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We want to take a moment to welcome aboard our new intern Jordan Langley, BA, BS onto the Healing Reflections Therapy Team. She is completing her Master's degree in Marriage and Family Therapy and is ready to see clients. She is currently accepting spots for individuals, couples, and families virtually. A little down the road she will be able to see kids in-office. She is a great option for folks need lower fee accessible services. Feel free to send folks her way!  A popular point of discussion on social media these days is narcissism. It seems like everyone's parent or ex has been deemed a narcissist.
While in some ways the discussion can be helpful in recognizing abusive behaviors that can impact one’s own mental health, the overuse of the term has taken away some of its power and can lead to misunderstandings. Although it is common these days to toss around phrases like “my ex was such a narcissist” to such an extend that it seems like everyone dated a narcissist. However, the actual presence of Narcissistic Personality Disorder only occurs in 1% of the population. A person can exhibit moments of narcissism ( arguably all of us), but not be a Narcissist. So what does a Narcissist in clinical terms look like? The classic signs of NPD include:
Someone who may be very full of themselves, vain, or overly self-confident. They may have little insight into themselves. The may have little empathy for others and see themselves as the victim in situations where they are the offending party. Often people initially find them very amiable and “charming” is the word that repeatedly comes up in domestic violence circles. They have a way of drawing people to them with their charisma and enigmatic personality, but often their words and gestures are hollow with little sincerity, thoughtfulness, or follow-through. Because they make such a great first impression they can easily trick judges, police, family, and others in authority into believing that they are just a great, well meaning person and their counterpart is suffering from mental illness (enter gaslighting). Narcissism and its role in Domestic Violence Just because your significant other said you were exaggerating or doesn’t recall your side of the events does not mean they are gaslighting you. Gaslighting is a strategic way certain abusers systematically try to make their partner think themselves crazy. It is designed to break them down. Most relationships have couples that widely misperceive or misinterpret events, where one may be experiencing cognitive distortions and have a hard time separating feelings from facts or another may be bad at reading or responding to emotions non-defensively...that does not make them gaslighters or Narcissists. Gaslighting came from the old classic 1944 film “Gaslight” where the main character attempted to convince his wife she was crazy by stealing things from the home and accusing her of stealing or misplacing things, then telling her she had a poor memory, and climbing into the ceiling and adjusting the gas in the ceiling lights and acting like it wasn't happening to convince her she was going insane. It came to be known as a specific form of domestic violence, though can be used by anyone in power/authority, or looking to gain something from someone else for malevolent means. It essentially is intentionally saying/doing things to make someone believe they are going crazy…usually in effort to gain control over them/their things/or to just be antisocial and abusive and enjoy others suffering. Narcissists may use their charm and charisma to get others to align with them against their victim. The victim feels crazy and their self esteem and self-concept are eroded. They may exploit the victim's vulnerabilities to their own advantage physically, financially, or emotionally. Narcissists have more than average encounters with HR, police, civil and criminal suits, protection orders in which they see themselves as the wronged party. They may cry, pout, sulk, yell, namecall, deflect, project, deny, become puffed up, enraged, and incredulous if their behaviors are pointed out. One noted hallmark is the tendency to accuse others of the very behavior they themselves are exhibiting while admonishing it in the other person (kinda makes you feel crazy, right?). If they do admit what they have done wrong, it will be your fault because you “made them do X”, or you “made them feel Y”. Ultimately, they will usually take the stance of “it’s your fault.” I.e. "It’s your fault I cheated because you were not having sex with me enough.” Charming Narcissists may start out with lovebombing and seeming like the perfect person. When getting lovebombed it might feel like you are the main character in your favorite romcom and you likely will feel very special, but usually after 1 year or so of after they get their partner “on the hook” with marriage, housing, loans, or a child their veneer begins to fade and the other side starts to emerge- sometimes classically known as the Dr. Jekyl/Mr. Hyde personality. The victim tends to spend a lot of time in ever shortening cycles of domestic violence idealizing the perfect periods and struggling to see the holistic pattern that tells much more about the overall personality structure of their partner and the waning hope for change. Partners, employees, and children or narcissists tend to develop a lot of insecurity about themselves, are highly attuned to slight reactions from others in a “walking on eggshells” approach to maintain survival and avoidance of further pain. Gaslighting vs Perceptual differences By contrast, Most relationships involve 2 people disagreeing about something because of their own past experiences, internal thought processes/distorted views of the world, and resulting different perceptions of the experience. In most cases, people are not intentionally trying to convince someone they are crazy-though this may be the inadvertent result. Take for example the Michael Brown shooting. They had 64 witnesses and their perceptions and reports of their experience differed wildly. Sure, some may have been motivated by secondary gain to report the way they did, but they were by far not outliers (https://www.motherjones.com/politics/2014/11/inconsistencies-what-happened-during-michael-brown-shooting/) There are famous experiments in cognitive psychology where people can be engaged in a game of basketball and a man in a gorilla suit can walk straight through the court and when asked later about it, most players and witnesses of the game will not see it, because they are focused on the ball (https://www.youtube.com/watch?v=vJG698U2Mvo). A person could easily say “wow, did u see that gorilla?!” And the other person might be like “what are you talking about? There was no gorilla.” An argument ensues and one or both may feel crazy and this is where pop psych gets it wrong-someone might say-“you are gaslighting me.” This is not true, unless the person was intentionally trying to make the other person think they are crazy. And the added piece with cognitive psychology research by Elizabeth Loftus teaches us that people are especially bad historians. Our memories are very fallible and maleable to suggestion, which is why eyewitness testimony is considered the weakest/most unreliable form of evidence, despite people having the most confidence in it (https://www.science.org/content/article/how-reliable-eyewitness-testimony-scientists-weigh#:~:text=As%20Loftus%20puts%20it%2C%20%22just,that%20their%20memory%20of%20an). So, when thinking of gaslighting, ask yourself about the overall behaviors and intentions of this person. Do they generally mean you goodwill even when they are not trying to lovebomb or get something from you in a manipulative fashion? Do they try to help/support/lift you up/encourage your dreams and best version of yourself? Or do you usually feel bad/smaller/more out of control in ways that is usually inconsistent with how you view yourself/others/the world. Narcissists in Therapy Joseph Burgo in the book “The Narcissist you Know” talks about different types of Narcissists, the ones that want to be held in high esteem, famous, or revered and will happily step on anyone who gets in the way of achieving their goal. Dictators, politicians, and some actors and models have been known to fit this mold. Others have a veneer of wanting others to see them as great, but they are much more shallow and easily wounded and resort to lashing out when that is not validated. They are likely to throw a fit, use injurious words to cut down anyone that might see through the veneer and cut the person out of their life entirely. Some may be philanthropers or nurses, teachers, or ministers, or police , or even therapists where they are in the position of being admired and praised, but the people that are closest to them like their partner, parent or child may have a very different experience of them than their public persona. Narcissists are not historically known to show up for therapy unless court mandated or coming in with their partner for couple/family therapy. It is sometimes said that narcissists in therapy only become better at manipulation and therefore a clinician that recognizes the perils should proceed with caution. In these settings they tend to first focus on winning over the therapist by being a “good client” or they finger point all issues as originating with their partner/boss/family member/ex/etc and take no accountability for the work they need to do on their end to make repairs. Essentially, they take the stance of wanting the therapist to validate their concerns as the injured party and try to co-opt the therapist to get the other person to take the responsibility for the problems in the relationship. They may seem agreeable to homework, but have little follow through if the expectation is for them to focus on change within themselves, yet be simultaneously demanding of change and work from their partner. They usually do not see their hypocrisy and are emboldened by their narcissistic injury to overlook their injurious behaviors. Theories of what causes Narcissistic Personality Disorder Theories on the roots causes of NPD vary. Sometimes it develops because they grew up in entitled settings where they were pushed to be “the best” and likewise developed little empathy for anything/anyone that did not meet those standards. Conversely, some were treated so poorly from developmental/attachment trauma that they develop a false sense of self/veneer to convince themselves they were ok to steal themselves up from the outside threats. This is the narcissism that is much more fragile, because if they allow their guard to come down and see their own flaws, their core sense of self may be at threat. They may be vulnerable to experiencing the extreme pain of their early trauma, so they fight hard to allow those vulnerable feelings from being experienced. Traits vs personality disorder Maybe you have read this and thought you for sure know someone who is a Narcissist, but to be clear, the pervasiveness and chronicity and truly heinous impact of this abuse is what makes it unique. You likely have someone who treated you poorly, made you question yourself, did not validate your feelings, took advantage of you, or behaved poorly during an argument and did not share the same perspective as you, but it does not necessarily mean they are a Narcissist. If you reflect, maybe there are times you could say the same for yourself too. This popsych mislabeling is a disservice to real sufferers of narcissists, and gaslighting. Your ex- boyfriend may be a selfish ass, but probably isn’t an actual narcissist. We need to be kinder to one another and more magnanimous sometimes in how we interpret others actions. Fore more readings on the subject, you can read here: www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662 https://emedicine.medscape.com/article/1519417-overview?form=fpf Gaslight(1944).www.youtube.com/watch?v=QJtJsFdpRm8 The Narcissist You know by Joseph Burgo By Megan Garza, MA, LMFT First and foremost, it has been the case in our clinical practice that many Queer and Trans people who come to us for services are only hurt, angered, or feel cut off from their family members who choose to take actions such as not attending their weddings. As the person getting married did not choose and cannot change their sexual orientation or gender identity, family rejection does not send an actionable message to the person, just that family who object to their being out or in a marriage to a person of the same sex are incapable of seeing them for who they truly are and loving them as they are.
In our experience, people who may hold religious convictions that homosexuality is wrong or evil may feel as though they have the moral high ground in their family and social dynamics and may overlook the fact that LGBTQIA+ family members will object to their judgement and disdain and may cut them out of their lives as result. Just as we know there are correlations between Queer people not being able to be "out" as themselves or Trans people not being able to have their identified name and pronouns used and respected and the risk for depression and suicide, it stands to reason that parents of Queer and Trans children will cause often irreversible harm to their child's emotional well-being by choosing to put their own judgements in this area ahead of actions that communicate support and love. If you are someone who is not homophobic or disapproving of your Queer or Trans child, but simply feels less than comfortable due to lack of exposure to those communities, the concerns and values that your child likely holds, speaking from clinical experience, those adult children often just hope that their loved ones will do their best to communicate their love and support and be respectful and not say hateful/judgmental things or use dead names or incorrect pronouns. Many clients report that they are willing to accept that their family may not be capable of being completely open and affirming without reservation if their loved ones are willing to inform themselves, make an effort to see the world through their child's eyes, and not cut them off emotionally or financially when applicable. We recognize that, if you have an LGBTQIA+ child and are grappling with these questions, the likelihood that you would reject or disown them may be lower than the average, but we feel it is important to consider the impact that letting disrespect or even discomfort destroy one's most important relationships will often lead to sadness, loneliness, and regret. As therapists who support and align with the Queer and Trans communities, we are happy to meet with clients who may fall on either side of this dynamic and help them work through their feelings about the actions or identities of their loved ones in order to facilitate stronger individuals, families, and to continue to support the wonderful diverse nature and possibilities for the modern family. Author~Chris Scarberry, MA, LPC As a family therapists we often run into clients or family of clients that are struggling with political and religious conflict with their family members from the LGBTQIA+ community, sometimes to the point where rejections, and cut offs are being considered. During the holiday season these conflicts tend to reach a fevered pitch, often being the driving force for many to begin/return to therapy. Adding another layer of complication, many individuals tend to get engaged over the holiday season, which prompts a flurry of spring weddings and pre-wedding angst. When the person getting married is your family member and the wedding is a gay/queer wedding, it may bring up a lot of emotions and turmoil over how to respond depending upon your level of acceptance of the entirety of who they are as a person. If you are someone who is struggling with determining what the best choice is for you, we've come up with some discussion points for the family of Queer loved ones to think about to help you gain clarity and hopefully some peace with your decision.
After taking time to read these questions, we suggest that you sit with yourself and notice your reactions. Did you notice any changes in your body as your reflected on them? Notice the questions that made you most uncomfortable and be curious and ask yourself why those questions brought on that reaction. Change is often uncomfortable, and we do a lot to resist change and return to homeostasis-where things were before and what we were most acclimated or used to. Sometimes discomfort shows up when we are at our learning edge, the place where we are challenged and struggle between our old beliefs and the introduction of new thoughts, feelings, or experiences that challenge them. We know sitting with your thoughts can be uncomfortable. One of the hardest things for folks during the pandemic was not having the usual distractions and being forced to sit with their thoughts (which had the unfortunate consequence of increasing substance abuse to re-bury these thoughts). Be kind to yourself. Let go of the judgment. Just notice and curious. If it helps, write down your thoughts to help you gain more clarity. Authors~Megan Garza, MA, LMFT & Chris Scarberry, MA, LPC In doing my clinical work, I spend much time supporting and processing the reactions of vulnerable clients from marginalized populations to the current and recent political climate in the United States which has included the Supreme Court ruling that took away federal abortion protections. For myself and among clients I see, many of whom are not female assigned or identified, a fear nonetheless set in that many of the freedoms, values, and protections that came about as the result of tireless fighting and advocacy for workers, women, people of color, and LGBTQIA+ people, and others could/will be on the chopping block.
Doing the clinical work that I do, I especially found many of my transgender and/or Queer clients fearing for the state of their marriages, their employment, their right to a safe abortion and also for their physical safety in ways that they had not since before the Obama administration. In many cases, this very real fear has led to an exacerbation of mental health symptoms already present or created symptoms of a severity and duration necessary to warrant an Adjustment Disorder Diagnosis or a diagnosis of Major Depressive Disorder. To look at how some of the composite reactions I've seen have led to symptom creation and exacerbation, let's take a look at the criteria for Major Depressive Disorder as it relates to the experiences of clients and others as reported and observed and discuss how we as clinicians in this practice approach supporting clients with these symptoms and societal concerns. The symptoms that are potentially part of a depressive episode include: depressed mood, loss of interest/pleasure, weight gain or loss, thoughts of death or suicide, feelings of worthlessness/guilt, fatigue, insomnia/hypersomnia, decreased concentration. These symptoms need to exist in an episode which lasts 2 weeks or more. I have seen symptoms such as these arise for the first time or be exacerbated by the current circumstances. In my clinical work, most notably, I have seen these symptoms arise in clients pertaining to both the recent Supreme Court ruling coupled with comments made by a justice that he might be inclined to vote to overturn the past Marriage Equality ruling that federally legalized marriage for Queer-Identified Individuals. These federal events coupled with Missouri taking steps to orchestrate one of the most rigid statewide abortion bans in the country, led many of my clients to contemplate leaving the state or residing in a more progressive country. In terms of how I’ve seen symptom creation, depressed mood was most frequently caused by negative and invalidating reactions to the local political situation by clients’ loved ones. The disillusionment caused by this disconnect often leaves Queer and Trans people wondering how their family and purported friends can support politicians, institutions, and businesses that have agendas and take measures that treat marginalized people in invalidating, harmful, personal safety-jeopardizing ways. Loss of interest/pleasure in activities often relates to limits in the ability to comfortably engage in hobbies. Clients often have feelings of worthlessness related to feeling as though their safety and value as a person are being undermined when things like so called “bathroom bills” are being voted upon to not allow transgender people to use the bathroom that corresponds with their identified gender or when Queer and Trans client see reproductive rights for women being rolled back and understandably worry that their much more recent/tenuous rights will be next on the chopping block. All of these concerns can and have disturbed my clients’ sleep, appetite, and made them feel drained and exhausted. As such, some, in addition to considering relocation are considering trying psych meds for the first time. We have been processing the resulting elevated symptomology with our clients and, when needed, referring them for additional services like psychiatric care, support groups such as those at MTUG, 12-Step meetings at place such as the Alano Club, and normalizing our client’s fears and concerns related to the ways in which they are understandably symptomatic/experiencing elevated levels of symptoms due to the fear of losing the already unacceptable level of rights and benefits that were fought for during Stonewall and for decades since, and generally assisting in the formulation of “created family” for our clients who are often being harmed by their biological families and systems of power. If you are someone who is hurting or feeling isolated or in-danger as a result of the current political environment, please know that you are not alone and that others are also struggling markedly with their mental health. Please know also that even though it can be especially scary for people who have been let down and marginalized by people who should have helped and cared about them, there are service providers some of whom are in the community who are open, affirming, and are advocating both in the field and in their personal lives for LGBTQIA+ people, their marriages, their personal safety, their need for safe spaces including bathrooms, and the need for greater awareness of the needs of this community for the competence of service providers. While many of us feel that these are dark, scary political times and will be for some time, we at Healing Reflections Therapy are dedicated to affirming and defending the rights of the Queer and Trans communities as well as cisgender women and communities of color. ~Chris Scarberry, LPC As part of the National Partnership for Ending Interpersonal Violence (NPEIV), I have committed myself to the cause of ending violence across the lifespan. Along with my colleagues Dr. Pearl Berman, Joyce Thomas, Dr. Karen Rich, Susan Omilian and I recently worked in collaboration to present a webinar series on addressing the impact of violence in Pennsylvania communities, with emphasis on trauma-informed care related interventions. You can watch the video here https://www.youtube.com/watch?v=bafhxI6PIlc&t=6s to learn more or tune into NPEIV's youtube channel to watch the video series that follows up on resilience. If you want to collaborate and help end interpersonal violence, consider joining NPEIV and attending this year's Think Tank in San Diego, CA on August 27, 2022 https://www.npeiv.org/think-tank Healing Reflections Therapy is excited to announce the addition of our new Intern, Mckayla Kagie. She is completing her graduate program at Capella University in Marriage and Family Therapy. She has immediate availability to see individuals, teens, and adults for $40 per hour, or couples or families for $50 per hour. She has afternoon and evening availability for virtual sessions. She specializes in Marriage and Family Therapy, depression, and Trauma and will be working under the supervision of Megan Garza, MA, LMFT 2011011850 MO. If you are interested in working with McKayla, contact us at [email protected]  My favorite activity in session is to create coping skills cards. This can help both during a crisis, when decision making ability is limited, or in the in-between times to stave-off a crisis. Watch this tutorial I am pleased to announce the publication of the book chapter I co-authored with Dr. Karen Rich on Trauma-Informed Systems of Care in the new resource Handbook of Interpersonal Violence Across the Lifespan.
Rich K., Garza M.R. (2020) Trauma-Informed Systems of Care. In: Geffner R., White J.W., Hamberger L.K., Rosenbaum A., Vaughan-Eden V., Vieth V.I. (eds) Handbook of Interpersonal Violence and Abuse Across the Lifespan. Springer, Cham. https://doi.org/10.1007/978-3-319-62122-7_293-1 "Survivors of interpersonal trauma are vulnerable to risk of re-victimization when seeking help from community agencies such as welfare offices, substance abuse clinics, schools, homeless shelters, medical facilities and criminal justice agencies. Re-victimization of trauma survivors can lead to client dropout, “resistant” behavior, and treatment failure. It can also lead to stress, conflict, burnout, and frequent turnover among staff. Trauma-informed care is a community’s best approach to supporting survivors of interpersonal violence, but many agencies under-estimate its value or lack a comprehensive approach to its implementation. Budgetary concerns, resistance to change, turf issues, hierarchical power structures, lack of training, fears of trauma contagion and negative attitudes towards service recipients contribute to the problems. Interdisciplinary collaboration, investment in prevention, concern for employee wellness and top-down commitment are essential features of trauma-informed agencies. This chapter will present an overview of trauma-informed care, the benefits to clients and providers, obstacles to implementation of best practices, and research initiatives in the field." This handbook is a project of The National Partnership for Ending Interpersonal Violence (NPEIV), an organization I have been a part of several years dedicated to ending interpersonal violence. The chapters in this handbook are comprehensive in covering the most up-to date research on various forms of interpersonal violence. Over 200 authors, clinicians, and researchers contributed to the handbook, with all proceeds benefitting NPEIV. Introduction: The Handbook of Interpersonal Violence Across the Lifespan is a comprehensive state-of-the-science reference work for researchers, practitioners, and policy makers. It is written from a trauma-informed perspective, and utilizes adverse childhood experiences research as its basic developmental framework along with the traumatic effects all forms of interpersonal violence tend to produce. With public health and social justice in mind, this human-rights based handbook also focuses on the overlap and continuum of the various types of interpersonal violence. It integrates all forms of interpersonal violence while dealing with key issues of intersectionality and systems responses. This two-volume handbook is published in collaboration with the National Partnership to End Interpersonal Violence Across the Lifespan, which aims to:
I encourage anyone with an interest in ending interpersonal violence to make a pledge to NPEIV today at www.npeiv.org/donate-2 |
AuthorSMegan Garza, MA, LMFT is a certified Specialist in Treating Trauma at a Supervisory level and is Licensed as a Marriage and Family Therapist. She specializes in work with sexual abuse survivors. Archives
June 2024
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