Narcissism Pt. 2 – Antidotes to Narcissism

In the previous post I talked about Narcissism. In this post, I will talk about some of the antidotes to narcissism. Severe narcissism such as in full-blown Narcissitic Personality Disorder is notoriously difficult to treat with psychotherapy, however, more mild forms of narcissism can be worked with. Really, it depends on how much access the person has to their true self. The paradox of narcissism is that healing requires that the true self be loved and accepted, and the narcissist so identifies with the image they have created that they reject any love given to the true self. They feel intense shame and vulnerability when the true self is even seen. However, sometimes narcissism can partially or totally remit on its own.

Narcissism sometimes remits when the person reaches their 40s. Also spontaneous remission of Narcisstic Personality Disorder sometime occurs in response to an immenant threat to life itself. The direct experience of one’s own mortality, can bring one into the real, in a way that nothing else can. I suspect the reason that remission sometimes occurs in mid-life is that mid-life also brings the realization of mortality. Narcissism is in part a choice to deny the visscitudes of life, mortality, aging and impermance in favor of an immortal image. Also, of course, one can meet the recognition of mortality with denial, which brings the classic mid-life crisis, the attempt to remain young forever. This is especially prevalent in Western culture, which glorifies youth.

That brings us to the first antidote to narcissism, mortality.


My own recognition of my mortality is what first knocked loose my transgender identity and eventually led to the opening that enabled me to heal. When I was 30, I was diagnosed with Stage IV cancer. Fortunately, it was one of the more curable kinds of cancer, but I was given only a 50:50 chance to live. The knowledge that I could be about to die paradoxically made me much happier than I had been. It released me from the relentless pressure to be perfect, and I just played for the first time. A few months later, still not knowing whether I would live or die, I found myself reading Jung. In particular, I encounter some of Jung’s writing on “anima possession”, where a man is taken over by his anima. . In reading this, I felt my body unwind and that there was truth in it, that I had become possessed by a false self. I still could not let of go of this female identity for ten more years, as there was so many things to work through. The encounter with mortality opened the door, and enabled me to begin truly working on my healing.


One of my favorite exchanges in Game of Thrones is the Bravosi greeting. They say “Valar Morgulis” – All men must die. The expected response is “Valar Doheris” – All men must serve. This is because service to something greater than oneself is a healthy response to mortality, and ultimately what is most fulfilling. I first noticed that there was something wrong when I was in my mid 20s and I became involved in groups where there was some emphasis on service. People would volunteer with relish and might even spend their entire festival working in the kitchen. I noticed they had an access to a happiness that I did not. I thought I would try to emulate that, and volunteer, but I didn’t really feel anything. Being wrapped up in the fantasy self acts as a barrier to the human feelings underneath. One of the great joys of working through these issues is the ability to feel the joy of doing something good for another in deeper and deeper ways. This is a much more nutritious food than the more shallow food of attention and validation. What matters here is not the magnitude of the service, but the intention behind it. Indeed narcissists sometimes perform quite valuable acts of service in service to their egos, but that is not what will create healing.


The field of Positive Psychology studies human flourishing. Most of clinical psychology is concerned with pathology, and relieving pathology. One of the findings of positive psychology is the development of character strengths and living in accordance with these values. Each person has their own particular strengths. These strengths specify the ways in which people are most fulfilled in serving the world. However, at first they exist as potentials only, and must be cultivated. Positive psychologists have identified 24 character strengths, and created a test to see which ones resonate with you the most. This value-orientation is very different than the identity-orientation, because it requires action. The identity-orientation says that you are what you perceive yourself to be, no action required. The value-orientation is not just something you are, but also something you do. This orientation to life goes as far back as Aristotle, who defined virtues as habits that were built over time. Who you are is your character, and is based on what you do and what habits you develop, not on how you think of yourself.


Embodiment is being in one’s body and being connected to our own instinctual processes. One of the problems I had with living in my fantasy self was that I was disconnected from my body and usually in state of dissociation. I didn’t even know what dissociation was because it was just my normal existence. My body had a lot of tension. My body is also how I came to know what was real and what was not, because in my head I could be absolutely anyone, but that was not true in my body.


One of the largest determinants of happiness is the quality and depth of human relationships. Having deep intimacy, seeing another and being seen by them, is one of the great joys of life. Narcissism impedes this, because having another see your image is not the same as having another truly see you. It also hard to truly see another if you are fixated on your own image. One of the reasons I let go of my transgender identity was because it interfered with my being present for another, this was particularly true as I began to see clients as a therapist.

Empathy / Universality

Narcissism arises from the belief that one has to be unique and special to be loved. The best medicine for narcissism is to receive empathy, and empathy for the real self. Empathy is not based on what is unique about us, but on what is common about us. We share certain things with all humans, certain things with only some humans, and certain things are unique to us. It is the common things that allow us to put ourselves into the shoes of the other. We all have feelings, we all have pain and pleasure, we all grow old and die. What is unique about us is important also, but does not generate empathy. A person who feels they can only be loved for their specialness is disconnected from our common shared humanity which is the source of empathy.

I see my journey of returning to male as being a letting go of fantasy and returning to what is real, and working to let go of narcissism. I do not mean to imply that all transgender people suffer from narcissism. The research does show elevated rates of narcissism particularly with MTF folk, but does not show that all MTF or FTM folk have problems with pathological narcissism. It is just that since the essence of narcissism is identifying with a grandiose or fantasy self, if narcissism is present as well, it seems possible the two are related. They certainly were in my case.


  1. Excellent point. I totally agree with the strong correlation between narcissism (even if not pathological narcissism) and transgenderism.

    Ironically, in my case, my own therapist is worried about my (mild) rejection sensitivity — because I always fear to not be pleasing enough to others, I always do my best to please them, at the expense of not thinking of myself enough (and even hurting my career or relationships because of that). By contrast, when I am crossdressed, I engage in full narcissistic behaviour — for a while, at least, I can forget about pleasing everybody else, and just worry about myself for a bit.

    However, I do recognize, at least at an intellectual level, that narcissism is not good for me, and have spent all my life repressing it as much as I could. That exaggerated level of deliberate self-denial and putting myself at the service of others all the time finally resulted in (atypical) depression.

    It’s complicated, but actually my therapist encouraged me to present myself as a woman more, and simply learn to say ‘no’ to others more often!

    Obviously each case is a case. In general I would agree with you that most transgendered individuals that I’ve met have gone through a narcissistic phase, and, in some cases (fortunately not many), they have convinced themselves that transition was the only choice for them. I surely hope they made the right decision…

    1. I think there is a big difference between playing a different role and living another life in a temporary context, and permanently adopting a persona of some kind. The first of those can be a great way to express parts of yourself that you aren’t able to express in your day to day life, and especially if you are too other-focused in your day-to-day life, exploring more of a self-focus can be a great thing.

      It sounds like what you are doing is working for you and that is great.

  2. A friend linked me to your your site, after I told them my own half cocked theories about the correlation between narcissism and transgender. It’s an intense relief to see that I’m not alone in thinking about this. Some of my trans friends treat me like I’m breaking some unwritten law by broaching the subject, and a small few seem to understand completely.

    I went from watching zizek videos to reading hegel, from reading about narcissism on the last psychiatrist blog to reading kohut and jung. The initial unveiling of narcism as the creation of a false persona hit me way too close to home.

    I appreciate your work! Glad to see I’m not alone in the universe.

  3. A friend linked your site to me after I told them my own half cocked ideas about the correlations between narcissism and the transgendered. She agreed with me and thought she was operating under the same strictures.
    It felt really good to realize I wasn’t alone in the universe. I really appreciate your posts.

    For what it’s worth, I came to the idea of a correllation after reading a lot of Hegel, and going from the last psychiatrist blog to Kohut and Jung.

    Is there anything you’d recommend reading?

    1. If you are looking to read about narcissism in general in addition to what you have already found, I recommend Alice Miller’s Drama of Gifted Child, and also Masterson who talks about treatment of narcissism. The Last Psychiatrist is one of my favorites!

      Speciffically related to trans issues there is not much, but Anne Lawrence talks a little bit about narcissistic rage and transgender issues, and there is a research article summarized here finding narcissistic patterns in MTF transsexuals:

      1. This is a very small study and N is almost zero. However, cluster 3 showed no narcissistic pathology. These people lived more or less in disguise. Do you think that may be somehow related to absence of narcissistic traits?

  4. I like the topic “Antidotes to Narcissism” as well as the way you consider it and write about it – it’s the first time I read your blog.
    Thank you

  5. “Who you are is your character, and is based on what you do and what habits you develop, not on how you think of yourself. ” I’m unclear whether you consider this your own view or not and if you do isn’t how you think of yourself and your virtuous or unvirtous character intrinsically linked/correlated with one another?

    1. I think there are ways that how you think of yourself can help to live a virtuous life. There are some ideas in positive psychology that identifying with various virtues can help to express those virtues. This is different than say identifying with a certain group. Most people think of themselves as being good people in one way or another some of those being virtuous and some of them not.

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