Scorpion in the Bed, The Narcissist in Couples and Couple Therapy

By Ronald Mah

"Scorpion in the Bed, The Narcissist in Couples and Couples Therapy" guides essential adjustments in therapy to deal w/ the narcissism of one partner in a couple. Otherwise effective couple therapy interventions fail if narcissism is missed, since narcissism affects all aspects of relationship functioning: intimacy, communication, reciprocality/mutuality, equity negotiation, boundaries, roles, & so forth. Intimacy & connection as expressed goals do not supersede the narcissist's compulsive needs for grandiosity, omnipotence, self-righteousness, & entitlement. Understanding narcissistic disruption & attacks- scorpion stings difficult to manage in individual therapy, direct dealing w/ couple therapy complexity including the partner who has endured narcissistic stings.

Origins & characteristics of narcissistic personality disorder guide couple therapy similar to, but often highly distinctive from individual therapy. Beyond the therapist & narcissist dynamics, are 3 additional dynamics crucial to couple therapy: therapist & non-narcissistic partner, narcissist & non-narcissist partner, and therapist & couple. More passive or egalitarian therapies are shown to be counter-indicated because they often do not deal w/ grandiosity, self-righteousness, & resultant entitlement to strike out at others. Conceptual foundation & strategic approaches require the therapist to take a powerful, assertive, & authoritative role & stance to confront & successfully address individual narcissism & its effect in the couple.

The therapist will learn interventions based on anxious partner scrutiny of the therapist to see if he or she will be similarly manipulated & abused. Therapist failure to successfully manage narcissistic assaults destroys the partner's hope for successful therapy & an improved relationship. The strong counter-transference of disliking the narcissist improves accurate assessment of narcissism & gives direction for effective treatment. The therapist must own & manage his or her need to be liked & respected, including any overt or latent personal narcissism. The therapist will learn how & why the narcissist instinctively & overtly attacks such issues in the therapist. A third-observer strategy to deal w/ narcissistic dismissal & omnipotence is presented for empowering both partner & therapist feedback. Without this key strategy, the therapist remains disempowered & dismissed by the narcissist to offer any interventions not to his or her liking.

The therapist is directed to recognize that couple therapy may be the one & only opportunity to salvage the relationship. Despite recommendations to refer the narcissist to individual therapy to deal first w/ the personality disorder, the couple's viability may not tolerate any delay in treatment. Couple therapy is conceptualized as the best opportunity to force the individual teetering on the precipice of relationship dissolution to face his/her narcissism, including specifically his/her grandiosity. The book also describes the several types of & rationales for partners, specific personalities, & personality disorders who couple w/ narcissists. Included is a type of partner w/ non-pathological but defining family-of-origin experiences, who is also most likely to eventually transcend the partnership w/ a narcissist. The therapist is guided how to simultaneously manage these various partner styles along w/ the narcissistic personality for effective couple therapy.

Couple therapy that includes a narcissistic partner is significantly more complex & difficult. The narcissism is not an extra or merely an important element in the couple, but fundamentally defines the couple, including how & why the partners coupled & remain coupled or not. Successful couple therapy that includes a narcissistic partner requires a conceptually sophisticated & skilled therapist wary of but able to deal w/ the scorpion's sting.

• Language: English
• Publisher: Ronald Mah
• Release date: Jun 2, 2013
• ISBN: 9781301835492

Ronald Mah

Therapist, educator, author and consultant combine concepts, principles, and philosophy with practical techniques and guidelines for effective and productive results. A Licensed Marriage & Family Therapist (licensed 1994), his experiences include:Psychotherapist: individual, child and teen, couples, and family therapy in private practice in San Leandro, California- specialties include challenging couples, difficult teenagers, Aspergers Syndrome, Attention Deficit Hyperactive Disorder, learning disabilities, cross and multi-cultural issues, foster children, child development, parenting, and personality disorders;Author: twenty-one project/books on couples therapy for a doctoral program, including substantial work on major complications in couples and couples therapy (including depression, anxiety, domestic violence, personality disorders, addiction, and affairs); articles for the Journal of the California Association of Marriage & Family Therapist (CAMFT) on working with teenagers, elder care issues affecting family dynamics, and assessing dangerous clients, online courses for the National Association of Social Workers- California chapter (NASW-CA) on child abuse prevention, legal and ethical vulnerabilities for professionals, and difficult children, “Difficult Behavior in Early Childhood, Positive Discipline for PreK-3 Classrooms and Beyond” (Corwin Press, 2006), “The One-Minute Temper Tantrum Solution” (Corwin Press, 2008), and “Getting Beyond Bullying and Exclusion, PreK-5, Empowering Children in Inclusive Classrooms,” (Corwin Press, 2009); Asian Pacific Islander Parent Education Support (APIPES) curriculum for the City of San Francisco Department of Human Services (1996), 4th-6th Grade Social Science Reader, Asian-American History, Berkeley Unified School District, Berkeley, CA, (1977), and trainer/speaker of 20 dvds on child development and behavior for Fixed Earth Films, and in another time and career three arts and crafts books for children: two with Symbiosis Press (1985 &1987) and one with Price, Sloan, and Stern (1986);Consultant and trainer: for social services programs working with youth and young adults, Asian-American community mental health, Severe Emotional Disturbance (SED) school programs, therapeutic, social support, and vocational programs for at risk youth, welfare to work programs, Head Start organizations, early childhood education programs and conferences, public, private, and parochial schools and organizations,Clinical supervisor: for therapists in Severe Emotional Disturbance (SED) school programs, child and family therapists in a community counseling agency, Veteran Affairs in-patient clinician working with PTSD and dual diagnoses, foster care services manager for a school district, manager/supervisor for the Trevor Project-San Francisco, and therapists in a high school mental health clinic;Educator: credentialed elementary and secondary teacher, Masters of Psychology instructor for Licensed Marriage & Family Therapy (LMFT) and Licensed Professional Clinical Counselor (LPCC) track students, 16 years in early childhood education, including owning and running a child development center for 11 years, elementary & secondary teaching credentials, community college instructor, and trainer/speaker for staff development and conferences for social services organizations including early childhood development, education, social work, and psychotherapy.Other professional roles: member Ethics Committee for six years and at-large member Board of Directors for four years for the California Association of Marriage & Family Therapist (CAMFT), and member Board of Directors of the California Kindergarten Association (CKA) for two three-year terms.Personal: married since 1981 after dating since 1972 to girlfriend/wife/life partner with two wonderful strong adult daughters, and fourth of five American-born children from immigrant parents- the older of the "second set" of children.

Book preview

Scorpion in the Bed, The Narcissist in Couples and Couples Therapy

Scorpion in the Bed, The Narcissist in Couples and Couples Therapy

Ronald Mah, M.A., Ph.D., L.M.F.T.

Published by Ronald Mah at Smashwords

Copyright 2013 Ronald Mah

Ronald Mah's website- http://www.ronaldmah.com/

Smashwords Edition, License Notes

This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you're reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.

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Linked Table of Contents

Abstract:

Chapter 1: AMBUSH! THE NARCISSISTIC PARTNER IN COUPLE THERAPY

SEVEN DEADLY HABITS

Chapter 2: FEATURES & CRITERIA

PERSONALLY DIMINISHED

NARCISSISTIC INJURY

SUPERIORITY

Chapter 3: NARCISSISTIC PERSONALITIES IN COUPLE THERAPY

KOHUT AND KERNBERG

CRISIS

ONE OPPORTUNITY

SELF-ESTEEM VS. NARCISSISM

Chapter 4: NARCISSISTIC PERSONALITY DISORDER AND/OR OTHER DISORDERS

FLUID DIAGNOSIS

YOU THERAPISTS…

BORDERLINE, NARCISSISTIC, AND PARANOID… OH MY!

THERAPY CHANGES WITH DIAGNOSIS

Chapter 5: KILL THE THERAPIST

TARGET OF THERAPEUTIC ENERGY

SCRUTINY

Chapter 6: SUITABILITY FOR COUPLE THERAPY- SUITABILITY AS A COUPLE

DISLIKING AND FEELING SORRY

Chapter 7: PARTNER MATCHES WITH THE NARCISSIST

PLEASER

VICTIM

POTENTIAL FOR VIOLENCE

MARTYR

STRATEGIES FOR PLEASER-VICTIM-MARTYR PARTNERS

Chapter 8: DSM PARTNER DIAGNOSES

BORDERLINE PERSONALITY DISORDERED PARTNER

DEPENDENT PERSONALITY DISRORDERED PARTNER

NARCISSISTIC PERSONALITY DISORDERED PARTNER

HISTRIONIC PERSONALITY DISORDERED PARTNER

THE NON-DISORDERED PARTNER TO THE NARCISSIST

Chapter 9: ETIOLOGY

LACK OF MIRRORING

MISMATCH FOR TEMPERAMENT

GENDER CONSIDERATIONS

CULTURAL INFLUENCES ON NARCISSISM

ETHNOCENTRISM AND NARCISSISM

Chapter 10: THERAPY

NARCISSIST-THERAPIST DYNAMCIS & PRESENTATION IN THERAPY

THIN-SKINNED

THICK-SKINNED

FALSE-SELF

Chapter 11: THERAPIST FRUSTRATION/CLIENT ANTAGONISM

OBSERVATION & METACOMMUNICATION

THIRD-PERSON OBSERVER

ASSERTING THERAPIST SUPERIORITY

CONCLUSION: GAZING INTO THE ABYSSS OF NARCISSISM

Bibliography

Other Books by Ronald Mah

Biographic Information

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Abstract:

Scorpion in the Bed, The Narcissist in Couples and Couples Therapy guides essential adjustments in therapy to deal with the narcissism of one partner in a couple. Otherwise effective couple therapy interventions fail if narcissism is missed, since narcissism affects all aspects of relationship functioning: intimacy, communication, reciprocality/mutuality, equity negotiation, boundaries, roles, and so forth. Intimacy and connection as expressed goals do not supersede the narcissist's compulsive needs for grandiosity, omnipotence, self-righteousness, and entitlement. Understanding narcissistic disruption and attacks- scorpion stings difficult to manage in individual therapy, direct dealing with couple therapy complexity including the partner who has endured narcissistic stings.

Origins and characteristics of narcissistic personality disorder guide couple therapy similar to, but often highly distinctive from individual therapy. Beyond the therapist & narcissist dynamics are three additional dynamics crucial to couple therapy: therapist & non-narcissistic partner, narcissist & non-narcissist partner, and therapist & couple. More passive or egalitarian therapies are shown to be counter-indicated since they often fail to directly deal with narcissistic issues and behaviors. Conceptual foundations and strategic approaches require the therapist to take a powerful, assertive, and authoritative role and stance to confront and successfully address individual narcissism and its effect in the couple.

The therapist will learn interventions based on anxious partner scrutiny of the therapist to see if he or she will be similarly manipulated and abused. Therapist failure to skillfully manage the narcissist's assaults destroys the partner's hope for successful therapy and an improved relationship. The strong counter-transference of disliking the narcissist improves accurate assessment of narcissism and gives direction for effective treatment. The therapist must own and manage personal issues: to be liked and respected, and especially any overt or latent personal narcissism. The therapist will learn how and why the narcissist instinctively senses and then attacks such issues in the therapist. A third-observer strategy to deal with narcissistic dismissal and omnipotence is presented for empowering both partner and therapist feedback. Without this key strategy, the therapist remains disempowered and dismissed by the narcissist to offer any interventions not to his or her liking.

Couple therapy may be the one and only opportunity to salvage the relationship. Despite recommendations to refer the narcissist to individual therapy to first deal with the personality disorder, the couple's viability may not tolerate any delay in treatment. Couple therapy is also the best opportunity to force the individual teetering on the precipice of relationship dissolution to face his/her narcissism, including specifically his/her grandiosity. The book also describes the several types of and rationales for partners, specific personalities, and personality disorders who couple with narcissists. Included is a type of partner with non-pathological but defining family-of-origin experiences, who is also most likely to eventually transcend the partnership with a narcissist. This person's growth offers direction for individual treatment within couple therapy. The therapist is guided how to simultaneously manage these various partner styles along with the narcissistic personality for effective couple therapy.

Couple therapy that includes a narcissistic partner is significantly more complex and difficult. The narcissism is not an extra or merely an important element in the couple, but fundamentally defines the couple, including how and why the partners coupled and remain coupled or not. Successful couple therapy that includes a narcissistic partner requires a conceptually sophisticated and skilled therapist wary of but able to deal with the scorpion's sting.

link to Table of Contents

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Author's Note: Other than public figures or people identified in the media, all other persons in this book are either composites of individuals the author has worked with and/or have been given different names and had their personal identifying information altered to protect and respect their confidentiality.

Chapter 1: AMBUSH! THE NARCISSISTIC PARTNER IN COUPLE THERAPY

Cheri had called and set up the couple therapy for herself and her husband Jaymes. She said they have some communication problems they wanted to work on. Cheri got up quickly when the therapist came into the waiting room. About forty-ish years old, she could have been any suburban housewife, professional, administrator, nurse, teacher, and mother of three. Well-groomed and eager, she also seemed a bit nervous. I'm Cheri and this is my husband Jaymes. Jaymes was about mid-forties- a large man. Jaymes looked up from the magazine he had been reading and slowly unfolding his formerly athletic frame from the couch. With a deep resonate voice, he said Pleased to meet you, as he looked the therapist intently in the eyes. Is it Doctor? I didn't see it on your brochure. The therapist clarified having a Masters level clinical license and hence, had not earned an honorific of Doctor. When they entered the office, Jaymes veered off to look at the therapist's display of license, diplomas, awards, and other certifications. Hmmm... said Jaymes as he scrutinized the framed credentials.

Cheri quickly took a seat across from the therapist's chair, while watching Jaymes. After a half minute or so, the therapist said to Jaymes, Have a seat, directing him to a chair next to Cheri. Humph, grunted Jaymes as he left the credentials and sat down. So, what brings the two of you here? asked the therapist as a generic therapeutic opening. Well, began Cheri hesitantly, we've been married for ten years after being together for three years... Jaymes interrupted, We knew each other for three or four years, but we didn't get together until I started at marketing department at the tech start-up. So that makes it about one and a half years before we got married. Anyway, continued Cheri, we have some problems communicating, so we thought couple counseling might help. She looked to Jaymes for confirmation and for him to speak. Jaymes paused a moment, sighed, and began, Yeah, Cheri has problems communicating what she wants to me and has trouble understanding what I want. She wanted to try counseling, so I thought I'd give it a shot.

The therapist asked Jaymes, What do you think is not working well for you in the relationship? Well, I'm pretty ok unless Cheri has problems. You must have seen this stuff... these problems before... haven't you? How often do you do couple therapy? I see your diploma up there on the wall. I know they have a good engineering program and a prestigious business school. What's their reputation for psychology... or couple and family therapy... or whatever they call it to prepare you to be a therapist? And for most of the rest of the session, Jaymes conducted an interrogation of the therapist's professional credentials: license, training, education, theoretical orientations, experience as a couple therapist specifically and as a therapist in general, and personal relationships and marital circumstances: married? divorced? break-ups? quality of relationship? Alternately feeling professionally naked and demeaned, the therapist felt compelled to defend hard-earned and well-deserved educational and professional credentials. It took a conscious and difficult effort, but the therapist was able to get a bit more background about their relationship before the session ended. At the end of the session, the therapist felt uneasy asking for the session fee due in no minor part to Jaymes' slight rolling of his eyes and barely perceptible sigh. In the next session, Jaymes began by identifying all the things the therapist did incorrectly in the first session! Ambush! Expecting invested and respectful, if nervous clients, the therapist instead had been ambushed.

The therapist could have been a licensed Psychologist with a doctorate degree and entitled to be addressed as Doctor. That was not the issue. The therapist could have been educated at the most prestigious institutions, with multiple awards, publications, and acclaimed by professional peers. The therapist could have been a blend of therapist and theoretical icons such as John Gottman, Sigmund Freud, Virginia Satir, and Salvador Minuchin with a bit of Mother Teresa, the Dalai Lama, and Oprah Winfrey thrown in. Credentials, experience, and competency mattered less to Jaymes than his need to maintain superiority and avoid any vulnerability to potential criticism of an omnipotent self-image. Although, Jaymes and Cheri presented for couple therapy, the therapist had made a critical therapeutic error to assume that intimacy and connection were the mutual goals for therapy between the partners. Cheri had made a similar mistake many years before. Although Cheri thought she had found a wonderful life partner, as their relationship progressed she had discovered that Jaymes was instead like a scorpion in the bed. Whether one rolled on top of it or it crept silently and unsuspected under the sheets, it could strike at any time. While Jaymes verbally professed the same desire as Cheri for intimacy and connection, Cheri had regularly suffered the stings of Jaymes' deadly precise words inflicting cruel wounds upon her. He had another agenda over and above the partnership.

Similarly, despite professions of a desire to improve intimacy and connection, these were not really the mutual goal shared between the couple and the therapist. Although, both partners verbally and overtly aligned with intimacy goals that the therapist offered, Jaymes had more urgent lifelong needs that drove his behavior. Not just the first session, but also any effective therapy might be waylaid in the face of Jaymes compulsively asserting narcissistic goals. His narcissistic needs define himself and thus, also define the couple's relationship to a large degree. As a result, his narcissistic issues also completely would compromise if not sabotage couple therapy, if the therapist does not identify them. The therapist must to recognize the scorpion in therapy- that is, the narcissist in the session room. Or, the therapist will also suffer Jaymes' sting. The therapist got a taste of the sting in the first session. A sting is what a scorpion has. Stinging is what a scorpion does. Even if the therapist accurately diagnoses narcissism in one of the partners, and therapy shifts to include dealing with the narcissism, the process of therapy and successful therapeutic outcomes become significantly more difficult. Ignoring or missing the narcissism moreover, virtually dooms effective couple therapy. And will make the therapist question his or her own competence and/or become frustrated and angry with the narcissistic partner.

SEVEN DEADLY HABITS

William Glasser in the article Counseling with Choice Therapy: A New Mental Health Model (CAMFT Therapist, Jan/Feb. 2005) named seven deadly habits that sting. These habits can destroy all relationships. They are:

1. Criticizing

2. Blaming

3. Complaining

4. Nagging

5. Threatening

6. Punishing

7. Bribing or Rewarding to Control

It would behoove partners and couples to reframe from or minimize these deadly habits. The couple therapist should therefore be alert for these deadly habits and work with the partners to eliminate such behaviors, as well as helping them develop positive behaviors. Glasser also names seven caring habits that he feels facilitate healthy intimate relationships. These are

1. Supporting

2. Encouraging

3. Listening

4. Accepting

5. Trusting

6. Respecting

7. Negotiating

Most couples and probably all therapists already know these two sets of relationship behaviors or habits facilitate or harm intimacy and trust. They know that they should not be mean or negative to each other, and that they should be nice instead. However, problematic relationships and consequently effective therapy is not merely about knowing what to do and not do. Partners who can refrain from negativity and being mean and can consistently act nicely and positively probably function relatively well and happily as couples. They are also less likely to need couple therapy. Or, if such partners have glitches in their relationships, they are more likely to activate previously learned communication and behavior to restore intimacy; or are more likely to utilize lay recommendations and pop psychology (including couples retreats, self-help books, relationship advice columnists, family, friend, or pastoral advice). When they realize that they are engaged in negative relationship damaging behavior they are able to follow the advice of Bob Newhart (YouTube, viewed January 6, 2012) in his comic skit as a psychotherapist. They can rather readily Stop it! And conversely, start it… start the nurturing healing behaviors that build intimacy and trust. Occasionally, relatively healthy partners arrive for couple therapy needing only some basic communications training and therapeutic guidance from the therapist. They also can stop it. For example, refrain from the seven deadly habits. Or, start it by regularly and sincerely practice the seven caring habits. Couple therapy is easy efficient and both partners and the therapist feel fulfilled.

And then, there are the individuals who are difficult to work with although they may conceptually understand and articulate both the negative behaviors to avoid, eliminate, or minimize and the positive behaviors to activate and maximize consistently. However, in spite of such impressive recitation, they somehow cannot follow through in the couple's daily interactions. Criticizing, blaming, complaining, nagging, threatening, punishing, and bribing or rewarding to control among other negative behaviors may be regular dynamics in the relationship. Or they may only occasionally manifest but with vicious intensity… with emotional or psychological surgical precision in some cases or with gross brutally in other couples. Besides the poisonous sting, the deadly habits or aggression may be repeated pinpricks of being subtly discounted, control or domination- socially, physically or financially, emotional or psychological or spiritual water torture, or crude clearly brutal physical abuse. Resisting the seven deadly habits may be of particular difficulty for individuals with narcissistic tendencies or narcissistic personality disorder. Many of the therapeutic approaches and theoretical orientations to couple therapy can be waylaid by narcissistic energy from one or both partners in a couple. The therapist could barely get past a generic opening question with Jaymes before being overwhelmed with narcissistic defense mechanisms. Resistance, manipulation, and intensity can ambush the therapist who fails to note narcissistic personality disorder or narcissistic tendencies in the relationship. These issues can be anticipated and more effectively incorporated into the therapy. The therapist may be unfamiliar with narcissistic personality disorder and/or have frustrations that he or she did not recognize originated from narcissistic issues in a client.

Guidance from other therapeutic assessments may also be significantly complicated by narcissism. For example, an indicator of marital satisfaction is seen in the degree to which partners differ in their respective levels of social individuation. It appears that, in such mismatched dyads, it is the partner who is high on social individuation who is the more dissatisfied, presumably because the low social individuation partner fails to respect the strong distinction between self and other ('what's mine is mine and what's yours is yours') that the high social individuation partner needs to establish and maintain (Charania and Ickes, 2007, page 205). The individual with very high social individuation may also be a narcissistic individual. His or her status and success is his or hers alone. "With regard to social individuation, it is important for counselors to know that individuals who score high on social individuation find it difficult to be satisfied in a relationship with a partner who seems to habitually ignore, discount, or otherwise fail to respect the strong distinction between