June Membership Meeting Write-Up — Kirstin Carl, MS, LMFT

Narcissist: The Skilled Abuser
presented by Dr. Catherine Barrett

This presentation is on a topic that we may often encounter but may fail to identify comprehensively. This presentation fills in the gaps and brings together aspects of narcissism so that we can develop a more effective treatment approach.

Dr. Barrett started off with the idea that many therapists do not know how to properly identify victims of malignant narcissism. These therapists may suggest that these clients attend Codependency Anonymous (CODA) meetings and focus on themselves. This is not enough. Rather, therapists need to understand the cycle of this abuse and what happens. One difference between narcissistic abuse and other types of abuse is that narcissistic abusers may not know what they are doing.

Dr. Barrett then offered the idea that what we often think of narcissism in our society and in our community is likely not. Narcissists with covert symptoms that do not appear to have anything wrong with them at all are the ones that tend to be the abusers. We need to get bigger than the DSM. Many graduate programs tend to gloss over personality disorders. These programs tend to gloss over how tormenting it is for not only the person who has the disorder, but also the effects that it has on the people who are in their lives. These programs also don't go into the depth and the experiential pieces of what this looks like in-person. Thus often we don't learn about the real-life abusive tactics used to manipulate and control the victims. One problem about this is that many victims know more about it than therapists. She asserted that this problem makes us incompetent.

Dr. Barrett then talked about what narcissistic personality disorder actually is. Is it a disorder, or is it a deficiency? These people lack a sense of self. Early injuries crushed their ability to develop any personality at all. That is why it is so easy for them to adapt to different situations. They become chameleons, doing whatever they can to fill the void and get their needs met. They can quickly morph into new personas. Their thoughts are often delusional. This disorder is so detrimental and so misunderstood that we need to get true and get deep about it. They have the inability to separate themselves from another human being. You are simply an extension of them. You are simply an object to them. What may look like guilt is actually shame.

Dr. Barrett continued by saying that we need to look at narcissism as on a spectrum or a continuum. We all have levels of narcissism. She discussed the difference between Narcissistic Personality Disorder and Antisocial Personality Disorder. Some individuals who have narcissism also meet criteria for Antisocial Personality Disorder. Individuals who meet all criteria for Narcissistic Personality Disorder are known as "malignant narcissists." The main difference between Narcissistic Personality Disorder and Antisocial Personality Disorder is that narcissism is built of defense mechanisms. These people have a deficiency, and rely on outside sources for validation, and to be fulfilled – to fill that void that will never be filled. Antisocial Personality Disorder is more defined by neuro-structure. Those with Antisocial Personality Disorder are not as emotionally reactive; rather, they are emotionally void. A narcissist will disappear without "narcissistic supply."

Can Narcissistic Personality Disorder be cured? At the level of the malignant narcissist, not likely. These are people who will not even admit that anything is wrong with them. Everything is about externalization of blame. Defense mechanisms replace the character. They don't know who they are; they buried that a long time ago.

There is something known as "trauma bonding." Even their victims fall for their con-artist schemes. This is where our work will come in. They have to be in control and have power. They can't handle mutual respect. Exposure is their worst nightmare. Many people with Narcissistic Personality Disorder present as the victim.

Dr. Barrett then addressed the cycle of abuse. Narcissists are never loyal, because they are addicted to supply. They can't bond beyond a superficial bond. They are only there to get their needs met. Every victim has a shelf life. Once they have you, the trauma bond is formed. There is a term called "hoovering," which is the process of sucking victims back in. They are not done with you until you are done with them.

How do we identify this in the room? We will see Complex Post-Traumatic Stress Disorder. We will also see many other symptoms.

Dr. Barrett then discussed different types of codependency on a continuum, in relation to attachment systems. Many victims of narcissistic abuse do not get closure. Therapy offers the opportunity to get closure. Closure brings peace and comfort. If you rush this, you are disallowing a central piece of their process. We need to give them a platform to tell what happened. This is very important for them.

She then offered the idea that it is important to establish no contact. Abusive narcissists are good at using manipulation to get their victims to come back. No contact is the only way someone can move on. When working with these individuals, it is important to help them find a sense of self-empowerment and help them break free from what they thought was an actual relationship. They were in love with a ghost. That's hard for a lot of people to recognize. If the abuser is a family member and thus the victim can't establish no contact, she suggested developing strong boundaries.

As you can see, the presentation is full of relevant information that we can readily apply in our offices.

Kirstin Carl, M.S., LMFT, has a private practice in Encino, specializing in trauma, faith-based therapy, and adolescents. Practicing for over 10 years, she is passionate about her work. Currently seeking certification in Emotionally Focused Couples Therapy, as well as participating in training on Voice Dialogue Therapy, she remains strongly committed to her development. You can reach her through her website kcarlmft.com, or at 818.593.9047.