Run-of-the-Mill Narcissist Behavior Found in Psychotherapy and How It May Impact ‘Outside’ Relationships for the Patient

February 14th, 2011 MarcosDorados 0 Comments

In the situation of psychotherapy sessions, narcissistic behavior by the patient would seem to be routine. After all, one of the rules of the patient-therapist agreement is that each session will key exclusively on the client and his or her needs, rather than those of the therapist. In this sense, choosing to start psychotherapy is in itself a sort of narcissistic behavior. Some theorists such as Heinz Kohut conjecture that therapy acts in a compensatory manner, to make up for the pointed lack of sufficient parental empathy and mirroring that produces narcissism; narcissistic behavior by patients in treatment is therefore not only to be expected but should be encouraged.

While we expect our patients to be self-absorbed during sessions, such narcissistic behavior outside the context of psychotherapy would be inappropriate. One of the potentially adverse side effects of treatment, with its emotional satisfaction of long-unmet needs, is that patients come to long for similar gratification outside the session. Their intercourse with other people may then become pseudo-therapeutic. Emotional needs and psychological difficulties become the focus of their communications; in effect, it’s a 24/7 form of psychotherapy, where patients aspire to feel as if they were in session all the time. One of our aims as therapists is to assist clients to learn to accept that only in session is their narcissistic behavior proper. “Outside” relationships must be reciprocal; for each person to have his or her needs met, all relationships must yield gratification for each individual.

Occasionally in the practice of psychotherapy, one meets the patient who seems unable to feel any type of empathy for anyone, including the therapist, and can only view him or her in an idealized light. These people usually come from severely impaired backgrounds; their extreme narcissistic behavior bespeaks a desperate need for mirroring and empathic support because nobody else in their lives has ever been able to supply it. These clients can be quite arduous to work with as they have small tolerance for the ordinary interruptions in treatment: weekends and vacations, the periodic personal emergency. They may make persistent “emergency” phone calls; they may want to have constant contact with the therapist in between sessions and can’t tolerate any feeling of separation.

If they are even capable of continuing personal relationships, this kind of patient will also prove severely exacting and possessive of their friends and mates. Narcissistic behavior is pervasive in diverse forms: an intolerance for separateness, a wish to dominate the other person, and self-absorption so severe that they may be heedless of their friend’s or partner’s suffering, needs and wishes. An immature type of rage may be the reaction to disappointment or slights.

As a successful treatment continues, the client will learn to deal with separateness; obtaining the sort of empathy and mirroring that were missing from their upbringing will help lessen narcissistic behavior and encourage a new capacity for empathy. This may start in relation to the therapist: emotional lessons learned in the framework of psychotherapy sessions will at the end of the day generalize. Growth in the therapeutic relationship then creates growth in outside relationships as well. In this way, psychotherapy is a microcosm of the client’s larger world; Improvement within that microcosm produces “outside” growth as well.

Joseph Burgo PhD writes a psychotherapy blog for people who want to continue to grow after the end of psychotherapy, with the kind of relationship advice you won’t find elsewhere on the Internet

Powered by Article Dashboard bad debt debt advice debt help free debt consolidation,Powered by Article Dashboard psychology and mental health