humanizing the narcissistic style

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Flumarruzitg the Narcissistic Style STEPHENM. JOHNSON, Ph.D. ffi nxtl wfly W . W . NORTON & COMPANY . NEW YORK . LONDON

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Page 1: Humanizing the Narcissistic Style

Flumarruzitg theNarcissistic

Style

STEPHEN M. JOHNSON, Ph.D.

ffinxtlwfly

W . W . NORTON & COMPANY . NEW YORK . LONDON

Page 2: Humanizing the Narcissistic Style

INTRODUCTION

SouE op My BEST FRIENDS are narcissists. Much of my mostsuccessful and moving therapeutic work has been done with individu-als who can most accurately be understood by using the concepts ofnarcissism. But most of these friends and clients are not most readilyrecognized by their self-involvement, grandiosity, pride, entitlement'manipulativeness, etc., though these usually well-hidden features oftheir personalities certainly do exist. They are not those very dis-

"g...rbl., self-centered, often noncontributing rip-off artists who

.o-. to mind when one thinks of the narcissistic character disorder.In the main, these people contribute a good deal to their fellowhuman beings, but they pay dearly in pain and aliveness for theirdriven achievements. They are too busy proving their worth-ormore properly, disproving their worrhlessness-to feel the love, ap-preciaiion, and 1oy of human connectedness which their good worksLould potenrially stimulare in themselves and orhers. These peopleare not character disordered. They are people tortured by narcissisticinjury and crippled by developmental arresrs in functioning which,.ot ,h.- of thsrichness of life they deserve. They are good people,contributing people who are hurting - and often very badly. They areliving and sufferin g rhe narcissistic style.

This form of narcissism is part and parcel of our life-denyingculture, which places accomplishment over pleasure' status over love'appearance over reality. It is the endemic result of our culture's mate-,iai perfectionism. It bridles a very significant proportion of-our peo-ple and cripples some of our most gifted and giving individuals. Yetwhile the iult.rt. reinforces it, its breeding ground is the family.Though Madison Avenue plays on its existence and fosters its devel-opment, its roots are much deeper.

Individuals sufferins from the narcissistic style can be profoundly

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4 Humdnizing the Narcissistic Style

helped by those who truly undersrand the underlying psychic srruc-ture of narcissism and who possess the human and technical skills totransform it. vith psychological rrearment which is able ro meerthem where they truly are and give them what they truly need, theycan be brought to the experience of a real, emotionally connected lifein which their contributions to the rest of us are, if anything,strengthened. That is not pedagogical psychoanalysis or shorr-termbehavioral or cognitive modification or superficial scream therapy.Rather, it is a therapy informed by the deepest insights of psychoana-lytic theory and practice and incorporating active as well as receptivetechniques. These serve ro help the individual both move beyondarrested development and work through emorional injury.

In a good deal of the literature, the narcissistic characer disorder,as well as the narcissistic style, has been given a bum rap. Largeln thefocus has been on those very disagreeable characteristics of the nar-cissistically disordered person rarher than on rhe nature of his injury,the phenomenology of his pain, and the fragility of his self. A focuson these more phenomenological aspects of the narcissistic experi-ence will promote far more empathy and understanding, an attitudewhich must be the touchstone of our therapeutic approach to allnarcissistic persons. In this book, I will contrast the narcissistic char-acter disorder with the narcissistic style, focusing on the similaritiesand differences along this continuum of ego functioning and describ-ing the essential elements of the appropriate treatment for each.

I offer here an integrated psychoanalytic developmental theorywhich provides the underpinning for a synthesis of therapeutic tech-niques to be used with the character disorders and character styles. Inthe first book of this series, characterological 'fiansformation: TbeHard'work Miracle,I presented this formulation for the psychologi-cal problems deriving primarily from difficulties in human bondingand attachment. The presenr volume deals primarily with disorderiin individuation and the formarion of self-the failure of normalnarcissism which leads to a painful life of pathological narcissism.

In this integrated model, the presenting psychopathology is under-stood by appreciating the nature of the injury on the one hand andthe nature of the arresr in the development of ego and self on theother. The nature of the injury is best elucidated by more traditionalanalytic understandings, particularly those offered by characer anddefense analysis. The understanding of the developmenral arresrcomes best from psychoanalytic developmenral psychology, which I

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Introduction 5

use here as an umbrella label for object relations, self, and ego psy-chology. This unif ied psychoanalyt ic theory then provides thegroundwork for an integrated treatment approach which seeks toheal the emotional injury and work through to the maturation of thearrested ego.

Healing the original injury, particularly in its central pathologicalaffects, often requires the use of treatment procedures which empha-size accessing and expressing these archaic and often catastrophicfeelings. Such techniques range from calm genetic psychoanalyticinterpretations to the more active and often engaging interventions ofGestalt and bioenergetic therapy. By contrast, therapeutic proceduresaimed at remedying the arrested development of ego or self moreoften rely on explanation, reconstruction, and other supportive, cog-nitive, and behavioral interventions, which, while they may certainlyaccess feelings and produce frustration, do not rely on unusual oractive methods to deliberately do so.

It is my position that developmental psychoanalytic psychologyand character analytic approaches need to be informed by one anoth-er. Each approach risks an overemphasis on one side of the etiologi-cal-treatment picture. The perspectives of the developmental modelcan lead to an overemphasis on explanatory, interpretive' and sup-portive interventions, neglecting the crucial role of the awareness andexpression of primitive affects. But the more affective therapies canerr in the direction of overemphasizing the importance of primitiveemotional experience without a full understanding of ego and selfdevelopment, thereby missing what is not so much psychologicaldefense as sef-preserving strategies necessary to functioning. Finally,both of these psychoanalytic approaches can be greatly enhancedwhen informed by the nondepth psychology strategies which comefrom the cognitive therapies, behavior modification, family and sys-tems therapy, strategic therapy, neurolinguistic programming, trans-actional analysis, Gestalt therapy, and others. What I am advocatinghere is not a hodge-podge eclecticism. Rather, this is an integrateddevelopmental theory and a synthesis of treatment approaches aimedat psychological deficit and conflict resolution.

The integration provided in this book is really at three levels' First,it represents an integration of developmental psychoanalytic psychol-ogy. This is the synthesis of ego psychology, object relations, and selfpsychology. This first integration is the easiest because these threeschools share many similarities differing mainly in their point of

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6 Humdnizing tbe Narcissistic Style

emphasis. At this first level, however, I hope to make a contributionby disseminating what I view as incredibly important material whichis very often inaccessible to anyone but the most analytically sophisti-cated reader. In both this work and Characterological Tiansforma-tion,I have endeavored to translate as well as integrate the insights ofdevelopmental psychoanalytic psychology for those who might nototherwise be exposed to this rich body of knowledge.

The second level of integration maintains a psychoanalytic basebut incorporates the insights of character and defense analysis withinthe more elaborate developmenral strucrure provided by psychoana-lytic developmental psychology. Here I hope ro parricularly servethose who have taught me so much in the area of character analysisand bioenergetic therapy by integrating this imporranr body ofknowledge within the larger theoretical conrext in which it reallybelongs. Reichian and bioenergeric therapies really do nor need ro befringe movements seen by traditional therapists of nearly all otherpersuasions as just one more "flaky" fad of a libertine culture. Rather,character analysis is a branch of psychoanalysis incorporating ener-getic armoring as apart of classic defense analysis-a central elementof traditional psychoanalytic theory. Indeed, without this arm ofanalysis, the contemporary emphasis on developmental theory pullsinexorably for a greater concentration on theoretical and cognitiveunderstanding of psychopathology ar rhe expense of the critical roleof primitive affect in determining psychopathology and in effectingits cure. Many of us in the highly educated mental health professionstend to gravitate, almost automatically, to theoretical understandingsand cognitive (i.e., insight and explanation) inrerventions, for theyare safer than exploring the dark cauldrons of primitive emorion.Even when we acknowledge the critical roles of sex, aggression, grief,terror, etc., it is easier to talk about these feelings rhan to jump inamong them.

I hope that the affecive therapies (e.g., Reichian, bioenergetic,Gestalt, rebirthing, etc.) will persist through conservative times be-cause they are essential for keeping us in the true human drama thatpsychotherapy is largely about. These therapies are often necessaryfor the very reasons they are resisted. The restrictive, emotion-deny-ing, life-fearing aspects of our dominant Judeo-Christian culrure cre-ate the very pathologies that these affective therapies are designed toremedy. They have been popular in the expansive, experimental, and

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lntroduction 7

quesrioning periods of the pasr. Now they have lost some of thatpopularity as the more reasonable and conservative forces in ouriociety have become more dominant. Our culture is trendy. But thescience that is psychotherapy must transcend trends and continue toprovide a model for human growth which is both reasonable and yetiruly human. In this work, then, I hope to integrate, legitimize' andcontribute to the repopularization of these affective or expressivetherapies. This process is easiest with Reichian and bioenergetic ther-,py b..rute the underlying theory of character structure is so sub-stantive and compatible with the new psychoanalysis.

The third level of integration involves the synthesis of various ther-apeutic techniques under this developmental-characterological um-biella, so that an eclectic treatment approach may be pursued withrhe guidance of a unified theory. I have endeavored here to exemplifythe utility of this approach - first with a detailed practical descriptionof the conflict and deficit problems of narcissism, and second with atheoretically consistent set of therapeutic procedures which may beapplied to heal it. In this third level of integration-psychotherapytechnique- l am also at tempt ing to apply r ich psychoanalyt ic con-cepts to the more common once-a-week therapeutic hour' \X/hen thepatient is seen only weekly, the transference within therapy may beiess pervasive, bur the transference outside rherapy may be differen-tially more importanr. Additionally, where therapy is less frequentand problems of character style are involved, active therapeutic tech-niques are often more appropriate, as the problem tn these cases ismore in accessing and expressing primitive emotions than in contain-ing them.

In the developmental model presenred here, characterological ad-aptations represent achetypal manifestations of core human issues.For narcissism, these archetypal issues are formed in that cruciblecreated when the infant begins to become an individual, more auton-omous and self-willed than the more passive and dependent suckling'As this individuation process unfolds, the child requires more free-dom, more support for the development of autonomous functions,greater permission to experience and react to the frustrations of life,but r,,,,ith appropriate limits attuned to his developmental level. Insome ways, this is the most difficult time for one ro be a good enoughparent in that there are inevitable conflicts, both within the child andwith the surrounding environment. Perhaps the most difficult polari-

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Humanizing the l,larcissistic Style

ties of human existence are first encountered at this time and, as aconsequence, somc of the most universal of human dilemmas areoften left chronically unresolved.

The rapprochement uith reality is a most basic task of human lifefirst encountered in that subphase of individuation which Mahler(1972) has called rapprochement. Though initially this label wasused primarily to highlight the child's reemerging need to reconnectwith the mother after his striking independence in the prior practic-izg subphase of development, the label has taken on a far moreprofound and enduring meaning for me. The rapprochement firstcalled for by a mere 18-month-old child is really with some centralrealities of existence, including unity versus separation, dependenceversus independence, grandiosity versus vulnerability, the desire tocontrol versus the need to be controlled, limitlessness versus realistic.limitations, etc. Many adults are stil l having temper tantrums, delu-sions, depressions, debilitating anxieties, perfectionistic obsessionsand compulsions, and other painful adaptations to the failure torealize this rapprochement with reality. Due to developmental arrestduring this subphase of individuation, many of us are stil l dealingwith these dilemmas with quite limited and primitive ego function-i.rg.

Most individuals who suffer such difficulties typically have little ifany understanding of what they are really dealing with as they beginpsychotherapy. And they often possess little if any awareness of theways in which parental or other environmental figures made thisrapprochement difficult or impossible. The emotions of the unresolv-ed rapprochement were usually too painful to sustain, but they pro-vided the powerful underlying motivation for a characterological ad-aptation frozen at a time of limited affective, behavioral, andcognitive resources. Through denying the realities of the self, thefamily, and the very instinctual needs of the organism itself, thischaracterological adaptation has typically been supported, at least ingreat measure, by the child's family or its substitute. Driven by theunremitting force of painful emotion and supported by the surround-ing environment, the characterological adaptation became securelyfixed. The emerging real self literally did not have a chance.

The synthesis of characterological, object relations, ego, and selfpsychology provides the best available map for current understandingof this common human tragedy. The task of contemporary psycho-

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Introduction

therapy is to develop from this understanding an environment inwhich the real self may be reclaimed and the rapprochement withreality achieved.

one cenrral position set forth in these volumes is that achievingthese goals requires an integration of therapeutic techniques so as toaccomplish the building of ego resources' the phenomenology of asolid self, and the resolution of intrapsychic core emotional conflictsas required by classical psychoanalysis. This inregrarive, broad-spec-trum approach to psychotherapy requires maximum flexibility intherapeutic technique. It demands that the therapist be comfortablewith the most active of interventions characteristic of bioenergeticanalysis, behavior modification' or neurolinguistic programming, onthe one hand, and equally adept at the most receptive silence ofpsychoanalysis, which respects the necessarily creative process of self-discovern on the other.

This approach integrates what, rn Cbaracterological Transforma-tion,Irefer to as the conflict model of human pathology suggested bytraditional psychoanalytic theory with the deficit model contributedby the understandings of ego psychology, obiect relations, and selfpsychology. This integration allows one to consistently employ egobuilding techniques from cognitive and behavioral approaches on theone hand and conflict resolution techniques from psychoanalysis,Gestalt therapy, and bioenergetics on the other. This volume deline-ates the possible applications of this mixed model to the narcissisticcharacter structure, which develops out of failures both in individua-tion and in the necessary rapprochement with reality.

In Chapter I, I have briefly sketched the entire developmental-characterological model, providing a unified theory to inform thera-peutic intervention with the character disorders and character styles.Though this book is devoted to narcissism, at least some basic under-standing of the whole model is ne.cessary for effective therapeuticoperation in any specific case. This is so, in part, because pure narcis-sism, unaffected by other characterological issues, is extremely rare,if it exists at all. So, it is essential in any given case to be aware of theother interactive characterological issues which surround the narcis-sistic expression. In a sense, all characterological adaptations arenarcissisiic, in that they are defensive compensations to early injury.Understanding each of the basic types of injury and the characterolo-gical adaptations which they typically create is necessary for differen-

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10 Humanizing the I'larcissistic Style

tial diagnosis and treatment. In addition, this overall developmentalview assists the therapist in determining the individual's resources, aswell as his deficits. To do psychotherapy from the point of view ofpsychoanalytic developmental psychopathology, it is necessary to op-erate from an understanding of the entire developmental-charactero-logical model.

In this first chapter, as in all that follows, I have relied more heav-ily than in my prior rvork on the insights of Heinz Kohut. Kohut'sperspective is particularly useful when approaching the phenomeno-Iogical understanding of the development of self - so critical in un-derstanding narcissism. In addit ion, this more internal, phenomeno-logical approach assists us in understanding the experience of thenarcissist ic c l ient and helps us humanize our approach to him.

In Chapter II, I describe the narcissistic character structure. As inCbaracterological Transformation, the narcissistic conditions are dis-cussed employing the following outline:

o Et iologyo Affect, behavior, cognit iono Energet ic expressiono Therapeutic objectiveso Therapeutic techniques

Thus, in Chapter II, the archetypal etiological picture derived fromcharacter analysis, object relations, ego, and self psychology is pre-sented in detail. This is followed by a description of the archetypalpresentation of character as demonstrated in the individual's appar-ent and latent affect, characteristic behaviors, and characteristic atti-tudes, beliefs, and defenses. Following this, the insights of the bioen-ergetic therapists are used in a discussion of the energetic armoringcharacteristic of narcissism. Following this description, an outline oftherapeutic objectives is offered. Finally, the greater substance of thebook is devoted to the psychotherapy appropriate to narcissism.

Relative to Characterological Transformation, however, this bookis less a basic text; it assumes more practical knowledge of psycho-therapy and is less explicitly technique oriented. Here I present mod-els of human pathology and formulas for therapeutic technique.However, I want you to know that I know that these models andformulas are only that-maps of the territory to be understood, not

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Introduction 11

the territory itself. While they may guide the largely improvisationalinteraction of psychotherapy, they fail to fully capture the essentiallyartistic form that is the therapeutic process. It is rny intent to free up,rather than to constrain, our understanding and practice of psycho-therapy, so that more and more \^/e are limited only by the reality ofwhat our clients can use and less and less by the inherent constralntsof our models.

The material on treatment technique is organized around thetriadic presentation of self shown by the narcissistic person. ChapterIII discusses therapeutic responses to the syfttptomatic self , whichincludes depressive, somatic, and cognitively disordered symptoma-tology. Chapter IV is devoted to treating the mobilization of thenarcissistic defenses-the false self. Chapter V elucidates the treat-ment of the emotions and demands of the archaic real self function-ing in the matur ing pat ient .

Chapters VI and VII il lustrate, through transcripts of recordedsessions, the group and individual therapy of narcissistic patients.These extended case reports present an integration of group andindividual treatment modalities in two cases-one exemplifying thenarcissistic style and the other the narcissistic character disorder. Forme, rhis is the richest part of the book because it gives a moment-to-moment account of a dramatic process that otherwise can only beconceptualized. Further, the chapters are largel,v written b.v thosepeople I mentioned at the outset-my narcissistic clients rvho havegiven to one another and to me so freely, who have shared their painso openly, and who in that process have found their long-losr selves.

Chapter VIII addresses the issue of transformation. I now knowthat the transformation of narcissism is possible through a usuallylong and often painful process of psychotherapy employing the mixedmodel of conflict resolution and deficit repair. Is this possible rvithless pain and in less t ime? Or is the promise of that s imply thenarcissistically motivated, self-serving delusion of a few con artists?These are good questions better considered at the close of the w'orkyou will be doing by engaging, not just reading, this book.