More threads by David Baxter PhD

David Baxter PhD

Late Founder
When a Therapist Fails to Diagnose Narcissistic Personality Disorder in the Extended Family
by Beth McHugh
16 Nov 2009

It is not uncommon for many of my clients to have previously entered therapy for a range of conditions including depression and anxiety-related disorders and to be treated as what is known as the "Identified Patient" by their therapist and labeled with these disorders.

While they may be suffering from anxiety, depression and a range of other related emotional afflictions, these disorders are secondary to the principal problem in the person's life. And that is the presence of a narcissistic parent.

Having a parent, particularly a mother, who suffers from narcissistic personality disorder (NPD) is a particularly heavy burden for a child to carry and that burden is more often than not carried well into adulthood as the parent's condition remains undetected and unsuspected.

I have had clients tell me that they have been diagnosed with a "mother fixation" or have "failed to mature and successfully make the parent-child break" and lead a life of their own. Here, the therapist in question has completely missed the core problem of the adult child of a narcissist. It is the narcissist who has the mental illness, and the adult child, now in therapy, is displaying typical but completely normal symptoms in response to what is an abnormal situation.

To go on to label such an individual with a mental illness as per the above is both unethical and cruel. It also re-victimizes the adult child. While there are some cases where the abuse from the NPD parent has been so severe that there can be genuine mental illness in the offspring, these cases are relatively rare.

What is more common is that the adult child of the NPD parent is at a genuine loss as to what is going on, or they feel so out of control with anger and frustration that they cannot even converse with their parent anymore. Or they crave the love they never got from the parent to the extent that they make themselves sick and ruin other important relationships in their lives.

Most commonly, the adult child of a narcissist feels a deep sense of worthlessness, of invisibility, of not being "good enough". The end point is anxiety, rage, depression - all perfectly normal end points for a person living for decades in such a situation.

Why many therapists have a problem in correctly diagnosing NPD in a client's parent is unknown. But there is a common theme that children blame their parents for everything and therapists, in the main, try to steer their clients towards self-responsibility and self-motivation. Perhaps that is why NPD is missed so often.

However, when one has an NPD mother, it is almost inescapable that the child and later the adult child in particular will become consumed by the actions of that parent. They are desperately trying to make sense of the often bizarre and cruel treatment of narcissistic parents, while at the same time forever hoping that one day their parent will suddenly snap out of this state and see their child for the wonderful caring person they truly are. It is this latter behavior that keeps the adult child stuck and in pain and which the therapist needs to work on, rather than continuing to label the client as "sick".


Contact Beth McHugh for further assistance regarding this issue.
 

Mashka

Member
What I find disturbing about NDP parents is that they made the conscious decision to have children while having to know, on some level, that they are unfit to care for them. Sometime in the 9 months that a mother carries her child, the thought must cross her mind about being a good mom. Just because a person has a certain disorder does not excuse them for being cruel. Maybe I'm just being mean because I've known many narcists, and one was a very close friend who I just couldn't bare (bear?) to be around anymore. I find it so horrible and inhumane to deprive an innocent child of a normal life-nobody should have to reassure their mother that they are beautiful and better at things than their father at any age. Blargh, my scientific and emotional sides are arguing with each other.
 

Andy

MVP
I can see your point here but there is so much more to it than that,In my opinion.

I think every mother wonders if they will be a good mother or not. I also know that not every mother planned to become pregnant and also not every mother is thinking about the impact they will have on their child, they just want a child, or are pressured to have children etc.

My mother, in my opinion has NPD not just little bits of narcissism here and there but the actual disorder. Of course she has never been diagnosed with it, that's just my brothers and my opinion. I think my mom was really into having children, thought she would do better then her mother and father. It's a hard job without having issues and even though I know my mom may have done and still does a lot that is completely hurtful I do know that she doesn't want to be that way.

I think people without disorders can be just as if not more cruel to their children.
 

Mashka

Member
This is where I haven't made up my mind. I have two sides, my scientific side which provides me with a reason, and therefore an excuse for any behaviour, and my personal side, which deals with the moral issue of it. I cannot imagine what it would be like to have a NPD mother. How can you tell they truly don't want to be that way?
 
I'm always really uncomfortable with the whole "who should and shouldn't have children" thing. There are a lot of people out there who believe anyone with a diagnosed mental illness shouldn't have children. I know that's not what you're saying, but there are people who think that way. It's scary to me. I do get what you mean though. I don't think there are any easy answers.

I'm not sure too many people go into having children thinking they're going to abuse them. I don't know much about NPD. I don't understand much of what I do know about it. I agree with STP that there are varying degress of it. I'm not really sure people with NPD DO realize how they are and how it effects their children. That's what is so sad to me. I'm not sure many people with NPD ever seek help because they can't or won't see they have a problem. Maybe they think they're going to be the best parent ever. I don't know.

I suffer from different mental disorders and it's something I beat myself up about constantly. Am I going to ruin their lives because of my problems? Are they going to inherit what I live with? I constantly monitor myself and I know I probably mess up a lot.

I didn't have the greatest childhood, but I am glad I was born. I don't think a child of a mentally ill parent is destined to be damaged for life. There is hope to overcome the damage. No, it isn't ideal, but we don't live in an ideal and perfect world. We are all going to suffer and we are all going to have obstacles to overcome. There is help to do that and that's what people who suffer must seek.

I'm just uncomfortable with this for some reason. Children certainly do deserve to be treated with love and care and respect. This just isn't going to happen a lot of times unfortunately and I think the focus should be on helping the survivors. For most of us, life is not ever ALL bad. There are good moments too and I'm glad to be alive for those moments.

I don't know. It's 4 in the morning and I'm probably not making sense. :panic:
 

kashley

Member
I'm a sophomore in college, and earlier this semester I started going to see a therapist for individual counseling at our university counseling center. I went in because I knew I wasn't happy, but I wasn't necessarily unhappy. I couldn't identify a specific reason as to why I felt that way, though.

Anyway, over several sessions talking to my therapist about my parents (who separated 5 years ago), she told me that my dad had NPD. She told me about it and I also looked up the disorder a bit myself, and my dad fits nearly every aspect of the disorder to a T. Yet, he takes on the role of doing what looks right in other people's eyes, i.e., making sure I'm "taken care of." Though, the only thing he thinks he needs to do is take care of me in terms of finances, even though he thinks that giving me $100 a month is enough to support me. Thank the Lord for financial aid! He also relies heavily on guilting me into doing what he wants, telling me what he has sacrificed for me...in one conversation a couple weeks ago he even implied that he "can't die" because I won't be taken care of financially. It might seem caring at first glance, but he was trying to make me feel badly that I was too dependent on him, almost like a ball and chain.

The understanding of my father that came with the realization that he has NPD was both relieving and frustrating at the same time. Though I'm only in the very beginning stages, I'm starting to see that a lot of the things I have always blamed, berated, or questioned myself about were not entirely my fault. And I'm finding that I wasn't entirely crazy for being horribly depressed (I find that, lately, I'm having small bouts of depression again, but my meds work wonders ;)) or for having anxiety about my self perception and my perceptions of others. But this is a double-edged sword, because it makes dealing and talking with my father so much more difficult. There are times when I wish I were just ignorant to his behavior again, because then I wouldn't feel so badly for lying to him (currently) and lying to myself (previously).

My mom has suffered because of his behavior as well, and when I told her about NPD, she realized that it explains a lot of what he does. Although, I think she is, sometimes, hell bent on revenge for what my dad did to both of us (pretty much abandoning us and blaming the two of us for it), so she didn't hesitate in telling him that I'm in therapy because of him. I had no plans to tell him in the immediate future, and for good reason. He told me that he didn't understand what was so wrong with my life that I need to go talk to a stranger about it. He said that he had given me everything (he emphasized everything) I could ever want, and he couldn't imagine what else I could need.

If only he could realize that what I need isn't something tangible. Unconditional love and understanding from him is what I need, but I don't want it from him. Even if there was some miraculous change in his behavior, I would never trust him enough to believe that any of it was genuine.

Even though I don't like him for the things he has or hasn't done, I don't really blame him. His perception of his reality is skewed, and even though it hurts a lot of the people around him, I don't think he would have asked to be this way, if he had the objectivity to do so. As Cat Dancer mentioned, my dad really has no clue the effect the he has had, and still does have, on me, though if I were to point it out, it would most certainly be my fault. It's easier to realize that this is the way he is and deal with it, rather than dwell on what I never had with him. Nonetheless, it's unfortunate.
 
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Andy

MVP
This is where I haven't made up my mind. I have two sides, my scientific side which provides me with a reason, and therefore an excuse for any behaviour, and my personal side, which deals with the moral issue of it. I cannot imagine what it would be like to have a NPD mother. How can you tell they truly don't want to be that way?
lol

I don't think I excuse her behaviour. I am aware of it and know for the most part (maybe not instantly, but soon enough) what she is doing. I'm use to it, that doesn't mean I think it's ok.
I'm afraid your going to have to explain the "moral issue of it".

I can tell that my mother doesn't want to be that way because I know her, she is my mother. Maybe, she doesn't notice the majority of the time but every so often when she does/says something, whether she notices on her own or if someone points out things to her she will back pedal or suddenly be extra nice to me. Aside from that she is not just "NPD"(to reiterate, she is not diagnosed) she is also human.

"I cannot imagine what it would be like to have a NPD mother". Aside from the crappy stuff, the rest is great, I love her very much. I don't know any different. I cannot imagine having your mother. lol That sounds so rude, I obviously know nothing of your mother, good or bad, I am sure she is a beautiful person, I am just saying if you don't know any different then it all seems normal (until you do).
 
Hi All, I am the author of this article on Narcissitic Personality Disorder in the Extended Family and I'd firstly like to answer the initial comment about mothers as narcissists. The whole paradox of having NPD is that the person is unaware of it. As it is a personality disorder, it permeates the entire personality and the narcissist, in particular, does not possess the skills for self examination. Therefore, it is not possible for a NPD mother to look at herself and question whether she is a "good mother". If anyone were to ask her, she would invariably reply "well, of course, I am!" without so much as a second thought.

Other, more balanced mothers have inbuilt checks and balances in place and sometimes believe that they could have been better mothers. Hence, as an adult child of an NPD parent would know, it is not possible to communicate on a real level with a narcissist, as there is no "other" in their lives.

One of my specilalities in my practice is working with the adult children of narcissists. I have a series of articles on this disorder that you can read at Your Online Counselor - Beth McHugh - Online Psychological & Relationship Counseling.

If you feel you need additional help in coping with your NPD parent then you can also contact me at the same address for online counseling.

Best wishes,
Beth McHugh
B.Sc. B. Psych. Dip. Sc.
 
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