Heal NPD – Details, episodes & analysis

Dr. Mark Ettensohn answers questions and responds to viewer comments in a livestream broadcast from 7-25-24. 

In this episode, Dr. Ettensohn draws on psychodynamic dimensional models of personality development to describe narcissism and NPD at the psychotic level.

Characterized by compromised reality testing, symbiotic object relations, low integration between parts of the self, and the use of reality-distorting defense mechanisms, psychotic-level NPD represents both the least developmentally mature and most severe form of the disorder.

This episode explains the spectrum of personality development, from psychotic to healthy. It then explains the psychotic personality organization in detail, providing descriptions of specific defense mechanisms utilized at this level. Finally, psychotic-level NPD is described.

Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH

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VISIT THE WEBSITE: https://www.healnpd.org

Cited References:

Berney, S., de Roten, Y., Beretta, V., Kramer, U., & Despland, J.-N. (2014). Identifying psychotic defenses in a clinical interview. Journal of Clinical Psychology, 70(5), 428–439.

Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven: Yale University Press.

McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press.

In this episode, Dr. Ettensohn outline 4 reasons why empathy may be impaired in pathological narcissism and NPD:

1. Lack of self awareness 2. Objectification of the self and others 3. A 'starvation mindset' 4. Avoidant attachment styles

Dr. Ettensohn also discusses his disagreement with Dr. Ramani's ideas concerning empathy and NPD, as expressed in the following video on her channel: https://youtu.be/O7qxMu3nSLw

Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH

LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8

VISIT THE WEBSITE: https://www.drettensohn.com/

References: Ettensohn, M. D. (2013). The relational roots of narcissism: Exploring relationships between attachment style, acceptance by parents and peers, and measures of grandiose and vulnerable narcissism. Dissertation Abstracts International: Section B: The Sciences and Engineering, 73(10-B(E)).

In this episode, Dr. Ettensohn explores the connection between illness anxiety and pathological narcissism. This episode explores how illness anxiety in NPD can be disguised anxiety about loss of self or psychological disintegration.

Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH

LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8

VISIT THE WEBSITE: https://www.drettensohn.com/

References:  Segal, H. (1957). Notes on Symbol Formation. Int. J. Psycho-Anal., 38:391-397

Winnicott, D.W. (1974). Fear of breakdown. International Review of Psycho-analysis, 1: 103-107.

The term ‘narcissistic abuse’ has been, itself, heavily abused. Is has largely been a pop-psychology term that means different things depending on how and where it is used. It is often used to demonize individuals with pathological narcissism and NPD, who represent an at-risk population for depression, self-harm, and suicide. 

In this episode, Dr. Ettensohn provides a new definition for narcissistic abuse - one that is *actually* specific to pathological narcissism and NPD. This new definition is based on the psychodynamics of the disorder itself, and describes an inter-generational chain of emotional mistreatment that creates narcissistic pathology in children, who then grow up to use people in the same way that they, themselves, were used. 

In this episode, Dr. Ettensohn discusses the emptiness that individuals with pathological narcissism and NPD often experience using the concept of ‘Self as Object.’ 

Individuals with pathological narcissism and NPD often report having been treated as an object for someone else’s gratification in childhood. This early exploitation can cause profound disconnect from emotional authenticity, because it necessitates the development of false self adaptations to protect against overwhelming shame, envy, and rage. 

Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH

SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8

VISIT THE WEBSITE: https://www.drettensohn.com/

In this episode, Dr. Ettensohn discusses the relationship between social anxiety and pathological narcissism and NPD, focusing on underlying fears of shame and humiliation, loss of self, and the legacy of relational trauma.  The second half of the episode discusses general strategies for addressing social anxiety.  References:

Sartre, J.P. (1964). Nausea. New Directions Publishing Corp. 

In this episode, Dr. Ettensohn clarifies the concept of Malignant Narcissism, drawing on the model developed by theorist Otto Kernberg. Common misconceptions are dispelled. Object Relations Theory is used to discuss the origins of both NPD and Malignant Narcissism, highlighting developmental differences between each disorder.

Two meaning of malignant narcissism are discussed:

1. Malignant narcissism is a combination of narcissistic personality, antisocial traits, ego-syntonic sadism, and paranoid thinking that represents its own personality constellation distinct from Narcissistic Personality Disorder.

2. Malignant narcissism represents a phase or episode of narcissistic pathology in which repressed or split-off identifications with sadistic objects rise to the surface and become enacted in relationships. This is often due to loosening of grandiose defenses in psychotherapy.

Link to Episode discussing Borderline Personality Organization referenced in the video: https://youtu.be/ZZP6gAm5L6c

VISIT THE WEBSITE: https://www.drettensohn.com/

BUY THE BOOK: https://amzn.to/3nG9FgH

References:

Ettensohn, M.D. (2011). The relational roots of narcissism: Exploring relationships between attachment style, acceptance by parents and peers, and measures of grandiose and vulnerable narcissism. (Doctoral dissertation).

Goldner-Vukov, M., & Moore, L. J. (2010). Malignant narcissism: From fairy tales to harsh reality. Psychiatria Danubina, 22(3), 392-405.

Kernberg, O. F. (1970). Factors in the psychoanalytic treatment of narcissistic personalities. Journal of the American Psychoanalytic Association, 18, 51-85.

Kernberg O.F. (1984). Severe Personality Disorders. New Haven, CT: Yale University Press

In this episode, Dr. Ettensohn discusses the topic of integration. Pathological narcissism is a disorder in which different parts of the self are not well-integrated, creating large disparities and discontinuities in identity, self-image, and perception of others. This phenomenon is sometimes called "splitting," and is thought to be partly due to chronic relational trauma and neglect in early childhood. Dr. Ettensohn explains how this occurs and provides suggestions for beginning to approach life more wholistically. 

In this episode, Dr. Ettensohn discusses the importance of recognizing the resiliency of those who struggle with NPD and pathological narcissism. Each person's psychology is a story of survival. In our focus on deficits and pathologies, we often overlook the strength of the individual and the sometimes surprising and ingenious ways that they have found to survive. 

References:

Rogers, C. (1980). A way of being. Houghton Mifflin.

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