Narcissist’s Dream: The Dream (Part 1 of 2)
A man who believes he is a narcissist has a dream in which he is in a run-down restaurant with two friends. He is confronted by an old, obnoxious, drunk woman who throws food at him, and he calls the police. He then opens a dam and water flows through a huge room. He sees a pretty woman but does not meet her due to getting grease on his hands and clothes. He is then confronted by a policeman who tells him to leave town. The man feels both elated and ashamed and does not know where to go.
Passive-Aggressive (Negativisitic) Patient Therapy Notes
The negativistic, passive-aggressive personality disorder is not a formal diagnosis in the psychiatric community, but it is widely diagnosed and treated. In a simulated therapy session, Mike, a 52-year-old male diagnosed with negativistic or passive-aggressive personality disorder, attends therapy at the request of his wife. Mike is emotionally absent and aloof, and he regards psychotherapy as a form of conartistry. He admits to being unappreciated and underpaid at work, and he believes that he deserves more than that. Mike is a cantankerous curmudgeon who sulks and gets into arguments.
Borderline Personality Disorder Patient Therapy Notes
Do is a 26-year-old female diagnosed with borderline personality disorder. She struggles with maintaining a stable sense of self-worth and self-esteem, and her confidence in holding onto men is low. She has had six serious relationships in the past year, all of which ended due to violent fights over trivial matters. Do admits to physically assaulting three of her ex-partners and has suicidal ideation, which sometimes manifests in minor acts of self-injury and self-mutilation. She also struggles with drug use, shopping addiction, and binge eating.
International Classification of Diseases (ICD-10)
The International Classification of Diseases (ICD) is published by the World Health Organization and included mental health disorders for the first time in 1948. The ICD-8 was implemented in 1968 and was descriptive and operational, but sported a confusing plethora of categories and allowed for rampant comorbidity. The ICD-10, the current version, was revolutionary and incorporated the outcomes of numerous collaborative studies and programs. However, an international study carried out in 112 clinical centers in 39 countries demonstrated that the ICD-10 is not a reliable diagnostic tool as far as personality disorders go.
Brain Injury, Head Trauma, Personality Disorders
Head trauma can cause temporary narcissistic behaviors and traits, but it cannot induce a full-fledged personality disorder. People with brain injuries may acquire traits and behaviors typical of certain personality disorders, but head trauma never results in a long-term personality disorder. Medical conditions can activate a narcissistic defense mechanism, and certain disorders, like bipolar disorder, are characterized by mood swings that are not brought about by external events. The biochemistry of narcissistic personality disorder is not well understood, but there seems to be some vague link to serotonin.
Narcissist: Normal People are Enigma
The narcissist feels that they cannot understand normal people and that they are often exploited in their relationships. They try hard not to offend others and give a lot, but it seems that they can do nothing right. The narcissist feels that they are a mental leper and that people only tolerate them because of what they can offer. They acquiesce in the asymmetry of their relationships and have known no differently since their early childhood.
Narcissism of Small Differences
Narcissism of Small Differences is a phenomenon where people reserve their most virulent emotions, aggression, hatred, envy, towards those who resemble them the most. The ugliest manifestations of racism up to genocide are reserved for immigrants who look, act and talk like us. The more they try to emulate and imitate us, the harder they attempt to belong, the more ferocious our rejection of them. The more similar you are to someone, the more you want to distance yourself, the more you want to render yourself unique, the more aggressive and violent and vicious you are likely to be towards him or her.
Narcissistic Grandiosity Bubbles
Grandiosity bubbles are a rare event in the life of a narcissist. They involve the creation of an imagined, self-aggrandizing narrative that the narcissist weaves around elements of his real life. The narcissist modifies his behavior to conform to the newly adopted roles and gradually morphs into the fabricated character he has created. The deflation of a grandiosity bubble is met with relief by the narcissist, who views it as an experiment at being someone else for a while.
Narcissist: You are Cardboard Cutouts, Avatars
Narcissists lack object constancy, which means they struggle to see people as reliable, predictable, and trustworthy. Instead, they create mental representations of people, which are often confabulations and projections of their inner world. These substitutes provide the narcissist with narcissistic supply, but they have little to do with reality. When confronted with real people, the narcissist is often dismayed and refuses to accept the facts, preferring to interact with their mental avatars instead.
Narcissists Hard to Spot
Narcissistic personality disorder is difficult to isolate with certainty, and it is important to distinguish between inherent traits and reactive patterns. Narcissism is considered pathological only when it becomes a rigid personality structure with primitive defense mechanisms and leads to dysfunctions in one or more areas of life. Pathological narcissism is the art of deception, and the narcissist projects a false self to manage social interactions. Victims of narcissists often find themselves involved before discovering the narcissist’s true nature, and the narcissist emits subtle signals even on a first or casual encounter.