'I Work With Narcissists'

As a therapist I actually fell into working with narcissists some time before I studied how to practice therapy with narcissistic clients.

In my first year as a Gestalt therapist in 1974 I had a client who loved me, and then all of a sudden she got really nasty and told me I was uncaring and unprofessional. She left the session and I was left wondering what had happened.

A couple of months later I had another client and the exact same thing happened. Then, it happened a third time. My supervisor explained that I was seeing people with personality disorders and I would need to study psychoanalytic therapy.

I wanted to know the difference between borderline personality disorders in general and narcissistic personality disorder, and through my studies I came across the Object Relations theory.

Narcissism isn't a name for a person, it's a name of a pattern that a person has adopted in childhood. Saying a person is a narcissist is shorthand for saying that a person is exhibiting a pattern of behavior and thinking that is characteristic of narcissistic personality disorder.

If we have a childhood where our parents love us despite our flaws, we are punished proportionally to our bad behavior and it feels like our parents still respect, love us and want us to be safe, we will be able to put together that our good mommy and the mommy who punishes us are the same mommy. We can understand that she is one person, and we can also integrate the good and bad parts in ourselves into one stable, realistic person.

However, if your parents don't see you realistically or treated you as all good or all bad, you're not going to learn how to see good and bad within a whole person. It's called whole object relations.

If you don't have it, you see other people as either all good, or all bad. And you will see yourself as all good or all bad. So what was happening in those sessions was that these people were switching from seeing me as all good to all bad.

There are several common traits I see that present in all narcissists. Firstly, narcissists almost entirely lack emotional empathy. This is the ability to feel something of what someone else feels in the moment. If you want to know whether you have emotional empathy, watch someone who hits their hand with a hammer by accident—you'll cringe.

I have seen how in relationships where one partner is a narcissist, their lack of empathy and their ability to be triggered and have this response of you being "all bad" can cause them to say very abusive, mean things.

Narcissists are also hierarchical. If you imagine a ladder that goes from the bottom of a pit filled with excrement to the sky, and there's only room for one person at a time on each rung, that's how life is for narcissists. So they fight to stay on their rung and get higher. They suck up to people above them and devalue the people who are "below them."

Narcissists are very good at setting up a status hierarchy when they enter a room, they will do it based on the things that they value and see as high status. So they might notice riches or designer clothing.

As a result of all these factors, you have a person who can only see you as special or worthless, who doesn't have any empathy for you and who is status driven and highly competitive.

It's only recently that there has been awareness from my clients that they might be narcissists, as now I often get men who have been referred by their wives. It's more commonly women referring men to me, though of course the person has to be on board and then contact me themselves.

Narcissism, Narcissists, Therapy

These men come to me and say that their wife wants to divorce them and says they are a narcissist, but they don't even know what it means. They think they're a great person!
In the course of talking to me they might do half a dozen narcissistic things and I will tell them the traits they have displayed.

I also explain to my clients that there are actually three types of narcissists, using James F. Masterson's work on personality disorders. Exhibitionist narcissists are what most people think of—the show off who dominates the conversation.

Closet narcissists are more hidden, they don't share that grandiosity and they are very indirect. And the final type is malignant narcissists—who take pleasure in the downfall of others. You have to understand the underlying motives because you will see the three types of narcissists do the same thing for different motives.

We go to the movies and we see characters who may fit some of these types—but they obviously aren't given a diagnosis. An example would be the character Richard Gere plays in Pretty Woman. His character's job in that movie is to take over companies against their will, run by powerful men. He dismantles the company and takes pleasure in humiliating the men at those companies. The woman he ends up with is a hired prostitute, so he can see himself as many levels higher on the "status ladder" than her. So you could say he fits the characteristics of a malignant narcissist.

A good recent example of narcissistic behavior in action happened at the beginning of the COVID-19 pandemic in the U.S. There was a shortage of toilet paper and I was hearing that certain narcissist men were telling their wives that they were using toilet paper improperly to wipe their female parts—that these men knew better how to fold it so the women would use less.

Trivial domestic things can trigger a narcissist because they can only see all good or all bad, and they attribute the reason for their bad mood to you. A narcissist might tell you that you load the dishwasher wrong, and then proceed to unload it, reload it and scream at you.

In a relationship with a narcissist you will be flawless during courtship, and all they can think about is the chase and having you. But once they have you they really don't know what to do with you. An example I use is that a dog will chase a rabbit, but not because they love the rabbit. The partner is the rabbit if they are caught by a narcissist. Suddenly, they see our flaws.

Narcissim, Therapy, Narcissists
Elinor Greenberg has been practising as a therapist for more than 40 years. Over the years she has had many narcissists as clients. Elinor Greenberg

Now the narcissist will start noticing things that they wish you would change. That might involve telling you what to wear, how to behave or what to do better. Everyone tries to change their partner to some degree, but most people the growing intimacy will be a substitute for thinking they would get everything.

A very common example of narcissistic behavior I see is the act of telling a partner to change their outfit before a party. An exhibitionist heterosexual male would say they want the other guys to to envy him, and tell their partner to dress in a more provocative, sexy way. One woman I treated in this situation refused to change, and though they did go to the party her partner kept her up for two nights after screaming about it.

If you're in a relationship and your partner starts devaluing someone on the street, insulting their outfit for example, you might make excuses thinking they're joking. Then, they might then do something else like being mean to a waiter, I would suggest they're possibly a narcissist and you shouldn't go any further with them.

Because that's going to be your life, everything is run by the feelings of the narcissist. And if the narcissist has violent tendencies you could really be at risk when they get triggered and see you as "all bad." One woman went on a trip to another country with her narcissistic boyfriend and he left her there the first day. He got triggered, left her on the first day alone in the hotel room and got on a plane. You could be left in a strange country, told how to load the dishwasher or literally how to wipe your vagina better.

I have learned from my work that there are little red flags when you're in a relationship with a narcissist that people don't see, or make excuses for. But I want people to remember that if the person is a narcissist—they are not joking when they make devaluing comments. It's important to recognize this, because dealing with a narcissist's behavior will become your life—and it won't get better on its own.

Elinor Greenberg, Ph.D., CGP, lives and works in New York City. She has been practising as a therapist for more than 40 years. Elinor specializes in the treatment of clients with Borderline, Narcissistic, and Schizoid adaptations. She is the author of the book: Borderline, Narcissistic, and Schizoid Adaptations: The Pursuit of Love, Admiration, and Safety.

All views expressed in this piece are the writer's own.

As told to Jenny Haward.

Editor's Picks

Newsweek cover
  • Newsweek magazine delivered to your door
  • Unlimited access to Newsweek.com
  • Ad free Newsweek.com experience
  • iOS and Android app access
  • All newsletters + podcasts
Newsweek cover
  • Unlimited access to Newsweek.com
  • Ad free Newsweek.com experience
  • iOS and Android app access
  • All newsletters + podcasts