All patients are narcissistic. In fact, we all are. People care about themselves more than anything else. This is normal human behavior and a necessity for survival. If we did not care for ourselves, we would not be able to survive as a species. Think about this, in a moment of survival, the human being will try to safe itself instinctively. If there is an airplane crash, all survivors will push each other to get out of the aircraft first. Its survival of the fittest. There is nothing wrong with this behavior. However, when it regresses to more immature behavior, it causes problems with others. That is when a person turns into a “patient”.
I make a living of listening and treating people. Sometimes I am appalled at the expectation of people. If you try to point it out to them, they get defensive and angry. We psychiatrist use a lot of terms to describes these people. However, I’ve learned that the best way to understand what I am trying to say is to be descriptive of their behaviors.
On the hit show “Monk” from USA network, they make mockery of one such type of patient. Adrian Monk is an obsessive-compulsive detective, i.e. OCD that solves crimes in spite of his mental handicap. The first time I watched the show, I did not find it funny since I know many patients that are like this and are so sick. However, the more I watched it, the more I enjoyed it and laughed. If you watch closely at the show, you will see how narcissistic the character “Monk” is. He never cares about his assistant, Natalie or her needs, it is all about him. In the episode, “Monk goes to group therapy”, is the best example of how he did not like group therapy because everyone else was talking about their own problems and not listening to his. This brings me to our real world. Every patient that walks into my office has several degree of narcissism.
Narcissism is defined by the English Assistance; US as “an extreme interest in your own life and problems that prevents you from caring about other people”.
People that are depressed wallow in their own self pity. They talk about it, rehearses it, repeat it to anyone that is willing to listen but don’t make any attempt to change their situation. A good example is the alcoholic person. This lady came into my office extremely depressed. Her husband left her, she had no job, she had no money and she had her neighbor paying her rent, food, utilities, taking her to the doctor and paying her doctors visits plus her medication. He is helping her get back on her feet with the condition that she stops drinking booze. The lady is drinking daily 2-3 bottles of liquor a day. She cried during the interview because she had “all these problems”. When I told her that she needed to stop drinking, her answer was, “I stop yesterday but you need to give me a pill so I won’t drink”. Every suggestion on rehabilitation, detoxification or AA, (alcoholic anonymous) brought out a new excuse of why she couldn’t do that. By the end of the interview, I gave up. She was in the position she got herself into. I had no pity for her. The neighbor seemed upset when she confessed she had continued drinking even though she denied it to him so he would continue paying her bills. I heard him tell her that he was cutting her off if she did not stop drinking. Having worked with addicts for years, I knew that it would take much longer before he gave up on her. The lady was so into herself, i.e. narcissistic, that she couldn’t see how she had created her own situation.
Teenagers and young adults tend to be more narcissistic since they have very little life experiences. Most of us grow out of this since life has the ability to humble us. Losing a spouse through a divorce or a job makes us look into ourselves and reflect if we did something wrong to merit our loss. However, not everyone is so insightful. People tend to blame others for their misfortunes. “It was that bad boss I had that made me lose my job”. Or, “my spouse was a jerk and that is why the marriage did not work”. Even if some of this may be true, have you looked into yourself and figure out what did you do to contribute to the problem? If you do, you may make yourself a better person.