Deconstructing Rigid Meanings
Therapeutic approaches to narcissism are most effective when they address the rigid and polarized meanings that narcissists often impose on themselves and others. The process starts by questioning certainty and promoting curiosity.
Moving beyond the fixed meanings of the narcissist’s imaginary involves a shift from absolute certainty to a space of exploration and interpretation. This means focusing on the underlying meaning of words, recognizing that these can carry multiple interpretations and are open to subjective understanding. This challenges the rigid, all-or-nothing thinking that often characterizes the narcissist’s worldview.
For example, if a narcissist describes a situation where they perceive themselves as entirely “right” and another person as entirely “wrong” or even “crazy,” the therapist might gently explore the nuances of the situation. Instead of accepting the narcissist’s polarized perspective, the therapist might ask questions like, “What might have motivated the other person to say or do that?” or “Can you imagine what their perspective might have been in that moment?” This encourages the narcissist to consider the other person’s experience as separate from their own, opening up the possibility of understanding the other as a distinct individual with their own motivations and feelings.
By introducing this degree of uncertainty and nuance, therapy can help them move beyond the fixed, often polarized meanings they impose on themselves and others, fostering a more complex and nuanced understanding of interpersonal dynamics.
Clinical Vignette: The Tyranny of Reason
Another patient often becomes angry with his partner, with his boss, or with anyone who, in his view, does not behave “rationally” or says things he considers “nonsensical.” He is convinced that he is always right and only feels comfortable with those who think like him. Conversely, he feels great embarrassment when he forgets something or makes mistakes—faults he rarely admits, often searching for justifications instead.
He struggles to see that what he considers “rational” or “objective” is actually filtered through his own personal values and worldview. For him, there is only one standard of correctness, and he finds it intolerable when others introduce subjectivity (or, in his eyes, “irrationality”) into their opinions.
Clinical reflection:
This case illustrates how difficult it can be for some individuals to recognize the subjective roots of their own reasoning and opinions. Therapeutic work here often involves gently inviting the patient to consider that their logic, too, is influenced by personal desires and perspectives—and to tolerate the discomfort of acknowledging their own fallibility.
Engaging the Emotional and Relational
Narcissists often prioritize logic, rationality, and external achievements, neglecting the emotional and relational dimensions of experience. Therapy aims to cultivate an awareness of these often-disavowed dimensions, fostering a capacity for genuine connection. This involves helping them recognize and process their own emotions, often buried beneath layers of defense mechanisms, as well as understand the impact of their behavior on others. Helping them see others as separate individuals with their own subjective experience, independent of the narcissist’s needs and projections, is crucial.
Exploring the Unconscious
The narcissist’s relationship with their unconscious is often characterized by denial, avoidance, and a lack of introspection. Helping them access and understand their unconscious (through free association, dream analysis, exploring transference dynamics, etc.) can help them understand the hidden drives behind their behavior, including the underlying fears and insecurities that fuel their need for constant validation. Accepting the inherent unknowability of the Other, both internally (their own unconscious) and externally (the inner world of others), can lessen their anxiety and create space for genuine self-reflection and a more nuanced understanding of human experience.
Challenging Beliefs with Sensitivity and Timing
While challenging a narcissist’s deeply held beliefs can be productive, it must be done with extreme sensitivity and careful timing. Their rigid adherence to their idealized self-image makes them particularly vulnerable to perceived criticism, which can trigger defensiveness and rage. However, carefully crafted challenges, delivered with sensitivity and at opportune moments, can disrupt their fixed narratives and create an opening for exploring alternative perspectives. This can lead to moments of surprise and self-discovery, potentially destabilizing their rigid self-image and fostering a greater awareness of the “Other” and the complexities of human interaction.
By addressing these key areas, therapy can help the narcissist gradually dismantle their fragile fortress of defenses and begin to build more authentic connections with themselves and the world around them. This is a delicate and often lengthy process, requiring patience, sensitivity, and a deep understanding of the narcissist’s unique vulnerabilities, defenses, and fears. It is important to note that not all individuals with narcissistic traits are receptive to therapy, and progress can be slow and uneven.
Ultimately, working with narcissism in therapy is not about breaking down defenses, but about patiently accompanying the person as they gradually discover new ways of relating to themselves and to others. It is a process marked by setbacks and breakthroughs, requiring both humility and hope—from both patient and therapist. This slow, painstaking process is not just about change, but about creating the conditions for real encounter — with oneself, with the other, and with the unpredictable richness of life.