Doing couples therapy with a narcissist

Share on Facebook Share on Twitter Share on Google+ Share on Pinterest

Coming back from Los Angeles and Terry Real’s Relational Life Therapy training earlier this year, I mulled over what I learned. One of the things Real specializes in is treating couples where one person is a narcissist. Every therapist knows how hard it is to work with individuals with a personality disorder, and the narcissist is no exception. Unfortunately for us and the world, they exist in plentiful supply. Imagine: A person who thinks he* knows more than anyone and looks at others in a “looking-down-at-them and I-know-better-than-you” position, with a steel-reinforced defense mechanism and/or boundary-less offender. Add to that a strong resistance to change and learning new things and ideas … if it sounds like it would be difficult to help them, you’d be right.

I feel I must say that for couple’s therapy to be truly successful, we need each person to enter the arena with a humble heart — open to admitting what they may be doing wrong, seeing the other person’s perspective, and eager to make things right. Narcissists simply cannot do that, and most often when the therapist hits resistance from them and their steel defense mechanism, (and they will!), the narcissist will refuse to return to therapy. Heaven forbid that their sensibilities get offended. They often refuse to return to the therapy, with while telling their spouse later that the therapist was a “quack” or “idiot.”

So how to break the code and get the narcissist to play ball in the therapy arena? It involves first, educating them about the details of what their personality really says about them — never using the word narcissist unless you really think it would make a positive difference; that they have come out of childhood with a very damaged ego system, that at the bottom of it is a belief that they aren’t good enough, and the puffed up arrogance that has resulted is really a false self-created long ago to get them through life. The problem with that is …

1. They aren’t being genuine and authentic, and it takes a lot of energy to keep supporting a false self by putting on an act every day. 2. It is not relational. People simply cannot have a healthy relationship with a person who looks down at others and either has an iron wall up or has no boundaries at all.

3. The false self, defensive walls or boundary-less behavior are a result of toxic shame taken on in childhood. Toxic shame is the underlying belief that a person is defective or not good enough.

So after educating them about their personality traits and how those traits are not conducive to relationships, we introduce a strategy of joining with them through a little dose of the truth: “How you are behaving is not a good thing … is this who you really want to be?” “Do you really want to be this person to your children?”

We know that underneath all the puffed-up-ness is a real human being that is functional and able to give and take and love deeply. The arrogance and defenses or boundary-less behavior can be controlled because we have evidence that in some circumstances, say in the workplace or with friends, he does control himself and act reasonably. We simply have to get him to access his better, more kind and gentler self, the one that Pia Mellody-trained therapists call “The Functional Adult,” and the Christian religion refers to as the Holy Spirit. We want him to use it instead of his ugly side. If he succeeds he has a chance at having healthy relationships with the people he loves the most.

Another important part of this is to show couples the Relationship Grid graphic. This way they will know absolutely that their stance is not conducive to having a healthy relationship, creating a visual that makes it impossible to deny that a person is not functional enough to be relational. If you’re personality falls into the green area, something isn’t working.

Here it is:

The Relationship Grid graphic shows us that dysfunctional people’s self-esteem is either openly grandiose or shame-filled, meaning their behavior exhibits they think they are better than others, or less than others; and emotionally and boundary-wise they either hide behind a wall (walled-off) or have endless need for their partner’s connection (boundary-less). Find out which combination you and your partner have, and you’ll find out why your relationship doesn’t work.

It is probably important to understand that in the center of the grid is the healthy person, who has neither walls nor endless needs and is available and able to connect and be close or to give space, and neither thinks they are better or less than anyone else. These people have a basic respect and love for themselves and other human beings.

A narcissistic person is going to be on the grandiose end of the spectrum, and they will either be walled off or boundary-less. Show them this and there will no doubt that their stance will not work within a romantic relationship. Of course, if the partner is a one-down person and walled off or boundary-less, we will need to work on them to have healthy self-esteem, to strengthen their spine when it comes to dealing with their “I know best” partner, and to exhibit moderation in their need for connection.

* Narcissists come in both genders, of course. I use the pronoun he here for ease of communication.

Reader Interactions

Originally published at marriagecrisismanager.com on June 17, 2016.

Too Many Know Nothing About Having Healthy Relationships

Share on Facebook Share on Twitter Share on Google+ Share on Pinterest

Very few adults know a thing about how to have healthy relationships, and I’m sick and tired of it. Seriously, too many people are lonely, miserable, insecure, fearful, depressed, anxious and low on self esteem and confidence, they’re have difficulty functioning, and you know what they’re doing? Dating, getting married, and having babies!

Like a cat driving a car, people who don’t like themselves very much (or too much) and have dysfunctional coping and relational skills get behind the dating wheel and advertise themselves as licensed to date. They meet, marry, divorce, and broken families become commonplace. It’s truly sickening that we’ve allowed our lives to unfold this way.

For those of you think I’m talking about other people and not you, hear this: I don’t care if you dropped out of school in sixth grade, have more degrees than a thermometer or feel you are a graduate of the school of hard knocks, you probably know very little about how to have a healthy relationship with yourself or anyone else. This is a national problem, it’s epidemic, and I am calling for Americans to step up and do something about it — it all starts with each of us as individuals seeking answers for ourselves.

The reason we end up operating at a remedial or preschool level relationally (defined as our ability to have healthy relationships with others) is because we were never taught the concept of healthy mental health and healthy families in school or anywhere else. It is a terrible cultural omission that our education system does not thoroughly instruct us about brain, emotional and relational health. Who decides things like that? Apparently it is an organization called the Common Core, who brags on their web site about how they prepare us well for college and careers, but the question is, why don’t they consider that functioning healthily as a human individually and in relationships as an integral part of that?

So in high school, when we are ripe to learn about these things, we pith frogs, study English literature instead, and then enter the world of relationships completely winging it. Giving credit where credit is due, I’d say most people are aware that in relationships you probably ought to be kind and thoughtful, and as a person it’s probably good to be hard-working and able to provide a living. We know these things but when many get out into the world, doing these things is easier said than done. We discover life is hard and people are difficult.

Since we really don’t know how to handle these life obstacles, we go with what we know and follow what our role models were or were not doing­­ — both in the negative and positive sense. We either try to do (or not do) what our parents and family did or told us, sprinkle in some stuff we learned in television shows like Oprah, Sex and the City, The Kardashians and Dr. Phil, a romance novel or two, and the next thing you know we think we’ve got this, but we don’t.

So we struggle trying to be adults in the world not knowing basic relationship skills or the symptoms of brain illness, which so many of us will have. Once inaccurately referred to as mental illness, with a “you are crazy” stigma attached to it, mental problems were not talked about for eons as the mental health profession is less than 120 years old and there was no serious treatment except to cart people away to asylums or back rooms.

Once treatment started being available it was extremely time-consuming and expensive, and those who were brave enough to seek treatment usually did it secretly. Today, the idea that a brain illness means you’re crazy or shows that you are weak and can’t handle life is, thankfully, starting to dwindle, and treatment is much more short term, accessible and affordable.

It has helped immensely that well-known people such as Tipper Gore, Patty Duke, Brooke Shields, ABC news anchor Dan Harris and many more who have openly discussed their struggles with it. The truth is that the majority of us have experienced some form of brain illness, most commonly as depression, anxiety, fearfulness, worry, obsessiveness, addiction or even difficulty adjusting to new situations such as a move, marriage, new job, loss of a relationship or loved one. Though many of us have or had it, including myself, the majority have not sought treatment. In addition to the shame of seeking counseling or therapy, many people are still are influenced by how expensive it is, and unless they are totally incapacitated with depression or panic, don’t think they need it. Insurance companies don’t help at all. They are very conservative about they allow to be treated and for how long, and when it comes to couples or family therapy, many don’t cover that at all. So availability is still a huge issue.

What’s funny is that few call a therapist to just talk about how to have better or healthier self esteem and/or relationships with others, and all of us need to. Many of us are accustomed to feeling uncomfortable in our lives, and we duck and dodge our co-workers and partners and find coping and defensive mechanisms from alcohol to griping to friends and emotional withdrawal to be able to get through the day. The average person is scared to death to have a direct conversation with someone about a concern or need they may have, and that is a huge problem. That alone can be the cause of depression and anxiety, so if you have that problem, ask yourself, “Why have I done nothing about it?”

I am one of many therapists who charges a large hourly fee to see clients, and I don’t accept insurance because it’s a pain in the backside to deal with the insurance companies. I hate that I have to do it this way, but I feel there is no other way. A person with my level of education has spent over $100,000 to be where they are just for their graduate school education, which means many of us have huge student loan payments. Also, we have to invest in continuing education yearly to keep our license and stay abreast of the latest interventions and techniques in our field. As for me, I spend over $5,000 a year investing in more training. As much as we charge, we still don’t make a whole lot of money.

If you are not able to get your needs and wants met, if you cannot have a two-way adult conversation with someone about concerns you may have, if you don’t feel excited about your life and have plenty of energy and vitality to get through the day, something is wrong. If you don’t sleep well, worry, have trouble making choices and decisions, are afraid to be alone, feel lethargic and unmotivated, something is wrong. If you think you are always wrong and other people are always right or vice versa, something is wrong. If you think you are defective and that something is wrong with you, something is very wrong. If you allow people who treat you badly into your life, allow people to take advantage of you, and feel like a beat down dog, something is wrong.

If all or some of these things (there many other dysfunctional behaviors not mentioned here, too) exist in your life, there are so many things you can do that would help you and change your life for the better. It is impossible to have a healthy relationship with yourself or anyone else if these things exist in your life. Since it wasn’t taught in school, start reading as many books as you can about being healthy in your mind, body and spirit. Listen to Podcasts, audio books, talk to friends that seem to be having well-rounded and positive lives. Get hungry to learn how to feel and live better. Go to a therapist and allow them to educate and mentor you through a growth process that leads you to be the best you can be, but whatever you do, don’t stay uncomfortable and unhappy in your life. There is so much this life experience has to offer, and you can have it if you’ll learn what it is and how to advocate for yourself.

Originally published at marriagecrisismanager.com on January 12, 2016.

Bedtime Issues of the Sleeping Kind

Share on Facebook Share on Twitter Share on Google+ Share on Pinterest

Part of having a great marriage is being respectful of your spouses needs, wants and desires, and that means in the morning, afternoon, and of course, at bedtime. No one expects to have every single request fulfilled in marriage, but some things really do matter, and when it comes to bedtime, my clients have asked me to intervene in certain issues when their own requests got no results.

One husband, who was a physician and had to be at the hospital by 6 am every week day, pleaded with his wife to not watch the television when he was trying to get a good night’s sleep. Even worse, she wanted to keep it on all night as background noise. For me, the therapist, it was hard to understand why the wife, a stay-at-home mom, would not accommodate her husband. Despite every effort ­other than turning off the TV — like suggesting she get headphones, he get earplugs and blinders for his eyes, nothing brought him peace and she would not budge on having the noise of the television. A few years later, they divorced.

As a marriage therapist I sometimes have to be like a judge in a courtroom. It’s not my favorite thing, but some people really do have unreasonable beliefs and demands. Part of my job is to inform them that that what they are asking is too much. Once I do that and we find that they are not willing to at least look within and examine what I’m saying, then it pretty much tells me I am dealing with a person who is not bendable, and that’s not good in marriage.

In the bedroom requests are very serious, because sleep is very serious. We all need good, deep sleep to be healthy and some of the issues I have dealt with might blow your mind …

A wife was disgusted with her husband’s propensity for grooming his nails in bed. “I hear a click, or crack, and every now and then a piece of toe or fingernail hits me in the face or flies across the room and bounces off the wall!” she would report. “Even if the nails weren’t hitting me, I find it totally disgusting to have him doing his nails in bed. He doesn’t care at all about what I think!”

This man’s dad had groomed his nails in bed and he had thought it was funny. I had to tell him that it was not.

We all know about the husband (or wife!) who snores and the spouse has to sleep in the guest bedroom, and then there is the partner who can’t stay up past 7 pm while the other spouse is a night owl. One wants it to be hot, the other cold. Door open, door shut. Curtains open, or closed. Fourteen pillows, no pillows. Heated blanket, no blankets. Dog and cat in bed, get them out of the bed — battles for sleep comfort can be endless.

So, here is what I would recommend to assist with any of these issues:

• Have the spouse who is bothering the other one to develop empathy for the other, surely they can think of things that annoy them — how would they feel if the person annoying them wouldn’t take the disturbance elsewhere?
• Work out a compromise and find intelligent solutions. Instead of having it 60 degrees in the room, make it 68, and the other person can wear heavier clothes and use blankets. People who are hot can put fans on themselves.
• When push comes to shove, the person who creates the problem, whether it is noise, lights, unsanitary habits, heat, chill, pets or whatever, should remove themselves to a different location.

Another way to look at it is this: We all seek inner peace. That’s why couples come see me, because they want inner peace and something is going on in their marriage that it is taking it away. So, the rule is, it is never OK to expect or demand your partner to give up his or her inner peace so that you can have it. You must be willing to negotiate a compromise that will enable you both to have inner peace. If you are the one with with the annoying habit, the onus is on you to take it away or adjust it so that you may help your spouse have inner peace.

Having a great marriage is about taking action daily to love your partner. Forcing annoyances or unusual habits on them is the opposite of that. Good sleep is such an important issue that it really is important to find a compromise that works for both, or be nice, loving and considerate, and take yourself and/or what annoys your spouse away.

Originally published at marriagecrisismanager.com on December 23, 2015.