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Recognizing Narcissism - For Therapists

The Little Shaman is a spiritual coach & specialist in cluster B personality disorders, with a popular YouTube show and clients worldwide.


Victims of narcissistic abuse know that couples' or family therapy with a narcissist is a nightmare. Seen by narcissistic people as just another opportunity to triangulate someone against the victim and win, it is often spectacularly unsuccessful. Many times, it actually makes the situation worse.

Well-meaning but uninformed therapists and counselors can do a lot of damage to victims of narcissistic abuse because they do not understand the dynamics of these relationships. The things that work in a relationship where there is no pathology present do not work in situations that involve narcissists. In fact, many times it is the exact wrong thing to do. Situations that involve a narcissist must be handled differently. For example, the focus generally is not on repairing the relationship or facilitating communication with the narcissist, as this is simply not possible. Focus would generally be on supporting the victim and helping them to understand.

We've seen it over and over again: a well-intentioned therapist is manipulated by a narcissist and weaponized into just another object with which to attack the victim. Even when the narcissist is gone or not participating in therapy, that lack of understanding is still a large problem. We hear it every single day: "My therapist is no help because they just don't understand narcissistic abuse." We want to try and bridge this gap.

Here are five guidelines that may be helpful when dealing with clients who are reporting abuse:

  1. Don't assume that the person who seems emotionally dysregulated or upset is automatically the problem. Many victims of narcissistic abuse have been literally tortured and are unable to regulate their emotions anymore.
  2. Don't ignore divergent realities! When two people have a completely different recall or understanding of events, this should be considered a big red flag.
  3. Don't assume that something is not true because it sounds unbelievable. Pathologically narcissistic people count on the fact that no one will believe the victim about the things that have happened.
  4. Don't assume that because somebody is not a therapist or a doctor, they don't know what they're talking about. Many victims know more about this disorder or these problems than the people they are coming to for help. Don't just dismiss their information or their theories. Therapists and counselors should remember that they are seeing the person for an hour at a time in a very controlled, validating setting, whereas the victim has been living with the situation - and often the person - 24 hours a day for months or years.
  5. Don't dismiss or invalidate someone's claims of abuse because you don't understand them or are unfamiliar. Don't assume that the victim cannot communicate properly or try to negotiate them out of what they are saying.

This is of course not to say that people who are not clinicians can diagnose somebody. What it does say is that things should not be dismissed simply because someone is unfamiliar with them or because the person reporting it does not have a medical degree. People know how they feel. They know what happened to them.

Narcissistic abuse can also be difficult to detect, especially considering that victims may not even realize they are being abused. If you deal with couples or families, chance are good that you have or will eventually deal with narcissistic abuse - especially in situations that involve domestic violence. Listen with an open mind and learn to catch the red flags, because if situations that involve narcissists must be handled differently - and it must - then it is important they be recognized in the first place.

Below is a list of 20 red flags that could suggest the couple or family you are dealing with might have issues with narcissistic abuse. Please note, that as with all red flags, the appearance of any or even all of these does not guarantee the existence of pathological narcissism in the situation. Rather, they should alert the therapist to evaluate the situation for other signs of abuse.

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Note also that it doesn't matter which person appears to be throwing the red flags. It is not uncommon for narcissistic people to engage in projection. The presence of these things in general should trigger an alert. If narcissistic abuse is indeed present in the situation, the abuser will reveal themselves to the astute observer.


Narcissistic abuse is on the rise in communities all over the world. Therapists, counselors and healers of all kinds are among the first responders, dealing with the casualties of this unfortunate epidemic. Arm yourself as much as possible so that you can help those who need it most.

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Recognizing Narcissism - For Therapists

© 2019 The Little Shaman


Lorna Lamon on April 13, 2019:

I found this article extremely informative and as a mental health therapist I feel that this is a specialist illness requiring a training program for therapist's in order to become better informed and equipped when dealing with NPD in all its forms.

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