This is the second part of a two-part post exploring secondary narcissism.
The uncommonly-cited condition of secondary narcissism could use a closer look as it may be both temporary and more easily treated than primary narcissism. The cardinal features are isolation, grandiose delusions, and turning love away from others and toward the self. In the last post I discussed research that suggests that hopelessness in childhood renders one susceptible to this extreme method of coping, this "reactive" secondary narcissism. Below, we will consider other causes and corollaries of secondary narcissism, as well as treatment.
A Word About Envy
Withdrawal from others, turning love upon the self, and grand delusions can be due to unconscious or conscious envy (Klein and Vaknin). The narcissist compares himself to others and he feels lesser-than. Because he must excel at all things, his envy is based on oppressively high standards. Reality, such as the abilities of others, can feel like an aggression against the self, so he self-soothes with withdrawal, delusion, and self-love.
The Paranoia That Emerges
The uprising of harsh, critical figures in the narcissist's inner world can also catapult the narcissist into retreat and paranoid delusions as well as grandiose ones. After a brutal fall, if introjects — prominent past or present figures in the inner life — turn demonic and harsh, then mini-psychotic, paranoid episodes might arise. In high-functioning people, paranoia may be well-hidden and/or circumscribed – applied to a single person or situation. The paranoid person may embark upon injustice-collecting or turning slight past offenses into major violations. Contorting the past is a way to justify present aggressive or passive-aggressive behavior — which is, in part, a response to the paranoid distortions. It is also an expression of the "shadow side" or the underbelly of the self that was warded off in the mind. By leveling subtle or overt accusations or cruel behaviors at the "persecutory" target, usually a loved one, the narcissistic person can externalize, project, or discard unwanted qualities. He can retaliate against this imagined perpetrator who, in turn, has no idea how he or she is suddenly a malevolent person in the mind of the narcissist.
A New Way to Understand Narcissism
Current researchers (Caligor, Levy, and Yeomans) purport that the DSM-5 criteria don’t completely capture this complex illness with its variable presentations of narcissism – covert and overt, grandiose and fragile, primary and secondary. They consider underlying motivations, styles of relating, and identity issues.
People with narcissism may also feel empty, lack self-definition, need constant approval, be unaware of personal motivations, blame others, make decisions based on external stimuli (Vaknin) rather than internal cues, set stratospheric standards to feel exceptional, or minimal standards based on entitlement (above mundane tasks), lack empathy, not perceive when others are put off, retaliate ruthlessly against criticism or rejection, feel inferior, prefer surface interactions as they minimize conflict and exposure, invest in relationships motivated by secondary gains such as status, gifts or opportunities, feel like nothing if they are not their ego ideal, be driven to attract others and be admired by them, be the center of attention, experience boredom and become sensation-seeking, and display emotional reactivity.
Caligor et al write, “The sense of self in narcissistic personality disorder is brittle and somewhat removed from reality. It is predicated on maintaining a view of oneself as exceptional, requiring a retreat from or denial of realities that do not support grandiosity." Substance abuse, anti-social personality disorder, and paranoid personality disorder often accompany this condition. Self-medicating behaviors can be spurred on by feeling dependent, desperate, persecuted, empty, and ill-defined. The ever-present drive to seek outer reinforcements, simply to stay intact, is exhausting.
How to Help
How can therapy help? The therapist tries to do a number of things: Help the person tolerate vulnerability, fallibility, and flaws. Create object constancy and secure attachment through a trusting therapeutic relationship to combat hopelessness in object relations (loving relationships). Rid out-of-sight, out-of-mind stances. Guide the afflicted person to a pleasure-possible reality instead of having to rely on grandiose fantasies. Mitigate the paranoia by gently confronting the distortions and exploring their etiology. Help them embrace learning. (People with narcissism eschew learning or advice from experts because learning and advice suggest that they didn’t know something or didn't know everything, which feels humiliating.) Lead them to tolerate sadness, disappointment, and even a few serious blows without needing to check out. Manage shame. Learn to integrate, not split, the good and bad parts of others and the self. Lose the need to idealize, devalue, love bomb, and then discard and destroy the intimate partner. Some research suggests that partners thrive when finally free of the covert and overt oppressions of the narcissistic person, while he declines.
Patience, empathy, and a slow chipping away are paramount for the treatment process. Too deep of an interpretation, too direct a comment, or a truthful observation too soon, can cause defensiveness. Recommended treatments include Transference-Focused Psychotherapy, Schema Therapy, and Mentalization-based Therapy.
In the End
Once the false self collapses, it takes a long, long time to develop a robust, true self that is spontaneous, non-calculated, and vitalized in everyday interactions. True self is less about particular passions and more about feeling free to experience things without hyper-vigilance and self-consciousness. The true self is nascent or ossified because so much of life was spent in the false persona. But there is hope for the secondary narcissist. When one finally identifies innate sources of vigor and is able to weave them into real life rather than running away, things fall into place.