- 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.
For a person who actually has to live with that,
day in and day out, it's a nightmare.
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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 depression
because they might be very irritable.
We'll see that in men.
What will happen is, you will sometimes confuse the two,
as well, because the type of narcissism
we're gonna 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 downtrodden, that they look depressed.
And then all of us will treat them
as though they're depressed,
and we're making absolutely no headway.
And then one day it dawns on you like,
oh, this isn't depression at all.
So actually, quite frankly,
we'll often treat the, we'll think they're depressed.
Before we'll think they're narcissistic.
- Yeah, but wrongly so.
- But wrongly so.
The covert, or vulnerable narcissist.
These are the "woe is me" narcissists.
You know, if the world could see how great I am,
I'd be one of the great ones,
but nobody gets me, because I'm ahead of my time.
And so they'll, you'll often find them sort of
at home, huddled over their computer, 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.
They seem vulnerable, because they almost feel like
the world doesn't get them.
They're hyper, hypersensitive to criticism,
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 listen to that
and when you would first meet somebody like that,
you'd think, oh, they just have low self-esteem.
- Yeah, bingo.
- But all narcissists have low self-esteem, right?
- Bingo, exactly.
- That's why they're doing that.
- Exactly.
So the covert narcissist, they lead with that.
But it looks like, it's almost like
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.
You're like, okay, well it was
a little bit of a strange pause.
But it's a, they're like, yeah, I already read that book,
but why would you care?
You know, it's like one of those.
- Wow.
- It's a little bit, there's an edge.
It's almost like you're sticking your hand
into a bucket of barbed wire.
It doesn't feel good.
- But even with those examples,
even though they were just like, random examples,
I still feel the pain for that person.
- Oh, they feel the world pass them by.
- Yeah, but I don't feel the same way
with a grandiose narcissist.
- You won't as much, no.
The covert narcissist, they'll ultimately will get
to the point where they feel the world owes them something.
The world owes me, and there'll be a real edge to them,
you know, 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.
There's nine possible symptoms
of narcissistic personality disorder,
which means there's thousands and thousands
of possible combinations.
- Right.
- But if we're 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.
And I'll say, ah, but it's a similar pattern.
Let's get down to the brass tacks
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,
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.
- Again, just highlighting how important it 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 co-existing with bipolar disorder,
which is also a very messy, kind of issue to treat,
because the grandiosity of the mania,
and the grandiosity of the narcissism often collide.
- Double whammy.
- So you'll see that too.
When I've worked with families,
when they have adult children who are substance abusers,
and as the adult child goes into rehab,
I'll also note that adult child has narcissism.
People who have narcissistic personality disorder,
or even narcissistic 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, cocaine use, you know,
a stimulant use, that kind of thing.
So you'll see some of that.
They're thinking, their child's gonna 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 gonna 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 to get, yes, exactly.
Cause the substance use was sort of
helping them kind of, shore up their defenses.
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 co-existing with narcissism, as well.
It just makes everything that much harder to treat.
- Yes.
- That's what it is.
Cause you don't tend to get as much emotion.
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.
When we look at self, 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.
- Thanks for watching.
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