Understanding Narcissism

Ask the Experts by Marla K. Ruhana, LMSW

Q: I've just learned that an adult family member of mine may be a narcissist.  Can you tell me more about narcissism?  What causes it? My current understanding is that these types of individuals operate in an adolescent manner. After all these years helping this person, I feel so used, manipulated and not valued...was I so enmeshed that I never realized this?  I was thinking that I needed to go to therapy and couldn't understand what I have done wrong to be totally excluded from her life.  I always thought we were close, but it seems we were only close in my mind and for her purpose. What's the best way for me to manage socialization with this type of person, since they are a part of our family?

A: Your question is a very good one. Let me begin by saying we all must be careful with labels, as many folks have traits of certain psychiatric disorders, yet might not meet the full criteria for the disorder. That said, unless a psychiatrist has truly diagnosed your loved one with narcissistic personality disorder, they might just portray particular traits of this disorder.

Many people have particular traits, and yes, these traits can be difficult if you are on the receiving end, such traits would be, feeling others are envious of him or her/being envious of others, taking advantage of others to achieve their own ends, constant need for admiration, a sense of entitlement, and a grandiose sense of self importance to name a few traits of this disorder.

Other ways to describe narcissism would be to say, these are typically one-sided relationships. The relationship only benefits them, leaves you feeling completely drained, often used, and many do personalize this behavior and begin to question themselves and beat themselves up unnecessarily, as if there is a missing piece to the puzzle, feeling wronged, when their certain they've done absolutely nothing wrong.

If the individual is a family member, indeed it is more difficult to cope with as the family dynamics have likely been this way since birth, as abnormal as it is, it might have been the only "normal" you knew. The older we get, the more problems we experience, we being to see we no longer want to tolerate the intolerable and often times do seek out psychotherapy for ourselves to cope with a narcissist.

In the field of mental health, often times, "the patient is not the patient"....the patient comes in seeking help, feeling victimized by the wrongdoing from the narcissist in their lives. It is unlikely that a narcissist with the full blown disorder,(and there are many variations, as I've mentioned of this disorder), will not seek out treatment for themselves.

These individuals believe there is nothing wrong with them and blame all of those in their lives for their troubles.

Q: So I am not crazy? Because when I am around this person and their manipulative ways, I start to feel crazy, my head spins and I can barely comprehend the things they are saying, as if I am somehow the problem or in the wrong? I am utterly exhausted and being at family functions stresses me out, I become irritable and short-fused with other family members and my children. How do I cope?

A: Being around an individual with narcissism CAN make you feel crazy. Often times the things they are saying, well, if you begin to notice, they are not taking about you at all, and really only speaking of themselves. Many describe it as if there were a missing piece to a puzzle, as if they have somehow missed a vital aspect of a dispute and yet they are now being blamed for it. You are correct it can be incredibly draining to encounter these individuals.

Q: Well, I do not want to stop attending family functions and we all have dinner once a month and celebrate birthdays and holidays together. It just feels that it is more aggravation than it is worth. I'd suggest not inviting this person, but my parents would object and everyone else seems to look the other way, no one calls her out, yet all of the while the toxic behavior is directed at me, and it makes me cringe.

A: My suggestion to you is to negotiate how many family functions you want to attend under these circumstances. The narcissist will never change without help. You can only learn to change your reactions to this person.

Q: Well, it is difficult, as she is also an alcoholic and highly unpredictable, it is to the point, I do not even want my children around to see her disrespect me. Is it common that a person with this disorder or traits of narcissism may also be an alcoholic?

A: It is not uncommon to have a dual diagnosis, but again a psychiatrist would have to evaluate the individual. You must think of safety first, for you and your children, as well as the long term ramifications of socializing at family functions and encountering this individual. Your predicament is a very difficult one and I empathize with you greatly.

Q: Well thank you, as others minimize the severity of this dynamic on so many levels and act as if I'm the drama queen.

A: The healthier we get, the more empowered we feel to limit our time with those who manipulate and hurt us. The good news is you do have choices, and I understand it is difficult as it sounds like it is an immediate family member causing you this angst, however you do have other options. You can set limits and boundaries to protect yourself and your children in many ways. Life is difficult. 

You can choose to host family functions without this individual. You can seek out psychotherapy for yourself to have the therapist assist you in coping with these challenges. I would also suggest reading the books, "The Wizard Of Oz and Other Narcissists", by author, Eleanor Payson, "Boundaries" by Cloud & Townsend, and focus on your own mental well-being.

Many feel that is selfish, however, when we introspect over our lives, typically, our best times, our happiest times, were when we were truly engaging in self care, doing the things we wanted to do, with the people we wanted to spend quality time with.

Q: So I am not a bad person if I decide to limit the time spent with this family member?

A: Many experience guilt and fear the opinions of others as we seek approval of other family members. You need to accept your decisions once you have processed them with a mental health professional and then lose the guilt, as you engage in self care you will be role modeling healthier behavior to your loved ones.

Marla K. Ruhana, LMSW is a clinical social worker in private practice in St Clair Shores. She also teaches cognitive behavioral therapy in the Graduate School of Social Work at Wayne State University. For more info please visit her website at www.marlaruhana.com or call 586-801-4701. Ruhana is a member of The Family Center's Association of Professionals.

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