Dr. Seth Meyers on Narcissistic Patterns and Phenomenology

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): Oceane-Group

Publication Date (yyyy/mm/dd): 2024/11/11

Seth Meyers, Psy.D. (Psychology Today) is a licensed clinical psychologist, T.V. guest, author, and relationship expert. He appears regularly on television on “Nancy Grace” and has also appeared on “Dr. Drew,” “20/20,” “Good Morning America,” “The Doctors,” “Fox News,” Showbiz Tonight,” “Bill Cunningham,” “Jane Velez-Mitchell,” “The Early Show,” “Good Day L.A.,” “KTLA,” and others. He has been featured in The New York Times, USA Today, and The Huffington Post. His official website includes many media credits and television clips. He wrote Dr. Seth’s Love Prescription: Overcome Relationship Repetition Syndrome and Find the Love You Deserve. His newest podcast, on Spotify and iTunes, is INSIGHT with Dr. Seth.

Meyers explains the complexities of treating narcissistic personality disorder (NPD), emphasizing the resistance to therapy due to narcissists’ lack of self-awareness and sensitivity to criticism. He discusses therapy options, the role of the false self, and the emotional toll on those close to narcissists, highlighting the frustration and self-erasure they often experience.

Scott Douglas Jacobsen: So today, we are here with Seth Meyers. We want to get some first thoughts on treatment modalities for either formal NPD or people along a spectrum of narcissistic patterns of psychology. So, what are treatment modalities available? What is the efficacy? What are your general thoughts on that, as an expert here?

Dr. Seth Meyers: Many individuals with mental health training will explain that a narcissistic personality is resistant to meaningful change. There are many different types of therapy that one could pursue for many different types of mental disorders, including personality disorders. One could seek out a behavioural type of therapy, such as dialectical behaviour therapy for the treatment of narcissistic personality, or one may seek out psychodynamic therapy, which is exploratory in nature to try to look at one’s unconscious drives, and motivations in order to see how that impacts their behaviour.

The same issue–let me put that differently; at root, narcissistic personality is a difficult disorder to study because it depends so much on the self-report of its subjects and because one’s self-image and presentation of self is central to the disorder, there is incredible loading or possibility for skewing and dishonest reporting. So, studying narcissism is much the experience of many reports of having a relationship with a severe Narcissist, which is to say, “Frustrating” because it is a complex construct that is difficult to truly examine.

Jacobsen: Is the difficulty in truly examining it due to the longevity of the enriched falsehoods that build or construct the complexities of the false self? The false self starts early to replace the true self or the authentic self–as placeholder terms.Does the longevity of this false self-existence and development make it that complex construct?

Meyers: So, to begin with, your question shows just how theoretical the construct of narcissism is. We have no ability toprove it. We will never prove the roots of narcissism.

Now, many people will talk about how there are two selves: a false self and a public self. As a practitioner and psychologist, I believe that. I also believe that we can glean that at some point in time, there was the construction of the bifurcation of 2 different selves. The problem is when it happened, it happened early, and that 6-year-old or 14-year-old probably wasn’t available to fill out any surveys that we could use later for psychological data reports. So we don’t know, and there’s a lot of inference.

There’s a lot of presumption that happens when we think about narcissists. What is most important whenever the conversation turns to narcissism is, “What can we say for sure? What can we say with the greatest certainty? And then what solutions are the best possible solutions given this, given what certainty we have”? What is most certain that we know is that people many people report having conflictual relationships with a subset of individuals who do not seem to have personality characteristics that are consistent with social convention and the social rules that young children are taught and then expected to have mastered by adult age, and those include basic things like empathy, social reciprocity, perspective taking, thinking about another person’s feelings.

We know for sure that there is a subset of individuals that display a lack of some of these important social characteristics, and yet, it does not necessarily translate to another subset of individuals we know of that we think of as full-blown psychopaths. And this subset that we are talking about is safe to call them–it is safe to refer to them as–narcissistic personalities because the DSM does do a good job of capturing those characteristics. Now, why does a person become a narcissist? We can only presume. Also, what is an effective treatment for a narcissist? Is there an effective treatment for a narcissist?

We’ll never have a good answer for that question a) because we would require an individual to believe that they have a problem in order to submit to treatment, and a part of the disorder is to resist the idea of there being any weakness or flaw. So, I’ll round out what I’m saying to say that another thing many people will share at the water cooler is that narcissists are never present for therapy, and this is common. This is conventional wisdom that narcissists don’t present for therapybecause they don’t believe anything is wrong with them. In my experience as a psychologist and as a practitioner, someone who has conducted and also reviewed 100, if not thousands, of complex mental assessments, mental health assessments over a 20-year career working in community mental health, hospitals, clinics, et cetera, that narcissistic personalities will actually sometimes present for therapy. Now, why do some narcissists go to treatment?

They do not go to treatment to correct problems they believe they have. They typically go because someone in their close personal life has bruised their ego, and what they do is they use the therapy and the therapist as a vehicle to ally with them and support them against the perceived threat or perpetrator who bruised their ego. Essentially, a narcissist may go to see a therapist to get the therapist to say, “Oh, you’re right. Your husband, or your wife, is crazy,” and sorry for talking so much.”

Jacobsen: It’s instructive. So they go to them for this validation of their false reality.

Meyers: To be propped up, that false self to be propped up.

Jacobsen: So when they’re doing this, are there ways in which ethically viable methodologies can leverage this pathology of that personality construct to provide a modicum of treatment?

Meyers: A meaningful question that is worth exploring is this one. If there is any way to reach a narcissist and possibly motivate change, what would that look like? The only hope for reaching a narcissist is to make them feel safe and to avoid anything at all that could even remotely be perceived as criticism. The narcissist is sensitive to criticism and hypersensitive to–hypersensitive in a way that almost reaches a state of clinical paranoia–that the slightest thing that could be wrong with them could act as dynamite because it could be used later as leverage against them. So a lot of what motivates the narcissist, what keeps them going, their guiding principle is to avoid vulnerability at all costs.

Narcissistic personalities tend to be scorekeepers, and the mental world they live in is all about who has the leverage. So exposing themselves and being vulnerable makes them terrified at root because they perceive it as an opening for someone to take advantage of them or exploit them, And they will not allow that under any circumstance.

Jacobsen: So there’s a lot there. Fear is the emotion of vulnerability and living in terms of the mental mode and the presentation of a false self. So what links this root in fear reaction, something automatic, this false self, and this not wanting, this lack of desire–whatever the opposite of desire is for–any form of vulnerability?  So, the line of trend or thought is between linking both fear and not wanting any vulnerability. I guess the 4th one would be the extreme paranoia and the presentation of a false self in all ways. So let’s take a hypothetical–what happens if that person is, in fact, exposed and their illegitimate fears, in fact, do come true? What happens to this construct?

Meyers: One of the deepest and most primitive fears that a severe narcissist will have is the fear of being exposed, and that means being exposed as a human being with three dimensions and both strengths and weaknesses. See, flaws are not to be tolerated in the mental world of a narcissist. They cannot exist.

A lot of people will say that narcissism is a shame-based disorder, that the root of it is shame, that a young person was shamed so badly early on that it created this overcompensated self later. It’s a theory. Do I believe that that’s true? In some cases, though, that may not have happened. So now what happened with narcissism is you had some people that created this term.

“Well, these are covert narcissists,” “Well, these are these are more traditional narcissists,” and then you’ve got another camp that talks about malignant narcissists. All of these different terms show you how complex we are as everyday people; you know how complex this term is. And again, how frustrating because the truth is all we have are theories. All we really have are theories. But to answer your question in an organized way, what happens to the severe narcissist when exposed?

When a severe narcissist’s character defects are exposed, any vulnerabilities or weaknesses are exposed and able to be seen by others, especially anyone outside the home. The individual who perpetrated that exposure will become the target of rage. What most people cannot begin to relate to is the lengths to which the narcissistic individual has spent their life, their time, their energy, their mornings, noons, and nights trying to seal off any possibility that someone may come to see them as faulty in any way. The progression, the natural automatic reaction, is rage. Now, is there something biologically based happening?

Is there different amygdala functioning in narcissists? At what age? See, what we would really need in in the best best of all possible worlds, we would have really elaborate batteries of testing done, on children at 5, at 10, at 15, at 25. That way, then we could have a little better sense of the true roots of narcissism.

Jacobsen: It’s a good answer. What happens? Well, let’s take the inverse of these examples, and I don’t know how psychology presents itself. Healthy individuals, when they have their humanity shown, are not “exposed,” too, because “exposed” is a much more loaded term in this context. Although appropriate for the portrayal of the rage, coming out of the fear. So when someone has their regular self shown, they go to sleep. They go to the bathroom.

They wake up with bedheads. Just regular stuff. They got fired from some job some time ago. They failed an exam. Regular people stuff that happens from time to time. How does a normal, healthy person with a non-narcissistic psychological structure react, act, learn, and grow?

Meyers: So what I’m going to say to you is: I don’t know you, but I presume it will not make sense to you what I’m gonna say because my guess is that you are like most people.

If you ask a narcissist, what would you say are some of your weaknesses or some of your character defects? If you ask directly someone that you believe, and it’s only people, by the way, who truly can identify and know when an individual has this type of disorder, they feel it. They may not be mental health practitioners, but they know it; they feel it. They’ve read enough about it, usually people at work or people in their homes. Freud used to say that it is in one’s work life or one’s romantic life where one’s true deepest issues come out. It is true. It is within our work life and in our romantic life where, perhaps, our truest self gets to be known. Why? Because in those two environments, we are the most interdependent with others.

Interdependence, if you’re psychologically healthy, is terrific. Interdependence, if you are mentally unhealthy, is incredibly triggering. So a narcissist will tell you, will tell you, will look you straight in the eye with no effect, almost as if they don’t completely understand your question or are even slightly offended, will say, I don’t believe I really have any flaws.”

Jacobsen: That’s terrifying.

Meyers: Which is terrifying. Now, what a healthy person would say to the narcissist is, but are you do you believe you are not a human being? A part of normal social and psychological development, right, is for each one of us to progress from the age of children to adulthood to see our fallibility, our vulnerability. It is to say that, in some ways, to be a severe narcissist, their grandiosity is so extreme that, actually, they don’t see themselves in some ways as even human. Do you doyou know how wild that is to to wrap your head around?

Jacobsen: It seems as if from a non-expert perspective, when you’re saying these things, they are the literal case of a Martian, not coming down to Earth, but coming out of it, and finding themselves in a world in which their internal world is not fully integrated.

So there’s an insecurity of internal objects about life, ideas, people. So then, they have the paranoia example is quite interesting because it sounds they’re having a distorted interpretation of the events. Their internal objects are completely warped. So then, out of this paranoia, this misperception and misconception then becomes an extrapolated, to you, “Could you harm me sometime down the road? Therefore, I’m going to react and defend my hypothetical self.”

Meyers: That’s right. So, we are talking about cognitive distortion. We are talking about a type of cognitive distortion that can be so illogical. The question is, does it almost border on a mild psychotic process? At what point does someone’s grandiose delusion about their superiority break with reality to the point that we mental health experts would say, do we need to assess for psychosis? I’ll give you an example. I’ll share an example. I once had a supervisor in graduate school.

I went to grad school in New York. I once had a supervisor. She was working with a severely anorexic patient, severely anorexic. This individual had gone in and out of the hospital. The anorexia was so severe, and–I don’t know–you probably know enough about anorexia to know that this is a life-threatening disorder, anorexia. And this supervisor shared that she believed, based on her clinical expertise, she extrapolated that there may be what she believed is a psychotic element to that type of severe anorexia.

So, when we look at some of these cognitive distortions, now, we’re talking about severe narcissism as just one example, but there are many examples where one’s cognitive distortion about a thing, whether their own value as a person–narcissism, their own body–anorexia nervosa; when it can get so extreme that we really do have to ask ourselves to also rule out psychotic process diagnostically.

Jacobsen: Those seem like things you could potentially have a metric in terms of even gross anatomy of the mind. For things like the Penfield Map, you do actually get proportional sizing of things based on the number of nerves. If someone has a warped self-map with body dysmorphia and bulimia nervosa, could you, in fact, find something like “neural correlates” for these kinds of things?

Meyers: This is exactly why, in most colleges and universities, the psychology department is in the social sciences or inthe humanities department and not in the natural sciences. I do think that it’s possible. But any time we are trying to examine a disorder that is so interwoven with self-image, we will always have a challenge.

Jacobsen: Just mindful of time. So, what about the consequences, not for the individual? Those seem a little more obvious because if the person is living a false self, they’re essentially living a lie to themselves. When they are with others, when they want to date, mate, as they do, or others want to do with them–for a variety of reasons? What are the consequences of those relationships for people who find themselves in this vortex?

Meyers: Yes, so we are talking about the phenomenology of being in emotional proximity to a narcissist, the phenomenology of what it feels to be in a relationship, a consistent relationship with a narcissist.

I have written extensively about narcissism. I have worked with so many individuals who have had experiences with individuals who have narcissistic personalities. The experience is typically frustrating and self-erasing, self-dismissing. The individual in proximity to the narcissist, in regular proximity to the narcissist, comes to understand that their thoughts and feelings don’t really matter. Their thoughts and feelings are dismissed and waved away with a callous hand.

The individual comes to understand to keep the relationship; they must submit and agree to the spoken and unspoken rules that are outlined by the narcissist. Now, in the end, many narcissists are left either in work environments. People tend to leave those jobs or in romantic relationships; people will typically walk away. Children of narcissists will, sometimes, estrange themselves forever or for periods of time. Friendships will be abandoned altogether.

A lot of times, people that are blood ties or financial ties are the one thing that can keep people somewhat connected to people who are narcissists.

This has been fun. You’re great.

Jacobsen: Thank you very much. Appreciate it.

Meyers: Thanks, Scott. See you later.

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