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Suggest Treatment For Narcissistic Personality Problem

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Posted on Thu, 23 Jun 2016
Question: Family issues, who's at fault and what to do about the constant problems I face? Mother with OCD and other issues. Long discussion required to understand.
doctor
Answered by Dr. Chintan Solanki (28 minutes later)
Brief Answer:
narrate brief details and ask specific questions

Detailed Answer:
Hello,

Thanks for writing us again.

I am somewhat aware about your/your family problems through our past communications.

Please narrate brief details and ask specific questions for which you need answer.


I will be happy to help further after your response.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (24 minutes later)
Thanks for your reply. I have a few things to discuss but I didn't see your past message until now and reply now to it below:

"For further discussion I need detail history since her childhood. Her brought up, education, work details, behavior as a wife, mother and friend and many other details needed. And also there is need of examination and mental status evaluation of patient in person by a psychiatrist. If you feel you can write these may lots of details, you are welcome."

Her childhood - she claims she didn't get on with her mom as well as with her farther. The older sister was bossy according to my mom and she was also younger than the brother.
She had a private education I believe and then a job for a short while, hasn't worked ever since.
She developed alcohol addiction at early age but claims to XXXXXXX given this up whilst pregnant with me and had some after for a while.
As a wife I she is very bossy and domineering. She gets my dad to side with her whatever, and I'd say if she doesn't get as she wants then she turns into a bully.
As a mother, I felt a lack of empathy, I felt she was unreasonable quite often and was overly strict. If I'd made a mess as a kid it would be a strongly punished. Threats were often made such as "You'll be sent to boarding school, etc". Locked in room by parents with string attached to not exit. Witnessed mother rage on occasions when young. Such as against my father whilst I was in the car attempting to swerve it to on-coming traffic making me upset. Smashing a gaming console my father brought me because she didn't like the size and my dad wouldn't instantly take it back. Raged at neighbors because the dogs kept coming on the frontage.
She has fallen out with, or lost contact with the family. Has no friends what so ever. My dad also has no friends to speak of. I have one close friend because I've possibly got similar genes or learnt bad personality.
My mother easily finds fault in others.

These are the main things that come to mind for now. Hope this helps you conclude, but please ask more questions to help if need..
Also, after this, I need advice on how to deal with the wider family.
Thanks
doctor
Answered by Dr. Chintan Solanki (3 hours later)
Brief Answer:
possibility of narcissistic personality is likely

Detailed Answer:
Hi,

Thanks for information.

It seems that she has narcissistic personality problem. One limitation is that such persons cannot be convinced that there is problem in them and they do not become ready for treatment/psychotherapy.
Most of the patients are brought by relatives.
Transference Focused Psychotherapy (TFP) is indicated in treatment of such cases. It is modified psycho dynamically oriented approach, highly structured with rigid twice a week sessions.

Diagnosis confirmation is possible only after interviewing her.

Let me know how many symptoms (below mentioned) are present in her according to you,

- Grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).

- Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

- Believes that she is “special” and unique and can only be understood by, or
should associate with, other special or high-status people (or institutions).

- Requires excessive admiration.

- Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).

- Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).

- Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.

- Is often envious of others or believes that others are envious of him or her.

- Shows arrogant, haughty behaviors or attitudes.

I will be happy to help further after your response.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (8 hours later)
Thanks for your reply. This is what was bothering me. However, she has seeked treatment (i've never been, it was her and my father). I believe she ended up seeing multiple psychiatrists because she wasn't happy with their service (usual stuff).

In the end she was diagnosed with OCD, apparently. She admits she has this.

To answer following as I believe:

- Grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements). I would say No. She doesn't boast about achievements or talents.

- Preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. Keeps wishing about a dream home or winning the lottery. Nothing about beauty I've heard or ideal love.

- Believes that she is “special” and unique and can only be understood by, or
should associate with, other special or high-status people (or institutions). Not really. She is 'different', but she doesn't say out-right that she is above over people.

- Requires excessive admiration.
Not sure, I'd say No, not from me anyway.

- Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
Sort of, yes. As said before she seems to want people to click to what she wants most of the time.

- Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
I'd say it's a possibility. I can't say for sure.

- Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
Yes, I am aware of this. Her mom had cancer and she didn't seem to care much, she was more annoyed that no family member had told her personally. (The cancer was breast).

- Is often envious of others or believes that others are envious of him or her.
I'd say yes, deep down. Her lack of social skills make her envious of others. She looks up many people on Facebook are generally criticizes them (people who she doesn't really no, including a neighbour.)

- Shows arrogant, haughty behaviours or attitudes.
Yes. Definitely at times. My dad's mother is getting old and my mother had taken insult to a few minor things. My mom said I wish she would die. I doubt my mother would be so bothered about my dad's mother is she wasn't leaving a will $.


--
I'd like to also discuss the wider family. Where should I stand in this, are they so bad, and what's going on?
doctor
Answered by Dr. Chintan Solanki (10 hours later)
Brief Answer:
only traits of narcissistic personality

Detailed Answer:
Hi,


Thanks for answers.

She does not have narcissistic personality disorder that is conformed now as per your answers she has only few traits of that personality.

If it is OCD, it can be treated. Can you tell me what are obsessions and compulsions in her case and what medicines have been given until now?

I am sorry but I didn't get your point that what do you want to discuss about wider family. Please clarify.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (52 minutes later)
Thanks for your reply and information.

Her brother (my uncle) is now in hospital after long life of smoking and alcoholism (he has days to live). He also has such similar issues to my mother (hates people, anger, no friends, divorce, etc).

I'm trying to see the deeper picture here. I continue.

The ex-wife of my mother's brother has become very close with the mother of the two many years back against my mother and her brother (neither wanted that). Yet, the older sister recommended it.

This ex-wife could never have afforded a holiday (especially considering the split up with my mother's sister). So she wanted a holiday and found this ex-wife would go on them... many many holidays now 10 or more? Seems to be at the anger of my mother and her brother. Yet, the older sister 'approved' it as she didnt want to basically have to go and claimed someone is better than no body.

Because my aunt, this bossy older sister, was great to be growing up, I feel like I don't know where to turn now. And what about this ex-wife, also my ex-aunt if you like?...

With my uncle's alcohol issue he rang the entire family with abuse on the phone. My mother said she couldn't deal with that. So, she ended up having nothing to do with her brother for 8 years. Since my uncle now has days to live, I recommended she could ask if he might see her, he did. She went to see him for last time.

Next? Ex-wife gets on the phone calming she shouldn't have visited.

I can't go on more. But you see here there is some big issues, but who is creating them? Please help!
doctor
Answered by Dr. Chintan Solanki (15 hours later)
Brief Answer:
it is difficult to judge that who is responsible

Detailed Answer:
Hi,

Sorry for delayed response.

There are many family issues. Your mother and her brother share genetics and that is why nature of both are likewise and somewhat abnormal in context of normal social norms.

Your mother's brother's ex-wife may be having some problem or problems might have started after marrying to him.

To decide how these all issue arose everyone involved in matter should be interviewed. I am really sorry that it is somewhat difficult to judge from this information that who is creating this.

The best part is family counseling which I told you before.

If at all family counseling is not possible, you should learn to live in this environment or leave the environment. You yourself consult psychiatrist for counseling and treatment.

All the best and take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (29 hours later)
Hello,
Thanks for the reply. So what do you think it wrong with my mother? Can you help conclude on that? And was is caused by the upbringing environment? Or only genetics?
Family psychiatrist wont be a solution for them as they wouldnt go.
doctor
Answered by Dr. Chintan Solanki (7 hours later)
Brief Answer:
both upbringing and genetics are responsible

Detailed Answer:
Hi,

She has likely some personality problem with frequent anger outbursts which are part of episodes of depression. Medicines can help her in controlling anger as well as frustration.

This is causes by upbringing environment as well as genetics both. In most of the psychiatric conditions there is no specific single etiology. There is Bio-Psycho-Social model of etiology which includes genetics, neurochemical changes, social factors, stress factors and person's psychology which in turn based on genetics and environment.

You should also think in the way that you have tried best to solve the issues but it is not in your hand so you just can try to make yourself comfortable first.

All the best.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest Treatment For Narcissistic Personality Problem

Brief Answer: narrate brief details and ask specific questions Detailed Answer: Hello, Thanks for writing us again. I am somewhat aware about your/your family problems through our past communications. Please narrate brief details and ask specific questions for which you need answer. I will be happy to help further after your response. Regards, Dr.Chintan Solanki.