The Maintenance of Self-Preservation in Narcissistic Personalities: Suggestions for Partners, Family Members, and Friends

Abstract

This paper examines narcissistic personality disorder as a psychological reaction against internal fragmentation brought on by the activation of unresolved core maladaptive emotional states that shape a foundational sense of self. The goal for the individual exhibiting narcissistic behavior is to maintain self-preservation. Restorative regression can cause interpersonal damage that may leave partners, family members, and friends feeling like their reality testing has been distorted. Treatment approaches are suggested based on where an individual falls on the psychotic-borderline-neurotic continuum. Considerations for partners, family members, and friends are explored, including education and prescription of narcissistic behavior for self-preservation.

The term narcissism has become a catchphrase in contemporary society. At times, this term may be used accurately when describing narcissistic tendencies; more often, however, it seems to be employed to label individuals who seem self-centered or self-serving. It is easy to find a website or online group that caters to the study or experience of narcissism as a personality structure. While this may be helpful in some situations, it can also blur, over-simplify, or exaggerate concepts describing narcissistic personality disorder, potentially leading individuals to place unwarranted (and unhelpful) labels on partners, family members, and friends.

Narcissism as a Form of Developmental Arrest

Research into the biology of narcissism has shown links between narcissistic personality disorder (NPD) and oxidation levels, prefrontal brain structure, and brain development (Jornkokgoud et al., 2023; Lee et al., 2020; Nenadic et al., 2021). From a psychological perspective, narcissism is rooted in preverbal developmental arrest and is likely a consequence of lacking or limited consistency in nurturing care in childhood. This deficit in care interrupts the development of a cohesive identity, resulting in an unstable sense of self. These individuals learn to read the environment as a way to avoid psychological fragmentation, or an internalized shattering of oneself (Stolorow & Lachman, 1980). This fragmentation can occur suddenly and often creates devastating impacts on significant others.

The need to maintain self-preservation prevents individuals diagnosed with NPD from taking ownership of their behaviors. When things are working well within their cognitive schemas, they appear smooth on the surface. However, when challenged by others who they perceive as a threat, they may shatter and resort to blame, ridicule, or invalidation of others to restore themselves.

While it is easier to hide narcissistic tendencies at younger ages, it can become more difficult to mask into adulthood and when forming intimate relationships. The individual can still be perceived as quite charming when a relationship feels less threatening, the other person is able to remain under their control, or when they are putting significant energy into securing that relationship. This may be why clients in relationships with these individuals often mention their partner was not always this way. It is sometimes helpful to explain to these clients how narcissistic tendencies may have developed, what maintained them, and, importantly, validating the challenge of identifying these tendencies early on in their relationship.

Core Maladaptive Emotions

Emotionally focused therapies illuminate the concept of core maladaptive affective states (Greenberg & Johnson, 1988). These are unresolved, vulnerable, emotional states that shape the foundational sense of self that originated in early childhood, including feelings of shame, worthlessness, inadequacy, and insignificance. How these various affective states shape and influence individuals’ interactions with others and the world around them is unique to each individual and the perception of their experiences.

The function of defensiveness exhibited by individuals with NPD is used to defend against activation of core maladaptive affective states. When intentionally or inadvertently triggered by a partner, co-worker, or family member, the individual becomes internally fragmented. This often results in defensive or aggressive behaviors toward the person believed to be the trigger; this is referred to by the author as restorative regression, whereby the regression serves to restore the self. Pica, Welches, and Engel (2003) reported on the unresolved feelings of shame, inadequacy, and inferiority that drive aggressive behaviors with participants in an experientially-based, inpatient, anger management group. One woman shared her struggle of feeling ignored and invalidated from a young age (i.e., inferiority, worthlessness). This led her to becoming physically aggressive and violent toward a stranger who stepped in front of her in line after perceiving this person as invalidating her existence. While her outward expression was one of aggression and violence, her internal state was fragmented and destabilized. Once restored, she was left with the consequences of this restorative regressive episode. Consequently, the partner, co-worker, family member, or friend is left to feel like they are walking on egg shells (Mason & Kreger, 2010). The individuals in a relational dynamic with someone living with NPD likely have a similar internal experience to them, feeling almost constant, unpredictable, and fluctuating emotional states.

Character Structure Continuum

McWilliams (1994) described a continuum of character structure that ranges from psychotic to borderline to neurotic. It is important to note that McWilliams’ verbiage surrounding character structure (i.e., psychotic, borderline, neurotic) is conceptually distinct from the clinical language used to describe the same terms within the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2022). According to McWilliams (1994), where individuals fall on this continuum is based on their ability to readily maintain their internal cohesion or self-preservation. In general, individuals living on the psychotic end of the character structure continuum struggle to maintain a cohesive self and live with a distorted perception of reality. Those with a borderline character structure maintain a cohesive self when the world is functioning in accordance with how they believe things should be. When their interactions with others and/or with themselves does not align with these engrained mental models, the individual may become internally fragmented and can regress to the point of becoming paranoid, reactive, and/or irrational. Once restored, people with a more borderline character structure may reappear as a good neurotic, which describes individuals who generally maintain their self-cohesion across circumstances with only mild and/or shortened regressions. Individuals with a neurotic character structure tend to maintain the most consistent experiences of self-cohesion, allowing them to function in their environment by utilizing more accurate reality testing and by exhibiting more adaptive behavior and relational patterns. These individuals may experience minor, short-lived fragmentations, however, they may be more inclined to self-reflect and take ownership for their actions (McWilliams, 1994).

A critical point to note relative to character structure is the variation amongst individuals labeled narcissistic; they present in a variety of ways at different times and in different settings. The differentiation between a psychotic, borderline, or neurotically structured narcissistic individual is key as it informs what the most effective treatment approach for the client’s unique and specific character structure may be (McWilliams, 1994).

Psychotherapeutic Considerations for Psychotic, Borderline, and Neurotically Structured Narcissistic Personality Types

Individuals who fall in the psychotic and borderline area of this spectrum may be challenging in therapy at times due to the level of threat they readily perceive and their tendency for fragmentation, regression, and emotional dysregulation during session. Those in the borderline range may derive benefit from a more structured, psychoeducational, or skill-based approach as this style of approach may feel less threatening than an insight oriented or emotionally focused psychotherapy. Treatment for individuals within the psychotic range might include a referral for medication management along with a skills-based approach to psychotherapeutic intervention.

Individuals who fall in the neurotic range typically have a solid enough sense of self to begin exploring their vulnerabilities, focusing on empathy,  and taking accountability for their behaviors. It is important to locate in their body where they feel fragmented and utilizing breathing and tense-and-release exercises to regain control of their feelings and their internal fragmentation. The ultimate goal is for the client to learn and understand the difference between feeling stable and feeling fragmented.

For clients who are able to explore their core maladaptive emotions, examining early childhood relationships and more realistic aspects of the caregiver dynamics might prove useful. It may offer a perspective to make sense of their vulnerabilities, shedding light on the function of their defenses. Individuals on the narcissism spectrum may inaccurately portray the experience of an ideal childhood, which may be associated with their defense against experiencing a vulnerable affective state. In other words, individuals with narcissism may choose to perceive an idealized experience as a result of not having the emotional resources to tolerate the vulnerability of being raised in a difficult family system. Perceiving any faults in a family system they are a member of may put pressure on them to identify faults within themselves, which is something that is often too painful to face.

Treatment Considerations for Partners, Family Members, and Friends

Individual treatment for clients who are partners, family members, or friends with someone living with NPD starts with the decision to stay, maintain, or leave the relationship. For those who decide to stay, validation and education become the most powerful tools. Clients may feel embarrassed falling into the same dysfunctional patterns, to which normalizing this part of the process of understanding a person living with NPD should be emphasized. When these clients wonder if foundational change is possible, it can be impactful to explore how the person with NPD is able to manage their developmentally arrested behavior.

Quite often, a recommendation is made to prescribe the behavior; that is, knowing the behavioral script and understanding how it is going to play out before it happens. In actuality, the script is quite simple. It comes as a surprise when the clinician can so readily describe the script without ever having met the partner, friend, or family member. Being grounded in the script removes the surprise when it begins to play out in real-time. It then becomes easier for clients to remain firm in their boundaries and stable in their sense of reality and rationality.

It is crucial to remind clients that the unconscious goal of the person with NPD is to maintain self-preservation. This can be confusing for the client when the individual may appear calm, likeable, confident , and charismatic to those that have not experienced the less than healthy sides of them.  Individuals with NPD may politic or talk poorly about their partners or family members when fragmented. Making someone appear worse than they are, however, remains a secondary goal to self-preservation. Partners, family members, and friends have a hard time understanding that not all actions taken by the person with NPD are consciously manipulative. It may as easily occur as an unconscious attempt to maintain self-preservation, which may subsequently make one look good or better to others in the process.

Summary and Conclusion

Treatment for partners, family members, and friends relies on psychoeducation of character structure, arrested development, and fear of vulnerable affective states. The unrelenting commitment to self-preservation results in patterns of defensiveness toward the activation of core maladaptive emotions like shame, inadequacy, and worthlessness. Prescribing the behavior is suggested to help ground partners, family members, and friends by anticipating and preparing for the predictable behavioral and emotional responses that have been exhibited in the past. Maintaining an internal sense of control that is grounded in reality can be a functional and adaptive response to these interactions and may lead to a more evolved dynamic and/or a more evolved self.