The Limits of Reason: How to Think about Your Date, Your Boss, Your Mom, etc.

https://i1.wp.com/www.southdacola.com/blog/wp-content/uploads/2009/04/rodin20thinker.jpg

As a therapist, I hear a lot of concerns from my patients about parents, bosses, romantic partners, and so forth. The thoughts often take the form of “Why did he do that?” or “What was he thinking?”

Some of this is worth questioning. In life it is useful to take the role of the other person, to look at things from his or her perspective, to try to “understand” that individual’s motivations and reasoning process.

But, there are limits. Here are just a few that make understanding difficult:

1. People don’t always carefully weigh their decisions before making them. We humans frequently think and act impulsively or emotionally. It can be a bit harder to fathom an ill-considered act than one that is carefully reasoned.

2. The person whose mind you wish to enter may not know himself well at all. When you recall what he says are the reasons for his actions, you need to be aware that he may be fooling himself. Alternatively, he might be dishonest with you, giving you less than a full set of data, trying to prevent himself from looking bad in your eyes, or attempting to protect you from being hurt by the truth.

3. We all act in self-serving ways much of the time. The same person who says that he hates it when someone ends a relationship without explaining why — not even making contact or returning phone calls — might well avoid the discomfort of a final farewell or confrontation himself when he decides that a relationship should end, thereby doing the very thing that has been done to him.

4. Most people, in or out of therapy, are often indirect in expressing their unhappiness with you or their disappointments about your behavior. (Marital conflicts and parents talking to children can be noteworthy exceptions to this general rule). But, in the absence of direct communication, it is difficult to be a good mind reader. Indeed, crystal balls are in short supply whenever I go shopping.

5. When trying to understand others, we look for some form of logic. To seek something that is often missing within the person is a pretty big misunderstanding of how people think and act.

6. You may not have enough history and background information to make an accurate analysis of what drives this individual to do what he does.

7. Do you really know the person well “under the skin?” There is often a mismatch between what is happening on the inside and what is occurring on the outside. Put differently, the contradiction between surface appearances and internal truth often affirms the old saying, “Don’t judge a book by its cover.”

Too much time trying to figure out another person is unproductive. For this reason and those cited above, I encourage my patients to set some limits on the amount of time they spend attempting to get into someone else’s head. At bottom, I think, what most of us are looking for is the understanding that will allow us to return to the relationship and put it right, now that we have found the “answer” to what transpired. Or, something that will console us or produce the closure that we are hoping for at the relationship’s end. By attempting to “understand,” we are frequently seeking a sense of intellectual control, partially to acquire information that will prevent future disappointments, but also to compensate us for our loss and to silence the nagging internal voice that asks “What happened?” and “Did I do something wrong?”

It is better, beyond a certain point, to consider several things about oneself:

a. Why did I choose that person to be with? (Obviously this doesn’t apply to your parents; nor does it always apply to bosses or co-workers).

b. How did it happen that I missed the early warning signs of trouble? Oh, I know that you might think that such signs didn’t exist, but it could be that you ignored them, minimized them, or had a blind-spot for them.

c. Why didn’t I set some limits on the relationship in order to prevent the other person from injuring me? And, if I tried, why did my efforts fail?

d. Why didn’t I leave the relationship earlier?

e. What, if anything, did I contribute to the problems that occurred between my friend/partner/lover/boss and myself?

f. Have I grieved the loss or disappointment fully (including attention to both my sadness and my anger)?

g. What do I have to do differently in order to minimize or avoid problems like this in the future?

Instead of addressing the situation in these ways, with these questions, most of us spend no small amount of time ruminating, and then looking for something we can say to the other person to get them to behave as we wish. With some individuals that is possible, but not with everyone.

Jackie Robinson’s breaking of the baseball color-line is instructive in this regard. As you might know, Robinson and his boss, Branch Rickey, agreed that he would not respond to the abuse from fans, players, and coaches that both expected he would receive when he became the first black man in the 20th century to play in the Major Leagues. But, despite two years of taking every racially demeaning insult known to mid-century white males, he succeeded in playing well. Moreover, by this time there were other blacks in the Major Leagues and a great experiment in civil rights had succeeded.

If the story I’ve heard is true, Robinson and Branch Rickey had a conversation at the beginning of Spring Training at the start of Robinson’s third year with the Brooklyn Dodgers. They agreed that Robinson could now be himself, and fight back with words or fists, if necessary. Soon after, the Dodgers played the Philadelphia Phillies, who did not know that Robinson was no longer on a leash. The middle-aged man from the deep south who coached third base therefore once again began the verbal onslaught that he had performed with impunity for the two previous seasons. Robinson called time and walked over to the third base coaching box.

Remember that Robinson had lettered in four sports at UCLA, including football (as a running back). More than most, he radiated intensity, strength, courage, and intelligence. So it was that Robinson moved within inches of the bigot, looked straight into his eyes, and said: “If you ever say anything to me like that again, I’ll kill you.”

Now, I bring this up not to recommend death threats, but rather to point out that Robinson knew exactly who he was dealing with. He knew this man was not going to be persuaded to behave himself by high-flown verbal eloquence; he knew that spending much time thinking about this man’s character was a waste. What Robinson knew for certain was that there was only one thing he needed to understand about his nemesis (his intolerance) and only one approach that would work:

  • I’m bigger and stronger than you are, so if you don’t stop, I will beat the crap out of you.

Everything changed that day as others quickly realized that Jackie Robinson was not a man who could be insulted any more.

Of course, we all need to spend some time thinking about others and why they do what they do. But, endless rumination on the subject rarely is enlightening or successful in making us feel better.

Some people are like boulders. They are big, hard, insensate, obdurate, and potentially damaging objects. It is essential to see their potential to injure and realize that when you are downhill from such a human bolder, you are in danger.

If you understand how gravity works and get out-of-the-way, that is all you need to know and do — all you can do.

A shame, but true.

The image above is The Thinker by Auguste Rodin.

Fear of Change: the Therapeutic Implications of Japanese Holdouts

Onoda-young.jpg

Things change. The question is, do we change with them? Or, do we instead, continue to operate by the same outdated rules of conduct.

I often said to my patients that they seemed to be behaving as if the conditions of their early life still existed. They had long since fashioned solutions to problems that they faced many years ago, and continued to use the same solutions, even though those methods of living didn’t fit with their current life situation. It is as if one were born in Alaska, learned to wear multiple layers of heavy clothing and then moved to the tropics without a change of attire. The warm clothes were helpful up North, but are a disaster down South.

What does this have to do with the “Japanese Holdouts of World War II? The answer is that these men lived by an outdated set of rules with heartbreaking consequences.

If you recall your history lessons, you will remember that the Japanese soldiers of that period were trained according to the principles of Bushido, a feudal fighting code that derived from the period of Samurai warriors. Above all else, weakness was condemned and surrender was disgraceful. Death by one’s own hand was seen as preferable to permitting oneself to be captured, so as to avoid both personal disgrace and family shame.

The Allied approach to the war against these very soldiers in the Pacific was one that involved “island hopping.” The strategy passed over certain islands, both to save men and ensure that the Allies would be able  to capture those islands that were of the greatest strategic value. When the Japanese surrender came in 1945, numerous Japanese troops found themselves stranded on out-of-the-way Pacific islands, cut-off from their command, and without the capacity for communicating back home. These men neither knew the war was over nor could imagine that any honorable soldier, let alone their entire nation, would surrender. Some were in small groups who gradually died from disease or starvation; others were, at least eventually, alone.

While many never surrendered and died still waiting for reinforcements that never came, it was not uncommon in the late 1940s and 1950s to read news accounts of isolated Japanese combatants giving themselves up. The photo at the top of this page is of Second Lieutenant Hiroo Onada, who finally surrendered in 1974, and would not do so until his former commanding officer, by then a bookseller, personally ordered him to lay down his arms.  At that point, World War II had been over for nearly 30 years.

Thirty years. Yes, 30 years dedicated to a war that was over and a life of desperation that was no longer required.

But how many years, if any, have you given up to a thread-bare, bankrupt strategy of living that has long since outlived its usefulness?. And, more to the point, how many more will you endure? When will you realize that your “solution” has now become the problem?

In my psychotherapy practice I saw numerous variations on this theme. People who were abused or neglected  or criticized as children and who continued to live in terror of disappointing others. Those who found substance abuse the only available way of treating the depression or anxiety they experienced when they were young, and who continued to do so. People who avoided challenges because they were scared of failure, having failed many times in the past. Individuals who wore a chip on their shoulder, forever sensitive to insults and injuries that reminded them of long ago attacks, but now were only injurious in their imagination. And those poor souls who expected rejection because of past rejection. Like the Japanese holdouts, the years pass but the fear doesn’t, and the possibility of satisfying relationships and happiness slips away.

If you still are responding to the present as if it were the past, with solutions that solve little (even if they were once necessary), then it is time to change your life. The barricade of your life’s defenses might be protecting you only from the phantom of an enemy who lives within you, not on the other side of the fortification.

A good therapist is likely to be able to help you develop a new way of living, one more appropriate to the world as it is, not the world as it was; to set aside and heal old wounds.

Is it time?

What is the continuation of your old way of living costing you?

The war, your personal war, might just be over and you don’t know it.

Health Care Reform and Unintended Consequences: A Prediction

Health care reform has been necessary for a long time. But having said that, I’d like to give you an example of how the expected changes might lead to some unfortunate results, as well as some that are helpful.

My example will focus on Medicare. Everyone knows that Medicare is expensive for the government and that it will ultimately suck the life out of the national economy if costs are not restrained. One way to restrain costs is to require physicians to accept lower fees for their services, something that Medicare has struggled to do for a while, even before passage of the recent health care legislation. Providers are already getting paid less than they were a few years ago, but even more extensive mandated annual changes have been regularly rescinded by the Congress. If they are actually accomplished in the future, Medicare would pay out still less to those same MDs, Ph.Ds, and other health care professionals.

What will happen when reduced fees become more significant? Some healers will decide that it is financially unwise to see patients who are covered by Medicare. They will drop out of the Medicare panel of providers. The greater the fee reductions, the smaller the number of physicians available to see Medicare patients, while at the same time the number of individuals covered by insurance is increasing, led by the large expected additions to the rolls of the insured because of recently passed health care reform legislation.

Let’s say you are the following person: someone covered by Medicare who doesn’t have the cash to pay for treatment out of your own pocket, who also has a medical problem or concern that cannot wait very long. The good news in this hypothetical example is that your MD still accepts Medicare. But when you call your doctor’s office, you are told that you can’t have an appointment for four months—again, hypothetically speaking. The problem and the pain aren’t getting any better in this period of time, maybe they are even getting worse. So what should you do?

First, you will probably try to find another medic who accepts your insurance and has a nearer-term appointment for you. But given the anticipated shortage of people who do take Medicare patients, it will be unlikely.

Eventually, however, you will do what any sensible person would do once the problem becomes really acute—and what your doctor’s office will probably advise you to do under the circumstances—go to the emergency room of your local hospital.

Since emergency room care is notoriously expensive and since the condition might be harder to treat because you waited, this will only serve to drive up the amount of money spent on health care, something that the intended reduction in doctor fees was expected to reverse. Whether the decrease at one end will outweigh the increase at the other, I do not know.

And, instead of the growing number of  people who had no health insurance being the impetus for the increased use of the ER, it will now be people with health insurance who are using it more because they have no other readily available alternatives.

I don’t have a handy solution to this problem. My hunch is that there is some amount by which doctor’s fees can still be cut before they start dropping out of the Medicare system in large numbers. It may be that only trial and error will determine exactly how much cutting is possible before producing the unintended consequences I’ve described. The good news, however, is that where there is a high demand for services, eventually supply does catch up, although in the case of producing more docs it will takes years to do so.

Surely, there will be many more unintended consequences of health reform just around the corner. Some might actually be beneficial, but certainly not all. The system we have is not working well for many of our fellow-citizens, so the status quo is not a good answer. Doubtless, once legislators hear enough complaints about problems such as the one I’ve described, they will attempt to alter the system further. How long it takes before we get something that works well is unknown. It is likely that we will eventually have a two-tiered system: a universal, government-run insurance plan on one side, and some number of pretty rich people simply paying for health services out of their own pockets on the other.

In the short run, all of this reminds me of an old joke Woody Allen told at the end of one of his nightclub routines.

It went something like this:

I’d like to leave you with a positive message.

But I can’t think of one.

Would you take two negative messages?

What Children Need From Parents III: Beware the Extinction Burst!

https://i2.wp.com/upload.wikimedia.org/wikipedia/commons/1/1d/Albino_Rat.jpg

Popular culture gives us just enough information to be confused.

Not surprisingly, many parents who have never taken a psychology course know it is important to set limits on their children and to be consistent in enforcing those limits. Despite this, a good many parents don’t have the strength of will to withstand the repeated pleading of their kids, or the energy to do so.

If your child wants you to buy him a candy bar or a toy while you are in the store, many parents believe it is simply easier to give in than to listen to the endless entreaties of their offspring.

In some cases it can be too exhausting or overwhelming to have to deal with a persistent child, in other instances the parent might fear losing the child’s affection if the desired treat isn’t forthcoming, and in still other situations the parent feels guilty if he or she deprives the youngster of something.

For all the reasons I’ve just mentioned, I always tell parents before they intend to change their style from one that inconsistently reinforces their child’s misbehavior, they have to be strong enough and knowledgeable enough to be prepared for what comes next.

And what comes next is something pretty powerful.

Its called an “extinction burst.”

First, what is “extinction?” Extinction occurs when a behavior that has been previously “reinforced” (some would use the word “rewarded”), no longer receives reinforcement. Eventually, the organism (animal or person) will stop performing the behavior. Put differently, the undesirable behavior is “extinguished.”

Take, for example, a laboratory rat. You can teach these creatures to press a bar in order to get a food pellet. Rats are good at this. But, if you no longer give the rat food pellets for pressing the bar, the critter will eventually stop doing the bar press. But there is a catch here and it relates to the word eventually. And the catch is what is called an “extinction burst.”

Let us assume your child, like the lab rat, has learned something about how you deliver reinforcers. The reinforcer could be the aforementioned candy bar or toy; it could be money; it could be your attention; it could be staying home from school; it could be a lot of things.

And, let’s further assume that you no  longer want the child to keep pestering you for whatever it is that he wants. Now, remember he hasn’t gotten what he wanted every time, but often enough to learn to be persistent and keep at it until you “break” under the assault.

The “extinction burst” consists of the young-one doing even more of the behavior you want to eliminate at the point you stop reinforcing him.

That might mean he will be louder, or pursue you longer, or repeat more often whatever has worked before. It can go on for a very long time until, finally, the child learns the lesson you want to teach him; in other words, learns he will no longer receive what he wants for his inappropriate actions.

But if you finally do break down and reinforce the child with what he wants during the “extinction burst,” he will have learned an awful truth: “Well, maybe I just have to do this behavior longer or more or louder in order to get what I want.” Indeed, the child doesn’t even have to be able to think or say this to himself.

Even laboratory rats operate according to the same rules of learning, and no one I know has had a very deep conversation with a rat lately.

At least, not the four-legged kind.

Parents sometimes tell therapists they have tried to be consistent and it failed. In other words, that the science regarding “extinction” and setting limits is inaccurate.

But what has really happened in this kind of case is the parent wasn’t ready to deal with the extinction burst. Their inability to tolerate the “burst” of seemingly relentless pestering or complaining eventually led them to reinforce the child once again for the undesirable behavior; and, in so doing, made it harder to extinguish the behavior than when they started.

Had the mom or dad only be able to stay-the-course and resist the child a bit longer, the “extinction burst” would have ended.

The moral of the story is to prepare yourself before changing your parenting-style in an effort to become more consistent. If you aren’t absolutely sure you have the organization, energy, strength, patience, and self-confidence to withstand the “extinction burst,” don’t even try. You will only make things worse.

And don’t expect your child to really believe you when you say “this is the last time I will let you do this” while you once again reinforce troublesome behavior.

Talk is cheap and, like those same lab rats who can’t understand your language, your child will pay attention to what you do and not what you say.

But, if you do have the requisite qualities that any good parent needs and you are fully prepared to hold your ground with your child, you might be quite pleased at how you have reasserted yourself and gotten control over the home situation.

To do that, the earlier you start in your child’s life, the better.

You may be interested in the following post on the topic of consistency: What Children Need From Parents II: On Slot Machines and Candy Machines.

The photo of an Albino Rat was sourced from Wikimedia Commons.

What Children Need From Parents II: On Slot Machines and Candy Machines

https://i0.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Slot_machine.jpg/500px-Slot_machine.jpg

Do your kids see you as more like a candy machine or a slot machine?

It’s not a silly question.

The two machines are rather alike. Both require you to insert some money. Both then demand that you engage the machine, set it in motion. In the case of the candy machine, you press a button or pull a lever to make your choice. The slot machine waits for your follow-through on its lever or “arm,” hence the name, “one-armed bandit.”

That is where the similarity ends and the answer to the question becomes essential: do your kids see you as more like a candy machine or a slot machine?

The reason is as simple as it is important. The candy machine is dependable, reliable, and consistent. Every time you insert your coins and make  the selection, it provides you with the item you have chosen. If, by chance, it should not, you would quickly stop inserting coins because your knowledge and experience tell you that no matter how many more coins you deposit, the machine will not do what you want. It is broken.

The slot machine, however,  is another story. Your knowledge and experience tell you that the machine’s failure to provide you with winnings on one occasion doesn’t necessarily mean that you won’t be a winner the next time, or the time after that. It might take you a very long period of failure and much expenditure of hard-earned silver dollars before you would come to the conclusion that the machine is broken. The machine, when its working correctly delivers winnings on an intermittent (or inconsistent) reinforcement schedule.

Getting the picture? If your children see you as consistent and reliable (like the candy machine) in responding to their requests and their pleadings, they will know that asking for what they want more than once will do them no good: the answer will be the same on the 10th request as it is on the first. And once they have learned this, they will make very few additional requests of you beyond the first one.

But if they see you as similar to the slot machine, boy are you in trouble! They will keep at you, over and over, because they know that one failure at winning doesn’t mean the game is lost. Perhaps the second try will work, or the fifth, or the fiftieth. They will know you better than you know yourself. Simply put, they will know that they have a good chance of wearing you down so that they can have the toy, the TV show, the attention, or the food they want; they will know that the punishment you are trying to enforce also can be changed, maybe not by pleading their case only once, but by repeated appeals to you. Your goose will be cooked.

Kids, of course, have more energy for this sort of “back and forth” than most parents do, so time is not on your side. And the longer they have experienced your inconsistency, the longer it will take for them to “unlearn” what you have taught them about yourself.

The message is simple. Say what you mean and mean what you say. Do what you say that you will do. It will easier on you and better for your children. But before you get started, be prepared for the “extinction burst.”

What is that, you say? I’ll cover that topic in my next blog.

The above image is a Slot Machine by Jeff Kubina from the milky way galaxy, sourced from Wikimedia Commons.

The Upside of Depression and the Downside of Medication

https://i1.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/d/dc/Depression.jpg/500px-Depression.jpg

Are there advantages to being depressed? Something good about something we think of as so bad? A recent New York Times Magazine article by Jonah Lehrer makes just that case: Depression’s Upside.

The essence of the argument is that some episodes of depression allow for and encourage a kind of analytic rumination that is productive. Put another way, the tendency in depression to focus on a problem, mulling it over to the exclusion of other thoughts, permits the sad person to find a solution to his difficulty and change his life in a positive way.

The counter-argument, however, is that the ruminative process is both painful and unproductive — that it often creates a kind of self-flagellating preoccupation with one’s trouble rather than a process that leads to something good; that unhappiness and focusing on pain and its concomitants simply feed on themselves to no helpful end.

In my clinical experience, therapy with people who are depressed over loss or injury often breaks down into two phases. The first of these is a grieving process, where the person expresses and processes (or sometimes purges) the feelings of anger, sadness, emptiness, desolation, and hopelessness that come with the loss of something of value — a love, a job, high social status, a capability, a fortune, etc.

The second phase involves learning from one’s painful experience about how to live differently, make different decisions, associate with different people, become more assertive, overcome fear; value things differently in life such as money, material things, status, accomplishment, friendship, and love.

Naturally, neither of these two phases is absolutely discrete — they blend into each other and overlap each other. As a practical example, someone who has had a series of bad relationships will typically need to grieve the unhappy end of the most recent one and, in the process, learn how he happened to choose a person or persons who made him so miserable; then changing whatever needs to be changed internally and externally so that different and more satisfying choices occur in the future.

People who are like the hypothetical individual just cited usually come into therapy in emotional pain and seek relief of that pain as promptly as possible. This desire is entirely reasonable — who wouldn’t want this? Some of them request medication, which is often the fastest way to “feel better.”

But many are leery of psychotropic drugs and see them as artificial, hoping that therapy will produce a more lasting fix without dependency upon a foreign substance. Indeed, while a good therapist will strongly encourage the use of medication for someone who is seriously depressed, i.e. suicidal, unable to work, sleeping away the day away (or almost unable to sleep); that same therapist will also know that medication sometimes serves to “de-motivate” the patient, giving him or her a relatively quick solution that allows that person to tolerate an intolerable situation. In the New York Times Magazine article mentioned above, Dr. Andy Thomson describes this problem eloquently:

I remember one patient who came in and said she needed to reduce her dosage. I asked her if the antidepressants were working, and she said something I’ll never forget. ‘Yes, they’re working great. I feel so much better. But I’m still married to the same alcoholic son of a bitch. It’s just now he’s tolerable.’

Clearly, this woman was aware that she needed to be in some amount of discomfort in her relationship with her husband in order to be motivated to get out of it. The drug made her feel better, but, it also reduced her incentive to change herself and her life. It was, in effect, a kind of band-aid, rather than a real cure. It anesthetized her and, in so doing, robbed her of something that was essential for new learning and behavior change to occur.

Unfortunately, most people who come to therapy are neither as courageous or insightful as the woman just described. Once they feel significantly better, whether due to therapy or medication, it is common for them to be less interested in continuing treatment. They have recovered from the event that precipitated their entry into therapy, but they might not yet have learned enough to avoid making the same mistakes that contributed to the problem in the first place.

Such a person can reason that the cost of therapy (both financially and in terms of time, effort, and the difficulty that comes with changing one self) is now greater than emotional pain from which they might still be suffering. Put another way, at this point, doing therapy “causes” more difficulty and pain than not doing therapy, just the reverse of what seemed true when they started the treatment process.

At this stage, those who continue in therapy have something that an old mentor of mine, Truman Esau, used to call “therapeutic integrity.” What he saw in some of his patients was an almost heroic desire to make themselves better regardless of how much the actual process of doing so was difficult, uncomfortable, or painful.

These patients didn’t shy away from problematic truths about themselves or others. They worked hard to stretch and challenge themselves, knowing that it was crucial to improve. They didn’t simply want a quick fix. Like the woman in Dr. Thomson’s example, they recognized that some pain was essential to being motivated. They knew that there was no such thing as “a free lunch,” and were willing to do whatever it took to repair and better their lives.

If you are in therapy now, it will be important for you to be sensitive to this shift from the often intense distress that brought you into therapy, to the point when the therapy itself might seem distressful. This can mean that the therapist is not skillful or that he is pushing you too much, but it just might also signal that some of the most difficult life changes you need to make are still ahead of you, even if the cost of making those changes seems greater than when you started treatment.

If you leave therapy because it is hard and unpleasant work, the problems you have won’t care. They will simply continue to reside in you, work on you, and trip you up. It is not enough to get over your last disappointment or unhappiness, but to change yourself enough to avoid future problems.

Few things that are worthwhile come to us for free.

The above image titled Depression is the work of Hendrike, sourced from Wikimedia Commons.

Are You Narcissistic?

https://i2.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/b/b0/Fran%C3%A7ois_Lemoyne_001.jpg/500px-Fran%C3%A7ois_Lemoyne_001.jpg

Have you ever been called a narcissist? What does that mean? Let me offer you an image that might help you understand it.

Imagine that you are standing in front of a mirror, but at some distance from it. You can see yourself, but you can also see a great many other things around and behind you. Now envision yourself walking toward the mirror.

If you get close enough, you will see only one thing: yourself. It is not necessarily that you are indifferent to whatever else might be behind and around you; rather, you are so taken with your own likeness, that you become unaware of other people nearby and how they might be faring.

That is narcissism: a fascination with and almost exclusive focus on yourself. The word comes from the Greek myth about an unusually attractive young man named Narcissus, who falls in love with his reflection in a pool, not aware that he is looking at his own image. Inevitably he perishes because he cannot get over this preoccupation.

At the extreme, too much narcissism becomes a Personality Disorder. That means it is a pattern of behavior and internal self-involvement that is rigidly pervasive and leads to problems in relating to others. People who suffer from Narcissistic Personality Disorder tend to lack empathy for others; they are grandiose in their inclination to overestimate their worth. They usually assume that others will not only share in this high appraisal of their value, but treat them accordingly. Indeed, they expect to be admired and take that admiration as an entitlement.

The word insufferable comes to mind.

https://i0.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/d/de/Michelangelo_Caravaggio_065.jpg/240px-Michelangelo_Caravaggio_065.jpg

Such people believe that the rules that apply to most others might not apply to them because of their special qualities. Nor do they clearly see the injuries that they inflict on others; or show empathy even when such injuries are brought to their attention. If you are useful to a narcissist, able to help him advance his agenda, then he will probably want you around.

At the moment that you are no longer of value, however, or have been replaced by someone deemed better or more useful, you are in danger of being set aside or discarded.

The narcissist tends to have fantasies of great achievement or idealized love and exploits others. And when his behavior fails to lead to the result that he believes is his due, it is rare for him to fully recognize and take responsibility for that failure. Without that awareness, circumstances and other people are blamed, and he is likely to continue on the same unfortunate path indefinitely.

And to answer the question posed in the title, given the blind spot just mentioned, if you are narcissistic, it is unlikely that you will so identify yourself.

Initially, you might find such a person dashing, enormously self-confident, and appealing, perhaps even a visionary — definitely a big personality. Closer and more frequent contact, however, begins to reveal the dark side. Loving someone else is difficult for the narcissist, who is already in love with himself.

Do you need an example?

At least as he has been represented in the press, the Governor of South Carolina will serve that purpose. Obviously, one cannot diagnose him or anyone else on the basis of news accounts, but they suggest that he might fill the bill.

He is said to be taken with himself, preoccupied with his achievement and appearance, and fancies himself (and his South American lover) as sharing some sort of idealized, almost mythic love. Meanwhile, in the course of his affair, the wife and kiddies back in the States were set aside; even his responsibilities to his constituents were ignored, as he took secret trips to visit his girlfriend, leaving South Carolina without anyone in charge while he was away.

I suspect that you know some people who are pretty full of themselves and might have some of the other characteristics I’ve mentioned.

Want to change them?

Good luck.

Personality Disorders of this kind are not easily altered. Indeed, such people rarely see the need for treatment — their reflection in the mirror looks more than good enough to them. Self-awareness is not one of the narcissist’s strengths.

No, change won’t come easily.

A better question to ask yourself would be the following: why would you WANT to be with him?

The painting at the top of this essay is Narcissus by Francois Lemoyne, from 1728, sourced from Wikimedia Commons. The second image is Caravaggio’s take on the same subject (1594-1596), from the same source.