“I really appreciate your seeing me again,” Estelle Peterson says wringing her hands. I had previously seen Mrs. Peterson for a number of years. Although we made some progress in curbing her anxiety, she remained a constant worrier.
“My daughter’s pregnant,” she says.
“Congratulations. I remember you were afraid you’d never have a grandchild.”
“Yes, yes, that’s true,” she says dismissively. “But she lives in Florida.”
“And that means?”
“Zika!”
“Oh, you’re worried about her getting the Zika virus.” Concern about Zika is certainly understandable, but I suspect it will only fuel Mrs. Peterson already considerable anxiety.
“And having a deformed child! I can’t imagine anything worse. I told her she has to leave Florida. Right now. Right away. She doesn’t have to worry about me, but she has to take care of her baby! I told her to go stay with her sister in Connecticut.”
“And she said?”
“That it wouldn’t be a practical. That she and Jonathon have jobs. That they just couldn’t pick up leave.”
“I told she could just quit her job and Jonathon can stay here, that she’d be all right with her sister. Then she got mad at me and told me to stop it. I told her I couldn’t stop it, that I couldn’t bear to spend the next six months worrying about her baby. They hadn’t even told me right away, so I’ll probably worry anyway, worry if one of those mosquitos got her early on. But she won’t listen to me. I don’t know what I’m going to do. How am I going to get through her pregnancy?”
“How’s your daughter feeling about being pregnant?”
“What? Oh, she’s pretty good. She said that some of her morning sickness was pretty bad, but I told her not to worry about that, that was to be expected. I remember when I was pregnant with her and her sister. I thought I would die. But I didn’t. And she won’t die either. But I might die of a heart attack if I have to worry about the baby for six months.”
I remember now. It wasn’t only Estelle’s constant worrying that was so difficult, but also her need to make everything about herself. Everyone’s pain becomes her pain. She sees herself as being constantly worried about others, but really she’s concerned about dealing with her own anxiety and discomfort.
“So how can we help you to survive the next six months?”
“No, you have to help me convince Diana. Tell me what I can say to her to make her leave?”
“Even if I could do that, which I can’t, it seems to me we both need to respect your daughter as an adult, to respect her decisions and to try to be as supportive of her as you can.”
“How can I respect her decision when it’s endangering her child, when it will leave me, her mother, a nervous wreck until the baby is born?”
“Do you generally respect your daughter’s decisions? Did you respect her decision to marry her husband, to become a teacher, to move to Florida?”
“I definitely wanted her to move to Florida. I wanted to keep an eye on her. Becoming a teacher was okay, although I wondered if she couldn’t do better. I guess that was true of Jonathon too, but he worked out pretty good.”
Knowing that I am most likely talking to myself, I continue on, “Mrs. Peterson, respecting your daughter’s decisions means recognizing that she’s an adult apart from you who has a right to make a decision even if it is different from the one you’d make.”
“Even if it endangers her child? No, I can’t respect her decision.”
And I don’t respect Mrs. Peterson’s way of being in the world, making it difficult for me to espouse respect when I don’t feel it myself. Perhaps I can try to accept Mrs. Peterson for who she is, and thereby move us both towards a more tolerant view of others.
“Mrs. Peterson. I suspect that you’re not going to change your daughter’s mind about not leaving Florida. Perhaps I can help you to accept that fact and perhaps we can work on managing your anxiety.”
“You’re not being helpful.”
“Sorry. I can only do what I can do.”
“You used to say that to me all the time, that I had to accept my limitations, that I couldn’t control everything, that I could only do what I could do.”
“Yes, that’s true.”
“But maybe this time I can do more.”
“I guess we’ll continue this discussion next week.”
“I got into a ridiculous argument with my ex this past weekend when I went to pick up the kids. She greeted me with, ‘Are you a narcissist?’ I knew she’d read about that study that said you could identify narcissists just my asking them if they were narcissists. Of course I said, ‘No.’ Then I asked her the same question and she said no too. But she is a narcissist. So then we got into this whole argument.”
Spencer is probably my fourth patient who has brought up that study which I had also read about. Defining a narcissist as someone who is egotistical, self-focused and vain, the researchers found that asking the one question, “Are you a narcissist?” was as effective as identifying a narcissist as a 40 item diagnostic test. Although I have seen neither the study itself nor the 40 item test, my experience – both clinically and personally – leads me to question whether narcissists will so readily identify themselves.
“It’s so ridiculous. I can’t see how someone who has had all the plastic surgery she’s had, who takes hours to get ready to go out, can call me a narcissist. It takes me five minutes to get ready for work and if I never looked in a mirror again that would be fine.”
“Why did Bonnie think you were a narcissist?”
“She said I never think of anyone but myself, throw a fit when I don’t get my own way, and am very superficial. Superficial! Look who’s calling who superficial. She’s never done anything worthwhile in her life. I’m the one who busted my ass to get my doctorate, to become a tenured professor, to provide the home that’s now hers, the life-style that she’s grown accustomed to. Superficial, my ass! And I also don’t call that thinking only of myself. I did it for her, for them.”
“Is that true, Spencer, did you do it for them, or did you do it to prove to yourself – and to your father – that you were smart and worthwhile and accomplished?”
“And that makes me a narcissist?”
“I didn’t say that, Spencer. I think there’s always some self-interest in what we do. I was just questioning your saying that you did it for them.”
“That’s beside the point. I was just refuting Bonnie’s argument. I can’t believe I’m wasting my time – and my money! - talking about this. Do you have anything worthwhile we can talk about?” he asks, sarcastically.
I’m instantly flooded with feelings – anxiety, anger, fear. I feel both challenged and diminished. Not for the first time, I’m aware that Spencer reminds me a great deal of my father – angry, demanding, short-tempered and, yes, narcissistic. I’m also aware that the fear and anger are feelings both Spencer and I experienced as children in relation to our respective fathers. This awareness doesn’t make my feelings vanish, but it does help me to remain in my role as therapist.
“Well, I think it’s very important, Spencer, that we look at what’s going on between us right now, because I think you’re treating me just as your father treated you as a child. You’re being challenging, angry, and dismissive towards me just as your father was toward you. And that leaves me feeling both angry and less-than, just as you felt with your father.”
“So now I’m a less-than narcissist,” is Spencer’s retort.
“I can see how tough your father was, Spencer; how he never gave you an inch; how he didn’t listen to what you said; how he always had to come out ahead. I’m not your father, Spencer. I’m not trying to diminish you. I wonder if you could take off your father’s glasses and see me through your own eyes.”
“So do you think I’m a narcissist?” Spencer persists.
“You’re unrelenting, Spencer,” I say shaking my head. “You know when you said before, that you’re a less-than narcissist? Well, there’s a lot of truth in that, not especially for you, but for many people who have some narcissistic characteristics. They’re people who feel less-than, but who have developed a way of feeling better about themselves, of keeping that less-than feeling at bay. I think you do it by being angry, by shutting down alternative opinions and, probably most importantly, by trying to convince both yourself and others of your accomplishments and specialness.”
“So you’re saying a narcissist looks like someone who thinks a lot of himself, but actually doesn’t think much of himself at all.”
“That’s exactly what I’m saying.”
“I don’t know. I’ll have to think about it. And I’ll have to think about whether it applies to me.”
“I appreciate your being open to thinking about it.”
“I’ve decided I’m going to break up with Tim,” Allison announces at the beginning of her Monday session.
“Really?” I say, obviously surprised. I see Allison three days a week. On Thursday there was no intimation of her breaking off the relationship. “I thought you and Tim were doing very well.”
“Wow! I finally got to shock you,” she says laughing, passing her fingers through her curly, brown hair. “Yeah, we were. But, I don’t know, I think he’s too boring for me.”
“Too boring,” I repeat.
Allison is a 30 year old drug rep who came into therapy because she made repeatedly poor choices in men. We came to understand that Allison chose men who were similar to her grandiose and narcissistic father, a man who was always too busy and self-involved to attend to Allison. By choosing boyfriends who were like her father, she hoped to win in the present the love she couldn’t achieve in the past. Such a strategy never of course works, since choosing a narcissistic boyfriend will lead yet again to disappointment and pain.
“Yeah. I don’t know, the relationship is just too predictable, maybe too easy.”
“Too easy,” I say.
Allison laughs. “I’ve clearly thrown you for a loop. I love it!”
“So maybe our therapy sessions were also too boring and you’ve just spiced them up.”
“I never thought of that, but maybe,” Allison replies, still gleeful.
“Okay, so here are my questions: What’s wrong with easy? What makes easy uncomfortable? And what happened in the last four days?”
“It’s just not exciting. There’s no spontaneity. He’s always there – trusty, reliable Tim.”
“And you could say the same of me.”
“Yes, that’s true, you’re trusty and reliable, but I kind of like that from you.”
“Except you liked ‘throwing me for a loop.’”
“Yes. But that was like I kind of one upped you, like you know so much and sometimes it seems you can even read my mind and here I am able to surprise you. It makes me feel like I got you!”
Thoughts race through my mind. Allison feels she has just won a competition. With her father? More likely her mother. Allison and I have spent so much time dealing with her father, that her mother is a more shadowy figure to me. Still, my sense is that she too was fairly narcissistic and definitely intent on receiving as much of her husband’s meager supplies as possible. And there’s still the question of what changed in four days. Was the weekend break difficult for her? Was I too know-it-all in our last session?
“Did you have a hard time with our weekend break, Allison?” I ask.
“This has nothing to do with you! Why do you always want to make it about you?” she says angrily.
“I guess that makes me feel like your parents.”
“Now that you mention it, yes! I think you just wanted to deflate me because I surprised you.”
I consider Allison’s accusation. “I’m not consciously aware of competing with you or wanting to deflate you, but I am aware of being disappointed in your so easily discarding Tim and what seems like such a good relationship. Perhaps it made me feel you were discarding our work together and perhaps that made me want to reassert my presence.”
“Wow! There’s a lot of stuff in there. You certainly think a lot about why you do what you do.”
“I try to. I think it’s very important that we try to understand as much as we can about ourselves and our motivations. Doesn’t mean we always succeed. We all have an unconscious – including me – and by definition the unconscious is unconscious.”
“I guess you’re saying I should try to understand why I want to break up with Tim.”
I nod. “Yes, I guess that’s what I’m saying.”
“He’s so much not my father. I know, I know, that’s a good thing. But it doesn’t always feel like such a good thing. It feels like I’m giving up so much.”
“You are. You’re giving up hope. You’re giving up the hope of ever getting the father you needed and deserved in both the past and the present and that’s very painful.”
“But you’re saying I should do it?”
“I’m not saying you should stay with Tim, but I am saying that until you mourn the father you never had and give up chasing him in the present, you’re going to face a lot of painful breakups in your life.”
