A Suggested New Diagrammatic Formulation for Narcissists

Nehmad, A., 2010. A Suggested New Diagrammatic Formulation for Narcissists. Reformulation, Winter, p.44.


For CAT, the key elements of the Narcissistic dynamic is the lack (or precariousness) of a “Good Enough” Warm-Accepting-Respectful to Secure-Worthwhile state. This means there is an absent or precarious sense of being Self-Respecting and Self-Accepting.

So the best way of not feeling bad is to be Admired-Admiring, which involves being Special. If this fails, the next best thing is to be Contemptuous of others (as one can still feel “Superior” to the “Contemptible”. (Otherwise, the only possible state is Contemptible, which is unbearable and unmanageable. If they are triggered into feeling this, Narcissistic rage will ensue, expressed against others or sometimes against the self).`

The above diagram is “Classical CAT” and has been in use at least since the early 1990’s.

It is very useful for therapists’ understanding, and sometimes, if well timed, for clients’ understanding as well. However, many of them dislike it (even if one changes the wording). It also does not have a clear enough and acceptable Aim. (It has a “healthy island/eyeland/I-land” in the middle, which is not the same as an Aim.

The Diagram below is more user-friendly and digestible.

For Narcissists, being Average, Ordinary, Normal, Happy Medium, or even “good enough” is terrifying and unacceptable, as for them it equates with being inferior and contemptible. For this reason, therapists’ attempts to deflect them from achieving Admirable work or status is likely to fail – and to be felt as an attack on them.

It is possible to convey to them (especially with the help of the “Narcissistic Triangle Diagram” below) that even when they achieve the Admirable state, this is precarious, and imprisons them rather than freeing them. A new option, with carefully chosen words which are meaningful to the patient, and different for each individual, can be drawn above the “Cage”.

This has an important visual impact: the new place is Free (of the Cage), and it is “above” the cage!

Acknowledgements

The triangular diagram below was first used by Stirling Moorey in the late 1990’s (I don’t know whether he invented it, or copied it from somewhere outside the CAT tradition).

Herbert Steiner added the idea, and picture, of the Cage in early 2009. (previously the bottom self-states were not boxed in.)

Annie Nehmad

Diagram

Full Reference

Nehmad, A., 2010. A Suggested New Diagrammatic Formulation for Narcissists. Reformulation, Winter, p.44.

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