N
Narcissism, Neuro-diversity, Neuroses, Non-Verbal
Narcissism
Narcissism means Donald Trump.
There’s just a touch more to it than that. But if you want to get what the ultimate presentation of clinical narcissism (Narcissistic Personality Disorder) looks like then look at Donald Trump. The key tell-tales are an exaggerated sense of self-importance, a constant need for validation, an inflated expression of achievements, a fantastic sense of prospects, an incapacity for criticism, a disinterest and disconnection with the needs of others, and an overwhelming arrogance.
Most or all of us will have narcissistic traits; if not then we’d have problems of self-worth. Loving ourselves is generally good. Loving ourselves to the detriment of all other people is generally bad.
Narcissism often arises in therapy with people who have themselves been the victims of narcissists: often parents, sometimes siblings or friends. Having suffocated in the airlessness of that person’s self-image, the client now wants to breathe fresher air but is not sure how that will feel. And that’s really important.
I’ve also had clients who worry about being narcissists themselves, perhaps because someone close to them was very narcissistic and they fear repeating the pattern. They needn’t worry. Almost by definition, no true narcissist will go to therapy. After all, nothing could ever be wrong with them, could it?
Neurodiversity
Neurodiversity is a funky word which essentially means ‘different ways of mentally operating’.
Although the term is relatively recent, the presentations which fall under its umbrella are longer-standing and increasingly well understood and treated. Appropriately for a term that originated with a sociologist rather than a psychologist (Judy Singer), the concept suggests that various behavioural, learning or social challenges arise partly out of the wider social context rather than being illnesses.
While some may dread being Othered by this label, many find it a reassuring collective term to mean “It’s not just me”. Whether you’re autistic, dyslexic, dyspraxic, have ADHD or one of a plethora of others, ‘neurodiversity’ suggests “this is a thing, many people experience it, and it can be treated, stabilised or managed”.
So perhaps it’s not just a funky word after all.
Neuroses
Neuroses are the bread and butter of the therapeutic process. Neurosis is the Freud word for anxieties we carry which express themselves in a manner out of proportion to the cause.
Nick gets so worried about people hearing him eating aloud that he never eats in company. Nick has a neurosis.
Nadz gets so worried about being alone that they have to phone someone every hour to feel safe. Nadz has a neurosis.
Nell constantly checks her phone for fear of bad news waiting for her on it, to such an extent that she finds it hard to sleep for fear of missing a crucial text. Nell has a neurosis.
All three people have anxieties which are not just peripheral concerns, they are properly limiting how they function in the world. They are all neurotic. They could all benefit from some therapy. (Probably in the North London area with someone who writes therapy blogs.)
Non-Verbal (Communication)
The non-verbal is where a lot of the most useful information about a client’s emotions, relationships and story can be located. The eye contact, the sitting position, the knee that jiggles, the playing with the watch, even where on a sofa they seat themselves (near me or at the far end) can give useful information.
Smiles are particularly telling examples, I find. It’s striking how often people smile while telling me about something incredibly challenging or distressing. Sometimes, when I’ve asked about it, they haven’t even noticed they smiled. It’s an in-built, instinctive, protective strategy designed to take the edge off a difficult experience. It’s as if they’re communicating “This was awful but I’m smiling so it can’t have been too bad”. Sometimes this might be a defence against me probing something too difficult; sometimes it’s a defence against them feeling something overwhelming. That’s why I never give therapy over the phone.
As in acting, it’s not what you say but how you say it.
Next Week: O
Object Relations, “Obviously”, Open Questions