:19:13.560 --> 0:19:16.159 out of the therapist. So, if you don't have a 0:19:16.200 --> 0:19:18.400 seasoned therapist, in the room. It can be a little 0:19:18.520 --> 0:19:21.680 risky because a grandiose narcissist may come in the room 0:19:21.720 --> 0:19:25.800 and say, WHOA, you went to UCLA. I'm a bruin Gosh, 0:19:25.840 --> 0:19:28.960 you must be so smart. I was told that's a 0:19:29.000 --> 0:19:31.359 really hard graduate program to get into. Wow, I'm so 0:19:31.440 --> 0:19:34.560 lucky we're in here. So you gotta be real resistant 0:19:34.560 --> 0:19:38.800 to not fall for that. Meanwhile, especially if the partner 0:19:39.040 --> 0:19:44.240 sitting next to the grandiose narcissist looks shredded, tired, sad, 0:19:44.800 --> 0:19:46.960 a lot of people make the mistake of like, this 0:19:47.040 --> 0:19:50.000 person's so big and bright and shiny, kind of feel 0:19:50.000 --> 0:19:53.960 bad that they're with this partner who's so glum. Be 0:19:54.040 --> 0:19:57.440 careful with that. That glumness is probably years and years 0:19:57.440 --> 0:20:00.520 and years of putting up with narcissistic abuse. The grandiose 0:20:00.600 --> 0:20:05.320 narcissists may look great in therapy until the therapist calls 0:20:05.359 --> 0:20:08.200 them out and may say, you know what, you keep 0:20:08.240 --> 0:20:12.919 talking over her, you keep interrupting him. He just shared 0:20:12.960 --> 0:20:16.040 his feelings, and you're denying what do you get to 0:20:16.040 --> 0:20:19.440 be judge and jury and his emotions. When the therapist 0:20:19.440 --> 0:20:22.800 starts doing that, you can almost very quickly see a 0:20:22.880 --> 0:20:27.800 switch in the grandiose narcissist. They can become quite angry, petulant, 0:20:28.160 --> 0:20:31.720 Sullen and I can all but guarantee you the next 0:20:31.800 --> 0:20:34.840 session they either won't show up, or won't want to 0:20:34.880 --> 0:20:37.320 show up, or they may not send the payment in time. 0:20:38.480 --> 0:20:40.879 So let's go then, because this becomes a natural shift 0:20:40.920 --> 0:20:44.439 over to what a lot of folks call the covert narcissist. 0:20:44.800 --> 0:20:47.680 The kind of the official term is the vulnerable narcissist 0:20:47.720 --> 0:20:50.439 or this covert vulnerable narcissist. How do they show up 0:20:50.440 --> 0:20:54.840 in therapy? Well, the covert vulnerable narcissist is chronically irritable, 0:20:55.560 --> 0:21:01.399 Sullen has lots of grievances, angry feels that people are 0:21:01.560 --> 0:21:05.960 to get them, really thin skinned, can look sad, can 0:21:06.000 --> 0:21:09.399 also look really socially anxious. So one thing that happens 0:21:09.400 --> 0:21:13.359 from the jump is the therapist actually may wonder is 0:21:13.400 --> 0:21:17.719 it this person's depression anxiety? Is there something else happening 0:21:17.720 --> 0:21:19.840 with this person? And there tends to be almost more 0:21:19.840 --> 0:21:22.639 of a clinical focus on the covert or vulnerable narcissist. 0:21:23.480 --> 0:21:28.760 That covert narcissist. Vulnerable narcissist will also look like they're 0:21:28.920 --> 0:21:32.800 in such a bad state that they may seem like 0:21:32.840 --> 0:21:37.879 they're even more unhappy than you. Covert vulnerable narcissists will 0:21:37.920 --> 0:21:41.800 often give one word answers. They'll sort of resent being 0:21:41.840 --> 0:21:45.040 asked to engage in this kind of level of emotional conversation, 0:21:45.480 --> 0:21:49.560 will feel chronically victimized. Nothing I do is enough, nothing 0:21:49.600 --> 0:21:52.239 I've ever done is enough. Everyone is out to get me. 0:21:52.680 --> 0:21:55.120 No one has ever told me I've done right by them. 0:21:55.280 --> 0:21:58.840 I give and I given. It's never enough. Victim, victim, victim. 0:21:59.640 --> 0:22:03.719 And you're trying to go into a deeper communicative space, 0:22:03.800 --> 0:22:08.359 and you've exhausted yourself doing that. You need a sharp, sharp, 0:22:08.640 --> 0:22:12.920 sharp therapist to pick up on those covert vulnerable kinds 0:22:12.920 --> 0:22:15.840 of patterns. Because it's a form of narcissism that's not 0:22:16.000 --> 0:22:19.720 often talked about. It often gets missed, and so there's 0:22:19.760 --> 0:22:21.840 a real risk that the therapists will think, Oh, there's 0:22:21.840 --> 0:22:25.479 an anxious, depressed partner with another partner who's also unhappy 0:22:25.520 --> 0:22:28.400 in the relationship, and that's what's being worked on, rather 0:22:28.480 --> 0:22:32.160 than those chronically sullen, resentful patterns. Now, when we get 0:22:32.200 --> 0:22:35.320 to the more severe issues, we get to malignant narcissism. 0:22:35.560 --> 0:22:39.240 Malignant narcissism is where we see patterns like coercive control, 0:22:39.560 --> 0:22:46.720 financial control, exploitation, isolation, using fear to menace someone you know, 0:22:46.760 --> 0:22:48.800 you better watch out, you better make sure you don't 0:22:48.800 --> 0:22:51.679 talk badly about me, because you know what I know 0:22:51.760 --> 0:22:54.199 some I know cops like they're not going to believe you, 0:22:54.480 --> 0:22:57.120 like that kind of thing, which can feel really unsettling. 0:22:57.640 --> 0:23:02.000 It is very unusual, very unusual for a malignant narcissists 0:23:02.040 --> 0:23:05.400 to show up in therapy with their partner. It may 0:23:05.520 --> 0:23:09.240 happen if, for example, the malignant narcissist is sort of 0:23:09.240 --> 0:23:13.800 being compelled to because by the courts they're being compelled 0:23:13.800 --> 0:23:16.879 to as part of some other process. Maybe the church 0:23:16.960 --> 0:23:19.760 is compelling to, but some other forces saying you've got 0:23:19.800 --> 0:23:23.439 to go into couple's therapy. But in general they're not 0:23:23.480 --> 0:23:25.920 going to show up, and it can actually be unsettling 0:23:26.000 --> 0:23:28.680