A Holy Man heard that his apprentice was able to walk on water. "How did you do this?" he asked the apprentice. "At every step I simply repeated your saintly name," said the apprentice, "and that is what held me up." So the Holy Man ran to the river bank and stepped onto the water. "Me, me, me," he said, and sank to the bottom.

Narcissism, the excessive focus on ones self, has provoked a great deal of discussion in the psychological literature and seems to be a major element in the problems we see at Saint Luke Institute. The term "narcissism" comes from the myth of Narcissus. Narcissus was "a beautiful youth" who, according to legend, rejected the love of several nymphs in a cruel and indifferent way. One nymph complained about Narcissus to the gods and suggested that he might experience what it was like to love and have no love returned. The gods granted this request; Narcissus saw his reflection in a clear fountain and fell in love with his own image. Each time Narcissus attempted to embrace his own image, the disturbed water would make the image vanish. Narcissus remained smitten and continued admiring his own image until his death.

Freud thought that the narcissist was someone who, like Narcissus, had fallen in love with himself. In explaining the narcissist's over-evaluation of their own worth, Freud noted that all of us, when we fall in love with someone, are inclined to idealize that person and overlook the person's faults. In the same way, Freud argued, the narcissist's self love includes an overestimate of self worth and a minimization of any flaws. Other theorists have remarked upon how this self love has its roots, oddly enough, in a family where there were chronically cold parents who were indifferent or rejecting. Often the child has some recognized special talent or intellectual ability that serves as a way for the child to focus away from parental rejection and toward an unusually glorified sense of themselves. This simultaneous negative picture of one's self (my parents reject me, I am unlovable) and highly positive view of one's self (I am beautiful or brilliant) is resolved by the child in favor of the latter but with the former lurking in the mental and interpersonal background. This provides fertile ground for the person who hides deep insecurities behind a self centered personality style and a focus on an inflated self concept. As one writer notes, a narcissistic person, "escapes the painful feelings of nothingness by molding himself in fancy into something outstanding." Because of their self absorption, people like this show little empathy for others and require much admiration from others. At their worst, narcissistic people will use and exploit other people to gain needed self esteem and treat with contempt those people who are not sources of narcissistic fuel.

Unlike dependent people who try to mold their likes and dislikes so that others will accept them or histrionic people who are entertaining or provocatively seductive, narcissistic people seem passively self-assured that others will admire them without much effort or reciprocity. This is part of the logical system of narcissism: if I had to work hard for the admiration of others that would undermine my specialness. Truly special people, the narcissistic person reasons, should gain recognition without trying.

Narcissistically disordered people will cause problems even when their needs for admiration are being fulfilled and may cause chaos when those needs are unfulfilled. In the best of circumstances, i.e. when the world is providing ample admiration, a narcissistic person will still be at risk for putting prestige ahead of productivity, for excessive expectations regarding what the world owes him, and for impaired interpersonal relationships. The search for prestige is a direct result of this person's needs for admiration. Thus, a pastor's effort at parish improvements may be done more for the impression it may give ("I turned that parish around") than for the spiritual benefit of the parishioners. The excessive expectations will emerge when the demands of the person seem poorly related to their effort or performance. An example of this is the scenario in which a priest or sister believes they deserve a particularly special or rewarding assignment to the astonishment of their superior who finds no justification why they might merit such an assignment. The risk for impaired relationships involves the narcissistic person's lack of empathy for others and tendency to use others for self absorbed reasons.

When narcissism is especially deep or when the narcissistic person's disorder has been aggravated by feeling hurt and aggrieved, the risks for more damaging events and relationships emerge. The exploitation of others may involve emotional or sexual behavior with dire consequences. Repeated romantic involvements with vulnerable parishioners may originate from needs for admiration unaccompanied by recognition about the impact these relationships may have on others. Sexual abuse of others may be justified as attempts to help others with sexual development issues or be rationalized away by blaming the victim (this thirteen-year-old boy seduced me) for instigating the behavior. Finally, when narcissistic persons feel insufficiently recognized and admired by those around them, this will provoke resentment towards others and a need to reestablish a sense of specialness and self worth. This may come by denigrating others for behaving "badly" and by creating larger illusions of self importance.

Unfortunately, trying to help people with strong narcissistic problems invites the very hurt to self esteem that narcissistic people have made a life long task of avoiding; i.e. the narcissistic person must be willing to admit to flaws and weaknesses that need fixing. Furthermore, one of the inherent elements in psychotherapy, self reflection and understanding, could add to the self absorption that is part of the problem. The task of tolerating the anxiety and pain that comes with realistic self appraisal is a difficult and often slow process. Group psychotherapy is often the key modality in getting help with self evaluation and the development of empathy for others.

Stephen Montana, Ph.D. is Clinical Director at SLI.