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.

Don Draper, Superheroes and Narcissism

Spoiler Warning: Contains Spoilers for Mad Men.

I recently finished watching Mad Men, one of my favorite shows. The story of Don Draper is the story of narcissism, set to the back drop of the 1960s. I find it easy to identify with him as my own journey was really only secondarily about gender, and first about healing from narcissism. I have never seen such a good portrait of narcissism, particularly from the point of view of the narcissist, as in this show.

The defining characteristic of narcissism from a psychological perspective is feeling that who you are is unacceptable in some way, then constructing a persona and totally identifying with that persona to the point of mistaking it for your complete self. This is due to feeling a great deal of shame around the real self and therefore wanting to bury it completely. It also has its roots in conditional love. A child that feels they cannot be loved unconditionally and can only be loved due to their achievements or certain traits can develop this dynamic. They build the false self in order to receive love. However, conditional love is not real love, it is only an approximation. The tragedy is that this conditional love can never completely nourish all the time. It is like eating a diet of junk food all the time, yes it might keep you alive, but will not allow for flourishing.

The classic portrayal of the narcissist is of an arrogant man who manipulates others and is abusive and self-centered. This is really just one type of narcissist. Narcissists come in lots of different flavors depending on the particular persona that is constructed. They can be quite self-effacing in fact. What is common is the creation and identification with a persona. I was never a classic narcissist, but the woman I was living as was a character I created, even if I wasn’t consciously aware of it.

Our ability to create a persona is not in and of itself a problem. Indeed it is vital to functioning in different social contexts and part of being a healthy person. A person might go to work and put on one persona in the workplace, and then a different persona with friends, and a third with family etc. The persona is a mask that enables one to take on a role and helps others to recognize that is your role. A doctor might adopt the persona of the doctor when in office, and then take it off when with friends. The mask is like a filter for the self-expression, certain aspects are emphasized and certain aspects are de-emphasized. A persona is not purely constructed, people have personas they resonate with more or less depending on their nature.

The difference between a healthy persona and a pathological one is if the person can take it off and put it on. A friend once observed that you can see this difference looking at superhero stories. The superhero dons their super persona in order to perform acts of heroism and then goes back to the mundane world where they have an ordinary identity and an ordinary life. They are part of the community and have friends, love and connection.

The supervillian is not part of the community and cannot take their mask off. They have no true friends, only subordinates or superiors. Both superhero and supervillian gain their powers in response to an extraordinary, often traumatic event. It is their response to the event that determines which way they go.

Returning to Mad Men and Don Draper: Don Draper was born Dick Whitman, to a poor family. He enlisted in the Korean War and eventually killed his CO, taking on his identity. He used his new background as an officer as part of his rise in social status, eventually becoming a powerful man in advertising. On the outside he is very successful, rich, handsome, powerful and a ladies’ man. However on the inside things are very different. He struggles with his past and his knowledge that on some level that he is fake. He drinks heavily, and bounces from unsatisifying relationship to unsatisfying relationship, always grasping for what is real. He has more and more success in his career, and makes more and more money. One point I get from the show is that while it very fun to watch Don Draper, and it might be fun to have a fling with Don Draper, it is terrible to actually be Don Draper.

The last season he almost totally breaks down. One day he goes into a meeting and just can’t take it any more. He gets in a car and just starts driving. He doesn’t know where he is going but just knows that he needs to get away from things. He confesses what he did to his CO to a group of veterans. He goes to a retreat center and has a moment of human connection. The next to last scene shows him in a group at the retreat center meditating when a smile crosses his face.

You might think he then leaves the advertising world forever, but he doesn’t. The last scene shows a classic coke commercial from the 70s, implying that he created it. That is because his advertising gift was part of his realness, that is the thing about the false self, it contains truth. It is not completely fake, rather it is the best the person can do. It is created as an attempt to avoid unbearable pain. It is the best attempt you can make at the time to be yourself. It is a lot like being a method actor, but being unable to let go of the role you are playing.

There are large cost to this. One of the main ones is that on some level you don’t really believe the persona is you, not completely, and so it requires validation to maintain it. Any challenge to the reality of the persona will bring back all of the toxic shame that led to the creation of the persona in the first place. People don’t have intense emotional reactions to being invalidated about traits they feel secure about, that is easy to brush off. If you mistake the persona for yourself, a threat to the persona is a threat to your very existence. So, there is this endless seeking of validation, which is sometimes called narcissistic supply and every time the persona is validated it feels good, but never enough. Every time the persona is not validated it feels so very painful.

The persona also prevents true unconditional love from reaching the heart, which is precisely what is needed for healing. This is what makes severe narcissism so difficult to treat in therapy. Narcissism is on a spectrum, so there is hope for some. However in some cases all we can do is help the person live the best they can under the constraints of the persona they have created, and maybe help them to not cause harm to others. If the persona they put forth is loved, that love doesn’t truly reach them, because again on some level the person knows it isn’t really them. ”If they really knew me, they wouldn’t actually love me”

Indeed, I think narcissism is the pathology of our age, not full-blown NPD, but a milder kind of narcissism that has become so prevalent that is almost the water we swim in, at least in 21st century America.

Some great things to read about narcissism:

Alice Miller is probably the most well known author on narcissism, in particular her book Drama of the Gifted Child is amazing.

The Last Psychiatrist talks a lot about narcissism and has a fascinating take on many issues.

Sam Vaknin who identifies as a narcissist, has a great site talking about his own experience and ideas about narcissism.


I haven’t wanted to write much the past few days. I am busy moving, and that is part of it. I also have been reflecting on the blog and why I write it. I felt burnt out after last week and did not want to write.

I have initially focused a lot on psychology and theory. I am glad to have written the things I have written, however much of the fruit of that seems to be to have provoked debates about psychology and theory. Discussing theory is good, but theory in and of itself is insufficient to produce growth. I fear that I may just be contributing to the incendiary discourse around these issues. There has been a lot of psychological writing on trans issues over the years, and I had read much of it during the time I identified and lived as a woman. It did not help me in any real way. Insight is also insufficient to produce change. I think particularly about reading Anne Lawrence’s book. She clearly has keen insight into her circumstances and what motivates her, however this insight does nothing to allow her to change them.

I do have a few more things to say about theory, but I think I need to focus more on personal stories and connection. This blog has not done as much as I would like in connecting with others and sharing our stories. By presenting a lot of theory, I have taken too much of an expert stance. I also need support around these issues, because detransitioning is difficult too. It is a lot like transitioning but there is no large support network around it, and the territory is much more unknown.

Also my journey is not really about gender at all, it was a very long, very slow recovery from narcissism. I was trapped in a hall of mirrors, looking for love in my own reflection, where it can never be found. The gender detransition is almost a side effect of letting go of that. I felt like I could not be myself and be loved and so constructed another identity. The ironic price of that is that it makes it impossible to experience true connection, because everything is filtered through this image. It was facing my own mortality, learning how to connect with others, discovering how to be part of a group, learning the true joy of service, and listening to my body that enabled me to let go of that identity. It was not any study of theory or psychological ideas that helped me. I think I would like to say more about that.

So I will think more about that, and what I want to say next, as I pack up and begin my move to my next adventures.