Sir,This letter is aimed for psychotherapy clinicians and researchers who should acknowledge the relationship linking Kohut's self-psychology and Glasser's Choice theory that can demystify relationship difficulties and mental health problems in narcissistic personality disorder (NPD). NPD is commonly experienced interpersonally by others as insufferable, pompous, and un-empathic.[1] NPD persons have been identified to possess giant self-centeredness, a certainty that they own supreme personality, and their humiliation of others makes them intolerable for interpersonal relations.[1] Importantly, Heinz Kohut's legacy to psychology is known as self-psychology and was centered principally on narcissistic personality development and treatment.[2] Suboptimal psychological development is thought to arise when maternal compassion is discriminately substandard.[3] As a result, the narcissistic self constructs a defense against the helplessness of a hurtful world.[3] Kohut[2] cited in Banai et al.[3] called the compassion required from maternal figures as “self-object needs” because these needs develop the self-image and are provided by external objects.By not receiving necessary self-object transferences through decisive epochs in development, the young individual cannot build the competence to control self-respect or construct a positive self-image.[3] Consequently, the child, now an adult, depends on other humans to construct their self-image. The self-object transferences received as an adult provide a feeling of significance, which was not established during child development.[3] However, NPD persons are apprehensive of meeting self-object absence as an adult.[4] In order to feel the control of their fate, NPD persons present a mindset of dominance in the interpersonal sphere. As a result of this authoritarian manner, persons with NPD typically have a record of numerous unsuccessful relationships.[4]
PARADOXICAL CHARACTERISTICS IN NARCISSISTIC PERSONALITY DISORDER
Thus far, this letter has acknowledged that NPD persons rely heavily on self-object transferences to develop a positive self-image. The behavioral characteristics of NPD persons reflect this need and are well documented.[5] However, what is paradoxical about these behavioral characteristics is that instead of behaving in a way to increase the chance of receiving self-object transferences in relationships, NPD individuals act in a way to reduce that possibility by destroying interpersonal relations.Glasser[6] has specified relationship building and destroying behavior in a grand detail in his Choice theory. “Seven Caring Habits” and “Seven Deadly Habits” offer superb rules for how psychotherapists should interact with clients to enhance the likelihood that these individuals use caring interpersonal habits to attain optimal mental health. It is evident from the literature that NPD behavioral characteristics reflect the “Seven Deadly Habits.”[1] Glasser's Seven Caring Habits are Supporting, Encouraging, Listening, Accepting, Trusting, Respecting, Negotiating differences and the Deadly Habits are Criticizing, Blaming, Complaining, Nagging, Threatening, Punishing, Bribing, or Rewarding to Control.
CHOICE THEORY
The writing of Kohut and advocates of self-psychology argue that the feeling of love, belonging, closeness, and connectedness with other humans are essential for individuals with NPD who requires self-object transferences.[7] Unfortunately, the pushing, demanding actions (Seven Deadly Habits or External Control Psychology) being used by NPD persons destroy relationships and therefore prevents self-object needs being met. When external control is used by NPD persons, it will destruct the capacity of one or both individuals to locate contentment, eventually resulting in severed relationships.[8] This interpersonal disengagement is argued to be the foundation for the majority of humanmental illness.[6] Choice Theory and the Seven Caring Habits are offered to replace external control psychology and the Seven Deadly Habits[6] to preserve relationships and optimal mental health.External Control Psychology is an attempt to control others to act in a way they do not want to.[6] This ideology of a person who uses external control does not permit individuals outside the self to formulate preference about individual freedom, and advocates that other individuals should be punished to modify their behavior to attain the controllers' needs.[6] The “Deadly Habits” demolishes individual freedom of the oppressed individual and therefore acts to disconnect relationships, as freedom has been identified as one of the basic human needs.[6]Consequently, a central thesis of Choice theory is that the only individual one can be in command of is themselves.[6] If the individual believes they can command other humans, then they will encounter anger and irritation leading to mental illness.[6] Anger, irritation, and mental illness will also arise if the individual believes that other humans can command them and then externalizes blame to the perceived controller for undesirable events.[6] For that reason, it is vital for the NPD individual to focus on internal control of their own choices and to value the rights of other people who have their own needs.[6]In conclusion, it is important that the caring habits be taught to the NPD client, once a therapist has identified an individual with strong self-object needs and who meets the criteria for NPD. Using Choice theory, the psychotherapist directs an individual toward fulfilling interpersonal relationships and educates the person to relate in more helpful modes using internal control psychology.[6] The better NPD persons are proficient at bonding and comprehending other individual needs, the better prospect they possess to receive positive self-object transferences and happiness.