The Narcissistic Patient - A Case Study

 

"Personality Disorders Revisited" (450 pages e-book) - click HERE to purchase! 

By: Dr. Sam Vaknin

Click HERE to view the video

https://samvak.tripod.com/covers.jpg

Malignant Self Love - Buy the Book - Click HERE!!!

Relationships with Abusive Narcissists - Buy the e-Books - Click HERE!!!


READ THIS: Scroll down to review a complete list of the articles - Click on the blue-coloured text!
Bookmark this Page - and SHARE IT with Others!



Subscribe to narcissisticabuse
Powered by groups.yahoo.com


Notes of first therapy session with Sam V., male, 43, diagnosed with Narcissistic Personality Disorder (NPD)

 

Sam presents with anhedonia (failure to enjoy or find pleasure in anything) and dysphoria bordering on depression. He complains of inability to tolerate  people's stupidity and selfishness in a variety of settings. He admits that as a result of his "intellectual superiority" he is not well placed to interact with others or even to understand them and what they are going through. He is a recluse and fears that he is being mocked and ridiculed behind his back as a misfit and a freak. Throughout the first session, he frequently compares himself to a machine, a computer, or a member of an alien and advanced race, and talks about himself in the third person singular.

 

Life, bemoans Sam, has dealt him a bad hand. He is consistently and repeatedly victimized by his clients, for instance. They take credit for his ideas and leverage them to promote themselves, but then fail to re-hire him as a consultant. He seems to attract hostility and animosity incommensurate with his good and generous deeds. He even describes being stalked by two or three vicious women whom he had spurned, he claims, not without pride in his own implied irresistibility. Yes, he is abrasive and contemptuous of others at times but only in the interests of "tough love." He is never obnoxious or gratuitously offensive.

(continued below)


This article appears in my book "Malignant Self-love: Narcissism Revisited"

Click HERE to buy the print edition from Amazon (click HERE to buy a copy dedicated by the author)

Click HERE to buy the print edition from Barnes and Noble

Click HERE to buy the print edition from the publisher and receive a BONUS PACK

Click HERE to buy electronic books (e-books) and video lectures (DVDs) about narcissists, psychopaths, and abuse in relationships

Click HERE to buy the ENTIRE SERIES of sixteen electronic books (e-books) about narcissists, psychopaths, and abuse in relationships

 

Click HERE for SPECIAL OFFER 1 and HERE for SPECIAL OFFER 2

 

Follow me on Twitter, Facebook (my personal page or the book’s), YouTube

 


 

Sam is convinced that people envy him and are "out to get him" (persecutory delusions). He feels that his work (he is also a writer) is not appreciated because of its elitist nature (high-brow vocabulary and such). He refuses to "dumb down". Instead, he is on a mission to educate his readers and clients and "bring them up to his level." When he describes his day, it becomes clear that he is desultory, indolent, and lacks self-discipline and regular working habits. He is fiercely independent (to the point of being counter-dependent - click on this link:  https://samvak.tripod.com/faq66.html ) and highly values his self-imputed "brutal honesty" and "original, non-herd, outside the box" thinking.

 

He is married but sexually inactive. Sex bores him and he regards it as a "low-level" activity practiced by "empty-headed" folk. He has better uses for his limited time. He is aware of his own mortality and conscious of his intellectual legacy. Hence his sense of entitlement. He never goes through established channels. Instead, he uses his connections to secure anything from medical care to car repair. He expects to be treated by the best but is reluctant to buy their services, holding himself to be their equal in his own field of activity. He gives little or no thought to the needs, wishes, fears, hopes, priorities, and choices of his nearest and dearest. He is startled and hurt when they become assertive and exercise their personal autonomy (for instance, by setting boundaries).

 

Sam is disarmingly self-aware and readily lists his weaknesses and faults - but only in order to preempt real scrutiny or to fish for compliments. He constantly brags about his achievements but feels deprived ("I deserve more, much more than that"). When any of his assertions or assumptions is challenged he condescendingly tries to prove his case. If he fails to convert his interlocutor, he sulks and even rages. He tends to idealize everyone or devalue them: people are either clever and good or stupid and malicious. But, everyone is a potential foe.

 

Sam is very hypervigilant and anxious. He expects the worst and feels vindicated and superior when he is punished ("martyred and victimized"). Sam rarely assumes total responsibility for his actions or accepts their consequences. He has an external locus of control and his defenses are alloplastic. In other words: he blames the world for his failures, defeats, and "bad luck". This "cosmic conspiracy" against him is why his grandiose projects keep flopping and why he is so frustrated.

 

Read more about the Narcissistic Personality Disorder (NPD) - click on these links:

Who is a Narcissist?

Narcissistic Personality Disorder - Diagnostic Criteria

Narcissistic Personality Disorder - Prevalence and Comorbidity

Narcissistic Personality Disorder - Clinical Features

Narcissist vs. Psychopath

The Inverted Narcissist


Case Studies

The Psychopath

The Paranoid

The Borderline

The Schizoid

The Histrionic

The Avoidant

The Schizotypal

The Obsessive-Compulsive

The Dependent

The Masochist

Negativistic (Passive-Aggressive)

The Sadist

The Depressive


Many additional Frequently Asked Questions (FAQs) about Personality Disorders - click HERE!


Copyright Notice

This material is copyrighted. Free, unrestricted use is allowed on a non commercial basis.
The author's name and a link to this Website must be incorporated in any reproduction of the material for any use and by any means.


Go Back to Home Page!

Malignant Self Love - Narcissism Revisited

More Journal Entries

Frequently Asked Questions about Pathological Narcissism

Excerpts from the Archive of the Narcissism List

The Narcissism List Home Page

Philosophical Musings

World in Conflict and Transition

Internet: A Medium or a Message?

Write to me: palma@unet.com.mk  or narcissisticabuse-owner@yahoogroups.com