Merger Fantasies in Psychotherapy

Joseph Burgoin
Depression and Bipolar Disorder
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Detours
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The Psychotherapy Relationship
18

Certain clients, especially those with personality disorders or issues related to bipolar disorder symptoms, often idealize their therapists, putting them up on a pedestal and worshipping every word they say.  Behind these feelings often lies a desire to merge with the therapist and to take part in that ideal life as a means of escape from personal torment.  These ideas of merger represent a kind of growth-by-annexation where, in fantasy, the client wants to get inside of and take complete control over the therapist.  This wish usually goes hand-in-hand with a belief that the client's own internal world is so damaged as to be beyond repair; they believe this magical usurping of the therapist's identity represents their only hope to get better.

As a therapist, you might notice that the client starts talking like you, echoing your phrases and speech patterns or developing a collegial manner in your relations.  Such fantasies of merger are especially visible in dreams, however.  Two dreams from one of my clients, someone I saw many years ago, illustrate the dynamic very well.  He entered treatment because of occasional but severely debilitating depressions in which he felt unable to work.  On the surface, Jim (mid-20s) appeared extremely appreciative; he was always telling his friends that I was a wonderful therapist and every week he'd repeat to them my "brilliant" interpretations.  He'd been in treatment for a few months when he brought in the following dream.

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Narcissism vs. Authentic Self-Esteem

Joseph Burgoin
Destinations
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Self-Esteem and Self-Sabotage
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Shame/Narcissism
34

You may have seen or heard about these two new studies on self-esteem in college students.  A recent New York Times article reports that, when given the choice, most college students prefer to receive a boost to their self-esteem in the form of a compliment or good grade over eating a favorite food such as pizza or having sex.  The article begins with the following question:  "Are young people addicted to feeling good about themselves?"

At first, I found this question idiotic.  I am sick and tired of how our culture has adapted the language of addiction to describe everything.  The more I thought about it, however, it did make a (limited) kind of sense to me, especially if you consider addiction to actual drugs as a means to avoid some other experience or to seek an inappropriate remedy for a very real problem.  As I've written elsewhere, narcissistic people crave attention and admiration in order to ward off feelings of inferiority and to  bolster a fragile sense of self.  In other words, they have no authentic self-esteem and look to others to provide a substitute for it.  The problem with external sources of self-esteem, as with all drugs, is that they wear off and you have to secure more of it to feed your habit.  As a result, those individuals without genuine self-esteem have an insatiable need for their their egos to be bolstered by the people around them.  In this sense, I suppose it makes sense to talk about them as addicts, even if "addicted to self-esteem" sounds ridiculous.  Besides, receiving a compliment has nothing to do with authentic self-esteem.

In my experience, you can't obtain real self-esteem from the outside.  Yes, it's important that our parents praise and encourage us as we grow up.  We internalize that praise, along with their values and standards and those of our teachers, peers and social environment; then, once they've become a part of us, we must live up to those standards if we're to feel good about ourselves.  I'm not referring to perfectionistic and overly harsh standards, impossible to meet.  I mean our own ideas and expectations, evolved from the disparate influences of family, peer group and culture, about what it means to be and behave like a person we would respect.

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A Portrait of Narcissistic Personality Disorder in ‘The Social Network’ (2010)

Joseph Burgoin
Shame/Narcissism
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Society and Culture
109

<a href="http://www.linkedtube.com/PuB_ng5uVaIa7d705f42ece6410819d8c7e20017d3a.htm">LinkedTube</a>

Throughout The Social Network, Mark Zuckerberg demonstrates most of the traits associated with what the DSM-IV calls "Narcissistic Personality Disorder."  If you've spent much time on my site, you'll have gathered that I'm no fan of diagnosis.  I don't want to end my discussion of the film before I've even begun by affixing a label to this character; instead, I'd like to use The Social Network as a way to approach a cluster of psychological traits that often go together.  Sometimes you see them in the bipolar disorders; or you might find them displayed by someone who'd receive a diagnosis of Borderline Personality Disorder instead.  In truth, the so-called personality disorders exist along a spectrum, nobody fitting neatly into any single diagnostic category, but I'll use the DSM-IV criteria for Narcissistic Personality Disorder as a basis for my discussion.  I'll invert the order of list and end with the earlier criteria since they raise some interesting and difficult questions.

According to the DSM-IV, you need to display at least five of these qualities to meet the diagnostic threshold.

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Relationship Advice You Won’t Find Elsewhere on the Internet

Joseph Burgoin
Destinations
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Relationship Issues
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Sexuality
49

There's a great deal of worthy, common-sense relationships advice to be found on the Internet.  Most sites repeat the same familiar truths and give similar relationships advice -- about the need for realistic expectations, about how soon to have sex, making room for personal differences once the initial euphoria begins to fade, or about how to recover from an affair, keep the romance alive, etc.  Most of this relationships advice tends to be practical; some of it is silly or manipulative.  Almost none of it suggests that your own psychological issues may lie at the root of persistent and recurrent conflicts in your relationships.

So here, in the form of a post that's almost entirely about "finding your own way," are my three personal, idiosyncratic and only slightly tongue-in-cheek bits of relationships advice for how to improve emotional rapport with your significant other.

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Envy and Self-Sabotage

Joseph Burgoin
Destinations
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Envy and Jealousy
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Self-Esteem and Self-Sabotage
43

I'd like to offer some reflections on the role of envy in self-sabotage based upon my personal and professional experience.  Bear with me; my conclusions might not seem obvious at first but I've seen them borne out again and again in my practice.  Let me start with the incident that triggered these thoughts.

Earlier this week, our friend Diane came over for dinner.  A family member had recently sold her a used Lexus sedan at a remarkably good price, a real "steal"; at the end of the evening, as we were walking her outside, I asked her how the new car was working out.  She immediately became visibly anxious and said, "I don't have a new car."  At that point, her significant other said, "Diane doesn't feel comfortable having such a nice car so now we have to call it mine."

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