Narcissistic Personality Disorders

• Accelerated Learning and Positive Templates by Francine Shapiro, 8/4/97
  • Personality Disorders by Philip Manfield, Ph.D., 8/26/97
    
    

I indicated earlier that I do not hold much hope for a client under the age of thirty five with a narcissistic disorder to remain in treatment long enough to address their underlying character pathology. I have been successful with older narcissistic clients, but I have only introduced EMDR after they have recognized that the source of their problems is within themselves.

A painful life process for all of us, aging for people with narcissistic disorders is a flaw that does not go away; this problem motivates them to seek therapy and keeps them coming to therapy. As they age, these clients feel less attractive; they feel an increased sense of isolation and a hopelessness about finding meaningful relationships in the future.

What do clients with narcissistic disorders want? Typically their histories include memories of feeling unseen, used, neglected, devalued and unfairly criticized by their caretakers. They may or may not have access to these memories, and if so they are unlikely to recall the intense pain that accompanied these memories; but in their present lives they tend to be extremely sensitive to criticism. The last thing they want is to be told that they are defective and need to be fixed. Identifying an EMDR target is often wounding to them. Never mind that they are sitting in a therapist's office; that is bad enough, especially when they view their problem as their unsympathetic spouse or the boss that does not value them to the degree they deserve. Even if there is traumatic physical or sexual abuse in their past, they are usually at the outset ill-prepared to address it, and they often deny it's significance; however, I have found that eventually many of these clients are able to reprocess memories of emotional or physical abuse with EMDR.

Clients with narcissistic disorders want to be seen, understood, respected, valued, supported and appreciated for their specialness. They generally feel this way when mirrored. They also want what Kohut referred to as a selfobject, a person who they think of as an extension of themselves who provides them with the self-regulating and self-soothing functions they lack. As the therapist provides this function the client becomes gradually trusting of the therapist and a consensus develops that the root of the client's problems is internal. This can take a very long time, often years. In most cases, I do not see EMDR as playing a significant role during this initial phase unless the client is relatively healthy and unusually motivated or has had a fair amount of previous therapy. Of my own successes treating narcissistic personality disorders with EMDR and those my colleagues have reported, the large majority were first treated in a traditional way for a year or more.

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