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 Section 
9 Disentangling the Effects of Genuine Self-esteem and Narcissism
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 As 
we discussed in the previous section, some depressed males have difficulty feeling 
empathy for their partners.  Have you found, like I , that male clients, who cannot 
  understand the feelings of others, are sometimes narcissistic? My working definition 
  of "narcissism" is when my client denotes extreme self-love, or at least 
  an appearance of self-love. 
 Have you found, like I, that extremely narcissistic 
  clients have low self-esteem and use bragging to protect themselves against the 
  fear that they are defective and unlovable? Narcissists focus completely on themselves 
  and thus do not have empathy for others; they have both a low self-esteem and 
  are self-centered.
 According to Depression, Suicide, 
and Human Existence, depression which can lead to suicide in men is mainly 
the result of conflicts and problems related to their identity. Earlier 
phases of doubt and feelings of inferiority are activated by interpersonal conflicts 
within the family or work situation. As you know, the narcissistic client is usually 
depressed. He is depressed because he feels insecure. Agree? He hides behind a 
pretense of arrogance and hyperindependence. In relationships, narcissism is extremely 
problematic, as in the case of David. In the last section, we 
saw how David had problems feeling empathy for Amy's emotions, until he felt empathy 
for himself. He didn't recognize that his fear of her anger was rooted in his 
own insecurity. David was narcissistic. He was so consumed with his own feelings 
that he thought his wife had to agree with him.  ♦ Three Self-Esteem 
Concepts After watching himself in the Fishbowl, as we discussed earlier, 
David was ready to work on his self-esteem. Here are some Self-Esteem Concepts 
that I give to clients like David:
 
 -- Concept #1. Focus on your strengths 
when evaluating yourself. I asked David, "Try to recall some people at work 
who have had failures." After he recalled a couple people and situations, 
we discussed the fact that that even colleagues whom he viewed as very successful 
have had failures. This helped David to put his failures in perspective.
 
 -- Concept #2. 
Decrease the gap between your expectations and reality. I asked David, "Do 
you expect to have a good day, or is it your choice to make it a good day? By 
accepting responsibility for your happiness, you can make choices that result 
in positive outcomes. In short, you'll feel more positive."
 
 -- Concept #3. 
The third self-esteem concept I give to clients is...and I feel this is the 
most important factor... Pay attention to your self-talk. I told David, 
"Listen to whether you are mentally patting yourself on the back or kicking 
yourself. Increasing your positive self-talk can result in increasing your self-esteem."
 ♦     Self-CenterednessAlong with having a low self-esteem, 
David was self-centered. Until Amy threatened to leave him, he was entirely absorbed 
in his own needs. His needs focused on his status and feelings about his job. 
When David did finally recognize Amy's pain, he tried to stop her pain as a means 
to prevent himself from having more pain.
 As you know, becoming 
less self-centered requires that your client become aware of his self-centered 
thoughts and behavior, which can be the next step to developing more empathy for 
others. Thus, the client perhaps becomes more willing to meet the needs of others 
instead of only his needs.  ♦ Technique: Pay Attention to Self-Centeredness To help David become aware of 
his self-centeredness, I told David to pay attention to his self-talk. For 
instance, David would often make comments like, "Who cares what they think? 
I know I'm right!" These statements limit what David can feel for others 
because they are so completely self-centered.
 Do you have a 
client that you feel would benefit by recognizing that his low self-esteem and 
his self-centeredness are getting in the way of his empathy for a significant 
other? Here's how I helped David to grow out of his self-centeredness. 3 Steps Used to Grow Out of Self-Centeredness  -- Step # 1 - I 
suggested first that David really concentrate on listening to what Amy had to 
say, not what he thought she should say. Listening to her would assist in preventing 
Amy from being merely a narcissistic extension of David.
 -- Step # 2 - 
As David was beginning 
  to get in touch with his own fears, he was starting to separate from Amy's fears. 
  Thus, he became more aware of his own insecurities.
 
 -- Step # 3 - 
  Finally, I told David to consciously 
  remind himself that Amy's anger was not a threat to him. I suggested that, if 
  it helped, he might consider reminding himself that he was still a man, even if 
  he wasn't in control of the situation at that moment. He said later that little 
  reminders of his self-worth helped him keep the anger of the moment in perspective.
 David was beginning to see conflicts as a natural part of relationships. He was 
  starting to see the possibility that conflicts are not a threat to his masculinity. Think 
of a male depressed, possibly at risk for suicide, that you are currently 
treating whose significant other has relegated to the role of a narcissistic extension 
of themselves. Would it be beneficial to introduce the esteem building concepts 
of strengths, expectations, and self-talk into your next session? As 
you can see, shame-based narcissistic clients can thrive on conflict in relationships. 
In the next section, we will discuss working through power struggles.Reviewed 2023
 
 Peer-Reviewed Journal Article References:
 Barnett, M. D., Maciel, I. V., & King, M. A. (2019). Sandbagging and the self: Does narcissism explain the relationship between sandbagging and self-esteem? Journal of Individual Differences, 40(1), 20–25.
 
 Grijalva, E., Newman, D. A., Tay, L., Donnellan, M. B., Harms, P. D., Robins, R. W., & Yan, T. (2015). Gender differences in narcissism: A meta-analytic review. Psychological Bulletin, 141(2), 261–310.
 
 Orth, U., Robins, R. W., Meier, L. L., & Conger, R. D. (2016). Refining the vulnerability model of low self-esteem and depression: Disentangling the effects of genuine self-esteem and narcissism. Journal of Personality and Social Psychology, 110(1), 133–149.
 
 Rentzsch, K., Erz, E., & Schütz, A. (2021). Development of short and ultra-short forms of the Multidimensional Self-Esteem Scale: Relations to the Big Five, narcissism, and academic achievement in adults and adolescents. European Journal of Psychological Assessment.
 
 Rohmann, E., Bierhoff, H.-W., & Schmohr, M. (2011). Narcissism and perceived inequity in attractiveness in romantic relationships. European Psychologist, 16(4), 295–302.
 
 Rohmann, E., Hanke, S., & Bierhoff, H.-W. (2019). Grandiose and vulnerable narcissism in relation to life satisfaction, self-esteem, and self-construal. Journal of Individual Differences, 40(4), 194–203.
 QUESTION 9
How can narcissistic depressed male clients hide their insecurities? 
To select and enter your answer go to .
 
  
 
 
 
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