Heal NPD

In this video, Dr. Ettensohn examines the online narc-abuse ecosystem and explores how content that initially feels validating and supportive can, over time, become thought-constraining and socially isolating for some viewers. Drawing on clinical experience and established research on high-demand systems, Dr. Ettensohn analyzes the rhetorical patterns commonly used across narc-abuse channels: the elevation of the viewer as a lone truth-seer, the narrowing of acceptable interpretations, the use of loaded psychological language, and the gradual erosion of trust in ordinary relationships. He shows how these dynamics can reshape identity, undermine critical thinking, and foster increasing dependence on content creators rather than encouraging reflection, complexity, or professional consultation. Throughout the video, Dr. Ettensohn carefully distinguishes between genuine abuse and the expanding, imprecise use of narc-abuse language online. He emphasizes that acknowledging harm and seeking clarity are legitimate and necessary, while also warning that one-size-fits-all narratives can distort meaning, escalate conflict, and contribute to unnecessary social rupture. The focus is not on dismissing people’s pain, but on examining how certain explanatory frameworks operate psychologically and what they may unintentionally cost the people who adopt them. This video continues Dr. Ettensohn’s clinically grounded effort to bring nuance, rigor, and psychological depth to public conversations about narcissism, offering a perspective that prioritizes complexity, reality testing, and relational context over certainty, moralization, or ideological alignment. Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8

This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. I n this session, the group discusses a recent meta-analytic review examining suicide-related outcomes in narcissistic personality functioning. The conversation explores why studies using DSM-based diagnoses of Narcissistic Personality Disorder consistently fail to predict suicidal ideation, attempts, or self-injury, while dimensional measures that include vulnerable narcissism show strong and reliable associations with elevated risk. Themes include the distinction between grandiose and vulnerable self-states, the limitations of trait-based and purely behavioral diagnostic models, and the deeper affective and regulatory structures that define pathological narcissism. The team examines how shame, identity instability, emotional dysregulation, and collapse of self-esteem stability contribute to suicidality—and how grandiose presentations can mask underlying fragility in ways that obscure clinical risk. Throughout the seminar, the group reflects on the developmental and relational origins of vulnerable narcissism, emphasizing the role of early emotionally invalidating early environments, contingent self-esteem, and dissociated self-states in shaping defensive functioning. The discussion also highlights clinical challenges in assessing suicide risk in narcissistic patients, including the role of masking, externalization, and shame-driven withdrawal. This seminar is designed for clinicians, students, and anyone seeking a nuanced, clinically grounded understanding of narcissistic personality functioning, suicide risk, and the hidden dimensions of vulnerability that are often overlooked in public discourse. To learn more about our work, visit www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH SUBSCRIBE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 Citation for the article discussed: Sprio, V., Mirra, L., Madeddu, F., Lopez-Castroman, J., Blasco-Fontecilla, H., Di Pierro, R., & Calati, R. (2024). Can clinical and subclinical forms of narcissism be considered risk factors for suicide-related outcomes? A systematic review. Journal of Psychiatric Research, 172, 307–333. https://doi.org/10.1016/j.jpsychires.2024.02.017 Full text link: https://www.sciencedirect.com/science/article/pii/S0022395624000803

This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Narcissistic Personality Disorder: Progress in Understanding and Treatment by Igor Weinberg, Ph.D., and Elsa Ronningstam, Ph.D. The conversation examines recent advances in how clinicians conceptualize and treat narcissistic personality disorder, moving beyond fixed trait models toward a dynamic, relational understanding of the self and its development. Themes include the interplay between grandiose and vulnerable self-states, the interdependence of self-esteem regulation, affect, cognition, empathy, and interpersonal functioning, and the recognition that narcissistic pathology evolves through cumulative disruptions in early attunement and relational safety. The discussion also explores how developmental misattunements - whether through neglect, overindulgence, or inconsistency - shape defensive adaptations and contribute to the oscillation between self-inflation and shame. Throughout the seminar, the team reflects on the therapeutic process of working with narcissistic patients, emphasizing empathy, reflective capacity, and the slow, relational work of rupture and repair that makes genuine transformation possible. This series is designed for clinicians, students, and anyone interested in a nuanced, compassionate understanding of narcissism, personality, and psychological change. To learn more about our work, visit www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 BECOME A MEMBER: https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join Citation for the article discussed: Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400. Full text of the article: https://pmc.ncbi.nlm.nih.gov/articles/PMC10187400/

In this episode, Dr. Mark Ettensohn challenges one of the most persistent distortions in contemporary discourse on narcissism: the myth of “the narcissist.” He explains how this cultural archetype, an image of coldness, cruelty, and manipulation, has eclipsed legitimate clinical understanding of Narcissistic Personality Disorder. Drawing on both the peer-reviewed literature and his clinical experience, Dr. Ettensohn describes how terms like narcissistic abuse, covert narcissism, and narcissistic supply have come to dominate popular psychology despite lacking grounding in peer-reviewed research. The episode explores how this narrative misleads clinicians, alienates patients, and perpetuates stigma, while offering a more accurate view of pathological narcissism as a defensive structure rooted in shame, vulnerability, and loss. Dr. Ettensohn argues that it is time to discard the myth of “the narcissist” and replace it with a more compassionate, evidence-based understanding of NPD...one that recognizes both the pain it causes and the suffering it defends against. Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH Related Links: In-depth exploration of the DSM NPD construct: https://youtu.be/I2fD65wy48I SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8

Dr. Ettensohn reflects on the recent loss of his father. Drawing on both clinical theory and personal experience, he explores how children internalize idealized images of caregivers as a source of safety and reassurance during times of vulnerability. This episode examines how these idealizations can provide stability but also carry developmental costs if they are never gradually tempered by ordinary disappointments and the recognition of parental imperfection. Dr. Ettensohn situates this dynamic within the broader context of self-psychology, showing how therapy can become a place where idealized projections are worked through and reclaimed in more realistic form. With psychological nuance and openness, he shares how this process unfolded in his own relationship with his father, moving from idealization toward a fuller recognition of imperfection, accountability, and authentic connection. The goal, as he frames it, is not to reject or diminish the idealized parent, but to integrate those images into a more grounded sense of self and relationship. Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org

In this episode, Dr. Ettensohn offers a groundbreaking perspective on one of the most misunderstood features of pathological narcissism: splitting. Drawing from the work of Philip Bromberg and his own clinical practice, Dr. Ettensohn reframes splitting not as black-and-white thinking, but as a dissociative process rooted in early relational trauma. Rather than treating splitting as a rigid symptom, this episode explores how dissociated self-states form when conflicting emotional truths, such as shame, longing, idealization, and rage, cannot safely coexist. What looks like instability or contradiction is actually a protective adaptation. Dr. Ettensohn shows how these self-states develop as compartmentalized responses to unmanageable experience, and how they survive into adulthood, shaping identity, memory, and relationships. Through clear explanation and compassionate framing, he illustrates how healing involves standing in the spaces between self-states, without collapsing into any one of them. Whether you live with these experiences yourself or work with people who do, this video offers a radically humanizing and clinically grounded way to understand dissociation, narcissism, and the divided self. References: Bromberg, P. M. (1996). Standing in the spaces: The multiplicity of self and the psychoanalytic relationship. Contemporary Psychoanalysis, 32(4), 509–535. Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org

In this Weekly Insight, Dr. Ettensohn addresses widespread misconceptions about narcissism by clarifying what the term does not mean. Drawing on clinical examples and years of engagement with public discourse, he explores how the label “narcissist” has become a cultural catch-all for behaviors that are often common, non-pathological, and only proximally related to Narcissistic Personality Disorder (NPD). This episode examines how actions such as setting a boundary, avoiding emotional intimacy, or disagreeing with someone’s interpretation of events are frequently misread as narcissistic - especially when filtered through shame, hurt, or interpersonal conflict. Dr. Ettensohn distinguishes these behaviors from the psychological structure of narcissism, which involves instability in self-esteem regulation and associated interpersonal strategies. He also addresses the growing tendency to conflate narcissism with abuse, control, gaslighting, or moral failure, arguing that these associations undermine both clinical clarity and compassion. Misusing the term “narcissism” can lead to stigmatization, inhibit treatment-seeking, and reinforce rigid victim-abuser narratives that obscure the mutual complexity of relational harm. This Weekly Insight is a call for greater nuance, clinical integrity, and psychological humility. By understanding what narcissism isn’t, we create more space to see what it is, and how it might be worked with more constructively in both cultural discourse and clinical care. Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org

What does it mean to say that narcissists lack empathy? In this Weekly Insight, Dr. Ettensohn challenges the common assumption that low empathy is a fixed trait in narcissistic personality disorder (NPD). Drawing from psychoanalytic theory and clinical observation, he explores how empathy in NPD often collapses in response to internal threat, and how this collapse is due to defenses rather than intrinsic empathy deficits. The episode identifies three core processes that disrupt empathic functioning in NPD: paranoid anxiety, dissociated self-states, and shame-driven defenses against dependency. These processes help explain the inconsistency, withdrawal, and emotional detachment often seen in narcissistic dynamics. Whether you identify with narcissistic traits or have been affected by them in others, this video invites a more psychologically informed and humanistic understanding of how empathy functions under distress. Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org Works Cited: Miller, A. (2008). The drama of the gifted child: The search for the true self (Rev. ed., R. Mannheim, Trans.). Basic Books. (Original work published 1979)

Link to episode 1 in this series, on psychotic-level NPD: https://youtu.be/IoxUCbNUJUE Link to episode 2 in this series, on borderline-level NPD: https://youtu.be/Oz-C503q_9Y Link to part 1 of episode 3 in this series: https://youtu.be/vUsnambadIE This is the third episode of a four-episode series describing the narcissistic personality style across different levels of severity. Due to the length of the material, this episode has been divided into three parts. This is part two. In this part, Dr. Ettensohn explores the emotional consequences of the developmental shift from borderline to neurotic-level personality organization. While borderline-level defenses aim to ward off annihilation through splitting, projection, and omnipotence, neurotic-level functioning introduces new emotional burdens: grief, guilt, and the realization that some losses cannot be undone. Drawing on psychoanalytic theories of the paranoid-schizoid and depressive positions, this episode examines how individuals begin to internalize the reality of separate minds, enduring subjects, and the permanence of emotional injury. These capacities open the door to deeper love, mutuality, and ethical concern—but also to sorrow, remorse, and longing. Dr. Ettensohn also outlines the core developmental conditions that support this shift, including “good enough” relational experiences that enable ambivalence to be tolerated and meaning to be preserved across time. Finally, the episode offers concrete strategies for strengthening neurotic-level integration and functioning, both in therapy and in everyday life. References: Bollas, C. (1987). The shadow of the object: Psychoanalysis of the unthought known. Columbia University Press. Gabbard, G. O., & Wilkinson, S. M. (1994). Management of countertransference with borderline patients. American Psychiatric Publishing. Johnson, S. M. (1987). Characterological change: The hard work miracle. W. W. Norton. Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psychoanalysis, 27, 99–110. Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press. Winnicott, D. W. (1949). Hate in the counter-transference. The International Journal of Psychoanalysis, 30, 69–74. Winnicott, D. W. (1965). The maturational processes and the facilitating environment: Studies in the theory of emotional development. International Universities Press.

In this video, Dr. Ettensohn examines the growing claim that Narcissistic Personality Disorder (NPD) is almost entirely genetic, offering a critical, clinically grounded reflection on what the current science actually supports—and where it falls short. He discusses how genetic contributions to personality traits are often misunderstood, and why claims of “hardwired narcissism” oversimplify a profoundly complex developmental process. Drawing from empirical research, neurodevelopmental theory, and clinical observation, Dr. Ettensohn explores how narcissistic pathology emerges not simply from temperament, but from early relational experiences—especially chronic emotional neglect, inconsistent attunement, and conditional regard. He addresses how brain plasticity, diagnostic controversies, and the misunderstood vulnerable core of NPD further complicate the genetic narrative. This video offers a nuanced perspective for anyone seeking to understand NPD beyond reductive models, emphasizing the importance of relational context, developmental history, and psychological depth. References: Brummelman, E., Thomaes, S., Nelemans, S. A., Orobio de Castro, B., Overbeek, G., & Bushman, B. J. (2015). Origins of narcissism in children. Proceedings of the National Academy of Sciences, 112(12), 3659–3662. https://doi.org/10.1073/pnas.1420870112 Chen, Y., Jiang, X., Sun, Y., & Wang, Y. (2023). Neuroanatomical markers of social cognition in neglected adolescents. NeuroImage: Clinical, 38, 103501. https://doi.org/10.1016/j.nicl.2023.103501 Gatz, M., Reynolds, C. A., Fratiglioni, L., Johansson, B., Mortimer, J. A., Berg, S., & Pedersen, N. L. (2006). Role of genes and environments for explaining Alzheimer disease. Archives of General Psychiatry, 63(2), 168–174. https://doi.org/10.1001/archpsyc.63.2.168 Horton, R. S., Bleau, G., & Drwecki, B. (2006). Parenting Narcissus: What are the links between parenting and narcissism? Journal of Personality, 74(2), 345–376. https://doi.org/10.1111/j.1467-6494.2005.00380.x Luo, Y. L. L., Cai, H., & Song, H. (2014). A behavioral genetic study of intrapersonal and interpersonal dimensions of narcissism. PLOS ONE, 9(4), e93403. https://doi.org/10.1371/journal.pone.0093403 Nenadić, I., Lorenz, C., & Gaser, C. (2021). Narcissistic personality traits and prefrontal brain structure. Scientific Reports, 11, 15707. https://doi.org/10.1038/s41598-021-94920-z Otway, L. J., & Vignoles, V. L. (2006). Narcissism and childhood recollections: A quantitative test of psychoanalytic predictions. Personality and Social Psychology Bulletin, 32(1), 104–116. https://doi.org/10.1177/0146167205279907 Schulze, L., Dziobek, I., Vater, A., Heekeren, H. R., Bajbouj, M., Renneberg, B., & Roepke, S. (2013). Gray matter abnormalities in patients with narcissistic personality disorder. Journal of Psychiatric Research, 47(10), 1363–1369. https://doi.org/10.1016/j.jpsychires.2013.05.017 Skodol, A. E. (2012). The revision of personality disorder diagnosis in DSM-5: What’s new? Current Psychiatry Reports, 14(1), 39–43. https://doi.org/10.1007/s11920-011-0243-2

In this Weekly Insight, Dr. Ettensohn explores the nature of grandiosity in pathological narcissism and Narcissistic Personality Disorder (NPD), emphasizing that grandiose self-states are distortions that mask underlying vulnerability. He examines how these states emerge, why they are so compelling, and how they become self-reinforcing through positive feedback loops. Dr. Ettensohn also discusses the hidden instability beneath grandiosity, the interpersonal consequences of maintaining a distorted self-image, and the trauma-based origins of grandiose narcissistic armor. Drawing on the work of Ernst Wolf and real-world examples, he offers a compassionate yet clear-eyed look at how grandiosity functions as both protection and prison—and how growth is possible even after years of wearing the armor.

In this weekly insight, Dr. Ettensohn addresses the common misconception that individuals with Narcissistic Personality Disorder (NPD) never seek therapy—and the even more misleading idea that simply wondering whether you have NPD means that you don’t. This episode explores the origins of these myths, explaining how they stem from a misunderstanding of personality disorders and the role of insight. While NPD often involves rigid, maladaptive patterns of thinking and an egosyntonic sense of grandiosity, it also frequently includes periodic self-esteem collapses, during which individuals experience deep distress, depression, and anxiety. It is in these moments that many people with NPD seek therapy—contrary to the popular belief that they never do. Dr. Ettensohn discusses how online narratives about NPD have distorted public understanding of the disorder, reinforcing harmful stereotypes that discourage those who need help from reaching out. Drawing from clinical experience and current research, he provides a more nuanced and accurate view of why individuals with NPD do, in fact, pursue treatment.