Showing posts with label #domesticviolence #NPD Abuse. Show all posts
Showing posts with label #domesticviolence #NPD Abuse. Show all posts

May 12, 2017

Read The Little Black Book of Bat Shit Crazy Free with Kindle Unlimited

The Little Black Book of Bat Shit Crazy!

This book is filled with Narcissistic predicaments every survivor finds themselves in. This forecast of narcissistic moods and behaviors should be read by anyone who is dating, getting married, getting divorced, wondering why your family hates you, questioning your sanity, or if you are just human and leave your house with the possibility of interacting with other humans. If you have listened to others who have experienced life with a narcissist then you know it's as if every narcissist was handed a playbook that guides them on how to abuse their victims to inflict the maximum amount of damage. If there ever was a Narc Manual then this is it. The knowledge within these pages will help you spot narcissistic behavior in order to avoid forming relationships with toxic people while simultaneously being your "ah ha" moment if you happen to already be in one of these high conflict nightmares. The information provided here is for both men and women and is not intended to be used as a tool for learning how to manipulate a narcissist. This is for your own knowledge to protect yourself from emotional and psychological abuse. I’m sharing this with the hopes that when and/or if you spot this behavior you can steer clear of these train wrecks.

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April 2, 2017

End the narcissistic nightmare and go no contact in ten steps

Stop allowing your narcissist to hang you out to dry and go no contact like a boss.

Dear Narcissist Problems,

Hi there, came across your page, and wondering if I can ask for advice? Thanks in advance it’s a really long story, short version I think my ex is a narcissist and he's still in my life. I've done the usual google to check but wanted to ask someone. 

A few of the things he's done - I met him at work in 2010, he told me he was divorced/ separated, he lied.  He got me sacked from my job and made me have an abortion. I would end it, and he'd contact me, he accused me then after 3 years of harassment and then took me to court, he even put me on a two year restraining order. My dog died in January 2016, he then messages me, knew about the dog dying and also knew about personal things in my life, as I'd gone back to college. He flirted, saying it's good to see me, how he's missed me and that he wants his friend back. He also said if he wasn't married I should know he'd be with me.

He manages to twist things, if it's his fault somehow it's mine, like with court I asked why did he take it that far? His answer “you were being a dick, so I was". Sorry probably too much information but I'd appreciate any advice I don't know if you can help at all? Or if it applies to what this page is about.

 Some examples: I'd ask to meet up, email or phone to talk. Because in the past he'd message me out of blue, after he'd ended the relationship, he created other accounts online to contact me, so I shouldn't of but I did the same to try to talk to him as I loved him. I was a bit of a pain. And I'd message I'd been told not to but didn't think that would happen. So much happened it's hard to explain but I'll try my best. The police weren't interested in my side. He came across as the victim to them. When I'm sure I am. Even officials at court said to be careful because it sounds like he's got it in for you. Also during the order, he would follow me online, create an account and show up.


“I'm a hot mess”

Dear “Hot Mess”,

Oh you definitely made it to the right place! There is no doubting that any longer. This is your official validation that you are now amongst others who know exactly what you are going through and I can’t think of a better place for you to be at the moment. Please join our support group and you will quickly realize exactly how not alone you are right now (and in the right place)!

The first thing I need to say is get this person out of your life like yesterday! He is an abuser! He might not be hitting you but he is emotionally, psychologically, coercively, and reproductively abusing you. A person doesn’t need to hit you in order for them to be an abuser. There is a cycle to all this madness when dating a narcissist and it goes like this: idealize (love bomb or reel you back in), devalue (tear you down), then discard (throw you away again). This guy has this cycle down to a T.

            Think of all the pain and heartache and grief this person has caused you. Do you really want to deal with this for another five years? This is what you need to do immediately which is to go NO CONTACT. Every time he ignores you for months (silent treatment/discard) and then finally sends a message and you reply is a HUGE power surge for him.

 He doesn’t miss you or care about you, it is ALL ABOUT HIM and the way it makes him feel knowing that he has torn your life apart and still you have left a space for him. “Friends” don’t get restraining orders against each other. “Friends” don’t force each other to have abortions. Our “Friends” are not married and secretly having affairs with us. He likes the feeling of knowing that he OWNS YOU and nothing more.

            I don’t want to sound harsh but I really need to get this point across to you. I talk to men and women every single day who have wasted YEARS and DECADES of their lives with partners just like the one you described above. Please don’t do this to yourself. You are going to need therapy! A normal friendship does not result in the need for intensive therapy focused on treating trauma.

First thing is first: Document the Crazy

I don’t know how long the restraining order was for but I’m going to let you in on a little secret. This man is saving EVERY single interaction you have with him and he now has the power to have you arrested because you are in violation of a court order. So what you need to be doing is documenting each time he contacts you.

 Let him know that you are not ok with him contacting you. Report to the police each time he contacts you. And take his ass back to court and get your own restraining order. You know what…. I’m going to throw in a link so you can ask a lawyer any questions you have regarding this case free and anonymously and you can go from there.

This narcissistic jacka&& (excuse my language, so sorry, I could change that word but honestly there is no other word to describe him at the moment) is ALSO going to use the documentation of your interactions to further coerce and blackmail you. If you ever threaten or he thinks you might try to contact the police or his wife he will use this “evidence” to make you shut up with the threat of jail time. YOU DON’T NEED THIS OR DESERVE THIS. As I stated above you need to go full blown NO CONTACT with this narcissistic loser and I’ll explain exactly what that means.


Some people decide upon going low contact which is to have minimal interactions with a narcissist as needed. These situations usually involve close family members or when you share children.  Usually when one starts the process of low contact they quickly realize that no contact is required because narcissists do not respect and never will respect your boundaries. Low contact is usually maintained as the result of a court order that forces parents to interact in regards to their children.

 In this situation, you need to go full blown no contact. What this means is that this is it. Keeping this person in your life will only result in more harm and destruction and you need to sever all ties completely. Once you go No Contact there is no going back. There will not be one last phone call or one last chance for them to explain things. They have proven themselves to be a toxic abuser. You have tried to fix the relationship numerous times and nothing has ever changed. You have officially reached the end of your rope. You have no option but to cut them out of your life because the abuse will never end.
Some people, typically abusers, love to point out that their victim has been giving them the “silent treatment” when they go No Contact.  So let’s take a moment to clarify that No Contact is NOT the silent treatment.  These are two completely different things and a distinction should be made at this point to clear up any confusion.

The silent treatment is a tactic that abusers use to manipulate their victims into compliance. An abuser will give their victim the silent treatment in order to control the behavior of the victim.  In your situation the silent treatment may have been utilized in order to get you to agree with having an abortion.

If you wanted to keep the baby and he did not he might have ignored you until you changed your mind. This is also known as coercion and reproductive abuse…. Which are two different types of abuse you should look up because I’m trying to get to a point but there is so much crazy to a narcissist that it gets a little difficult! (So note to self: look up Coercive control and reproductive abuse after I read this). Ignoring a person until they agree with you is not No Contact, it is the silent treatment.



You have accepted that your abuser will not change and have exhausted all avenues to maintain and repair the relationship. They have consistently shown you that they have no desire to change and they also probably see nothing wrong with their behavior which only reinforces your need to protect yourself.

 There is ZERO manipulation of another person involved with going No Contact. We do not go no contact hoping for them to change. We go no contact with the acceptance that they will never change and we need to protect ourselves from further abuse. With that said we can now get into what it will take to go no contact.


 Only you can gage how manipulative your narcissist can be. Close your eyes and picture what lengths they will go to in order to contact you and manipulate you back into the relationship. Think of the most outrageous stunt you think they would pull. Think of who they might contact trying to find you.

Think of all the crazy that will take place when they are in a rage at your decision to never speak to them again. Has your narcissist been known to get violent while in a narcissistic rage? How vindictive are they or have you seen them be? Have you ever seen them or have they ever told you that they destroyed someone’s property before? Do they break things when angry like throwing dishes against walls when in an argument? Vandalize property as payback when wronged in the past? Do they stalk? Have you ever seen them entice others into violence on their behalf? If you know or your gut is telling you that these things are possible then follow that natural instinct because whatever you think they are capable of doing they will.

Now multiply your expectations of manipulation, rage, revenge, stalking, and destruction of property by 1000. You can NEVER truly gage the level of crazy that will take place but I can guarantee you that it will reach a level that not even you could have imagined.


This really is like going to war and what you are fighting for is your freedom and sanity. List all of your social media accounts, emails, phone numbers, mutual friends, co-workers, neighbors, and on and on and on.

Really spend some time thinking about people that should be on this list. This could include your best friend little Kimmie from first grade you told him about one time or your Aunt Florence 3 states away.

Also make a list of “safe” people. These would be people that you know you can trust. They don’t know your narcissist and your narcissist has no way of knowing who they are. These are people that the narcissist will not be able to manipulate in any way, shape, or form into betraying you or telling the narcissist where you are. These people will also not be able to bring back little pieces of information that the narcissist wants them to tell you. Inform a few of your “safe” people, or even just one, of what you are dealing with. Don’t be embarrassed.

This is not the same as recruiting flying monkeys either where others are used to punish and harass on the behalf of a narcissist. This is so you have people who will check on you to make sure you are still with us on planet earth. These are also people who you can trust with your email and social media account information because you might need them to log into accounts later on in case you are harassed so they can print the documentation of the harassment so you don’t read everything and then start replying. If you can’t trust yourself to not respond to online contact then you need someone to do this for you.

No contact is the end. There is no need to continue defending yourself against their verbal attacks. There is also no need to continuously get hurt by all the awful things they are telling you in email or the mind games they are playing with their fake profiles.


 Go buy a flash drive to save anything from online like pictures or videos and documents. A blank notebook to document anything that might happen as well as a quick summary of what you did everyday, and a nice plastic storage folder/binder.

 You can also find some really inexpensive security cameras on Amazon, I’ll link a couple in. Well... I found one that was kind of expensive but its a freakin water bottle........ I'm not saying to buy spy cam's to stalk anyone but you do need to protect yourself. When you go no contact expect this person to rise to an entirely new level of crazy and this might involve the destruction of your property or breaking into your property. If its possible have a camera pointed at the front and back of your home.

 Some of the cameras below have night vision.... epic. Oh and one allows you to view remotely. Spy glasses? Seriously, I wish I had glasses that recorded every conversation with my narcissist! "Oh really, that never happened??? Well lets see what the footage from our conversation on April 2nd 2010 at approximately 5:47 p.m. was really all about shall we??"...... Let me just say if nobody has noticed I'm pretty serious about my legal documentation only because if I had been documenting all along I wouldn't have been blindsided in the first place so DOCUMENT THE CRAZY!!!


 Make it known that you want no further contact with them and make sure its in writing. This doesn’t mean take an ad out in the local paper. What this means is that they are aware (in the eyes of the law) that they should not be contacting you after this point. Any future contact is unwanted. This point of no contact will usually happen when they show up to your home or job after you have ignored some calls and emails. They will begin to push your boundaries at this point to see what you will let them get away with. Do Not Budge.

The only and final reaction they should get from you at this point is a written cease and desist statement. Most people would say “oh god honey just ignore them and be done with it”. I don’t suggest taking this route for one reason, documentation for court. You want to have it in writing either through an email that sends an alert when it’s been opened or through certified mail STAMPED WITH A DATE AND TIME and possible signature upon certified delivery from the post office.

Why? Because you’re probably going to need a restraining order. If you don’t have documentation that you didn’t want to be contacted then how would the narcissist know? They will just lie and say they had no idea.  Further, in most states now if there is a restraining order both parties are in violation of that order if contact is initiated. Document those violations!

Keep in mind, he isn’t used to you saying “no” and he has already taken you to court once. Do WHATEVER you need to do but get it documented that you don’t want any contact and make it clear that you WILL follow through with legal action if he does not desist from any future contact. You should be calling the police every time that order is violated by him because I promise you he will try to turn that around as if you were contacting him if he can, I’ll talk about how in step 7. This is useful information for men and women because narcissists are well known to come in both genders.


You are going to have some things to take care of.  Take out the list you made in step 2 and go through all of your online accounts and block all of his accounts so that it is impossible for him to contact you online. If need be make new accounts for everything and DO NOT SHARE THESE ACCOUNTS WITH ANYONE THE NARCISSIST KNOWS.

Further, manage your privacy settings on ALL social media so that they can’t spy on you. Make sure if you join a support group online that you are either able to use an alias or that the settings are “secret”. I honestly suggest making alias profiles in any situation where you are talking about your life online.

If a social media platform prohibits the use of an alias then don’t talk about your life at all on that account. Don’t share your location, pictures, people you hang out with, where you work, or anything else you’re your abuser will be able to use to locate you with. Facebook says they care about harassment but they are light years behind narcissistic stalkers and their policies do zilch to protect victims of stalking.

Make sure to delete anyone on your friend’s lists that you don’t know because they just might be one of his fake accounts. I personally did not use my name on social media for 4 years after going no contact. I made an account about six months ago with my name to test the waters. I have had to verify my identity to Facebook over 10 times already. Every time I log into my account and have any activity I get reported. Every. Single. Time.  

Make new email accounts and give a trusted friend access to your email that he contacts you through so your friend can check for messages. When he creates fake accounts to contact you have your friend print the emails, comments, and other online attempts to contact you. Take out your nice plastic binder and add each new encounter and keep these records in a safe place.


 This might seem a bit excessive but trust me on this one. You don’t want them to have your phone number and probably not for the reason you are thinking. Anyone with a smartphone can officially send text messages to cell phones and home phones these days. I will only cite one good reason to change your number as soon as you read this.

There is this nifty new app called a caller ID Spoofer. You need to protect yourself from the very real possibility that your narcissist will use this app to send themselves text messages from your phone number and then use those text messages to further harass you with court and police action. Please don’t end up in jail because you didn’t change your number.

 All they have to do is set the app up to send a text from your phone number to theirs with a statement like “When I see you I’m gonna beat the ever living crap out of you and torture you for weeks before finally finishing you off with my bare hands” and BAM! Just like that you might go to prison for not only violating your restraining order but threatening their life! Trust me, this just happened to someone in our support group and thank god they changed their phone number beforehand and the narcissist got caught!

8.    MOVE

Get as far away from them as possible and don’t look back.  If and when you move DO NOT tell ANYONE your new address. Get a P.O. Box and use that for utilities, driver’s license, and anything else. You don’t want to have to deal with this all over again in 2 years after these vulture companies start selling your contact information and you end up on one of those sites where you can look up anyone’s address on public record. Move as far away as humanly possible. If it’s possible to leave the planet and live on Mars at this point do it! Narcissists will NEVER stop hunting you down.


You really need to treat this as you would a cancerous tumor. You wouldn't cut half a tumor out and if you remove cancer you can't leave pieces of it behind or it will only grow back. This is alot like removing narcissists and flying monkeys from our lives. You gotta get it all or the disease will remain and slowly fester into your demise.

This is an especially difficult decision for those who need to go No Contact with abusive family members. If you need to go No Contact with a parent then you also need to accept and grieve the loss of many other family members who perpetuate, instigate, or condone the abuse. Many survivors of abuse find themselves utterly alone. Narcissistic abuse destroys generations of family members. Here is the thing though, if the abuse doesn’t stop with you, then where will it? With your children and you? With you and your grandchildren?

Narcissistic personality disordered children grow into parents and then grow into grandparents. I know I’m going to hear from the one “recovering” narcissist out there of how I should have compassion because narcissists are people too and they are capable of change but here is the thing; they aren’t. There is no known cure for this personality disorder. Many of those who suffer from it will never even be diagnosed because they will never see themselves as a problem. Do I feel bad for telling thousands of abuse victims that their narcissist will never change? Hell No. Go find another website for your cause if you’re here to convince people that anyone with a cluster B will change so I should have compassion. I’ve had 33 years of compassion….. I’m all compassioned out when it comes to narcissistic abusers. Sorry not Sorry.

Moving along, you will find that people might try to shame you, guilt you, and manipulate you back into contact with the narcissist. They will pretend to care about you. Ask you questions about your life. They want all the details. Here is another thing, they don’t give a shit about you they just want something juicy to tell your narcissistic abuser right after they hang up with you. They are also probably recording the conversation. Cut anyone who is not 100% for you out of your life. You’ve got a lot of work to do with yourself and you don’t need any more anchors holding you under water. You’re damaged enough and now it’s time to heal.


A narcissist will try every trick in the book to get you back into the cycle of abuse. They will say someone died when they haven’t. Hell…. One lady had a narcissist fake his own death and then he made up family members to call and harass her to “release” the body. She didn’t find out it was a lie until going to the coroner’s office. Anyway, they will try to get your pity, they will try to intimidate you, they will try to send others to sway you, and then when everything fails they will get downright destructive. If you do disappear, mark my words, they are sitting there waiting for some sign of you. Relentlessly googling your name for the hopes some new information will pop on Google. They will even hire private investigators to find you. Whatever they attempt DO NOT BREAK NO CONTACT!

I won’t promise this will be an easy journey but I promise that it will be worth it if you do maintain No Contact. You need to do you. You need to heal you. You need to get into therapy specialized for those who have experienced trauma. Most importantly you need to maintain no contact. Take a moment to realize that the narcissist will never stop. By going no contact with your abuser you have become a lifelong enemy. They will stop at nothing to seek and destroy. They will use numerous methods to get you to engage with them again.

They will even pretend to forgive you so that they can reel you back in. Once you feel confident that they might have possibly changed. They finally realized the abuse they had caused. When you finally feel at peace, loved, an appreciated. When you finally feel like this is a real relationship, a real bond, and all hurdles were overcome they will strike down with a vengeance like the wrath of Satan. Narcissists do not forgive. Narcissists do not forget. Narcissists do not change.

I really did not mean to write a book here but this is serious and there is so much more that I wanted to get into especially regarding the abortion. It doesn’t matter if he is a narcissist or not because one thing is clear to me. This person is an abuser and has no sense of boundaries even when it comes to your body. What’s his is his and what is yours is his and that really takes a pair of brass ones if you get my drift. I really hope that this helped you somewhat. Please start looking for a therapist that specializes in trauma and take these steps to protect yourself mentally and legally. I really wish you luck because it is a really long road to heal after narcissistic abuse.


Narcissist Problems

September 7, 2015

Dear Narcissist Problems: "Suddenly Slapped"

Dear Narcissist Problems,

Hello, I'm needing some advice concerning my wife. After much reading and honest thought, I believe she may be somewhere on the spectrum of NPD. I've been hit in the face multiple times, hard (to which she says, "it was a slap, my hand was opened")....well, I'm a 200# man, and my ears were ringing. She changes into someone else when she's mad. After following her around the country for her PhD (in psychology no less), supporting her all the way, only to have her abandon her dissertation at the last minute, and blame me for her quitting. Recently I believe that we've entered into the devaluation/discard phases. Over the past two years, I've been working on being my best, and feel I've made big improvements. 5 weeks ago, shortly after her getting a big raise, I noticed her not needing me emotionally anymore. She's always been very attention needy, so I knew something was wrong. I checked the phone records and discovered an hour/day phone relationship with a lawyer "friend". It quickly became her primary emotional relationship, and when confronted, she yelled at me for things in the past, and showed anger, not remorse. She's stated repeatedly that she "doesn't have much empathy", and that she "wants a man who would go to the ends of the Earth for her"- which I do. After asking the lawyer to stop talking with her, twice, with no reply, I threatened him with a lawsuit and he cut it off. Now she's angry at me, stringing me along with enough charm to get what she wants, and distant coldness, especially after intimacy. I could go on....but I'm trying to figure out if she is indeed on the spectrum of NPD or something else.

 Thanks much,

Suddenly Slapped

Dear Slapped,

    I would first like to say I do not hold a degree in psychiatry the only thing I can do is give advice from experience and help dig up some research.  Before I get into the research I would like to ask: “What in the hell are you doing with this woman”?  I see so many men stay in abusive relationships and I really need to understand this more.  I already understand why but are you seriously thinking of sticking around to salvage this train wreck?  It sounds to me like it doesn’t really matter how far on the spectrum she is with any disorder she is abusing you physically and financially. I was just participating in a conversation earlier in a group for people who support men who are abused.  This man posted a picture of what his girlfriend did to him.  I’m sure it started out with slaps but over time this escalated to being stabbed with a fork and onto a butcher knife.  He almost died!  This woman has also confessed to you that she has very little empathy, thank god she didn’t finish her dissertation in psychology.  My point is that this woman is toxic and I have seen from experience what an aggressive woman with no empathy is capable of.  They are capable of stabbing you, running you over with a car, and trying to smother you with a pillow in your sleep.  They will make your life a living hell and then tell the police and the courts that YOU were the aggressor.  You stated that you are a 200 pound man and I’m sure as soon as she turns on the water works the authorities will buy her story of self-defense.  Get away from her and make sure you document the crazy!

    As for how far on the spectrum she is According to the DSM-5 there are two criteria that must be filled to diagnose a person with a personality disorder.  Criterion A is used to test an individual’s level of personality functioning.  This is further diagnosed by assessing an individual’s pathological personality traits, Criterion B.  So if you are looking for how far down the spectrum your wife is you would want to ask how extreme her personality traits are.  It can be noted even by experts in the field of psychiatry that “numerous potential inconsistencies in the conceptualization of narcissism, including variants in describing its nature (normal, pathological), phenotype (grandiosity, vulnerability), expression (overt, covert), and structure (category, dimension, prototype). In all four of these areas of conceptualization, DSM descriptions of the concept have been limited.” (Skodol, Bender, & Morey 2014).  It is also noted in this article that there is very little research on narcissistic personality disorder, its manifestations, and treatment available.  As far as psychiatry is concerned the study of this personality disorder is lacking.  This is why you will find so many of these support groups and pages popping up all over the internet.  Victims of Narcissistic Abuse usually have no idea that they were abused or they blame themselves for the abuse and rationalize it away.  Moreover, the topic has such little research into it that when we do go to therapy we are further invalidated in our experiences. 

So what does it take to be diagnosed with NPD?

Narcissistic Personality Disorder (NPD) - The DSM Criteria

Narcissistic Personality Disorder (NPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as an Axis II, Cluster B (dramatic, emotional, or erratic) Disorder:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

Requires excessive admiration

Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

Is often envious of others or believes that others are envious of him or her shows arrogant, haughty behaviors or attitudes

I suggest visiting the above link.

There has been research springing up here and there that recognizes the need to further explore this personality disorder and the conclusion to a recent study was that “Conclusions: These findings suggest that DSM-IV criteria for narcissistic personality disorder are too narrow, underemphasizing aspects of personality and inner experience that are empirically central to the disorder. The richer and more differentiated view of narcissistic personality disorder suggested by this study may have treatment implications and may help bridge the gap between empirically and clinically derived concepts of the disorder.”(2008). This article goes on to say that “Despite its severity and stability (1 , 2) , narcissistic personality disorder is one of the least studied personality disorders.”

Attached is a useful study into the subject that will help you further explore what could be going on.


Narcissist Problems

 By: Elsa Ronningstam
Harvard Medical School;

Pathological narcissism is characterized by fragility in self-regulation, self-esteem and sense of agency, accompanied by strong self-protective reactivity, emotion dysregulation, and a range of self-enhancing and self-serving behaviors and attitudes. Areas or periods of proactive and healthy narcissism coexist with pathological narcissism. Self-regulatory fluctuations and accompanying shifts in self-esteem are context dependent and affected by situational, that is, interpersonal or event triggered reactivity. The phenotypic presentations of pathological narcissism and NPD range from interpersonal pretentiousness, arrogance, and assertiveness, to insecurity, shyness, and hypersensitivity (Cooper, 1998; Russ et al., 2008). Notable is also that narcissistic individuals’ internal experiences may differ significantly from their overt behavior and descriptive accounts. From an attachment perspective narcissistic personality style and pathological narcissism are suggested to be anchored in a detached-dismissing pattern (disliking attachment to others and preferring investment in interpersonal space and own agency), or in an avoidant pattern (defensive self-sufficiency). In addition, sensitive, vulnerable narcissism has been associated with anxious or fearful preoccupied attachment style (aspiring attachment but anticipating disappointment or rejection; Fonagy, 2001; Dickinson & Pincus, 2003).

Grandiosity and accompanying self-enhancing and self-serving incentives and behavior are part of a self-regulatory spectrum of narcissistic personality functioning. Overt as well as covert signs of both grandiosity and vulnerability coexist and affect narcissistic personality functioning in each situation (Pincus & Lukowitsky, 2010). Sense of competence, control, standards, and achievements are crucial for self-evaluation and self-esteem (Zeigler-Hill, Myers, & Clark, 2010).

Self-agency conceptualizes the subjective awareness and ownership of goal setting, and planning, initiating, executing, and controlling one’s own thoughts, intentions, actions, and accomplishments (Fonagy, Gergely, Jurist, & Target, 2002; Gallagher, 2006; Knox, 2011). It signifies implicit as well as explicit initiation, mastery, and self-direction, and it is a fundamental part of self-regulation and self-esteem. As such self-agency is a potential base for evaluating self-esteem regulation including grandiosity and inferiority. In social-psychological studies of narcissism, self-agency has been introduced to conceptualize narcissistic interpersonal and self-regulatory strategies, such as attention seeking, competitiveness, and self-esteem-enhancing relationships (Foster & Brennan, 2011).

Psychoanalytic studies noted that the subjective experiences of fluctuating or loss of self-agency are especially consequential for people whose sense of self-worth is fragile and whose ability for interpersonal relatedness is compromised (Knox, 2011). Disturbance in self-agency is an essential part of psychopathology (Spengler, von Cramon, & Brass, 2009; Fonagy et al., 2010). For example, schizotypal traits correlate with deficits in prediction which lead to weaker sense of self-agency (Asai & Tanno, 2008; Asai, Sugimori, & Tanno, 2008). Discrepancies between predicted and actual action–effect connection contributed to decreased sense of agency (Sato & Yasuda, 2005; Spengler, von Cramon, & Brass, 2009), and perceived reduced control of events was associated with decreased experience of authorship/instigation (Aarts, Wegner, & Dijksterjuis, 2006).

A young man, Bob 21 years old, dropped out of college and was hospitalized with a range of problems: At the initial evaluation the clinician noticed general anxiety, obsessive–compulsive preoccupation, racing thoughts, social anxiety, avoidance, and suicidality. Family members and friends portrayed Bob to the case-manager as inconsiderate, demanding, and demeaning, with threatening and verbally aggressive behavior, and involved in poly substance abuse. Bob described himself as struggling with internal agony caused by his inconsistent cognitive intellectual functioning, and feeling overwhelmed by insecurity and internal self-criticism. He often felt frustrated with other people; he found them stupid, unpredictable, and difficult to understand. In addition, he had been isolating and engaged in Internet sex-dating where he felt safer and more in control compared with if he tried to meet somebody at bars and parties.

Bob also described the week before being hospitalized; on Friday he met with his professor and began outlining a project for a paper. He thought the meeting went well as he perceived that his ideas were well understood and appreciated by his professor, and he left feeling motivated and competent. On Sunday he spoke in front of 10,000 people at a big sports event at his college. Apparently he did a good job, both according to his own assessment and based on the others’ enthusiastic feedback. With a smile he admitted that he felt he could become a future president of the United States. On Tuesday he found himself unable to speak in front of his class of 8 peer students. It was his turn to present the outline of his project, and just before the class began he experienced sudden anxiety with difficulties holding on to logical thinking and reasoning. When he was about to begin he experienced a total cognitive blockage and had to leave the room. A day later he saw no future for himself and struggled with excruciating self-reproach and intense suicidal ideations and impulses. He admitted that he anticipated critical and “stupid” comments from his peers and feared the anticipation of exposing himself to something he could not control. Most of all, he felt unable to rely upon his own competence and dreaded a sudden loss of his ability to think and speak.

Bob was highly intelligent, with an IQ in the range between 140 and 150. Some even considered him to be a genius, although he himself did not believe that, but he appreciated the admiration and acknowledgment. He was a competitive swimmer and leader of his swim team, and had encountered no problems with either swimming or team leadership. He had overall done well in college, especially on exams, and received high grades despite some inconsistencies. His professional aspirations and plan was to become a lawyer like his grand-father. He met 8 of the 9 Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM–IV) and fifth edition (DSM-5) criteria for NPD (not #6, interpersonal exploitive) according to the Diagnostic Interview for DSM–IV Personality Disorders, DIPD-IV (Zanarini, Frankenburg, Sickel, & Young, 1996).

After having presented this rather diverse set of experiences Bob said to the therapist: “I cannot trust my faculties, I do not know from one day to another whether I can rely on my thinking and reasoning, access my knowledge, communicate, and perform. I struggle inside myself with dreadful self-scolding, constantly comparing and criticizing myself. I am a perfectionist, and I know that I can be very good, even exceptional. I have been considered a genius, but it does not hold up. I can’t tolerate closer contact with people. I get so angry and frustrated at them. I can see that I may be unfair, at times . . . , but I just can’t stand it. It works much better when I am in charge or if there is a distance to other people, like if I have a large audience. I feel extremely afraid of the future and ashamed of having to be in treatment. Some days I really doubt that anything can change or that I can get help, other days I can feel more optimistic”.

Bob presented with areas and moments of real potentials, consistent competence, and proactive interpersonal functioning, that is, as a swimmer and team leader, and in individual academic performance and interactions with his supervisors. On the exceptional side was his ability to speak in front of large audiences. He had both unrealistic grandiose fantasies as well as real age-appropriate professional aspirations. He came across as confident and self-promoting, alternating between bragging and a disdainful attitude. However, internally he struggled with extreme self-criticism, self-doubt (the reverse side of perfectionism), and interpersonal insecurity when facing close and intimate or collaborative interactions with peers, as if they tend to become critical enemies. However, this most consequential vulnerability was not triggered in his physical sport activities, only in his intellectual academic activities. In terms of self-agency, Bob was unable to integrate and regulate perceptions of challenges, failures, and interpersonal limitations with his actual competence and real abilities. From a self-regulatory perspective he used perfectionism and avoidance as well as substances to enhance self-esteem, and sense of control and to modulate self-criticism, fear, and anxiety. Apparently he had reached a point where he faced a rapid and extreme downhill spiral. High ambitions, perfectionism, and intermittent experiences of competence and even exceptional abilities under certain circumstances, turned into escalating interpersonal intolerance and fear, insecurity, distancing and avoidance, self-criticism and self-scolding, with substance usage and suicidality.

Although grandiosity is a diagnostic hallmark for NPD, and an indication of the pathological grandiose self (Kernberg, 1975), its complexity and changeability suggest that the diagnosis of NPD should not depend heavily on overt indications of grandiosity (Ronningstam, Gunderson, & Lyons, 1995). State-dependent signs or temporary reactive increase of grandiosity can alter or coexist with more persistent overt or covert grandiose self-experience, as well as with more proactive or authentic functioning. Given narcissistic patients’ identity diffusion and difficulties knowing who they are, identifying and differentiating their real competence, assets, and accomplishments from exaggerated or non-existing achievement and wished for talents are important. Equally important is the differentiation of their age appropriate ambitions and proactive aspiration from high-flying or unrealistic fantasies. It is not uncommon that patients with NPD struggle with uncertainty, shame, excessive self-criticism, and insecurity related to their actual talents, value and competence, parallel with an enhanced self-presentation, especially if they are young. Like in the case of Bob, it is also important to acknowledge areas of actual individual uniqueness and special talents or potentials as part of the overall self-regulatory functioning. In addition, encouraging patients’ own narrative, especially describing moments when they experience incompetence, inferiority, and fragility, is also a most essential part of the diagnostic process. The shifts in self-esteem from grandeur to inferior or vice versa with accompanying self-regulatory change in self-enhancement and self-devaluation are most informative. The subjective experiences of those interpersonal or situational conditions that cause such shifts are diagnostic hallmark for pathological narcissism and NPD (Ronningstam, 2012a, 2013).

Diagnostic evaluation and treatment tend to mobilize self-protection and control in people with narcissistic personality functioning. Some can be extremely and effectively defensive, focusing on details or seemingly relevant issues while avoiding more urgent or deeper and challenging problems. Others can mobilize plasticity and adjustment, agreeing and following along, and still others can get argumentative, aggressive, and critical. Although on the surface intelligent and articulated, even with moments of perspective-taking and reflection, these people also present with a significant resistance or inability to deeply connect, attach, and change. Doubts, shame and insecurity, confused self-identity, and self-criticism, combined with a range of self-enhancing strategies, contribute to their sometimes drastic self-regulatory interpersonal stands.

A conditional and limited alliance is unfolding, that can seem collaborative and interactive with common language, and even with processing of challenging inquiries and complex interpretations. However, the patients’ motive for seeking help and experience of facing treatment may be totally separated from acknowledging their problems and work toward changes or modifications of problematic areas functioning. Their reputation of being difficult to treat, or even untreatable, stems from a particularly complex and constricting mental functioning. Clinical observation and empirical findings indicate compromised functioning and impaired abilities behind the NPD diagnostic traits that indeed underpin pathological narcissism and contribute to the specific internal and interpersonal regulatory patterns. Awareness and integration of these factors in the diagnostic process is crucial for gaining a meaningful identification of the narcissistic patient.

The first set of such factors concerns the ability to access, process, and identify emotions. Studies have shown that both defensive and compromised emotional functioning influence self-regulation in people with pathological narcissism or NPD (Model, 1975; Krystal, 1998). Avoidance of emotions, especially fear of failure and humiliation, is considered a motivating, self-regulatory strategy (Bélanger et al., 2012). Vigilance, sensitivity, and reactivity to negative events and anticipation of humiliation (Besser & Zeigler-Hill, 2010) can coexist with emotion intolerance and difficulties processing feelings, in particular fear and shame. Fear, recognized in both psychoanalytic and empirical studies as essential in pathological narcissism, is also underlying several management and avoidance strategies typical for narcissistic personality functioning, such as competitiveness, perfectionism, risk-taking, and procrastination (Ronningstam & Baskin-Sommers, 2013). Shame also plays a significant role, especially in narcissistic interpersonal relating, and can motivate avoidance as well as defensive, retaliatory anger to regain agency and control (Tangney, 1995; Trumbull, 2003).

Compromised emotion recognition, that is, impaired accuracy in recognizing facial emotional expressions in others, especially fear and disgust (Marissen, Deen, & Franken, 2012), weaken the narcissistic patient’s ability for interpersonal guidance and information processing. Similarly, alexithymia, that is, the inability to feel and identify own feelings, either because of unawareness or incapacity to distinguish physical and affect states or because of lacking words for emotions (Krystal, 1998) can also impede on the ability to recognize emotions in others (Fan et al., 2011).

Studies of empathic deficits, another outstanding feature of NPD, have raised the question whether motivation/self-regulation or actual deficits, or both, contribute to compromised empathic ability. Impairment in emotional empathic ability was found in patients diagnosed with NPD (Ritter et al., 2011). Although their cognitive emphatic ability was intact and influenced by motivation, their emotional empathic functioning was affected by compromised ability for mirroring and responsiveness to the emotional states of others. On the other hand, NPD patients’ failure to accurately recognize emotions in others combined with overestimation of their own empathic ability indicates a more general empathic deficit (Marissen, Deen, & Franken, 2012). Emotion intolerance may also play a role in empathic ability as the person may be able to notice feelings in others, as mentioned above, but the perception of others’ feeling states can evoke overwhelming powerlessness, disgust, shame or loss of internal control, and hence trigger strong aggressive reactions or emotional or physical withdrawal (Ronningstam, 2009). In addition, noticeable fluctuations in narcissistic patients’ empathic ability may be influenced by self-regulation, with increased ability to empathize when feeling confident and in control, and decreased ability when feeling exposed, inferior or threatened.

The specific attachment pattern associated with pathological narcissism and NPD, as mentioned above, contributes to a second set of factors involving significant difficulties relating and connecting, especially in ways that can promote change (Kernberg, 2007). NPD patients often do not know who they are on a deeper level, and their identity is influenced by more profound and persistent self-enhancing efforts. Difficulties with dependency and mutuality and strong tendencies for avoidance and control are also, like in the case of Bob’s choice of intimacy via Internet, typical indicators of compromised interpersonal functioning (Kernberg, 1998). Perfectionism is such an effort because it involves both exceptionally high or inflexible (although inconsistent) ideals and standards of self or others, with strong reactions, including aggression, harsh self-criticism, shame, fear, or deceitfulness when self or others fail to measure up (Hewitt et al., 2008; Ronningstam, 2010). In interpersonal and social situations perfectionism can be self-promoting to enhance certain qualities, but it can also be self-protective and serve to hide something non-perfect. On the other hand, self-prescribed perfectionism can contribute to extremely unyielding self-criticism, like in the case of Bob, with hypervigilance and automatic cognitive appraisal of interpersonal situations as overly provocative or threatening. Especially, it contributes to reluctance to acknowledge and being seen as imperfect, and hence, to seek help for own distress and to integrate and benefit from treatment interventions.

Impaired ability for self-disclosure, self-silencing, selective or noncommunicativeness, and inability to share feelings and thoughts (Model, 1980; Besser, Flett, & Davis, 2003) are all aspects of narcissistic pathology that contribute to diagnostic challenges. Similarly, reversible perspective taking (Etchegoyen, 1999), the tendency to smoothly adopt the therapist’s comments and interpretations and seemingly internalize those given perspective without changing one’s own, and without incorporating the therapeutic process to generate change in own personality functioning, is yet another complicating defensive feature.

A third set of factors relates to the specific psychological aspects of trauma that can reinforce pathological narcissistic functioning. A narcissistic trauma is caused by a subjective experience of loss of supportive or sustaining external life conditions, such as changes in marriage/family, work and career, or financial situation, or loss of connection to a good, supportive idealized other person, leading to a loss or distortion of internal ideals and meaning. Sudden loss of a sense of control and competence, like in the case of Bob, can also be traumatizing for people whose self-esteem is strongly connected with performance and achievement. Such losses cause an acute internal state that threatens the continuity, coherence, stability, and wellbeing of the self (Maldonado, 2006). Narcissistic self-protection aimed at organizing and understanding the traumatic experience fail, and the sense of loss, rejection, and abandonment, along with feelings of shame, fear, and worthlessness become overwhelming (Gerzi, 2005). A narcissistic trauma is more subjective and self-esteem related, and involving exposure and humiliation. Sometimes such trauma can even be entirely emotional and internal, accompanied by compromised hope, sense of value, control, meaning, and affiliation. This contrasts to more external obvious traumatic experiences, such as physical attacks, abuse, accidents, and so forth. Narcissistic trauma, like in Trauma Associated Narcissistic Symptoms, TANS (Simon, 2002) can be intrinsic to the characterological vulnerability to disruption of self-regulation, and loss of agency and self-esteem in NPD. On the other hand, narcissistic traumas, experienced in young age, can also be deeply internalized and subjectively organized in a narcissistic patient’s mind, contributing to an armor-like, seemingly impenetrable narcissistic character functioning, with denial, omnipotence, and organizing and protecting narcissistic fantasies, covering split off shame and fear. These types of traumatic experiences may easily be either misdiagnosed or bypassed in a diagnostic evaluation as they often differ from standard psychiatric definitions of trauma involving abuse, neglect, catastrophes, and so forth (Ronningstam, 2012b; Simon, 2002; Krystal, 1998) and can remain effectively shielded. Facing the impact of external life events might actually help some patients to begin to access and process such subjectively internalized experiences.

This study has focused on identifying underpinnings and self-regulatory patterns behind the diagnostic traits for NPD. A flexible, exploratory, and collaborative diagnostic process is recommended that attends to the patients’ internal experiences and motivations as well as to their external and interpersonal functioning. The patients’ limitations and compromised abilities, as well as their interpersonally provocative, although sometimes quite elaborative self-regulatory and enhancing strategies should be attended to in ways that are informative and meaningful for both the patient and clinician. Identifying and differentiating healthy or protective aspects of narcissistic patterns from those that are pathological and perpetuating is important. Clarifying the threatening, injuring, or traumatic experiences and situations that escalate narcissistic reactivity is equally essential. Clinicians’ observations of the narcissistic patients’ functioning often do not concur with the patients’ own experiences of themselves or formulations of their problems. More detailed exploration of a recent event that caused fluctuations in the patient’s self-esteem and agency can be a useful start. Such exploration can provide the opportunity to clarify the patient’s internal subjective perspective, needs, and motives for self-enhancement, experiences of vulnerability and deflation, and the organizing and protective role of narcissistic functioning, both internally in relation to self and in relationship to others. A focus on these areas of functioning is in line with the Workgroups proposal for personality functioning in DSM-5 Section III, which includes identity (regulation of self and emotions), self-direction (self-agency), empathy and intimacy (interpersonal relatedness). With regard to the diagnosis of NPD, these changes represent significant improvement compared with the entirely trait-based diagnosis. Encouraging self-assessment and the patients’ own narratives of their performance, anticipations, aspirations, and shifts in states, self-esteem, and emotions can begin to bridge the different perspectives of the patient and the clinician, and help reaching a diagnostic agreement and understanding of the patient’s functioning.

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Source: Personality Disorders: Theory, Research, and Treatment. Vol. 5. (4), Oct, 2014 pp. 434-438)
Accession Number: 2014-42878-005
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Russ, E., Shedler, J., Bradley, R., & Westen, D. (2008). Refining the Construct of Narcissistic Personality Disorder: Diagnostic Criteria and Subtypes. American Journal of Psychiatry AJP, 165(11), 1473-1481.

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