DeepSummary
The episode begins with a discussion on the different perceptions and definitions of narcissism, ranging from the popular culture notion of labeling someone as 'the narcissist' to the more nuanced psychoanalytic view that distinguishes between healthy and unhealthy forms of narcissism along a spectrum. Dr. Jonathan Shedler provides a clinical perspective, explaining that narcissism is a personality style that exists at different levels of organization, from neurotic to borderline to psychotic.
The conversation delves deeper into the specific characteristics of narcissistic personality disorder, highlighting the coexistence of grandiose and inadequate feelings. Dr. Shedler describes the defensive mechanisms employed by those with narcissistic traits, such as splitting, projection, and projective identification, which can lead to devaluation, exploitation, and gaslighting of others. He also discusses the challenges faced by therapists in working with patients exhibiting these behaviors.
Towards the end, the discussion shifts to malignant narcissism, which overlaps with psychopathy. Dr. Shedler emphasizes the importance of understanding human complexity and avoiding black-and-white categorizations of individuals as heroes or villains. He stresses the need for therapists to engage in personal psychotherapy, supervision, and consultation to effectively work with patients exhibiting narcissistic and borderline personality traits.
Key Episodes Takeaways
- Narcissism exists on a spectrum, with both healthy and unhealthy forms, ranging from neurotic to borderline to psychotic levels of organization.
- The hallmark of narcissistic personality disorder is the coexistence of grandiose feelings and feelings of inadequacy and emptiness.
- Defensive mechanisms like splitting, projection, and projective identification are often employed by those with narcissistic traits, leading to devaluation, exploitation, and gaslighting of others.
- Malignant narcissism overlaps with psychopathy, characterized by a lack of empathy, sadistic tendencies, and a primary focus on power and dominance over others.
- Therapists working with patients exhibiting narcissistic and borderline personality traits need to engage in personal psychotherapy, supervision, and consultation to effectively navigate the complex dynamics and countertransference.
- It's important to avoid reductionist categorizations of individuals as 'the narcissist' and instead recognize the nuances and complexities of human psychology and interpersonal dynamics.
- Self-awareness, acknowledging one's contradictory impulses, and avoiding dissociation or externalization are crucial for personal growth and healthy relationships.
- Understanding the psychological underpinnings of behaviors like gaslighting and abuse, rather than labeling them simplistically, can provide insight into the dynamics at play and potential paths for intervention.
Top Episodes Quotes
- “If we're going to get technical about it, at best, it's externalization as a defense. Right? If you're in a relationship with someone, if you're in an ongoing relationship, it's very complicated. There are two people's psychologies in the mix. There are two people's psychology is interacting. You know, it's very hard to disentangle what's what.“ by Jonathan Shedler
- “If we're trying to be self aware, trying to become better human beings as we go about things, we're not shutting out our capacity to do harm or, you know, our pleasure that we might take in cruelty. We're not pretending or dissociating and saying, that's not me. What we're saying is, I feel those impulses. I have fantasies, I have thoughts, you know, fantasies are free. Fantasies are not the same as acting on it, fantasizing, you know, about paying someone back.“ by Jonathan Shedler
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Episode Information
Psychiatry & Psychotherapy Podcast
David Puder, M.D.
6/30/23
In this episode of the podcast, we are joined by Dr. Jonathan Shedler to discuss narcissistic personality disorder. Dr. Shedler is a psychologist, consultant, clinical educator, researcher, and author with over 100 scholarly publications. His article, “The Efficacy of Psychodynamic Psychotherapy,” has garnered worldwide recognition for establishing evidence-based support of psychodynamic psychotherapy.
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