Has perfectionism ever kept you from doing something you really want to do? Let's give it another name: SHAME. What is it and how do we keep it from sabotaging us? (SPOILER: Shame almost kept me from making this video!!) If you like this video, please subscribe to my YouTube Channel for more videos like this one :)
Who has it? What is it? How do we get it? Happiness is subjective for everyone, but happiness must be defined by every person in order to be tangible. How does one achieve a goal without measurable tasks? It seems impossible to seek happiness but not know what must be done daily to have it.
So what is happiness? I ask clients to pretend as though they have a magic wand which they will use to make their life happy overnight. Then I ask, 'what has changed?' I often hear crickets to this question because it is difficult to envision what needs to change in our lives in order to achieve happiness if we do not examine the elements that make up our own personal happiness. Many psychotherapists, psychologists, and others in helping professionals claim to be happiness experts, but in reality, everyone who comes to therapy is the master and expert of his or her own happiness. It takes applied self-exploration to know what comprises happiness for you.
What does happiness mean to you? Is it feeling fulfilled by your job and family? Is it obtaining a goal, like a college degree or promotion? Or is it living in the moment and taking in the beauty of your surroundings? Is happiness comprised of other emotions, such as relaxation, excitement, energy, concentration, sadness, despair, or contentment? These are great questions to ask, but the deeper question left unanswered is, what measurable/attainable tasks must I accomplish each day in order to achieve my goal of happiness?
Instead of thinking that happiness is something that happens to you, a passive state, try to conceptualize happiness as something that you cultivate and nurture daily. If your goal is to feel happiness and fulfillment for most of your day every day, the tasks of meeting this goal must be concrete and based on knowledge of yourself to inform your choices (e.g. eating ten cupcakes might make someone feel happy in the moment but may cause lethargy, anxiety, or depression in the coming hours or days. The net outcome is not happiness.)
Maintaining a mostly happy life involves hard work and dedication to your cause at times. For example, I know that 30 minutes to an hour of exercise every day makes me happier, calmer, and feel better. I still struggle to do this because it does not bring immediate satisfaction to me personally. It is hard work to put in the time to maintain happiness through exercise but I KNOW that if I broke down the net outcome hour by hour the net outcome would be happiness. It would look something like this:
Being happy and fulfilled can be exhausting, taxing, and overwhelming, especially if you struggle with depression, anxiety, or other life stressors. If this is the case, start small! Create a goal of feeling happy (or whatever positive feeling it is that you wish to feel) for 5 minutes, 15 minutes, or an hour every day. Don't focus on big, overwhelming goals, but rather look for small things that bring you happiness like drawing or painting, listening to music, dancing in your house, smiling, playing with an animal, or anything else that brings on feelings of happiness without detracting from your overall well-being.
What does a state of happiness look like to you? And what do you have to do daily to feel happy?
"How do I find the right therapist?" I am often asked this question and would like to preface my opinions by saying that they are just that – opinions. Therapists are as diverse as their clientele and I presume that all would have something to add to this discussion, or perhaps an entirely opposite perspective. If you are looking for a healing, caring, supportive, and emotionally challenging experience, this is my take.
1. All therapists are different, but I would say that the primary characteristic of importance in your therapist is that he or she tries to make you feel comfortable and wants to be present with you.
2. Having said that, everyone will be nervous at the beginning of therapy, your therapist included if he or she is human, so give yourself a few weeks to settle in. If you feel inclined, talk to your therapist about feeling nervous and he or she should response empathically.
3. Therapy can be funny and light-hearted at times, but you should not feel the need to impress or entertain your therapist.
4. Therapy can be humorous, intellectual, and emotional, but remember that intellectualism and humor can be used to defend against difficult emotions. Therapists are in the business of emotions, so you may be challenged to access your own at times.
5. You should feel safe in therapy at all times and your therapist should be able to create that safety with you.
Many of the clients I see have discussed "settling" with their previous therapist(s). He or she would listen most of the time, or was good enough is not an ideal therapeutic situation. You have the right to the right fit for you. If it isn't ideal, talk to your therapist about what is missing. If he or she responds in a way that upsets you, say that you're upset. If it gets to the point where you want to end the relationship because of this disconnect, talk about it. A relationship with a therapist should enhance your ability to have relationships in the real world. As a model of relationship, a therapist should encourage honesty, even when it is difficult, and should always have your interest first on the list of importance.
Step 1. Assess your needs.
What do you need and what do you want? You can have both needs and wants met in therapy with the right person. Read the following questions for guidance on your needs and wishes for therapy.
Are you going through a life transition like college, marriage, divorce, parenthood, or late adulthood?
Are you a member of an oppressed group? Is it important to you that your therapist is a part of this group or has special training around your difference?
Will it be difficult for you to speak to a stranger for the first time?
Have you had therapy experiences in the past that did NOT work? What was missing?
Are you depressed, anxious, sad, or do you have a dominating emotion that comes to mind?
Have you consulted a medical professional and if so, what does he or she recommend?
Do you just want to talk and have someone listen?
Do you want to explore your past or focus on the present? Or both?
Do you want to be challenged or supported unconditionally?
Do you want to talk about goals and be accountable to your therapist in attaining them?
Do you seek structure or freedom in therapy?
Are you more comfortable with a particular gender, and why? Would it be helpful to you to have a therapist representing the gender of comfort or perhaps to have a new experience with the gender you do not prefer?
Are you comfortable with a particular age group, and why? How would your experience be enhanced or compromised with different age groups?
What are you able to pay for therapy?
Step 2. Find a recommended therapist
Word of mouth is the most helpful way of finding a clinician but more and more, therapists are advertising and promoting themselves online. There are some websites that verify the credentials of the therapists who are advertising (psychologytoday.com, goodtherapy.org) so make sure that the therapists you read about have credentials.
Money is usually an uncomfortable topic for most people, but prospective therapists should be clear about charges when asked. Some therapists work on a “sliding scale” basis, meaning that they have different rates depending on financial need. If you are in need of financial assistance, think about what you are able to pay and ask the therapist if the rate would be acceptable.
LPC-i and LPC – These therapists are master’s level professional counselors who are seeking or have obtained a clinical licensure. You can expect to pay more to see an LPC than an LPC-Intern.
LMSW and LCSW – These therapists are master’s level social workers who are seeking or have obtained a clinical licensure. You can expect to pay more to see an LCSW than an LMSW.
Psy.D. or PhD. - Psychologists are doctorate level clinicians who perform therapy and also focus on psychological assessment or testing. Psy.D. is a newer degree plan focusing on clinical psychotherapy as well as research and testing. You can expect to pay more for a doctorate level clinician than an LPC or an LCSW.
M.D. or D.O. - Psychiatrists are medical doctors who are primarily focused on psychobiological assessment and medication management for patients. Some psychiatrists are trained in psychotherapeutic techniques but most have little training in psychotherapy. You can expect to pay the most for a psychiatrist since he or she has a medical license and can prescribe medication.
Unfortunately, when assessing therapists one can rarely tell which will be a fit on paper. You may be able to read a bio on the therapist that may help you get a feel for his or her personality and theoretical leanings, but having a conversation is the best way to assess goodness of fit.
Use the questions from Step 1 to guide you in expressing your needs and ask about their training, specialties, and areas of practice. Despite the traditional hierarchy, you may find your needs anywhere in this ranking of therapists.
Step 3: Get to know the therapist
In order to assess fit, one has to “talk the talk” in some ways to understand how a therapist operates. Read up on types of therapies and you may find that one resonates with you.
Psych Central's article on Psychotherapy - check out the types of therapy on the left index
Ask questions and expect to get your needs met! This principle is basic to living a life with healthy self-esteem and self-care.
As always, take care.
Why therapists must be allies and advocates for clients of different races, religions, sexual orientations, sizes, ethnicity, genders, and any other point of diversity.
I wrote this post after an incredibly fulfilling discussion among colleagues about power and privilege in the therapy room. A colleague bravely disclosed that she feels that she should bring up the different racial backgrounds between her and a client of several months. The client is Latina and the therapist is white. The therapist feels at times that she is missing some of who the client is because she's a "white lady" talking to a person of color and that the client could be holding back parts of herself in therapy because race has not been addressed. Some felt that she should wait for the appropriate time to bring it up and some said that she should bring it up as soon as possible.
We arrived at the conclusion that as a therapist, we are put in a position of power from the beginning of every session. We automatically sit in the chair with privilege as we delineate the "rules" of therapy, collect payment from clients, and are the ones to say when time is up. When the therapist is in the position of power as the therapist and is in a position of power and privilege in society, it is doubly important to bring up issues of difference in the room so that the client can be free to explore, tell the truth, and be him/herself.
Here is how it could play out. A white, female therapist sees a black woman who comes to therapy every week. The client talks about work stress and her family life but feels she must leave out any mention of racism at work or family dynamics that are central to her culture because the therapist may reject her thinking. One day, the therapist brings up their difference; "you are black, and I am white. What's it like to talk to a white person about this?" It may be an uncomfortable moment for one or both of the two women, but now, the topic of race is on the table. Perhaps the client can label racism at work or explain family dynamics within her home and the black community once the issue is opened by the person who is seemingly in power.
When we hold power over our clients, we limit them from being able to have power in their own lives. Clients should feel empowered in session, even if not in society, to talk about issues of race, gender, sexuality, religion, language, or any other topic of dis-empowerment in their lives. The key to making this happen as a helping professional is a) recognizing your own privilege, and b) bringing up the difference between yourself and the client in session any time it could affect the therapy.
Our privileges can be things that are not conscious in our minds, like money, having a healthy marriage, having children, dressing nicely, speaking a certain way, being educated, feeling confident, being physically fit... it doesn't take a white, straight, male to trigger feelings of inadequacy, privilege, and power in a client.
Here's the really important part for clinicians and what I learned from the wisdom of the group; waiting until it's "comfortable" to talk about issues of diversity is a privilege as well. When I say that, I mean that when we think to ourselves, 'gosh, it's just not the right time,' or 'that would make things really awkward right now, I'd better wait,' the person who is on the other side deals with that discomfort every day, everywhere he or she goes, and with everyone he or she meets. If you are gay, you don't have the privilege of avoiding the topic of being gay. Straight people, however, do have the privilege of avoiding the topic of being straight because it's "the norm" in our society. (I put "the norm" in quotations because it is a terrible social construct that I do not wish to reinforce but is a more than prevalent thought, conscious and unconscious, so prevalent that we cannot ignore it if we are to disassemble it.)
Take your own difference and use it to have empathy for others.
If you have never read Brain Pickings, I highly recommend this thoughtful, well-done, search for "interestingness" spear-headed by Maria Popova (@brainpicker) and the occasional guest writer. The writing at first glance often appears outside my comfort zone, but I'm usually drawn in to subjects that I might naturally toss aside as too lofty or inapplicable to my daily life (i.e. too daunting/time-consuming/intellectual for moi). I love Popova's style; she can take a subject that is over my head and make it tangible and fascinating. Many times I find that these subjects intertwine with my own life, as a therapist and a person, more than I would have imagined upon reading the title. Cue my interest in F. Scott Fitzgerald on the Secret of Great Writing, a.k.a. 'how to be a great writer by one of the most famous writers of all time,' as my self-valuation interprets.I love to write, I aspire to reach other and connect through writing, so naturally this title both titillates and terrifies me. It triggers the immediate, vulnerable, knee-jerk, "am I good enough?" reaction that is the inevitable cost of putting ourselves "out there" for the world to see. Popova references a letter written by Fitzgerald to a young woman, a college sophomore, and family friend who sent her writing to him, presumably for critique and guidance. I don't know if this young person, Frances, was expecting honesty or fluff... but she got honesty. In Fitzgerald's response he references the "price of admission," or the cost of great writing quite harshly to an aspiring young writer. An excerpt:
"November 9, 1938
I've read the story carefully and, Frances, I’m afraid the price for doing professional work is a good deal higher than you are prepared to pay at present. You've got to sell your heart, your strongest reactions, not the little minor things that only touch you lightly, the little experiences that you might tell at dinner. This is especially true when you begin to write, when you have not yet developed the tricks of interesting people on paper, when you have none of the technique which it takes time to learn. When, in short, you have only your emotions to sell.
This is the experience of all writers. It was necessary for Dickens to put into Oliver Twist the child’s passionate resentment at being abused and starved that had haunted his whole childhood. Ernest Hemingway’s first stories ‘In Our Time’ went right down to the bottom of all that he had ever felt and known. In ‘This Side of Paradise’ I wrote about a love affair that was still bleeding as fresh as the skin wound on a haemophile...
That, anyhow, is the price of admission. Whether you are prepared to pay it or, whether it coincides or conflicts with your attitude on what is ‘nice’ is something for you to decide. But literature, even light literature, will accept nothing less from the neophyte. It is one of those professions that wants the ‘works.’ You wouldn’t be interested in a soldier who was only a little brave.
In the light of this, it doesn’t seem worth while to analyze why this story isn’t saleable but I am too fond of you to kid you along about it, as one tends to do at my age. If you ever decide to tell your stories, no one would be more interested than,
Your old friend,
F. Scott Fitzgerald
P.S. I might say that the writing is smooth and agreeable and some of the pages very apt and charming. You have talent — which is the equivalent of a soldier having the right physical qualifications for entering West Point."
Ouch, Frances. Ouch.
You may be wondering, as was I, why I felt as we may say in the therapy world over-identified with the recipient of this letter. Why would I focus on the potential hurt feelings of a stranger who aspired to write over seventy years ago and was given such a harsh critique? The obvious answer is that I'm focused on emotions in general. I did not accidentally arrive in the field of social work and therapy. A natural draw toward and affinity for emotional care and compassion led me here. The not-so-obvious answer is that I too fear judgment, harsh criticism, and critique as a writer, as a therapist, and as a person.
The vulnerability of writing, especially about matters of the heart weighs on me as much as it enriches my life. I write because it allows me to make sense of the pain, elation, and all feelings in between in the human experience. Rarely do I write of my own feelings because it is challenging, less comfortable, and scary. I could blame some lofty principles of maintaining my role as a therapist (which is a very important and entirely different discussion), but it is the feelings of vulnerability that usually hold me back. When I do share parts of myself and write about things that are subversive, I feel exposed, anxious, and at times, irrelevant. I worry that I've said 'too much,' gone 'too far,' or have been 'self-indulgent,' all judgments that I have made up in my head based on my own anxiety, experiences, and elaborations...
Writing can be a gut-wrenching process of displaying your inner-world, word by word, and opening oneself to strangers much like the courageous work of therapy participants. In many ways, I write to experience this vulnerability, risk, and potential benefit of exposure as a constant reminder of the risks that clients take. It is a reminder of the emotional cost paid by the brave people who sit in the chair and share their inner-selves and the respect, kindness, and admiration that is deserved for such an endeavor. There is a monetary investment for therapy as well which is a valuable topic of exploration, but they also pay with their honesty, their fear, their vulnerability, and the spoken or unspoken hopes and disappointments. At times, this is a high cost, more so than money.
Without hiding behind principles of "being a therapist," I'll share a specific fear that edits my writing, words, and thoughts. It is the fear of not being liked. There are variations of this fear, such as not being nice, agreeable, palatable, competent, or pleasant. Talking about things that are hard to talk about, uncomfortable, opinionated, or divisive also scare me. These fears are all bi-products of my upbringing and training as a woman, a social worker, and a therapist but to what end? These are questions that my clients ask of themselves and usually end up with a resounding sense of entitlement to feel, express, and be who they are. Undoubtedly being yourself is hard, and I'm not immune.
Lately, my reflections on this topic have turned toward a deep sense of gratitude for the opportunity to share myself with others and receive the kindness, accolades, and positive feedback that I've received as a result of writing, speaking, and being myself. In hindsight, when I am met with "negative" emotions from someone - disagreement, anger, and even contempt at times - the hurt feelings and vulnerabilities that I'm forced to acknowledge are far outweighed by the learning, the growth, the opportunity to practice compassion toward myself and others, and the disarming of my own defenses. These are valuable and sometimes priceless experiences.
As always, take care of yourself (while also stretching and growing when the time is right.)
I joke, but it must be true! Hangovers can be particularly brutal because they can come with so much mental, physical, and emotional turmoil. Most commonly, those who suffer from severe symptoms find that their hangovers come with lots of anxiety. People feel badly about themselves, ashamed of their behavior, and generally feel negatively about life when in this state.
Hangovers can cause extreme anxiety as a symptom of the withdrawal from alcohol or other substances. Alcohol is a depressant, which means it slows the central nervous systems and blocks the brain's ability to produce stimulating chemicals. The withdrawal from this state of depression turns the system up-side-down. If we think of depression and anxiety on a spectrum, with depression at the far right and anxiety at the far left side, you can picture a pendulum swinging from one extreme to the other.
While withdrawing from alcohol, the body overcompensates by "swinging" to the left, toward anxiety. The central nervous system is very activated and the brain is producing stimulating chemicals, but the body and brain are tired, unrested, and confused. Especially for those who suffer from anxiety naturally, this can be a powerful and awful experience.
Tips for getting through a hangover:
1. Take it easy on yourself. If you are turning your anxiety inward, meaning you are thinking bad thoughts about yourself, know that they are chemically induced. Have a mantra and repeat it - "these thoughts aren't real and I'm ok." Don't make any big decisions or sweeping judgments while in this state - that may not be possible but try not to act on any of them!
2. Despite your urge to eat the entirety of the fast food menu, eat something good for your body. A salad with veggies or some fruit can get you on your way back to health. Alcohol also dehydrates the body so drink lots of water.
3. If you can bear it, exercise. Exercise stimulates all the right chemicals in your brain to release and ease your body and mind. It can also speed the release of toxins so that you can feel better faster. Even a brisk walk can make you feel better since some say that fresh air is a cure to hangovers.
Happy New Year! Take good care of yourselves.
In the presence of darkness, we break, we wound, and we crumble inside; in the presence of kindness, openness, and love we heal with one another. When asked what my "style" of therapy is, I spout an eclectic mixture of therapies like "psychodynamic, supportive, and relational psychotherapy," but I truly believe that the most important element that can lead to healing in a therapeutic relationship is the connection between the therapist and client. This is not a typical connection, because it is not reciprocal; it is only intended to serve the client's interest. But it can be even more powerful in healing broken hearts and wounded souls because of the commitment of the therapist to the client.
Many esteemed researchers have come to the same conclusion through different avenues. Scholars like John Bowlby, Alan Schore, Daniel Siegel, and Robert Karen would liken this connection in therapy to healing wounds from lost or ruptured attachments in childhood and adulthood. There is neurological research proving that being in connection with another person can actually create new neurocircuitry, or pathways, in the brain in order to form new attachments to others (Schore, 2003). The authors of Relational-Cultural theory discuss connection as a "growth fostering relationship" leading to a fuller, happier life, as opposed to disconnection as "empathic failures" and missed opportunities (Jordan, Kaplan, Miller, Stiver, & Surrey, 1991; Jordan, 1997; Miller & Stiver, 1997). The arrival at this conclusion, that people heal in relationship with one another, is empirically undeniable.
But what does this look like in the therapy room? Many will experience it as discomfort at first because it feels unusual to have someone in front of you who needs nothing from you and is there to openly explore your psyche. I hope to alleviate some of that discomfort for those of you who are reading because therapists are humans too and we are both engaged in the process of relationship building the moment you walk in the door.
The experience "in the chair" can be enlightening for some in that it brings up feelings that are universal throughout the person's life. For example, a person comes to therapy with severe social anxiety. He tells the therapist this piece of information and the therapist responds by saying, "what a brave move you have made coming here since you are so scared to leave the house." The client may feel discomfort, vulnerability, and like he is being seen and heard, feelings he is uncomfortable with in the outside world and in the therapy room. The question is, what do you do with those feelings? Is the therapy room safe enough to explore those feelings of discomfort?
It is the therapist's job to make sure there is as much safety as possible for the client. In order for there to be safety, the client must understand that the therapist will be non-judgmental and genuinely caring. She must also know that the things she says are confidential and will be kept safe with the therapist. The client must also know that the therapist is taking care of herself and will continue to do so throughout the relationship. For example, the client must know that his therapist will show up on time, will hold to their agreements, will have taken care of her own needs so that she is present, follows her code of ethics in order to maintain a practice, and is working in the best interest of the client.
This is not to suggest that the skills therapists learn from other empirical research is useless. There is skill involved in exploration and presence while witnessing such important work. However, we heal through one another and it should be known that if you are experiencing emotions like discomfort, tension, frustration, resentment, happiness, or any other feeling, especially toward the therapist, they should be welcomed in the therapy room. They are incredibly helpful keys to unlocking closed doors in our minds and discovering how we behave in the outside world. They can also lead to healing old wounds and finding new ways to open one's heart to others.
If you're having an, "oh great, one more thing to worry about" response to the unfamiliar word "Co-Narcissism," you're not alone. I am not a proponent of inventing and loosely wielding new psychological problems, diagnoses, and concerns for people seeking help and understanding through their interpersonal conflicts, low self-esteem, and a myriad of other problems that we experience in relationship with others. At times, I believe that labeling, classifying, and over-extending our language around mental well-being can create an overwhelming sense of helplessness. However, after reading "Co-Narcissism: How We Accommodate to Narcissist Parents," by Alan Rappoport, Ph.D. I felt eager to share this article because it has the potential to provide clarity, compassion, and peace of mind for those struggling to understand his or her complex relationships with parents, partners, children, and other significant others.
Whether you are a therapy participant, a therapist, or simply curious about relationships, I can say with near certainty that this topic will resonate with you. I hope this new term can be added to our vernacular of interpersonal dynamics and provide insight to those who are looking for healthy ways of connecting by examining existing, learned patterns of relating to the world. As you read, remember that there is no one interpretation through which you can see yourself or your loved ones. I will also add, in an effort to quell the mounting anxiety of those who fear that being termed "Co-Narcissistic" is a negative attribute, it is not. It is one of many lenses through which you may find answers to your questions as you reflect on your upbringing, behavior, depression, anxiety, and relationship patterns. In the words of Alan Rappoport, Ph.D.:
"This article introduces the term “co- narcissism” to refer to the way that people accommodate to narcissistic parents. I use the term narcissism here to refer to people with very low self-esteem who attempt to control others’ views of them for defensive purposes. They are interpersonally rigid, easily offended, self -absorbed, blaming, and find it difficult to empathize with others. Co- narcissistic people, as a result of their attempts to get along with their narcissistic parents, work hard to please others, defer to other’s opinions, worry about how others think and feel about them, are often depressed or anxious, find it hard to know their own views and experience, and take the blame for interpersonal problems. They fear being considered selfish if they act assertively.
If any of this sounds familiar, strap in for a fascinating read.
Reprinted with gratitude and the permission of Alan Rappoport, Ph.D. A PDF version of this article can be found among his publications on his website. If you would prefer to hear a reading of this article, Paul Gilmartin of The Mental Illness Happy Hour podcast (http://mentalpod.com/) shares it with his listeners here.
Co-Narcissism: How We Accommodate to Narcissistic Parents Alan Rappoport, Ph.D.
This article introduces the term “co- narcissism” to refer to the way that people accommodate to narcissistic parents. I use the term narcissism here to refer to people with very low self-esteem who attempt to control others’ views of them for defensive purposes. They are interpersonally rigid, easily offended, self -absorbed, blaming, and find it difficult to empathize with others. Co- narcissistic people, as a result of their attempts to get along with their narcissistic parents, work hard to please others, defer to other’s opinions, worry about how others think and feel about them, are often depressed or anxious, find it hard to know their own views and experience, and take the blame for interpersonal problems. They fear being considered selfish if they act assertively. A high proportion of psychotherapy patients are co-narcissistic. The article discusses the co-narcissistic syndrome and its treatment, and gives case examples of patients who suffer from this problem.Narcissism
Narcissism, a psychological state rooted in extremely low self-esteem, is a common syndrome among the parents of psychotherapy patients. Narcissistic people are very fearful of not being well regarded by others, and they therefore attempt to control others’ behavior and viewpoints in order to protect their self-esteem. The underlying dynamic of narcissism is a deep, usually unconscious, sense of oneself as dangerously inadequate and vulnerable to blame and rejection. The common use of the term refers to some of the ways people defend themselves against this narcissistic dynamic: a concern with one’s own physical and social image, a preoccupation with one’s own thoughts and feelings, and a sense of grandiosity. There are, however, many other behaviors that can stem from narcissistic concerns, such as immersion in one’s own affairs to the exclusion of others, an inability to empathize with other’s experience, interpersonal rigidity, an insistence that one’s opinions and values are “right,” and a tendency to be easily offended and take things personally.
A high proportion of people in psychotherapy have adapted to life with narcissistic people and, as a result, have not been able to develop healthy means of self- expression and self-directedness. I have coined the term “co-narcissism” for this adaptation, which has the same relation to narcissism as “co-alcoholic” has to alcoholism and “co-dependent” has to dependency. Co-alcoholics unconsciously collaborate with alcoholics, making excuses for them and not confronting them about their problem in an assertive way. The same is true of the co-dependent person, who makes excuses for the other’s dependency and fills in for him or her as necessary. The wife of an abusive husband who takes the blame for her partner’s behavior is another example of taking responsibility for someone else’s problems. Both narcissism and co-narcissism are adaptations that children have made to cope with narcissistic parenting figures. To the best of my knowledge, every narcissistic and co- narcissistic person that I have encountered has had narcissistic parents, and the parents of their parents are reported to have been even more highly narcissistic.
To the extent that parents are narcissistic, they are controlling, blaming, self-absorbed, intolerant of others’ views, unaware of their children’s needs and of the effects of their behavior on their children, and require that the children see them as the parents wish to be seen. They may also demand certain behavior from their children because they see the children as extensions of themselves, and need the children to represent them in the world in ways that meet the parents’ emotional needs. (For example, a narcissistic father who was a lawyer demanded that his son, who had always been treated as the “favorite” in the family, enter the legal profession as well. When the son chose another career, the father rejected and disparaged him.) These traits will lead the parent to be very intrusive in some ways, and entirely neglectful in others. The children are punished if they do not respond adequately to the parents’ needs. This punishment may take a variety of forms, including physical abuse, angry outbursts, blame, attempts to instill guilt, emotional withdrawal, and criticism. Whatever form it takes, the purpose of the punishment is to enforce compliance with the parents’ narcissistic needs.Co-Narcissism
Children of narcissists tend to feel overly responsible for other people. They tend to assume that others’ needs are similar to those of their parents, and feel compelled to meet those needs by responding in the required manner. They tend to be unaware of their own feelings, needs, and experience, and fade into the background in relationships.
Co-narcissistic people are typically insecure because they have not been valued for themselves, and have been valued by their parents only to the extent that they meet their parents’ needs. They develop their self-concepts based on their parents’ treatment of them and therefore often have highly inaccurate ideas about who they are. For example, they may fear that they are inherently insensitive, selfish, defective, fearful, unloving, overly demanding, hard to satisfy, inhibited, and/or worthless.
People who behave co-narcissistically share a number of the following traits: they tend to have low self-esteem, work hard to please others, defer to others’ opinions, focus on others’ world views and are unaware of their own orientations, are often depressed or anxious, find it hard to know how they think and feel about a subject, doubt the validity of their own views and opinions (especially when these conflict with others’ views), and take the blame for interpersonal problems.
Often, the same person displays both narcissistic and co-narcissistic behaviors, depending on circumstances. A person who was raised by a narcissistic or a co- narcissistic parent tends to assume that, in any interpersonal interaction, one person is narcissistic and the other co-narcissistic, and often can play either part. Commonly, one parent was primarily narcissistic and the other parent primarily co-narcissistic, and so both orientations have been modeled for the child. Both conditions are rooted in low self- esteem. Both are ways of defending oneself from fears resulting from internalized criticisms and of coping with people who evoke these criticisms. Those who are primarily co-narcissistic may behave narcissistically when their self-esteem is threatened, or when their partners take the co-narcissistic role; people who primarily behave narcissistically may act co- narcissistically when they fear being held responsible and punished for another’s experience.
Narcissistic people blame others for their own problems. They tend not to seek psychotherapy because they fear that the therapist will see them as deficient and therefore are highly defensive in relation to therapists. They do not feel free or safe enough to examine their own behavior, and typically avoid the psychotherapy situation. Co-narcissists, however, are ready to accept blame and responsibility for problems, and are much more likely than narcissists to seek help because they often consider themselves to be the ones who need fixing.
The image I often keep in mind, and share with my patients regarding narcissism, is that the narcissist needs to be in the spotlight, and the co-narcissist serves as the audience. The narcissist is on stage, performing, and needing attention, appreciation, support, praise, reassurance, and encouragement, and the co-narcissist’s role is to provide these things. Co-narcissists are approved of and rewarded when they perform well in their role, but, otherwise, they are corrected and punished.
One of the critical aspects of the interpersonal situation when one person is either narcissistic or co-narcissistic is that it is not, in an important sense, a relationship. I define a relationship as an interpersonal interaction in which each person is able to consider and act on his or her own needs, experience, and point of view, as well as being able to consider and respond to the experience of the other person. Both people are important to each person. In a narcissistic encounter, there is, psychologically, only one person present. The co-narcissist disappears for both people, and only the narcissistic person’s experience is important. Children raised by narcissistic parents come to believe that all other people are narcissistic to some extent. As a result, they orient themselves around the other person in their relationships, lose a clear sense of themselves, and cannot express themselves easily nor participate fully in their lives.
All these adaptations are relatively unconscious, so most co-narcissistic people are not aware of the reasons for their behavior. They may think of themselves as inhibited and anxious by nature, lacking what it takes to be assertive in life. Their tendency to be unexpressive of their own thoughts and feelings and to support and encourage others’ needs creates something of an imbalance in their relationships, and other people may take more of the interpersonal space for themselves as a result, thereby giving the impression that they are, in fact, narcissists, as the co- narcissist fears they are.
Co-narcissistic people often fear they will be thought of as selfish if they act more assertively. Usually, they learned to think this way because one or both parents characterized them as selfish if they did not accommodate to the parent’s needs. I take patients’ concerns that they are selfish as an indication of narcissism in the parents, because the motivation of selfishness predominates in the minds of narcissistic people. It is a major component of their defensive style, and it is therefore a motivation they readily attribute to (or project onto) others.
There are three common types of responses by children to the interpersonal problems presented to them by their parents: identification, compliance, and rebellion (see Gootnick, 1997, for a more thorough discussion of these phenomena). Identification is the imitation of one or both parents, which may be required by parents in order for them to maintain a sense of connection with the child. In regard to narcissistic parents, the child must exhibit the same qualities, values, feelings, and behavior which the parent employs to defend his or her self-esteem. For example, a parent who is a bully may not only bully his child, but may require that the child become a bully as well. A parent whose self- esteem depends on his or her academic achievement may require that the child also be academically oriented, and value (or devalue) the child in relation to his or her accomplishments in this area. Identification is a response to the parent seeing the child as a representative of himself or herself, and is the price of connectedness with the parent. It results in the child becoming narcissistic herself.
Compliance refers to the co-narcissistic adaptation described earlier, wherein the child becomes the approving audience sought by the parent. The child is complying with the parent’s needs by being the counterpart the parent seeks. All three forms of adaptation (identification, compliance, and rebellion) can be seen as compliance in a larger sense, since, in every case, the child complies in some way with the needs of the parent, and is defined by the parent. What defines compliance in this sense is that the child becomes the counterpart the parent needs from moment to moment to help the parent manage threats to his or her self- esteem.
Rebellion refers to the state of fighting to not accept the dictates of the parent by behaving in opposition to them. An example of this behavior is that of an intelligent child who does poorly in school in response to his parent’s need that he be a high achiever. The critical issue here is that the child is unconsciously attempting to not submit to the parent’s definition of him despite his inner compulsion to comply with the parent’s needs. He therefore acts in a self- defeating manner in order to try to maintain a sense of independence. (If the pressure for compliance had not been internalized, the child would be free to be successful despite the parent’s tendency to co-opt his achievements.)Psychotherapy
Co-narcissistic people automatically and unconsciously assume that everyone is narcissistic. They have the same fear about the therapist, but are able to enter treatment because they also believe that the therapist may be different. The most significant aspect of co-narcissistic patients’ work in therapy consists of determining to what degree the therapist is narcissistic. We might even say that the therapy consists of helping the patient develop confidence that the therapist is not narcissistic . It is powerfully healing for the patient to experience a relationship that is not based on narcissism. Co-narcissistic people are therefore greatly helped by the therapist’s embodiment of Carl Rogers’ principles of accurate empathy, interpersonal warmth and positive regard, and personal genuineness. These behaviors by the therapist provide a direct contradiction to the experiences that have caused their problems. Patients will seek to determine how safe they are not to accommodate their behavior to the therapist’s imagined needs, but to be able to experience and express themselves freely. The patient will carefully observe the therapist’s behavior and make judgments about how much the therapist is able to consider the needs of the patient and how open he or she is to the patient’s experience. The patient will also want to see that the therapist is not co-narcissistic, so that the patient can use the therapist as a model who shows by example that she or he believes it is safe to be assertive and not to orient oneself around another’s needs. The patient will therefore observe the therapist for signs of how assertive he or she is, and also pay attention to examples the therapist may provide from his or her own life to assess how free of co-narcissism the therapist may be.
In addition to the beneficial effect of the relationship between therapist and patient, a major part of the therapy process involves understanding how events and experiences in patients’ early lives resulted in their current fears, inhibitions, and orientation towards others. I find it very helpful in my work as a therapist to explain narcissism and co-narcissism to my patients. Having an intellectual understanding of the nature of the problem goes a great distance towards helping them make sense of their lives and why their relationships take on the characteristics that they do. It also gives us a framework within which we can discuss the issues of concern to them, and helps them understand what to work on to free themselves from these problems. A description of my own theoretical approach can be found in the books, TransformativeRelationships (Silberschatz, 2005) and HowPsychotherapyWorks(Weiss, 1993).
Narcissistic people seek therapy much less frequently than those who are primarily co- narcissistic, and are more difficult to help. Their deep-seated conviction of their own worthlessness, and their strong defenses against the therapist discovering this “truth” about them, makes it difficult for them to feel safe with the therapist and to benefit from the therapeutic relationship. The therapist also has to cope with the patient’s poor ability to empathize with the therapist. This lack of empathy is manifest in a variety of inconsiderate behaviors, and can challenge the therapist’s ability to maintain a good sense of self-esteem. Narcissistic people, compared to co-narcissistic people, are therefore less personally satisfying for the therapist to work with when they do seek treatment. They are also less professionally rewarding to work with because of their difficulty in engaging in the therapeutic process. Treating them empathically, helping them to feel safer to empathize with others, not losing self-esteem in the face of inconsiderate behavior by the patient, and expressing one’s own experience as appropriate are all important elements in working with narcissistic people. (Once, when I told a narcissistic patient of mine that her criticisms of me were hurting my feelings, she was astonished. She said that she had no idea that her behavior had any effect on anyone. She became much kinder towards me following that interaction.) As with the co-narcissistic person, helping the person to gain an understanding of the origins of their problems (usually identification with a narcissistic parent) can also be very useful.Case Examples
Mario is the son of two narcissistic parents. His parents divorced when he was ten, and, thereafter, he spent half the week in each parent’s home. The difficulties this arrangement caused for him went unrecognized by either parent. Mario’s father was so isolated and self-centered that, during the times they were together, Mario was often completely ignored by his father and learned to endure long hours of loneliness without complaint. Mario’s mother was more able to engage with her son, as long as he was careful to attend to her emotional needs and not to make demands on her. Both parents moved frequently, making it hard for Mario to form friendships and develop a sense of connectedness, interpersonal security, and good self esteem outside of his immediate family. What proved of immense value to Mario in preventing more severe psychological damage than he might otherwise have suffered was that he spent summers with members of his extended family in Spain. These people were much healthier psychologically, and the relationships he had with them were supportive and rewarding.
Some of the effects of Mario’s upbringing were: a diminished awareness of his own feelings, needs, and point of view; a tendency to feel isolated and a difficulty connecting emotionally with others; a tendency to accept blame, control by others, and mistreatment without complaint and often without awareness that it was happening; and a loss of a sense of direction and purpose in life. He could also be moody and irritable.
As a teenager, Mario formed a relationship with Jill, whose parents were psychologically healthier, but whose mother was somewhat narcissistic. Her familiarity with narcissism and co-narcissism helped her relate to Mario, and Mario benefited by spending time with Jill’s family who were warm and accepting towards him. Mario and Jill eventually married and had two children. Mario did not finish college despite his high intelligence, but was successful in his career in business. He came to therapy at the insistence of his wife, who was troubled by his difficulty in forming good relationships with the children and his tendency to be interpersonally disconnected and insensitive. She was also troubled by the degree of influence his parents had over him. Mario had some appreciation for the validity of Jill’s concerns, and was distressed by the problems that occurred in his relationship with Jill.
Mario made good use of therapy. He initially discussed his wife’s concerns, and the problems these created for him. Her concerns primarily centered around his tendency to isolate himself, to go about his affairs without considering his effect on others, and not to maintain or value a close emotional connection with his children. She was also concerned about his tendency to idealize his parents, particularly his mother, and to make excuses for her behavior and not to recognize her self-centeredness with regard to himself or his family members. But Mario soon was able to understand how the experiences he had with his parents made it difficult for him to relate to others in a way that was satisfying to himself or to the other person. He appreciated the therapist’s interest in him, his ability to think about things from Mario’s point of view, and the value there was in understanding how his past experiences affected his current view of himself and others. In addition to spending time analyzing Mario’s past and current relationships, many of the sessions consisted of Mario’s describing his daily activities and his plans for the future. It was very beneficial to him to have someone who was interested in listening to him and who enjoyed learning about him and sharing his life. Other than in his relationship with Jill, this was a new experience for him, and it greatly helped him to have a better sense of self-esteem. The key for Mario, and for most people who suffer from the narcissistic/co- narcissistic dilemma, was to experience a relationship in which neither person has to sacrifice himself for the other, and each can appreciate what the other has to offer. While the therapy relationship is focused on the patient, it is important that the therapist engage in it as a real relationship, so that the patient can benefit from the experience of a healthy relationship in which both participants can express themselves and find value and satisfaction in their experience with each other.
As the therapy progressed, Mario reported enjoying his children more, feeling less co-opted by his mother and seeing her more clearly, isolating himself less, and experiencing a greater enjoyment of his life and the people in it.
Jane is the daughter of a narcissistic father and a co-narcissistic mother. Jane’s father was domineering with the family and with his employees in the highly successful business he built, although, interestingly, he was quite co-narcissistic in relation to his own father. Jane’s father was highly critical of her, her sister, and her mother. Jane’s mother had been severely rejected and criticized as a child and, as a result, she developed a strong sense of worthlessness, a loss of inner-directedness, and a tendency to accommodate to the expectations of others. Jane’s mother twice tried to divorce her husband, but her low self-esteem prevented her from doing so; nevertheless, she did decide to go to graduate school while raising her children, earned a Ph.D. in art, and taught at the college level. However, the criticism and denigration she received from her husband reinforced her low sense of self-esteem and prevented her from recognizing her talents or respecting herself. Jane, despite her high intelligence and independent spirit, did not do well either in school or socially. She seemed to lack the motivation to succeed, although while in college she started a home design business and consulted in graphic design. None of her efforts brought recognition or approval from her father, who was relentlessly disparaging. As a result of the constant undermining by her father, and the co-narcissistic model presented by her mother, Jane came to believe that she was unable to succeed in a career and could not form satisfying, stable relationships. Her relationships were marked by self-sacrifice, and she had no direction in her life.
Jane made good use of her therapy. Initially, she described the ways in which her family was dysfunctional, and she gained confidence in the accuracy of her views by the therapist’s agreement with her assessment. She also tested whether the therapist needed to criticize her by characterizing herself as inadequate in a variety of ways, but the therapist showed, by expressing a more positive and realistic view of her, that he had no wish to put her down. He explained these inadequacies as a compliance with her father’s characterizations of her and her identification with her mother. The therapist also pointed out her many talents, her creativity, initiative, and intelligence. Jane was able to make use of this support by doing better at school, becoming less enmeshed with her family, and starting a new graphic design business. Jane was late for a number of sessions, thereby again testing the therapist’s wish to be critical or disparaging of her, as her father would have done. Instead of being critical, the therapist interpreted these latenesses as an inhibition against acting in her own interests by getting the full benefit of her therapy, and therefore a compliance with her father’s view of her. Jane took heart from the therapist’s reactions by continuing to develop healthier personal relationships, being less subservient to her father, and becoming more assertive and successful in the pursuit of her education.Conclusion
All of us are narcissistic, and co-narcissistic, to varying degrees. When our self-esteem varies in relation to how others think and feel about us, we are experiencing a narcissistic vulnerability. When we feel helpful in overcoming narcissistic anxieties to realize that the other person’s behavior is a result of their own views and experience, is not a reflection on oneself, and one’s self- esteem does not have to be affected by their behavior. For co-narcissistic people, who experience strong feelings of guilt and blame, recognizing that they are not responsible for another’s experience is a great relief. It is important for people with either narcissistic or co-narcissistic problems to come to believe that they have intrinsic value, independent of their accomplishments or what others may think of them.
The reader is referred to Elan Golomb’s book, Trappedin the Mirror (1992) for a variety of examples of narcissistic/co- narcissistic parent-child relationships. Another discussion of narcissism can be found in Children of the Self-Absorbed (Brown, 2001).References
Brown, Nina W. (2001). ChildrenoftheSelf-Absorbed. Oakland, Ca: New Harbinger
Golomb, Elan PhD (1992). Trappedin the Mirror. New York: Morrow
Gootnick, Irwin MD (1997). Why You Behave in Ways You Hate: And What You Can Do About It. Roseville, Ca.: Penmarin Books.
Silberschatz, George, PhD, Ed. (2005). TransformativeRelationships. New York: Taylor & Francis.
Weiss, Joseph, MD. (1993). HowPsychotherapyWorks:ProcessandTechnique. New York: Guilford
Alan Rappoport, Ph.D., has practiced psychotherapy in San Francisco and Menlo Park, Ca. for twenty-five years.