So in the video below, Jennifer Sweeton, PsyD gets into one rapport-building strategy that can help increase your effectiveness when working with narcissism.
Have a look.
So for these clients, you may need a whole other strategy. For these clients, a lot of times they may be seeing you as the clinician, as someone who’s a threat in terms of a power differential or the power struggle. If inferiority underlies their narcissism or their grandiosity, they don’t want to go to a clinician who they feel has power over them. That’s going to make them feel inferior. In fact, you may be seeing these narcissistic traits even more so than some of the other people in their lives. You’re going to see it in full force because of the nature of this relationship. So you trying to address it directly, or you even trying to validate it, it’s almost like you’re pulling yourself at their level and this is going to make them uncomfortable, some clients at least, uncomfortable. So with these clients, it can be a very tricky thing, but you may want to watch trying to take over the session.
So sometimes I’ll talk to clinicians. I do a lot of consultation with clinicians and they’ll say, “Well, I feel like session after session is just the same thing. And if I try to say, ‘Hey, can we work on this? Or can we do CBT? Or can we do EMDR?’ I get immense pushback right away. It’s like, they don’t want me. They’ve hired me to be the professional, the expert. And yet they don’t want me in this role.” So what you may have to do is first of all, accept at the outset that this may be a fairly long process. And to also know that they may insist on guiding the session and what you’re trying to do is follow them. And every now and then take a little bit of a detour slightly toward a slightly different place. So for instance, they may be talking, again, about how they were successful and someone at work just didn’t see it.
And this person is obviously just not very intelligent. What you might try to begin doing, slowly over time, is ask them to engage in mentalization. So what I mean by that is taking another person’s perspective and it’s not important that this perspective is accurate at all, but you might just insert the question. “What do you think that coworker was thinking in that moment? What’d you think that coworker was feeling in that moment?” That, in a small way, is beginning to take them out of that narcissistic space, where everything is about them and revolving around them, and putting them in someone else’s mindset. So you can begin to do this over time, when you see that the validating is actually maybe making them worse.
For more expert strategies on working with narcissism, check out this course featuring Bessel van der Kolk, MD; Peter Levine, PhD; Pat Ogden, PhD; Terry Real, MSW, LICSW; and more.
Now we’d like to hear from you. What strategies have been helpful in your work with grandiose clients? Leave a comment below.