Narcissism | What You MUST Know

[Music] we've talked with Dr Romany about narcissism before but we've never got this in depth welcome to the med Circle Series narcissistic personality disorder the secondhand smoke of mental health you were one of the first people to ever come on Med Circle you have made such a huge impact I'm so glad millions of people's lives getting lots of emails I'm so happy because it's helping people understand this and sort of remove some of the responsibility from themselves and and come up with a realistic game plan which is so important to me that's why I'm in

this I mean to help people almost like help people save themselves and move into a far more bright future yes and we did one video on this topic I don't even know how long it was like 10 minutes something like that and now we're dedicating an entire series to the topic I think it's good because I think that's going to help a lot of people have a lot of questions and I'm hoping we'll be able to dispel some of that and create some more understanding before I sat down with you the first time I did

not know that narcissism was a personality disorder narcissism is actually not a personality disorder see then that's already one of the big misconceptions out there and why people get their sort of themselves all up in a froth is narcissism is a pattern I don't know that I'd call it a trait as much as a collection of patterns or traits um narcissistic personality disorder is a disorder and if you look at existing epidemiological studies 1 to 3% maybe mostly because these folks don't get into treatment because they don't think there's anything wrong with them right so

it's very difficult to get meaningful statistics on what the true rates of narcissistic personality disorder are in the population narcissism whole other game much more endemic it's a pattern people say well that don't label people I'm like that's no different than saying he's agreeable he's sweet he's funny he's narcissistic they patterns the first video we did on narcissism millions and millions of views still even growing at the time of filming this every day why is this topic resonating with so many people it's the topic of our time there's no two ways about it it's the

topic of our time it's misunderstood and it is absolutely destroying people the fact is because people don't understand it they don't understand that they're even in it it's almost like you're it's like having an illness and you don't know why you're getting more and more tired every week and then you finally go see a doctor and the doctor's like oh you have da or you're being exposed to Da and they're like thank you for the explanation then number of people I have worked with who said to me had I not come and consulted with you

clinically and understood what this pattern was I would have stayed living like this forever and probably ended up in an early grave I mean this is I but when you say that not because they have narcissistic personality so it's the issue of our time and here's where it gets tricky we've actually in we we've rewarded it in our society we're saying like behave badly treat people badly throw people under the bus let's reward you behave in a way that's uncivil and unkind and be mean and we'll give you your own TV show so that's what's

happening you said something to me and I don't remember if it was on or off camera but you said the book on narcissism could be titled how to be a man in today's world and succeed yeah absolutely it would be the same EX it would be same it it's like a rule book I actually had a student once come to me after class and say you know I'm trying to Succeed in Business and after learning about narcissism I now realize that if I do all these things I'll be really good at sales can you teach

me I was like no wait teach him how to be a narcissist yeah no that no okay but just for fun can you teach someone how to be aiss not really I'll be frank with you I'd be doing a lot better financially I a bit more narcissistic in fact so much money oh they do the research is actually quite clear the a trick called agreeableness which is actually quite opposite to narcissism people who are agreeable are friendly warm open gregarious helpful to other people they make significantly less income than people who are more antagonistic and

narcissistic yeah I mean it it costs you think about it you know like oh no that's okay you don't need to pay me for that you know that kind of thing you're like the Doctor Who takes your payment and pies rather than money you know it's like that kind of thing just a nice than you will do I will take a cherry pie from time to time you're not a narcissist uh what can you still though be strict and successful and aggressive and and make a ton of money and all these things without being a

narcissist I'm not sure even that answer is a really strong answer you're not sure I'm not sure I haven't seen much evidence of it I've seen some people really really make it but even they'll acknowledge I had to play a little bit of hard ball I had to put my needs way ahead of someone else and not stop to think how this may hurt them I mean there was definitely a relative empathy deficit compared to a far more agreeable person I just don't say business by large is a zero sum game yes and I think

when you're working in a corporate structure and you're having to answer to folks like shareholders and there's they don't care about sort of the rank and file employee that that's when the game changed I still think when you had company towns and the guy who ran the factory still knew of the lives of the others there was a bit more empathy that's kind of gone on you throw in other societal trends like social media where it's all about you know who can sort of social comparison who can look better that kind of thing it becomes

more superficial I think all of that is colluding that we don't value empathy anymore we really in fact especially in boys and men we're not teaching our boys to be empathic we're actually saying empathy is a weakness in boys and men and that's really one place we can really see a correction if we could do that but we're actually going in the opposite direction I mean empath's really kind of gone the way of the Atri track like not cool not hip you said 1 to 3% of the population has been diagnosed with narcissis that's the

research studies show and you know what I think we get caught up and like people say it's my boyfriend it's my husband it's my wife when you really open that net to mothers and fathers brothers and sisters bosses and co-workers Aunts Uncles you name it you'll see I actually don't know a single human being whose life hasn't really been touched by pathological narcissism what's interesting is that for some people it comes late in life so they had great parents nice husband good friends but then their sister marries a narcissist and that's actually worse like when

you're first encounter of it is when you're a full-blown adult because then you really don't know what to do it's like trying to learn to speak French when you're 50 like good luck with that you know so whereas others of us who've started early in this training in fact in this new book I'm writing I say who was your first narcissist for some people it was mom like you met her on day one for some folks n CU there's going to be one there's always the first wow uh for people who don't know who you

are why should they listen to you when it comes to narcissism you know they should listen to me because actually my way of coming into this area was through multiple Pathways the research in my lab at California State University of Los Angeles we focused on personality disorders there and narcissism was the one pattern where we saw it but wasn't behaving in a consistent manner but at the same time in my private practice I was astounded at the number of people who were coming in and literally saying the same thing and I'm like okay there's something

going on here and I really dug into it and said these these partners of them they're all narcissistic people and these people are so frustrated they keep trying everything their Partners don't change they get up every day thinking and hoping it'll be different it's not it's devastating and so then I did Research into I'm like wow this is really not very treatable the the the person with narcissistic personality disorder and even the pattern really wasn't that changeable and that just set me into a deep kind of Deep dive into the literature I interviewed people all

over the country in fact all over the world about their experiences with narcissistic husbands wives boyfriends girlfriends and then that culminated in my second book which is called should I stay or should I go surviving a relationship with a narcissist and and then it was kind of Off to the Races from then I think some things changed in our world and narcissism became more and more and more of a topic and I'm surprised at how many smart people just don't get it and and it's such a pattern I said you should almost be reassured a

lot of people say narcissists are unpredictable I said unpredictable they're the most predictable person in the room we know exactly what they'll do and that they say Jackal Hyde I said Jackal height is kind of predictable you know they're going to be mean and then they're going to be nice so that's the you know once you get that pattern into place and you know it and you know what you're dealing with I think our problem is we it's all about second chances that we give them we're a little bit too heavy-handed with the forgiveness and

I'm hoping we can sort of help folks work navigate those Waters in a way that's healthy for them and their families so we know what people who are in a relationship with a narcissist or know narcissist will get from this series oh yeah it's the hope it's the education it's actionable steps if there is a narcissist out there who stumbles upon this video because everybody in their life has told them you're a narcissist and they have even a little bit of self-awareness maybe I am what do you think they will gain out of the this

has become the question of the year because I get emails almost every day from a person some of them are angry some of them are down by threatening and some of them are really contrite where they're saying I'm this person and I don't want to be this person anymore and I've hurt people give me that person and we might have a little hope now here's the rub a person let's say a lifelong narcissist they're 30 40 50 years old this is how they've always treated people it's a tough fix it's almost like trying to take

someone who's really sweet and making them mean not easy to do it's the same thing we're just trying to flip it out in the other direction take a narcissist and turn them into someone who's more self-aware and kind what you might see is that you might get some small fixes from them but I do think it all is not lost I think if somebody is narcissistic and is willing to do the hard yards and put their head down commit with a good therapist really commit to mindfulness every day you might get someone that where you

might get enough of a change where their family notices a difference they may become a somewhat better parent they might become a somewhat better partner I mean I think are you ever going to make them the sweet agreeable teddy bear probably not I think what I see is when narcissists do enter treatment and become self-aware the thing that they become self-aware of and this is where it gets painful is the emptiness and how insecure they really are and that is one really tough look in the mirror that's what they were avoid avoiding all along that's

why they're so grandiose I don't want to see The Emptiness so when we strip away that Veil and I've worked with many clients where we finally got to the core of the insecurity they actually became down downright depressed wow and that's what they were trying to avoid all along so it's a it's a very complex Nuance long-term treatment plan but listen if you're self-aware and you're like I want to turn this around I think that commitment is most of the variants that's where it's at I think something can be done just a slow burn Dr

Romany describes narcissism as the secondhand smoke of mental health but why and why is narcissism more dangerous than just being self-confident what exactly narcissistic personality disorder is what is it okay all people with narcissistic personality disorder are obviously Nar narcissistic okay not all people who are narcissistic may have narcissistic personality disorder so it's a fine point but it's an important Point since everybody's throwing this word around these days right you know it's not unlike other diagnoses that have different meaning to them this one's sort of this is like a character assassination right so when we

talk about narcissistic personality disorder there's a long list of patterns and they have to have five of the nine on that list it has to be something we call pervasive meaning it cuts across situations with a variety of people in at work at home it's not just like they're narcissistic they're only you and they're nice to everyone in the world it tends to be pervasive but here's the rub it has to involve what we call social and occupational impairment and subjective distress that's a fancy way of saying it is messing up that person's life they're

aware it's messing up their life and they're uncomfortable with it and that's where you don't don't see as many people with narcissistic personality disorder so if their style of not having empathy of being entitled of being grandiose of being arrogant and superficial and all that is working out for them they're not going to walk around saying I'm having a problem they're not going to walk around saying this is causing me problems so if they don't acknowledge that piece of it then really they're a narcissist which is sort of a clinical term for being a jerk

and we don't get to diagnose people for being a jerk we may not like them but that's not a condition we diagnose we diagnose people because they're bringing in something that they're uncomfortable with or that's causing them problems the best example I can give you is let's say somebody's been using drugs for two years and their drug use results in DUIs and other problems in their lives okay when that happens they may themselves say I don't have a problem with drugs but I do have five DUIs and they did find me in the gutter from

my mom's house so I guess well maybe there's a problem in narcissism they may they may recognize that yeah sure I got in trouble at work and I was called out on this and that problem and I did cheat on my wife several times but it's working out for me is that distress he's being a jerk so Dr Alan Francis Dr Francis is actually one of the architects of this diagnosis originally in the DSM and he he himself has come out very clearly and said we don't get to diagnose somebody because we don't like them

that's not what this diagnosis is for it's for somebody who's actually having discomfort and distress because they're behaving in this narcissistic manner it's a fine point but it's an important point and here at Med Circle I really want to be careful as we use these two terms because I think a lot of the listeners don't know if their friend family member or boss has the diagnosis and may never find out unless that person that other person gets into treatment and their friend family member boss might just be a jerk they might be a jerk and

they may say why should I go get a diagn there's nothing wrong with me and if they're walking around saying there's nothing wrong with me and I'm fine to not they're not they're not a they don't have NPD no that's it and so and that's where people get upset I get emails every day will you talk to my husband and tell him he has narcissistic personality I'm like no absolutely not please I would love to do that no in there so that's a lot of the struggle here is that and you know what the pattern

of narcissism it's awful they may be fine with it but you as the recipient of that pattern it's not it's it's you you're going to struggle with it it's uncomfortable it's one of those patterns that's really unhealthy for the people around it I call it the secondhand smoke of Psychiatry like being near a person who's narcissistic it it's as unhealthy as doing it yourself whoa that is a great metaphor NPD is the secondhand smoke of Psychiatry and I'd say narcissism is the secondhand smoke of our timear of our time you stand close enough to it

you're going to get sick even that's a huge deal for people because somebody might not get get the diagnosis yeah they just but there still have all these toxic behaviors that are affecting you oh absolutely and you know what in some ways the diagnosis is irrelevant because all all that's doing is saying the person's having problems because of it but if they're lying manipulating exploiting raging at you who cares if they have a diagnosis that's not good for you to be in the presence of and then it takes us back to that more critical issues

why are people like this or like this because they're insecure and that makes people feel guilty well m if he's insecure and this is why he's doing this and that's what we're going to have to get to the core of when does normal self-confidence cross the line into grandiosity self-confidence is a healthy State and people who are self-confident don't need to blast their achievements from every rooftop and every social media platform people who are truly self-confident don't need to talk over other people and their achievement people who are self-confident don't require their achievements to be

front and center and ahead of everybody else's people who are self-confident are so confident in them their sense of self and their achievements that they actually can stay quiet about it in another video in this series we'll talk about the different types of Nar NPD but I'll give everyone a preview from the original video we did the communal narcissist ah the communal narcissist when you said it's that person who goes and volunteers on a Saturday but takes selfies the whole time in a full perfect face of makeup I go oh I so know that person

you know and it's also the person who you say like let's throw a Gala and you're like but the gala is going to cost 10,000 and you're only going to make 500 for the charity why not just write the full 10,000 for the the charity like but I need the gala they need Galas they need gas they need parties they need celebrations and you know what I'm smiling when you say that because uh I think smiling is one of my coping mechanisms by the way like laughter and smiling because the these are very deep and

heavy topics and they're affecting a lot of the everybody who's in a relationship with a narcissist which is almost everybody which is almost everybody and in a lot of cases there are narcissists or in people with MPD who who are suffering they well at the if you want to get down to the core of it they are suffering because they're deeply inure and that's where you know I mean but do they experience it a suffering I'll tell you this like I said with the people with NPD or narcissism where we start peeling back the layers

by the time you get down to layer 10 and you start looking in the gaping hole it's not comfortable for them and you do your heart does ache for them because there's such there's almost a childlike emptiness to them I'm not saying I'd want to be in a relationship with them though I can tell you that right now I mean I can handle it for an hour at a time but my God for a person who actually has to live with that day in and day out it's a nightmare are there common co-occurring disorders with

people with NPD people who have narcissistic personality disorder or even narcissist traits there are several co-occurring patterns we can see that are more likely to happen all forms of substance use disorders you know a lot of times it's to fill the emptiness or to enhance the grandiosity so alcohol use um cocaine use you know a stimulant use that kind of thing so you'll see some of that um depression interestingly narcissism and depression can hang out together a lot of it is that insecurity and that emptiness It's Not Unusual to see those two kind of hanging

out together but are they getting diagnosed with depression sometimes they're getting diagnosed with ression because they might be very irritable we'll see that in men um what will happen is you'll sometimes confuse the two as well because a type of narcissism we're going to be talking about today is called covert narcissism people who are covert narcissists they're a little bit like Eeyore from Winnie the Pooh it's like woe is me no one understands me how come the world is so unfair to me and they seem so downtrod in that they look depressed and then all

of us will treat them as though they're depressed and we're making absolutely no no Headway and then one day you you Dawns on you're like oh this isn't depression at all so actually quite frankly we'll often treat the dep well we'll think they're depressed before we'll think they're n but wrongly so yeah again just highlighting how important is to get the right diagnosis it really is because these personality patterns also make treating other mental health conditions for example It's Not Unusual for narcissism to also be found coexisting with bipolar disorder which is also a very

messy kind of uh issue to treat because the grandiosity of the and the grandiosity of the narcissism often Collide so you'll see that too and I when I've worked with families of um when they have adult children who are substance abusers and the the adult child goes into rehab I'll also know that adult child has narcissism and I'll I'll be I'll ache for them because I they're thinking their child's going to go to rehab not only come out sober but sweet they come out sober but they're still as irritable invalidating sort of mean as they

always were that part's not going to go away that's the narcissism maybe even more so even more so and you see this a lot in substance abuse treatment circles that you see a lot of it yes exactly because the the substance use was sort of helping them kind of shore up their defenses and so it can make treatment much much more complicated you'll also see a greater likelihood of for example like patterns that are sometimes labeled love and sex addiction kinds of like compulsive sexuality compulsive like relationship patterns you'll see that coexisting with narcissism as

well it just makes everything that much harder to treat yes that's what it is because you you don't tend to get as much motion there's a lot more defensiveness I know more than the doctor there is a lack of empathy there's a lot of projection all this stuff really makes it hard to do really deep Psychotherapy with somebody how many different types of MD are there well there's there's different kinds of narcissism whether those translate into subtypes of narcissistic personality disorder I once said there's nine possible symptoms of narcissistic personality disorder which means there's thousands

and thousands of possible combinations but if we were really to look at in five patterns that I've sort of broken down in my book and this is based on the theoretical work on narcissism drawing from other people's work when we talk about the types of narcissism they're not really subtypes of narcissistic personality disorder but there are different kinds of patterns we see of narcissism and I think it's important to see the differences because it shows us this doesn't look the same across everyone and then some people say well that's not narcissism the person I know

acts like this I'll say ah but it's a similar pattern let's get down to the Brass tax of what all narcissists look like in all narcissism we tend to see a lack of empathy grandiosity entitlement superficiality chronic seeking of validation outside of them uh arrogance and a real tendency towards rage as well as a tendency to manipulate or exploit other people those you tend to see across the board to varying degrees so let's start at the top with what I considered the most severe and problematic narcissistic pattern and that's the malignant or the toxic narcissist

these are the folks that almost look like Psychopaths they are they'll exploit other people they take advantage of other people they lie they cheat they um they work the system to their advantage they can often be quite successful you might wonder why am I not calling them Psychopaths they can sometimes feel remorse for what they're like this isn't cool but I just got I just got to get this part done and I'll make it right whereas the psychopath wouldn't need to make it right so there's just a really manipulative mean-spirited Edge to them that can

be very unsettling but but when you first meet them they're extraordinarily Charming extraordinarily charismatic um confident successful so that's sort of your malignant toxic type you'll often see these folks running big companies you know in at the heads of government all of that like they have they really know how to work assistant wow the next in the in the group is what I call sort of your classical grandiose narcissist and that's what most of us think of the person who's braggy who really is entitled I'm special I deserve special treatment it's almost like you're a

celebrity narcissist that's what your grandiose narcissists they brag a lot they show off a lot look at my new car look at my new this look at my new girlfriend it's a lot of Show and Tell they suck all the oxygen out of the room all the usual traits but they don't tend to be as exploit ative and as mean as a malignant narcissist but they are sort of your classical kind of narcissist the next narcissist on the list and this is probably the most mysterious one and maybe the most revealing to Med Circle listeners

is the covert or vulnerable narcissist these are the woe is me narcissist you know if the world could see how great I am I'd be one of the great ones but nobody gets me CU I'm ahead of my time and so they'll you'll often find them sort of at home huddled over their computer or being like a troll or like coming up with their next big plan but they almost have a failure to launch a lot of the time they can often look depressed there's a real they seem vulnerable because they almost feel like the

world doesn't get them they're hyper hyper sensitive to criticism um they're but they lack empathy and they can be very entitled like I deserve special treatment because you know the world doesn't know this but I'm the best what's interesting about that is I I listen to that and I when you would first meet somebody like that you think oh they they just have low self-esteem but all narcissists have low self-esteem right that's why they're doing that exactly so the covert narcissist they lead with that but it looks it's almost like they they feel like they're

they have this sort of strange I always say that the covert narcissist has this sort of weird pause they'll say yeah I went to that college but I guess nobody cares and they'll do that weird thing and you're like okay well that's a little bit of strange pause but it's a they're like yeah I I already read that book but why would you care you know it's like one of those like that's a little bit there's a there's an edge it's almost like you're sticking your hand into a bucket of barbed wire it doesn't feel

good it's like even with those examples even though they were just you know like random examples I still feel the pain for that person oh they're they're they feel the world pass them by yeah but I I don't feel the same way with a grandiose narcissist you won't as much no they the covert narcissist though ultimately will get to the point where they feel the world owes them something the world owes me and they'll be a real Edge to them you know because they but it is they seem really sad and you'll often try to

help them and you'll wonder why they're so ungrateful that's why that can feel really uncomfortable for other people who are so sympathetic to them and wonder why are they not ever saying thank you or recognizing all we did yeah now number four is the communal narcissist the communal narcissist can be very confusing because they're out there volunteering and flying all over the world and doing their own personal rescue missions and you know after every hurricane they're posting online hurricane goals hashtag hurricane goals and like let's all raise enough money and let's send lots of stuff

to they're The hasht Narcissist they're the hashtag narcissist but they're like it's all about their their goals for helping the world and and like you'll see them I mean you're an you know about animal rescue people like they're always holding their rescue dogs but then they go home and they're really mean to their husband and they love going to gas and they want buildings named after them and if they do give a donation they have to hold 20 gold shovels and have lots of pictures taken like it's all about the they do all these things

to get validation that's their tool for getting validation are often really unkind to the people they their their immediate family or the people who work under them there can be absolutely awful to them and people say oh my gosh you're so lucky you work with him he's so charitable and the people are just like oh no this is really that's one of many characteristics he is so so the communal narcissist is a very it's a it takes a while to sort of un to peel off that layer and then to sort of that's why I

always say pay attention to how a person treats the person who don't have as much power as them in that situation because that's going to teach you a lot so they'll be really sweet to the recipient of the charitable dollars but really mean to the person who's working with them and that doesn't add up the last narcissist is sort of kind of a good nature I'm going to call them the benign narcissist the benign narcissist is like this sort of Clueless uninsightful person who just says really vapid things very superficial only cares like all I

want is like a fast car and you know you're driving a piece of junk like they'll be a dismissive other people this sounds like every 16-year-old I've ever met in many ways if there's an adolescence there's an immaturity but they really aren't that mean-spirited and you can actually kind of say that's not a nice thing to say they're like yeah I guess so but then they'll go back and say it the next day I always say it's nice to have a few benign narcissists on Deck cuz they're fun to have at a party you know

like just keep them on that list but never turn to them at a time of need just because I'm curious and I get to ask questions which you know somebody put me in charge to do this you who would you most want to be in a relationship with those were the five those are your five oh mama you know and and just Solitude in in a cabin isn't because I'm GNA take if Solitude in a cabin is my option I'm going with that one okay so it's not an option I pref I don't think any

of those are a good you have to choose one you have to choose one you have to choose one I might choose the communal narcissist and just be glad they're doing nice things for other people to God they're nice to me but I I have to tell you that can be exhausting because when the whole world is saying you're so lucky he's so charitable you're like oh my gosh he hasn't said something nice to me in 15 years they're all painful maybe the benign one but even that you feel like you're forever in a relationship

with your high school boyfriend that's not nice right so I I if you're if you're if I if the cabin by myself for the rest of my life isn't a possibility I'm going Comm I get it with therapy I can have a cabin from you like two acres away and then we can just meet when we want to hang out I don't recommend any of these types for a relationship but what about my idea for I'll have a cabin one acre away from yours that I'll do that okay cuz you were shaking your head like

this I was like wow you might be a narcissist so we have to be wait till after my therapy s neor if you don't know what we're talking about go see the previous episode okay uh uh out of those five types is there one that's most common I would have to say probably the grandios the classical narcissist so that's why we think of it because the okay um what am I not asking you about narcissistic personality disorder as it is defined from understanding it that I need to be asking you know all the all the

patterns I gave you are what are what you see are the nine characteristics that a diagnostic manual like the DSM would require what's really interesting is that our diagnostic manuals are now taking sort of a new Direction in how we think about these personality patterns and in the most I mean to make too put too kind of bookish a point on it but the DSM now views narcissism and all of the personality disorders through a new kind of a lens and it looks at for example how a person uh views their own identity and the

narcissist identity is very much caught up in how they're viewed by other people so they don't have a core sense of self their sense of self is governed entirely by the world outside of them that's actually a terrifying feeling like the only way I'm good is if everyone tells me I'm good today that's very unstable we also look at go setting how do they how do they set their goals and narcissists set their goal in a way that will get them approval from the world so either they set their goals unrealistically high so they can

talk about the big goals they have which they're never going to meet or they set their goals a little too low so they know they're always going to surpass them so but no matter what they're goal setting once again is based on how they can talk to the world about these things then when we look at other areas we look at empathy and their lack thereof so now DSM is looking at this across all personality patterns and people with narcissism don't have empathy they look at people as existing to serve their needs what can you

do for me and then I'll make a relationship with you so that's why a lot of people say but that narcissistic guy was really nice to me I'm like yeah because he needed you as a sales contact they're like oh or they like the fact that you live in the right neighborhood in town There's a need being served and then finally DSM is looking at narcissism through the lens of intimacy and that's one thing that narcissists are not good at they're not good at intimacy they're not good at close Relationships by and large their relationships

are superficial and are really engaged in for personal gain so they might get a very attractive partner because that makes them look good to the world they might get a wealthy partner because that will make sure they have lots of money they might get a famous partner so that they look good to the world I mean the the the characteristics on which they choose the partner are deeply deeply superficial and so that's how a narcissist chooses and so when we look at those areas self uh goal setting empathy and intimacy that's another way to view

narcissism no matter what it's just really that it comes down to that core insecurity that sense they cannot regulate themselves from the inside out that they don't have a good sense of identity and that they're really reliant on the world for telling them what they're about which makes them actually quite resentful a recent study suggests that one in 16 Americans has been affected by someone with narcissistic personality disorder so what causes in PD and can it be unlearned what causes narcissism it's it's there's actually a lot of Pathways to this and the City of Oz

that we call narcissism there's a lot of ways you get there um a lot of people the big question everyone has is are you born this way or are you made it's mostly made but there is a little bit of born and what's the percentage on that I I you know I I I if I were to spitball I'm going to go with like an 8020 or 9010 in terms of made versus born I mean the inborn part is that because the fact of the matter is we see people come from invalidating early environments or

overindulged or spoiled at early environments and they don't turn out narcissistic so there's got to be something else at play right and that's probably where that temperamental piece comes in kids who are likely more hypers sensitive hyper emotional um if you look at Marshall Lan's work on borderline personality disorder she actually talks about that mix between the biological vulnerability plus the invalidation of the early environment there's likely something like that happening in narcissism too but it's mostly made so let's let's view it as almost concentric circles and let's start at the middle circle which is

really what happens in the family when the child is first growing up children who are children who don't get consistent emotional mirroring for the from their parents that's a setup for becoming a narcissist later on because that's how children learn to regulate their emotional worlds they learn how to self soothe their emotions they learn how to take responsibility for their emotions they learn how to understand their emotions from how they're mirrored by their parents and if their parents have consistent appropriate reactions and are available to them that's how the child learns that so if a

child for any number of reasons doesn't have that kind of consistent feedback from their parents the parents are distracted the parents are absent the parents don't care the parents are addicted to drugs and are not available in that way all of those could be contributors to that parents just are abusive in some way obviously that can be a contributor to to inconsistent kinds of mirroring and then the child doesn't learn like I said to sort of regulate their own emotion they keep looking to the environment for validation because frankly they're confused we also think about

narcissism in the early environment as a function of attachment children who have secure healthy attachments tend to go on to adulthood and make more secure healthy attachments but kids who have more anxious or avoidant attachments that can set the tone for attachment issues in adulthood and they're not able to make those kinds of successful attachments in in adulthood so their relationships are really fraught with lots of in and out back and forth rather than the consistency you'd see from a secure attachment with a parent um the other thing I often say is that parents who

are narciss parents who create narcissistic kids who go on to become narcissistic adults we see a pattern of simultaneous overindulgence and under Indulgence and what I mean by that is these are the kids where if they do the sport their parent wants or get the Straight A's or the Prima ballerina dancer or whatever it is they do the best violin player whatever they want to take over dad's business whatever the thing they say they want to do if the parents can get a good public face from it they will overindulge the kid in that way

they'll drive them to every practice they'll go out of their way but when that child has an emotional need that needs to be met the parents are nowhere to be found like they're interested when their kids on stage they're interested when their kids on the field they're interested when the child's getting an honor or doing what they want them to do but when that kid really needs her emotional needs to be met it's it's completely an impoverished environment that's what I mean by being over and under indulged um it's also what we call modeling so

what they see in their environment if they watch a parent constantly be entitled they're going to learn to be entitled if they watch a parent who has no empathy they're not going to learn empathy empathy is learned in childhood you cannot teach a 30-year-old how to be empathic that's an early game so that that was my question cuz if if you were saying that 80 to 90% of becoming a narcissist was taught then certainly later we could unte it but we no because you know what ends up happening is that ultimately these these environments for

children are inconsistent they're invalidating at the worst of it they can be abusive and dehumanizing and that's the Heartbreak is that I've worked with more than a few folks who are adult narcissists who did come from abusive invalid down downright dehum who have narcissistic personality disorder who have narcissistic personality disorders so their early lives were really really sort of wretched and and that's heartbreaking but that's still not a a get out of jail free card for treating other people badly like I'm not getting I'm not down with that and so but now let's take that

now we're in the family but we got to push this out a little bit Society is to blame too we tell kids it's okay at some level to behave if you as long as you win you got into Harvard Jr great whatever it took to get there as long as we start saying that you can shove important qualities like compassion kindness respect mutuality empathy as long as you're telling people it's okay to put that stuff away as long as you succeed our achievement oriented culture is a contributor to these patterns for sure because we're almost

saying empathy is a waste of time as long as you get straight A's you know who needs kindness when you can write code that's not going to fly you know so that's the other reason we're seeing more and more of this and then you add things like social media and the kinds of things Society values into the mix then that that's it I mean it's a perfect storm that's what I'm saying we've got you got the family you've got the community you've got the culture at large and then you have a little bit of individual

temperament thrown in there forget about it when you hear how narcissist narcissism is conditioned I'm surprised that it's only 1 to 3% of the population that has it remember that's narcissistic personality disorder which requires that person to have had problems in their life because of it awareness of it and feel like it's caused them trouble because narcissism works as a pattern in our society too often they don't feel a lot of distress so when you were talking about parents marrying or kids marrying their parents there are certain behaviors that I grew up with right in

my parents that I did until my mid 20s and then I thought I'm not going to do this anymore this is not healthy for me it's not nice I'm not going to do it and so I changed so why is it that I can change an undesirable Behavior but someone who has narcissistic personality disorder can't change because you've got because the core conflict is that insecurity that discomfort with themselves that sense of emptiness that's what has to be addressed so you may have seen that but it clearly didn't result in that kind of core insecurity

perhaps in you so when you were doing the yelling it's like well this is how it's done and they like whoa maybe this other person feels sad when I'm yelling at them this isn't okay so you were able to have that correction because a you were able to engage in empathy and B you may not have had that core insecurity remember the narcissist is absolutely reliant on the world for validation at all times when we need someone we resent them you know a child doesn't but the child grow even think about an adolescent every adolescent

out there um resents their parents why do they resent their parents because they kind of still need them they kind of still need them to be a mom but like I want you to be my mom I don't want you to be my mom and they go back and forth and then they hate you you know so it's that resentment comes from need and it's one thing to be five of course you need your parents that's built in but when you're 35 45 and you need people to tell you you're great all the time you

may not be aware of that need but you are aware that you're reliant on the world and that if you're having a bad day that the only way to Spring out of it is to get validation from the world that stinks so that's why it's very difficult to change it's not just about modeling empathy and there there is an interesting concept out there and it's something actually even in my social media someone we've engaged on about this idea of cognitive empathy you can teach people like that's how he feels okay got it do you understand

why that would be feel bad got it that's almost intellectualized and it's a little bit different than being in the emotional muck with someone I don't think is it like acting it's not no it's not acting it's knowing but it's not getting you I I know I know why this person would feel upset right now I know that might even get it a little bit but I'm not feeling it so much so that it'll stop my behavior in the future so it's like a half of a fix and when you're really in a close intimate

relationship some with someone and the best they can come up with is like I suppose I understand why you feel that way but they're still not like and they're not emotionally there with you that's incredibly unsatisfying it's kind of like when somebody says well I'm sorry if you feel that way yes narcissist monra I'm sorry you feel that way that's not an apology that's not that's not an apology exactly you have been in a relationship with a narcissist my myself yes yes of course I in different areas too Intimate Relationships familial relationships um work relationships

but just so all of meal knows it's not my ex-husband he's actually a great guy ex- we love my ex-husband so because I'm curious because if if 80 to 90% is taught were you hyper aware raising your kids to not raise a narcissist my the my ex-husband and I when we were raising our kids the one thing we 100% agreed upon he's like Romany we have a lot of things we have to get right but we looked at each other and said the one thing we must make sure we focus on above all else because

we only get one chance to get this right is empathy is empathy we didn't care how they did in school we didn't care if they didn't eat their vegetables we didn't care if they watch television 10 hours a day we just needed them to be empathic and there was a fine day when they were about eight or nine years old W DOD we got it was wait was your hold on I have so many questions was your ex-husband a a mental health professional okay so you have so these kids have two like renowned mental health

experts parenting them and the two of you both agreed that empathy was number one empathy is everything this is huge for parents to get huge because I'll tell you it's the core of why kids bully all the problems we have with kids it has to be about empathy am I telling you my kids have had the most smooth ride no one's kids are I mean and they're horribly mean to me cuz they're teenagers but I will say that that I can see in their face when they go one line too far as a teenager and

they say that one mean thing and they see my face change immediately the the empathy overtakes them quicker than their words do their face changes I've watched my daughters interact with people and I'll watch how quickly their face will change when they sense another human being in need and at those points I do heave that sigh of relief whatever path they take I do know that they're hyper aware of not hyper aware like in a neurotic way but they're very aware of the the needs and the feelings of other people and they will shape their

behavior in that way and that was the only thing that mattered because I wanted to put two decent kind human beings into the world that's really beautiful I bet if I lined up a 100 parents and asked them if you could only give your kid one thing what would it be I don't think one of them would say empathy that's terrible because I'll tell you I would the world isn't enough smart people and it turns out they do well in school but if I had to choose if somebody said you could give up your kid

getting into like a top college or something and trade that out for empathy I'd be like hell no empathy she could go I don't care what she does but I would not let her give that because parents are concerned they're sharing you know kindness being honest D diligent hardworking I've never heard empathy yeah it's it was everything the way I raised them in fact even how I breastfed my kids I'm like I'm going to stare at them face to face I'm never going to be distracted as much as I can't in the middle of the

night I would I would fall asleep I would stare at him face to face like I started that one early I'm like I'm mirroring these kids that was that important to you important to me was that important guys this is huge for the parents out there getting that because this is this is the leading expert on narcissism and a lot of other mental health topics and her ex-husband both have that shared goal it had to be narcissis I mean it had to be empathy because I think that that's that's the Pay It Forward that's going

to make them better mothers it's it's going to make them better Partners it's going to make them better workers it's going to make them better leaders it's going to make them better friends they win everywhere on that one that's the only quality to me that matters in a human being and so there from from there all other things would be built out whatever they do now you briefly mentioned that around the age of eight or nine there was a moment that you said oh they got it what was that they they were I was actually

watching my daughter play with another child and then something happened with what the child was eating or interacting with and so that child no longer had that thing and my daughter still had it might have been like ice cream or something fell out of it and her face you could see that she she almost got she she experienced that child's feeling before that child experienced her feeling and you could see the hurt in her face and then she's like we have to help them we have to help them and I'm like oh sweetie don't worry

about I think she was worried about the cost and she was even being empathic she knew I was struggling a little financially at that point and to buy another ice cream was going to cost money and she's like is it going to be okay to get them another I said of course sweetheart and then we ameliorated the situation and got a new ice cream but her caring for me having enough money that child suffering it was like it really you know she was me like should I cut mine in half but I already put my

germs in it you know the way a kid thinks it was so it was absolutely automatic for her and you know and we were very lucky they our children went to an infant care center actually at UCLA where empathy was the main thing taught to them all day long so you can build this into caregiving models of you know and I think that started in infant care it was in their preschools it was in their K through I mean I high school it gets harder but it's you know see how it goes for them like

I said as teenagers it doesn't always feel like empathy but I see it with their friends everyone but me and I'm fine with that AB now for now they'll become your friends later um so eight or nine years old you saw this empathe these empathetic tra even earlier but then it was clicked automatic for them when are you when do people start to exhibit signs of narcissism here's where we need to be careful almost by definition all teenagers look narcissistic they're deeply entitled arrogant they think they know uh what's the type of narcissist I compare

them to they them you would call them maybe more the benign narciss Ben narciss and I think that's what it is it is more of the benign narcissism and I think like that's why I'd be very loathe to use that term with an adolescence I always say that adolescence is like wearing a sweater that's way too big for them they're just growing into their personalities they're trying to figure it all out their bodies are changing the world treats them like an adult for one hour as a child for another hour so it's just hard to

be teenager really really is and it's hard to interact with a teenager so that combination means like we're just trying to put a label on it all so I say don't even use that word with adolescence even though the pattern seems to fit I wouldn't start really sort of saying this pattern's making me super uncomfortable probably until their early 20 20s like it's really in place and they haven't kind of grown out of it whether they've gone to college or military service or like trained in a job or something some of that should be correcting

at that point and that's why I would really really look for it in Earnest but would still look for some of the key issues that they are empathic as adolescence when they need to be they may not be to the parents but they should be with their friends and other folks in their purview you know are they really entitled do they really believe they deserve special treatment or you know kids making noise in a restaurant sure that's going to happen but like a kid walking up and saying hey why should I have to wait in

line you know I'm too important that's the problem yeah all right well that that was such a wonderful explanation of of causes and there are seven signs to look out for when spotting a narcissist we're going to go through those one by one what's the first one so the first one's lack of empathy and that's a defining characteristics that's a defining characteristic of narcissism in fact if I see that somebody has really well preserved empathy I'm like nah not even happening so that that to me almost is the requirement it's the Bedrock of this pattern

the second is entitlement entitlement is that sense is that that somehow someone is should deserve special treatment even if to the detriment of other people that somehow they are different than everyone else again sort of Special by Dent of their their existence yeah um the third is grandiosity it's sort of an unrealistic assessment of one's capacity or abilities or they talk about a grandiose world that they don't even live in the things that they may someday do you know someday I'm going to climb Mount Everest so they talk about it as though it's something they're

actively doing or have already done so it's it is a it is again a very unrealistic almost fantasy version of the world they'll often talk about having one day the greatest love affair or the greatest love story or the greatest wedding or the greatest career it's everything is just bigger and Larger than Life number four is superficiality there's a a very vapid quality to narcissism they're really only concerned about appearances how a person looks um what a person owns where they live what they drive what they carry the shoes on their feet it's very very

superficial to the detriment of other characteristics somebody out there might say oh but I love fashion but they're a very sweet kind person that's not what we're talking about we're talking about superficiality with absolutely no depth behind it or judging people solely on superficial um characteristics and quality number five is chronic seeking of admiration or validation it's the constant need to be be receiving praise recognition and nowadays that's really amped up because of social media that they have to get likes and they have to get lots of traction on their social media page and they

need lots of followers and all of that so it's that constant need but and it never stops if you're even close to them like you're their child or you're their partner you have to constantly be telling them how wonderful they are and how great they are and Way Beyond the thing that they've done it's almost a nuisance to get a gift from a narcissist because you have to thank them for it so many times it would have been easier to buy it yourself um number six is their tendency to rage they don't they don't have

good command of their emotions they tend to be all over the map and the one emotion they tend to manifest the most often is uncontrolled Rage that's often because they're so frustrated and they're so insecure and they don't have good ways of dealing with their feelings so it's not unusual for them to just come out when things don't go their way they don't have any tolerance for frustration so you'll see a lot of rage that comes out and number seven I'd really say is arrogance it's um I'm better than you and and in then some

ways that sort of draws from the grandiosity it draws from the entitlement but it can come off as a snobbery as a dismissiveness as a devaluation as an invalidation of other people just sort of like sweeping them away and so those are some of the seven key charact characteristics in my book I actually lay out what I call 31 characteristics it's like I think it's a lot more than just the seven and it takes in a lot more territory jealousy Envy getting pleasure out of other people's misery um lying cheating um you know things all

a lot of really negative interpersonal patterns people who are narcissistic often engage in projection they make their faults and flaws yours like I didn't say that I didn't do that you they'll accuse you of something they did and they'll like you you'll often be quite confused they engage in Dynamics like gaslighting where they question your reality and make you feel like you're literally losing your mind like that never they'll say things like that never happened you'll like but it did but it did and then you'll start questioning yourself did that happen and people who spend

enough time with narcissist find themselves plagued with self-doubt because narcissist so question their oh so often question their reality so with those seven do they have to have all seven of those you know the DSM has that list of nine which takes in most of those you only need five of the nine plus this idea that thing life isn't going well that distress to get it in the DSM I often I'm actually a little more generous I say like you need to have like if you have all if you have five of those seven you're

in trouble but the empath the lack of empathy is the requirement to me all everything so it's like that plus four or five others and not and a huge takeaway for me was in our last episode when you talk about empathy and how it related to raising your kids so if you haven't seen that episode make sure you go back one and take a look there because that was just absolutely for me phenomenal phenomenal um how quickly if I'm just at a party and I meeting people can I find out if someone's a narcissist I

mean I'm a pro and I'm in and out in 15 seconds like I got this i got this like I before I even s our session is going to be 15 seconds you can you know what is at a party it's almost easier right because you know it's kind of mean I probably like cast out a few I it might take me longer some people if they're a narcissist you're going to be able to tell quickly sometimes it takes you a little longer if it's a bit more subtle or covert or something like that but

it can happen pretty quickly you know watch the back and forth of the conversation is there a genuine curiousness about you like do you do you walk up to them and say hi nice to meet you I'm romeny and you'll say hi I'm Kyle and then it's the Kyle show and by the time this conversation is done there's no sense of anything about me and not even an opportunity for me to have offered that you know it also might be how they conduct themselves in that like do they just keep talking about themselves and only

in these sort of unrealistically glowing terms do they almost seem too but at The Other Extreme they also may be a little bit too slick and too smooth like you know maybe not like they're coming on to you but like it's just almost too Charming I find Charming people terrifying because I know that's often like the soft sign that psychopathy or narcissism is coming around the corner so Charming people I actually like uncharming people like the more socially awkward you are the more I'm like this could be a real sure this is great wonderful sign

me up so if I meet somebody and I suspect they're a narcissist because they're only talking about their themselves they're not interested in me at all they're very grandiose in their uh the content that they're putting out there are there any questions I could ask them that could give me some instant feedback you know what you can do is ask them something that has more that pulls them away from talking about their work like let's say they're talking bragging about work work work they're sort of like only talking about one thing try to change it

to something else like what are the things that bring you Joy like really ask them like a fely question and then if they like like they just sort of like become like huh feeling I'm going to go get another Martini like they run away that's probably a sign like if you I it's sort of a game for me at a party if I think I've met a narcissist I'll say can you tell me about a little bit about your inner world because I know what you do now and they I'll often get people who look

at me like I just I'm speaking in tongues and they'll often say I see someone over there I got to go and they'll often really cut the conversation people are going to be so nervous when they meet you at a party now like hey by the way I'm not a narcissist I saw you on out um that's also a show I would definitely watch you with a hidden camera just meeting people yeah in in La it's actually it's it's Blood Sport here fishing with dynamite it's like going it's like seashell collecting by the end of

a party you've got like enough you've got enough really I know we joke about how narcissistic La is but it really is true yeah we live here we work here it's Insanity it really is but here's one thing that you want to be I mean again I don't want people dismissing people in like the first 15 seconds they meet them let's say someone does talk about themselves a lot the other thing you do want to be mindful of is they may be socially anxious so they may have trouble kind of taking and rolling with it

that's why I'm saying if you could slow the conversation down maybe even make it about something that's happening around you like something very sweet like something that you know they're drinking or something special they may be wearing well but making them make it more special not like well this is the designer label but try to make it about the moment what's personal and see where they can go with it share a little of yourself also start talking about yourself a little they done their whole dog and pony show see what happens when you start talking

about yourself if they glaze over or they start using their phone at that point not a good sign if I do find myself in a situation where I'm in a relationship whether it's romantic or otherwise with a narcissist what can I do well that's you know here it is it's going to it's going to be painful if you really and by the time a lot of people detect these patterns it's been years sometimes um if we're lucky they don't have kids together because that can start getting messy if the relationship goes south because a custody

battle with a narcissist is is it's War it's it's one of the most painful things I've ever witnessed if you sense that that's where things are going you need to get yourself into therapy right away and you want to get the couple into therapy the challenge with couples therapy with a narcissist is unless you've got one very skilled therapist that narcissist can really play the therapist and I've seen that happen many many times you want to be really really careful how do they play the therapist they win them over they charm them and sometimes the

narcissist is sort of the more materially successful or the more successful seeming partner and they'll kind of again they they'll charm them they'll charm them you have to be somebody who just dislikes charm to really not be Charmed right so they'll really play them and work them and and and flatter them and narcissists actually are quite good at sort of sniffing out how to validate another person because they are they need it so much they're really good at dispensing it when they need to wow so they can really work the game but it's important you

get therapy you consider getting yourselves into therapy you pay attention to the patterns and you really have to do some hard looks into the mirror on if if this is as good as it's ever going to get which is probably the case can you live with this forever that's the question and if it's if it you don't like that then you've got one of two paths either you've got to adjust your expectations this is how it's always going to be or you got to get out well and those two paths is what we will be

discussing next you you mentioned to me off camera that there are people in a relationship with a narcissist and they don't even really realize that they're being abused explain that there's a couple of reasons that could happen one is what I call sort of the historical reason they may have come from a family where one or both parents or someone significant a family system was narcissistic or abusive so for them abuse and relationships go went back to the miring thing right so they just don't even like everyone's going to this is all I deserve this

is how I'm treated and so they're often a easy Mark for getting in with a narcissist whereas other people might have already broken up with the narcissist they end up with they stick it out because it's almost the sense of they they were sort of raised up in that and so they don't even think they deserve more or they just don't question it and so they're used to saying well maybe if I try harder they'll love me maybe if I try harder so it can it becomes a sense of there it's a self-blame the self

approach I this is my fault they're telling me that they're yelling at me cuz I didn't keep the house clean or I don't look good or the kids were noisy or I don't make enough money or I'm out of the house too much or whatever the reasons are and they actually blame themselves keep thinking if I fix this this and this then maybe this will turn around in what types of relationships do you find narcissism a problem the most I would say where you know listen the two sets of relationships where I think is most

problematic is in an intimate partnership like a husband wife um boyfriend girlfriend kind of thing or a parental relationship when it is your parent because the parental relationship is you know if you have a narcissistic mother or father or perhaps stepparent that sets a tone that you're going to take into adulthood and it's going to color how you choose a partner what you endure in a job it just your your own sense of self-worth so many things in the long term can get harmed by having a narcissistic parent it's not it's by no means a

sentence and I've seen many people have had brutally narcissistic parents who go on to joyful lives so it's not like you're doomed but it definitely is a vulnerability then in the flip side is obviously when you meet someone and you think you believe you've fallen in love with them and you try to make a life with them and they spend their days dehumanizing you invalidating you yelling at you putting you down disrespecting you that's miserable and you really you might stick it out because you feel like you have to or I'm not loving them well

enough it's you know sort of what I call the Beauty and the Beast fantasy maybe if I love the Beast enough he'll turn into a prince and there's a lot of people who sort of fall into that bucket and so it those are the two relationships where I see it's the most harmful but you know listen if you have a narcissistic boss it can throw off your career if you have a narcissistic sibling you might feel like you don't have a confident but I do think the parents the partners that's really where the rubber meets

the road what triggers narcissist narcissistic abuse well what triggers narcissistic abuse is the insecurity and the ego of the narcissist being threatened and they explode with narcissistic rage the problem is for a while you can't figure out what it is that's setting this narcissist off it can often be the littlest slight it could be that they had a bad day somewhere else and they're taking it out on you it's like coming home and yelling at a pet because you can't yell at your boss kind of thing so you don't know what the thing that set

it off but all you do know for sure is somewhere along the day their ego got injured they felt out of control their insecurity boiled over and it's the people people closest to them that often feel like they're easiest targets especially if you keep forgiving them and giving them Second Chances then they're like ooo this is great I can keep coming home and doing this get all my rage out this person's still sticking around great would a narcissist date somebody for let's say five years then get married and then start the abuse no a lot

of people say well they became narcissistic after we're married I was like oh no they did not first date it was there narcissism is a pattern that's that you bring into it from early adulthood on I mean it was developing all along right but it's there from the jump and when we do sort of the autopsy on the relationship and really go right back to the beginning they'll say yeah I guess he was late to all our few first few dates and there was a lot of really poor boundaries and one time he got screamed

at me because I mistakenly ate his order of fried rice or whatever it may be that the patterns were there they just were romanticizing it cuz like and he wanted to spend all this time with me he wanted to be with me 247 that to me is an alarm Bell that's really controlling this this series is about narcissism as a general uh topic however I look at this a lot as the the the series to watch if you're going to start dating amen this knowing this information having this power having this education allows you to

avoid 5 10 15 20 maybe 40 Years of disaster you better believe that prevention in this case is the best cure if we could keep people from getting these relationships in the first place because what you got to remember is I've known people who actually were well put together kind empathic relatively confident they'd get into a relationship with a narcissist 15 years later they're a shell of their prior selves they're riddled with self-doubt they uh they've complete an utter loss of self-esteem they don't know which way is up they completely think they're undeserving I mean

it really does a number on them from the inside out so if we could stop it from the first place because what ends up happening is once a person's in people will often fight for a relationship so that's where you want to stop them from getting in in the first place and especially if you have kids oh once you have kally if you're financially dependent on that person and many narcissists try to make their partner financially dependent on them they ensure that they quit their jobs or you know make it so that because that's one

way that can make sure that person doesn't leave them and allows them to control them because control is a big part of the narcissistic Dynamic yeah it's I'm I'm so thankful that I'm learning all this um if you find yourself getting getting abused by a narcissist in a romantic Rel relationship what are your tips for that person if you're being abused in a narcissistic relationship first of all I'm always going to say especially to Med Circle listeners if you're being physically abused or any other abuse that's putting yourself or other or children children or other

dependent adults in that environment at danger you must get help and I'm hoping Med Circle might even be able to put like a connection to the National Domestic Violence hline because you've got to get help immediately um that's that's that's a danger and a risk situation beyond that we're really getting also into psychological abuse which and emotional abuse which to me are equally harmful equally harmful as physical abuse that you need to ensure that you're getting appropriate Mental Health Services uh perhaps even through a support group that other people being affected by this narcissistic abuse

like kids are getting Mental Health Services because they're seeing this happen make sure that you take care of you because it's very easy for your health to fail when you're in a a relationship with a narcissist I've seen people get very very ill due to a variety of stress related illnesses and I had to wonder how much of this was really due to years of being in a relationship with a narcissist cultivate other support networks people who are narcissistic often try to isolate their Partners they don't want them to get the support and validation of

other people so break out of that isolation if it's friends at work friends at your spiritual Community your church your temple whatever you know but find a way to get those people you can someone at the gym somewhere create friendships in other spaces so you don't get too far down the rabbit hole family members just to get that dose of reality that kind of thing all of those things become important you need a reality check a lot of times people it's almost like you want people to see you with that person but here's the thing

thing a lot of time narcissistic people don't verbally abuse their Partners in front of other people they're smart enough to know they got to look good to the public and they save that for behind closed doors or in the car or whatever yeah that that's what I was just thinking is first Having the courage and education and wherewith all to know I'm in this scenario this is this is bad this is hurting me and it's likely because of this yeah I think people are afraid to admit that they're very they're ashamed there's a lot of

Shame it's so sad I've worked many people who were in a relationship with a narcissist and they were horribly ashamed and embarrassed that they let it get this far and I said you know what it's not like it went from this to this in a day no this has been happening over time and you've almost sadly slowly been adjusting to this change in the climate and now you're here and yes it looks gruesome from here but this didn't happen overnight and we're not going to be able to undo it overnight it's the Frog sitting in

a pot of water frog yeah but the Frog can still jump out so jump out yeah but until the Frog gets boiled to death that's the problem we're trying to catch people before that happens yes we are what about people who are in a who have a work relationship uh and they their coworker is narcissistic and abusing them how do they handle that when you have a cooworker who's behaving in that way you've really got to protect your interests because most HR departments can't do much without documentation I tell people when you're in that situation

you as soon as you start a new job create little email folders for everyone you work with and save everything hopefully you never need it and 40 years down the road you had the most exam wonderful career and you just they clear out your account and it's done it's not going to be most people so you save everything and it starts to get a little wonky and you have to be very careful because if it's a company server you may need to print hard copies of these emails you may not have access to that you

may not be able to do stuff with that at work make sure you create files when you work with difficult co-workers save every email save text messages I mean we're talking everything um when you try to meeting with them oneon-one alone if that's possible if you can have someone else in the room with you and you know it may sound weird you don't have to make it hostile but try to make it that there's other people present because then that gives you you know again another another set of ears however if you can't have that

one thing I recommend people who have a narcissistic coworker they're concerned about create a memo after the meeting send the memo say I just want to make sure that this is a very clear review of what we just met use quotes wherever possible put a read re seat on the email so you know they receive the memo and then keep that as a keep these things as records and so you really want to ensure that you have that because you can't do much in terms of HR or with an attorney until you have all of

that but we also know that workplace stress is actually the type of stress most associated with developing physical illness so it really is important that you manage your workplace stress once again consider getting therapy have a safe confidential space yes don't don't don't make this about workplace gossip it's so easy to have those whispered conversations then you're the one who might end up getting into trouble don't post your work not going to fix not going to fix anything don't put your workplace Strife on social media if you have a narcissistic cooworker and they don't go

and they decide to go there don't get in the mud with them you've got to play a clean game when it's this kind of situation make sure you engage in self-care and then you might want to slowly but surely if you feel like the writing's on the wall let's say this narcissistic coworker has outlasted everyone Maybe the culture of the company is that they're not going to get rid of this person maybe it's the boss exactly and if it's the boss you have even more problems same rules but you may need to start working on

an exit strategy sadly we do know that there's some interesting research that has come out that when people work in a narcissist like with a toxic narcissistic boss that you'll sometimes find that they ban together and do some interesting work together it can actually cause like when you're United around a common enemy that can create something interesting the boss is narcissistic and the co the workers might actually all Unite so that can sometimes be a nice Downstream effect make sure you have allies at work you know people you can turn to not for gossip but

just to ensure that you're protecting yourself but also realize you may need to cut your losses it may be the dream job but it's not the dream job if you're working with toxic colleagues slowly craft an escape strategy and do it quietly because in some places they may be vindictive enough to stop you from trying to get a new position it can get really dark really really fast I hope people had their pen and paper out for that cuz that was a lot lot of actionable amazing tips what about the support okay I have a

friend who's in a relationship with a narcissist how do I help that friend number one do not call their partner out cuz that person's going to feel the need to defend their partner don't okay don't call that don't call the partner out in any circumstance no definitely point out the patterns and the behaviors and listen non-judgmentally it can be very overwhelming it's so hard because you want to say here's my right now and to say you really want to say it it hurts to hear this it must be hurt even more to be experiencing it

that's good you know so when someone you love is telling you that they're being hurt in a relationship your temptation is just want to go tear that person's throat out be with your friend's pain but don't give them an unrealistic plan say right now we're going to your house we're getting your stuff or getting out they may not be willing to do that and that might scare them to even talk with you more listen listen not judgmentally tell them like this doesn't feel okay this feels like abuse to me are you okay and then ask

them the million dooll question how can I help we all want to give advice we all want to get in there and fix it how can I help your friend may say you know what you're helping just listen you know and I'm going to be calling you in the middle of the night and say I'm here instead of saying okay let's rent you an apartment right now let's do this right now you know that's overwhelming and a person may be really really freaked out so when our when our our loved ones are struggling we often

want to get in there and do what I call casser rolling like somebody died here's a tunic casserole I'm like I don't know that they want that maybe they just need you to listen and if they want a tunic casserole trust me the last yeah so ask them how can I help in conducting all these interviews with you and lots of other experts the power of asking a question to somebody you love is is probably the best way to show support if you ask it without judgment if you ask it with sincerity and if you

ask it without trying to get anything from them not like well do you think moving would help that's not the right question but how can I help I'm sorry you're going through that that must be T those questions I mean are so simple so easy they're huge and also don't second guess them a person in a narcissistic relationship is being second guessed and doubted 100 times a day last thing you want to do is say are you sure that's happening that's gaslighting your friend and that's now you're participating in the abuse yes you know I

mean you listen to your friend why is your friend going to lie about this and if this is a track record of lying about this stuff you need to find a new friend get a new friend you know so I mean but you really if this is because odds are by the time they're coming and telling you this it's been going on for a while yes wow uh I loved everything that you put out here because it gave me one big sigh of relief that there is hope there people are out there dealing with a

narcissist you know the thing that happens to people who are in narcissistic relationships is a phenomenon we call learned helplessness and is a you know theoretical model that came out in the 1970s but when it plays out here a person in a relationship with a narcissist feels that nothing they do helps no matter what they say what they do how they communicate how they look anything ever changes anything so they start feeling helpless and they get paralyzed and then they get stuck and many times they often become can also become depressed because learned helplessness is

considered to be part of the developmental model of depression so it is a it's that sense of nothing I'm doing is working when you're in a relationship with someone and you feel like nothing you're doing is working that could be a real ringer that you're in a relationship with a narcissist well luckily you provided plenty of tips plenty of actional steps for people to take but the question remains is there hope for the narcissist themselves Dr okay so first of you got to you got to get him into the therapy room right so most narcissists

do not come into therapy saying hi I'm a narcissist and I want therapy I had I did have one person in my career do that and literally walked in the drawer that's what he said I'm a narcissist and I want therapy I said have a seat let's see what we can do and um well hold on and was he a narcissist what a narcissist personality disorder and what kind of help did he get it's long-term Insight oriented work but it's slow it's really really slow and he's very committed to Growing to to doing better he

wants this and it's it's an incredibly slow process and this is a guy who wants it so when people say is there a treatment model that works well with them I would say we typically learn a person is narcissistic in therapy because they came in with some other problem I'm having problems with my girlfriend it might be substance use I've been feeling sad work isn't going well I'm not getting along with my boss I'm mad at my mother so they'll come in with something else and then they'll tell you their story and maybe by the

first or second session you'll be oh I'm getting this you might even notice in the first session because there'll be a real antagonism from them to you is sorry to interrupt you but we mentioned in a previous episode very quickly you can spot if someone's a narcissist you specifically if you're at a party in a therapy session it takes you one a long is it because they're guarded they're guarded and we're having a very curated kind of conversation you might Pi some of the top pretty they'll talk about all their achievements and I once had

somebody say you want to know how many cars I own let me tell you how many cars I own one person even said I could buy and sell you 20 times over and I was thinking more like 40 but okay um you know so some of it's like like right out there like you'd really what is your reaction when someone says that you know I mean utter humility I'm like that you know that's so interesting but I actually don't care so let's you know so say don't care then what do they say they'll say they'll

look offended and I'll say you know I'm actually trying to learn your inner World other stuff that's that's all fluff to me you know so please tell me about we're going to work on this inside and that's of course terrifying because those shelves are a lot more empty yeah that's why they have 20 cars exactly that's why 20 cars but you know there's no kind of there's nothing but room at the end kind of thing so it's that that's the struggle but I have to say that you often end up working on the thing they

came into therapy with the relationship problem the substance use issue whatever it is is okay but then you start working backwards on the other you know we dig deeper what was childhood like what was you know how do they manage frustration how do they manage anger and rage a lot of the work of therapy and working with narcissistic client is building a trusting Therapeutic Alliance you got to like them and I got to tell you I've worked with some people brutally brutally narcissistic I like them I mean some of them I've really liked I could

I'm like wow I see the vulnerability and I'll even see that I say I see the beautiful little boy and I'm so sad the world missed out on this and they'll cry and they'll cry a lot you know like and I'll see it like there's something there's no point I'm going to get paid the same whether or not I'm saying nice stuff you know what I'm saying like it's not like I get it paid on per compliment basis right so you're trying to you want to you want to get them to come in every week

cuz something's happening sometimes they try to outplay you or tell out with you and tell you I know more things than you and I said you know what I'm always I'm always a student so teach me so what I don't do is get in the mud with them I don't defend myself you know if they don't feel you know if they don't feel I'm good enough and I heard that like you know you're not that good I'll say that's absolutely important you feel I am good and I have a list of referrals and I pull

it out of my desk and I say I actually highly recommend these therapists as well so they're used to people going you know going you know head-to-head with them I don't play that game and I think good therapists who work with narcissists don't so it's really that you work on the current issue you work backwards you try to create a strong consistent empathic therapeutic Alliance when they tell you a sad story you genuinely feel sadness you'll say my gosh that's so sad and you know what I'll often get is I never thought of it that

way and I'll say really because I'm actually feeling that inside and then we'll break that down wow the the difference in our two emotional experiences so you sort of learn in the moment um I try to work on mindfulness techniques with them like how do they catch themselves before they say the hurtful words how do they manage the anger what's the sour we ask them what the source of the anger is so it's really about it's cognitive behavioral work but it's a lot of it's humanistic work there is something good in there and my job

it's almost like being a prospector we're going to find it we're going to show it to them and we're going to cultivate it and so it's some of its existential work can they learn to start taking responsibility for the hurts they perpetrate on other people and perhaps try to find another path next time if you're willing to do that kind of depth work we might be able to get you somewhere but it is they're baby steps let's say a really high functioning and athic solid person is sitting up here the kind of person who going

to take care of you if you're sick and is there for you and doesn't need validation all the time okay and a narcissist is down here okay or even down here we're not getting him here right we're not getting him here we're going to get him here and maybe that's enough that might be enough to say all right I'll stay in the marriage I realize it's not satisfying or someone's like all right I'll try to cultivate a relationship with my dad but realize it may not be what I wanted or yeah okay like you know

I can try to keep working with this person if you getting them from here to here is Herculean this isn't possible and if this is the standard it's not going to fly one of the traits of a narcissist is that they lie mhm and one of the keys to successful therapy is honesty yeah so how do you make that happen depends on what they're lying about depends on what they're lying about um they may lie about certain ridiculous kinds of achievements they might exaggerate the carrot weight of a DI ring or the price of a

purse it's such nonsense I wouldn't know you know what I'm saying if you tell me the the bag or the car cost this much it it's irrelevant it's really things like are they lying about whether or not they're using substances um are they being honest about something we made an agreement to be honest about and be make it that a high stakes game like it's almost like a contract you make with them say this is only going to work if you're honest with me the confidentiality brought about by therapy helps a lot because you can't

say like hey I'm going to call all your friends and say that blah blah blah you're having an affair or something like that that's not I'm not going to do that so it sort of stops kind of there and um so it is it's about creating that becomes an honest space the lying really there's no incentive they're not trying to date me so I'm not going to be impressed by their car you know what I'm saying because nothing like that is happening so it's in some ways you might have to catch them in their patterns

say gosh you come in here a lot and you talk a lot about all the stuff you have and while I'm sure you enjoy and while I'm sure it's beautiful it's really not relevant in here and it's getting in the way of me getting to know you you know and so you're kind of taking away their usual um their usual tools are there medications that can work depends on what else the person with narcissism is living with everyone wishes there was a magic pill of course everyone begs there's got to be something he can take

there's no jerk pill yeah like if there was the anti-jerk pill big Pharma would be making more money than they already are trust me okay so so sometimes people will try things like anti-depressants with people with narcissism because they are having sort of an irritable Edge sometimes it works sometimes it doesn't sometimes people will use anti-anxiety medication with narcissist because they're having anxiety about a specific situation in their life typically because they're not getting enough validation sometimes there'll be drugs used to manage issues around addiction but that's much more specific to the addiction and it's

not going to address the narcissism but it would be the other things kind of hanging out with the narcissism that you use medication for there is no known medication out there that is labeled for use to manage or treat narcissistic personality disorder or narcissistic traits if a couple is in therapy or couples that you've personally had have you ever suggested to The non- Narcissist in the in the couple leave if I'm working with a couple I've never done that but God I've been tempted I mean like you almost wanted to slip them a note like

on their way out right ethically it's not how I roll if there's a case of domestic VI