
If you’ve ever found yourself thinking, “Why is this client so hard to reach?” or “Why does every conversation turn into a power struggle?” this episode is for you.
Today, I’m joined by Dr. Anthony Mazzella, a psychoanalyst who specializes in working with narcissistic dynamics. We go far beyond surface-level conversations about narcissism. This isn’t about labels, buzzwords, or quick fixes. It’s about what’s actually happening underneath the behavior and what truly helps.
We talk about why arguing over “reality” never works, why confrontation often backfires, and how curiosity, containment, and staying with the process can completely change the way therapists work with narcissistic clients and how partners survive narcissistic relationships.
Whether you’re a therapist sitting with these dynamics in the room, a supervisor guiding clinicians through complex cases, or someone trying to understand a relationship that feels confusing and exhausting, this conversation offers a grounded and compassionate framework for understanding narcissism.
This is one of those episodes that stays with you, and I’m really glad to share it with you today.
Meet Dr. Anthony Mazzella 
As a leader and expert in the field, Dr. Mazzella holds various clinical positions, including, but not limited to, treating patients in his private practice, training professionals at two post-graduate training institutes, conducting research, and lecturing across the country. While his focus with his patients is psychodynamic in nature, his main goals are to build a trusting relationship and help each patient reduce the frequency and intensity of their emotionally painful thoughts and suffering. He helps his patients overcome both acute and long-standing problems that may be more embedded in their personality.
Narcissism Is More Than What the DSM Describes
Most therapists are trained to recognize narcissism through overt behaviors: grandiosity, entitlement, lack of empathy, and a need for admiration. While these traits are real, they only tell part of the story.
What often gets missed is the underlying structure beneath the behavior. Narcissistic clients typically have a fragile sense of self. Their confidence and self-esteem are not stable. Instead, they depend heavily on external regulation to feel intact. The grandiosity we see is often compensatory, not evidence of inner strength.
When therapy threatens this fragile internal balance, even subtly, pushback is almost inevitable.
Why Narcissistic Clients Resist Therapy
Resistance in therapy is not random. In narcissistic dynamics, it usually serves a protective function.
When a therapist asks questions that slow the client down, invites reflection, or shifts away from certainty, the client may feel exposed, shamed, or destabilized. The pushback we see is not a refusal to engage, but an attempt to regain psychological safety.
This resistance often shows up as:
- Dismissiveness or intellectualization
- Arguing over “facts” or reality
- Devaluing the therapist
- Withdrawing emotionally or disengaging
- Sudden defensiveness around boundaries or feedback
Understanding resistance as self-protection, rather than manipulation, immediately changes how we respond as clinicians.
The Trap of Arguing Over Reality
One of the most common mistakes therapists make with narcissistic clients is engaging in debates over reality. Who said what? What really happened? Who is right?
This approach almost always backfires.
Reality disputes escalate defensiveness and reinforce power struggles. They keep therapy at the level of content instead of process, and they move the client further away from emotional reflection.
Rather than arguing facts, the work becomes staying curious about meaning.
What did that moment feel like for them?
What did they experience internally?
What sense did they make of it at the time?
When therapists shift from correcting to understanding, the dynamic in the room begins to change.
Containment Instead of Confrontation
Another key takeaway from this conversation is the importance of containment.
Containment means taking in the client’s experience without immediately reacting, correcting, or challenging it. The therapist listens, organizes, and reflects the emotional experience back in a way that is digestible and regulating.
This is not the same as agreeing or offering surface-level validation. Containment involves helping clients put words to feelings they cannot yet tolerate or articulate.
Over time, this process allows narcissistic clients to develop emotional language, regulate more effectively, and tolerate vulnerability without needing to defend against it.
Why Interpretation Often Fails Early On
Many therapists are trained to make interpretations, linking current behavior to past relationships or childhood dynamics. While interpretation has its place, it is often ineffective early in work with narcissistic clients.
If a client does not yet have the capacity to mentalize, interpretations can feel intrusive, shaming, or irrelevant. Instead of fostering insight, they increase resistance.
Staying close to the present moment is usually far more productive.
What just happened?
What thought or feeling showed up first?
How did their body respond?
These questions help clients develop reflective capacity without overwhelming them.
Boundaries That Actually Work
Boundaries are essential when working with narcissistic dynamics, but they must be implemented carefully.
Effective boundaries are not about punishment or control. They are about clarity and self-definition. A boundary communicates what the therapist can and cannot participate in, along with clear consequences that are calmly enforced.
When boundaries are consistent and non-reactive, they often reduce chaos rather than intensify it. In many cases, narcissistic individuals respond positively to boundaries because they provide structure and predictability.
What Healing Actually Looks Like
A common question therapists ask is whether narcissistic clients can truly change.
The answer is yes, but not in the way people often expect.
Healing does not mean eliminating narcissistic traits. It means developing integration. As clients become more able to tolerate vulnerability, reflect on their own inner world, and consider the experience of others, their behavior naturally becomes less rigid and defensive.
The development of mentalization, the capacity to think about one’s own thoughts and the thoughts of others, is one of the most significant markers of progress.
Staying Grounded as a Therapist
Working with narcissistic clients can be challenging, but it does not have to be draining or adversarial. When therapists shift away from confrontation, labeling, and power struggles, and toward curiosity, containment, and process-oriented work, therapy becomes more stable and effective.
This episode reinforced an important truth. Narcissistic resistance is not something to defeat. It is something to understand.
When we do that well, real therapeutic movement becomes possible.
Gordon Brewer: Well, hello everyone and welcome again to the podcast, and I'm really happy for you to get to know today Dr.
Anthony Ello. Wi welcome, Anthony, glad you're here with me on this episode. Yeah, I'm very happy to be here. Thank you, Gordon. Yes, and an Anthony has a podcast, so he, he's a fellow fellow podcaster called The Narcissism Decoder. And so we're gonna spend a good bit of time talking about. That particular topic.
And but before we get to that, Anthony, as I start with everyone, tell folks a little more about yourself and how you've landed where you've landed.
Anthony Mazzella: Sure. So I am a psychoanalyst, which is a type of talk therapy where patients come in to see me anywhere between one to four times a week. So I've specialized more recently in my profession in narcissism, and I landed here because many years ago when I was working on my dissertation.
I was in a dialysis unit. That's where people go who have kidney failure, and we recognized there was a big problem with what they call non-compliance. Which means that they're skipping or shortening their dialysis sessions for dialysis. They usually go three to three times a week for three to four hours of treatment.
So it takes up a big part of their life. So rather than just. Listening to all the conflict between the staff and the patients. You know about how you're missing and you're not compliant. I tried to, well, I developed an intervention study where I wanted to just sit with them, you know, we had two groups, one who got usual care.
And one who got a psychodynamic intervention, which was me. Mm-hmm. Just basically sitting with them, Gordon, doing what you and I do best, right? Mm-hmm. Which is to talk therapy. And the whole goal was just to get closer to their subjective experience, what life was like, you know, how they experience living with dialysis.
And what I learned is. Many of them were in denial, you know, that they didn't really think they needed it, or even if they did cognitively, they knew they needed it. But emotionally they weren't ready to accept the treatment. They must, they, they would rather be off in Atlantic City gambling. You know? It's far more exciting.
Right,
Gordon Brewer: right.
Anthony Mazzella: Yeah. Listening to the staff tell you. That you're noncompliant and you need to do something, you need to behave in a certain way. So that's how I ran into it. At the time, I don't even think I fully appreciated the extent to which I was dealing with personality disordered patients and in particular narcissistic personality disorder.
So that's what landed me in this whole field because I really needed to better understand how to relate, how to get close, and you know how to help these people.
Gordon Brewer: Yeah. Yeah. Yeah. So, yeah, I, I know I meant to mention this at the beginning, but one of the things that Anthony and I have done is I was on his podcast or interviewed for his podcast here, the, in the last week or two, and mm-hmm.
We talked about it in the context, talked about narcissism in the context of, of relationships, and just what I've. Learned, you know, just clinically over working with couples and particularly if there's one that has ident that, you know, identifies having narcissistic personality disorder. But I'm curious, Anthony, as you think about it, how do you tend to define it?
And we've got the DSM. Definition of it, but I'm just wondering how you tend to think about it.
Anthony Mazzella: You know, I'm, I'm so glad, and this is one thing on, on my podcast that I mentioned. I'm just telling, telling your listeners that I was so impressed with the mature and sort of comprehensive way that you think about things, Gordon, and you're doing it already.
'cause you mentioned we have the DSM, right? It's like DSM, I don't know, we're up to maybe five at this point. Right. And it's, it's, it's getting better, but it's limited in the sense that it looks more at what we typically call, like overt narcissism. And it doesn't really take into account the whole structure.
This is what we call the grandiose or the omnipotence, which most people identify. They know about that type of narcissistic behavior. So there's, you know, the whole grandiose sense of self. It is very complicated, but I just wanna mention that it encompasses both that overt type of, you know, I need to be the center of attention, risk taking, look at me.
I need to be admired, but. At the same time, it also includes that more vulnerable side. So all those outward behaviors, we call them compensatory. In other words, they're there to defend against that more vulnerable, shameful side of oneself, which anybody who's suffering with these traits or anybody listening who's treated somebody like this, they know that when there are moments of like what we call a narcissistic slight, a disappointment of any sort.
Even everyday separation sometimes can make them oscillate between feeling like they're on top of the world to feeling very vulnerable, and then maybe sometimes they even end up overdrinking, turning to drugs, masturbation, pornography to the bedroom. Sometimes if they really collapse and they can't get outta bed or go to work for a period.
And all that happens because the underlying structure, and this is just one way to define it, and I know it's very complicated. Mm-hmm. But we think that they have a very fragile sense of self, which means that their self-esteem is very precarious and they're always trying to regulate their self-esteem.
So you could see then how that omnipotent sort of attention seeking behavior could work really well. To sort of puff up their image and make them feel better. Right. So that's, you know, a very high level, I would say, way of maybe us jumping into it or just,
Gordon Brewer: right. Mm-hmm. Yeah. And so, yeah. So one of the things I'm curious about is, is that little bit of, you know, kind of being honest here is, is that I think for a lot of people we don't find, narcissistic people necessarily always that fun to be around and maybe even, I think for a lot of us, I, I know even in my grad, grad school days when I was learning about personality disorders, it was kinda like, okay, these are things that are just hard to treat. Yes. And hard to deal with. And so I think for a lot of us that are therapists, we think, oh, I don't wanna.
I don't want to work with these kinds of folks or that, that sort of thing. But you've kind of found, found a way to kind of connect with folks mm-hmm. That are kind of meet those kind of criteria for being, having narcissistic tendencies. Yes. So what is it that you've, you've kind of learned along the way around that, around connecting with those folks?
Anthony Mazzella: Yeah. This is, I would say the, in my mind. There are, again, many different pieces to this, but if I had to sort of list them in importance, this would be the number one important thing, and this goes for anybody who's treating them or anyone who's listening to this, who maybe feels like they're in a relationship with somebody like this.
And if trying to figure out how to negotiate that type of relationship mm-hmm. Is appreciating the subjectively useful component of something that's maladaptive, but let me break that down. Okay. Right, right. We say it's a defensive posture. I said it was compensatory. So, you know, if you could appreciate that, if they're, you know, they know it all or they're arrogant or sometimes they're critical or condescending, they're oftentimes very dismissive.
Like, I don't need you because they know everything, so why would they need you? Mm-hmm. Appreciating that, what I mean is. That that's part of the structure that holds them together. And if you can appreciate that, immediately your defenses will go down Gordon, if that makes sense. Mm-hmm. Because it's not just that they're doing this to you because you're incompetent or not capable, but it's that that's what makes them feel better.
That's what they need to survive. Mm-hmm. The goal, you know, initially, at least before we get deeper into the work, is appreciating that by way of what we call containment. And that's just a fancy word, but that means that you wanna get as close as possible to their experience. Like that's what I was doing with those dialysis patients that I mentioned earlier.
Gordon Brewer: Right. You know,
Anthony Mazzella: really trying to understand, not telling them what to do, not educating them on why they need to be on, you know, on their dialysis and not skip the treatments. So it wasn't about education, it wasn't about ever telling them what to do, but it was about really appreciating how they choose to do it the way that they do, and then helping them understand how they come to those choices in life.
Gordon Brewer: Right. Yeah. Right. Yeah. So it's really just in, in therapeutic terms, it's really approaching really kind of validating their experience. And even though we don't see it, the world, the way they do is really being able to just simply acknowledge that with someone. And that probably goes a long way in building that therapeutic relationship.
Anthony Mazzella: Yeah. And I just wanna clarify one thing. I know you probably mean this, but for any of like your therapists that may be listening in your audience. Mm-hmm. So validation isn't just agreeing or just understanding, like, I call that like false empathy, you know? Mm-hmm. Like, oh, yes. That must have been so hard, you know, when your wife retired to the bedroom early, you know, and she left you feeling so alone.
I, I don't think of it that way. The way that I, when I say containing, it's like. What you're trying to do is take in their experience, right? Mm-hmm. And then what we call detoxify it. In other words, they tend to come in and complain. Let's just use that as an example. They like to complain. Mm-hmm. And everything is everybody else's fault, which is very common with personality disorders.
It's never their fault. It's always somebody else's fault. So what you're trying to do is you take that in and then you de, you know what we call detoxify it. In other words, you wanna give it back to them in a language, in words like this is the development of what we call verbal language, which they don't have.
'cause they can't express feelings because again, they're so defended against that. So what we do is we take it in. We ask inquisitive questions to get as close as possible and try to understand it from their perspective, and then we could give it back to them in a way that we call, I'm just using. Sort of beyond's language.
That's a psychoanalyst. Mm-hmm. Detoxified, in other words, in a way that makes sense to them. Mm-hmm. Now, now they can begin to get into a more regulated state of mind and begin to think about another side of themselves, which again I mentioned earlier, is that more vulnerable or shame side that they don't, they're not always in touch with, because that's typically what we call split off.
It like disappears because all you see is that more. You know, if this is the kind of narcissism that more grandiose presentation,
Gordon Brewer: right? Yeah. Yeah. So what, what have you found that helps kind of create a ca catalyst for change for folks that are, you know, work, working through this, this kind of, you know, personality disorders or narcissism, that kind of thing.
So one of the main
Anthony Mazzella: things is. Since they're not in touch with this other side of themselves. 'cause it's like fragmented or it's split off, right? We call this integration. So in other words, we wanna help them get more integrated so they could be exposed and begin to be able to tolerate and work through a whole range of different feelings.
So this way they don't need to get rid of them. Like again, just to use the example from the dialysis unit, it was much more pleasant to be in Atlantic City. But also like I say that to you. And I kind of smile when I say it, and I think you did too. But you could also appreciate at the same time. That, this way they don't have to feel any vulnerability.
They don't have to feel ashamed. They don't, we, there's nothing, there's no thought about all of what it means to be living with a disability. That you are dependent on a machine and on the staff. And by the way, just as a quick side note. People with these characteristics have a very hard time being dependent on anybody or anything.
Remember. 'cause they know everything, so they don't need anybody. So one of the main, just to go back to your question, is helping them develop a more integrated, complex sense of self where they can let different parts of themselves in that have been defended against. Split off and projected their whole life.
And then as they become more integrated, they don't need to get rid of these feelings. And getting rid of the feelings means then they don't need to be above everybody or act out in certain ways. Like I mentioned before, maybe with drinking or isolating themselves or whatever they may do.
Gordon Brewer: Yeah. Right, right.
Yeah. And I know, I know when we were. When we were having our conversation on your podcast one of the things that, kind of the flip side of this, besides the person that is being diagnosed with or has narcissism on, I don't know struggles with narcissism. I don't know the best way to, to frame that, but, Um-Huh how it affects relationships and the people that are around them.
Yes. And so you know, I think. Where, where we kinda left off in our conversation was just, and, and I think a lot of us have had these conversations with different clients, those of us that have been doing this a while, where you've got maybe a narcissistic partner and they're really trying to figure out, okay, do I stay, do I leave?
Do I mm-hmm. You know, do I, you know, how do I, how do I navigate all this? And then also just their own. You know, kind of the trauma of being in a relationship like that. Yes. Yeah. Yes. Yeah. Yeah. So I do, I was just thinking you know, maybe the question is what are your thoughts on that? Mm-hmm. You know, those, the, the healing on, on the, on the relationship
Anthony Mazzella: side.
Yeah. I love, I love this part because Uhhuh. I call it like low hanging fruit. I mean, it's unbelievable how much progress you can make with these patients once you engage their curiosity, because oftentimes they do come in struggling in a relationship, but relationships are so complicated they don't always see all of what's going on, and.
What I, what I tend to do initially is I help them if like, let's say you're in this relationship and you identify, or you're thinking that your partner may be, you know, have these narcissistic characteristics and you're not ready to leave that relationship. For whatever reason, you know, you've been with them a long time.
There are very genuine moments as well. You know, maybe you have kids or finances that are intermingled. So then the question becomes, how do you manage a relationship with somebody who you think has these characteristics? And a couple of things that I typically help them with, again, this is the low hanging fruit that I mentioned, is, yeah, the first step, if there were steps is.
Don't get caught up in fighting over reality because reality is very complicated and you're just gonna go back and forth in saying who was right and who was wrong, and what happened five years ago when you did this. So the first step is. Not becoming caught up in reality, but trying to understand your, your your partner.
And this goes for any relationship, by the way. Mm-hmm. And these things mm-hmm. Just happen more naturally, I think for people who are, you know, maybe more neurotic, you know, not personality disordered. So the goal is to understand, and we do that again, I know I mentioned this earlier, but it's such an important piece of it.
By asking in inquisitive questions. So the same way I described that, I work with these individuals who have these narcissistic characteristics. I always encourage the partners or, or the children, right of, of maybe their parents have these characteristics. Is to always take an inquisitive stance to try to understand their mother, you know, and why she says the things she, she says, now, Gordon, and I promise you this stuff like seems so simple, but I was just doing an interview a few weeks ago, and this woman spontaneously gave an example of a family dynamic.
I just posted this actually on my podcast. Mm-hmm. Uhhuh, and immediately I said. You are arguing with her over reality. Like you went in and you're talking to this mother-in-law, that was the example, right? Mm-hmm. And you are telling her what the truth is, but you don't seem interested at all in understanding her perspective.
So that would be the first place to start, is being curious, gathering information, and then checking with them. That would be, again, I'm not trying to give schematic steps. Mm-hmm. But it would be then. You listen and then you check with them and say, Hey, did I get this correct? So I just give a very simple example.
Your husband gets upset with you, or, or if, if, you know, again, clinician are mostly listening to this, a patient comes in and they complain about their husband, right? Who gets upset because you. Overcook the burger. Right. Again, I'm, I'm just kind of making this up, but you overcook the burger and they're yelling.
So then the first step is to do what? To try to understand mm-hmm. What's going on here and start to ask questions. And this is the same thing that I do, and what I find out is when you slow it down, you could say, tell me what was going through your mind. So what happened? This is what I do, by the way, with patients.
When they handed you that burger and you recognized it was overcooked, right? Mm-hmm. And what you typically hear often, more often than not, is. They didn't really, they, they didn't really they don't know me or they didn't listen to the way I like my burger cooked. Mm-hmm. And now you see, you get into something different.
You're not staying at the manifest level of the anger. Mm-hmm. You're listening for the deeper emotions behind underneath the anger, which are what that this guy. Blew up because he felt like he wasn't being heard. Now, I'm not condoning that behavior, by the way. Mm-hmm. We'll talk about that too, you know, at some point.
Yeah. You know, in terms of creating boundaries. But that's last, you know, that's typically what you hear from the, like the first recommendation is, well, you need to create firm boundaries. Mm-hmm. But my first step and second step is like gathering information, checking in with them. Listening for what the feelings are below the anger.
But look, I know there's a lot more to say, but let me, let me pause. Mm-hmm. And just see how this lands with you and, yeah,
Gordon Brewer: yeah. Yeah. One of, one of the things, and this is a dynamic that happens even when in, in, you know, in any couple really is, is that we can get into, this dynamic of criticism and defensiveness.
Mm-hmm. And, and once it goes there, then it just tends to escalate. I mean, as far as, like you said, trying to try to hash out the facts of the situation Yes. Is not gonna get you anywhere because. My facts are gonna be different than your facts.
Anthony Mazzella: Yep.
Gordon Brewer: Because my perspective is different from your, your perspective.
Mm-hmm. And it's it's kinda like an example that comes to mind for me is just kinda like if I showed you the front of a book. And I said, okay, what is this book? And you'll probably read the title and that sort of thing. And I would say, well, what does it, what does the predominant color of the book?
And usually there'll be some kind of graphic or whatever. But if I flip the book around and say, what is the, what is the title? You can't really know it unless you take the book and maybe start reading the fine print on the back of the book. Mm-hmm. But the truth is, is that if you don't know the title or you said it doesn't have a title from your perspective, that's correct because you're not seeing it.
Mm-hmm. And so the truth of the matter is it's not, it's, it is both sides of the whole of. Situations. And so when you know, and thinking about working with couples, you know, is trying to be able to get them to a place where they can kinda see the others' perspective. Yes. They, like you said earlier, get curious.
Yes. With their, with their, with their partner and that, that keeps the, keeps it from. Getting escalated or emotionally flooded, or however you wanna say that. Yes. And that that's a huge dynamic change for most people. Yeah.
Anthony Mazzella: And I, I love that analogy you used because when you said if you flip it around and you can't see the title anymore
Gordon Brewer: mm-hmm.
Anthony Mazzella: It's like you have to read the fine print or something, like you gotta look, you gotta delve into it, right? Mm-hmm. Mm-hmm. And that's very similar to what I was trying to get at, which is. What's the goal here? Do you want to get to know your partner? You know, and I, I've heard this before, it's like the other key is like, you don't label, like don't label people.
We're not here to like label. So sometimes they'll say, well, he's a narcissist, or he's a covert narcissist. And I told them that and it's like, okay. But the goal is to try to get to know him and not label him. But then they say, well, but it's true. He is a covert narcissist, so why shouldn't I use that language?
And it's like, it's not helpful to use that language because I could tell you, like, I'll stop them immediately because I know what's coming next. Which is, you know, it too, he's about to explode. Mm-hmm. Because that's a very dehumanizing way to just, you know, to talk to somebody. It's not a way to understand somebody by slapping a label on them.
So that's another technique. Okay. So I, I mean, going, and I could keep going, but I'll just say one more thing. Okay? Sure. Yeah. Keep going. So one thing again with couples that I find really helpful is to stay focused on the present. And what we call process, not content. So in other words, don't go back to the past and what happened five years ago.
Like, we have enough work to do right here in the moment. Mm-hmm. Between just helping the two of you begin to communicate without all these distortions, Gordon that you mentioned earlier. Right. Because everybody sees things through their own lens. Right, and just so you know, people with person, I mean, you know this, people with personality disorders unfortunately tend to distort it.
Their lens distorts things based on their own history and their own representations of people based on how they've been treated in the past, so, mm-hmm. That's like you gotta deal with misinformation that's coming in. See, we have plenty to do right now. We have to contain, we have to get them regulated, we have to get them curious.
Then we have to clar, clarify or clear up any distortions that are going on in the moment. So you don't need to go back, not initially, at least in the beginning phases of treatment. You don't need to go back to what happened 15 years ago or 10 years ago. And by the way, it gets so distorted, like it turns into what we call a screen memory.
Yeah. It has layers and layers of fantasy over it that it's just so far from reality it's not valuable to go back there.
Gordon Brewer: Right, right. Yeah, that's say same approach and I, I'm glad you said that, is that you know, in working with, working with other therapists, particularly in, you know I'm A-A-A-M-F-T approved supervisor, so I work with a lot of.
Folks that are you know, working through. So the, the licensure process, uhhuh, and I think so many people get intimidated by just working with couples in general because they're afraid of they're afraid of the content. And if you can take that content away and just look at the process and look at, yes, look at, okay. How are they communicating with each other right now? Mm-hmm. What is what is happening in the background? What is the, what is the, you know, when when somebody says this particular thing and this particular tone of voice, what's the response to that? Mm-hmm. And so you can change the responses. You can't change the content.
Yeah, that's, and, and you're gonna get, you're gonna get down a rabbit hole of, like we talked about is, you know, the, the truth for both people is something different. Yes. And so, yeah. Yeah. And so the getting, really focusing on the the process of what's going on rather than the content Yes. Is I think one of the most important things for people that are working with couples.
Anthony Mazzella: Yeah. Can, can I add one more? 'cause I'm so excited. Sure. Audience is a lot of, like you said, like mental health professionals maybe who are working in this field. Right. Another critical thing to do when you're working with these patients, I, I love this by the way, Gordon, 'cause I don't typically get to talk about this end of things 'cause it's always talking about relationships and people who are in these relationships with somebody.
Right. Right, right. But now we're talking about how we help somebody heal or how we heal relationships. Another thing is. Do not think about interpretation. And what I mean by interpretation is something that's outta their level of awareness that they're not seeing that's just too far away, making it conscious.
So we call it making the unconscious conscious, like maybe making a link. So I'll give you an example. You get very upset with your husband when he drinks on a sat, you know, Sunday afternoon and watches football. Then you give an interpretation, well, you know, I remember you telling me that your father drank.
Right? That kind of stuff typically upsets somebody with a personality disorder because they're not necessarily in that moment of making a link between, this is my father that I'm upset with and not my husband, and it means nothing to them. Mm-hmm. And typically it just gets them upset with you, and they don't have that capacity to make those lengths.
So. Another thing that I teach, you know, thera, 'cause I also supervise and I teach, but one thing I help them work on, which is really hard because I think therapists believe that they're supposed to be making like interventions or linking things together, going after the content like we described earlier.
But my, what I encourage them to do is just stay so close in the moment and just say, tell me what happened that moment when you heard him rip open a beer. What went on inside of you? What were you, what was the immediate thought and feeling? Mm-hmm. And you'll help them get to the, you know, right. That historical stuff with their parents.
If that's what's there and they're ready to go there. But I would only advocate not to force it. Just stay in the moment with them. That's where you know, you'll get the most bang for your buck. Right, right.
Gordon Brewer: Yeah.
Anthony Mazzella: Yeah,
Gordon Brewer: yeah. And that's a, and and truthfully, that's the only place where you can effectively create any changes in the moment.
Mm-hmm. I mean, that's a, that's, yeah. That, that's the truth with
Anthony Mazzella: that. Yeah. When they get later into the treatment and they're developing more of a capacity to really. Slow down and reflect and then try to make connections and understand why they behave. Yeah. At that point then maybe you could give that kind of interpretation where they're so close to it.
Mm-hmm. And they, and you feel like they could use it in a way, you know, that's beneficial. But typically that takes a long time and sometimes isn't even part of the process. Mm-hmm. I think you mentioned it last time, Gordon, just the process of helping them mentalize. I, I think we spoke about this. Mm-hmm.
In other words, to think about their own thoughts and feelings, but also somebody else's, like their partners. Yes. It's a major accomplishment. Right. And they, people always ask, can you really treat a narcissist? Like, are they really, you know, can you help? Them, do they really heal well, heck, this is part of healing right here.
To develop a capacity for mentalization. Mm-hmm. And be more thoughtful about what Gordon is thinking. Imagine that you could think about how that's a major accomplishment.
Gordon Brewer: Sure. Right, right. Yeah. Oh boy. This is, this, this is fascinating things to talk about. Well, I know, I know we've gotta be mindful of our time, but, i'm, I'm curious for you, Anthony. And just thinking about helping couples you know, just in this context of maybe a person is trying to figure out how to navigate through a narcissistic relationship and they are really thinking about you know, do I want to stay in this or not? Mm-hmm.
Mm-hmm. And, and also being able to, how they can set boundaries with the narcissistic person. Because I think that's one of the, one of the things that's you know, I think important for just any individual is know how to create boundaries for yourself. Yes. But, and just thinking with a narcissistic relationship, it becomes even more.
I think a little more of a challenge, so I'm not sure if my question's making sense, but just thinking about it in that context of working with the person that is maybe in a narcissistic relationship. You mentioned the low hanging fruit of just really focusing on the mm-hmm. On the present and that sort of thing, but what are, what are some other things that you've found?
That are helpful with those people.
Anthony Mazzella: So you mentioned boundaries. I, I could speak to that because mm-hmm. I think what happens if you really put in the effort and you try, like all of what you and I are discussing today and in our last episode as well, that we recorded. And nothing is really working, like you fail.
And, and that's if you're really trying. Mm-hmm. And you're trying to be inquisitive, you know, asking the questions, all the things we mention, right? Mm-hmm. And they're still very, like, let's say disrespectful. Like I, I'll just give you, again, I love examples. Just a very short one. I'm treating this, this fellow, he's a grown adult, but his mother's very involved in his life and his treatment too much, so.
Mm-hmm. And for months and months, Gordon probably almost like. A year now, she would send me very abusive emails and I would try to contain it and say, you know, we're here for him and let's try to, you know, work together to do what's in his best interest. And by the way, the mother is abusive towards me.
Yeah, because her son is getting better, and when you have a covert narcissistic parent, they cannot tolerate the separation. So she needs to interfere in the treatment process. But that's a whole nother story. Mm-hmm. So finally I get to the point where I say to her, something along the lines of, this relationship no longer works for me.
Right. So that's creating a boundary. Mm-hmm. But I'm not breaking it off. Mm-hmm. But then you put in a, a consequence if you behave or send me one more abusive email Right. Then I will block your email and you have to only correspond with me through your son. Mm-hmm. And immediately her tone changed.
Mm-hmm. Well, at the moment at least I can't predict what's going to happen in the future. Right. All right. She has become much more respectful because I don't think she wants to lose that relationship with me. Mm-hmm. But she needs now to contain her. Well, the boundary actually, yeah, the boundary helped contain her.
Mm-hmm. So when nothing else was working and I could not contain her, and again, she's not my patient, I think I would've worked with her differently, but then I had to put that boundary. And the important thing about a boundary is you have to give the boundary. Don't talk to me this way again, and the consequence.
Mm-hmm. Like this is what's going to happen. Mm-hmm. And I'm not blaming her and I'm not upset. I just say, this relationship doesn't work for me. That's the emphasis. Mm-hmm. So she can't get upset and argue with me 'cause it just doesn't work for me.
Gordon Brewer: Right. You know, so. Right. Yeah. I, I love that because I think it's, as much as anything. It's really, I think, with boundaries is being able to have a firm know and being able to stick by that. Mm-hmm. And and I like that piece too, about what are the consequences if they don't, you know, follow through on what you're requesting of them. You don't think that, yeah, it's not
Anthony Mazzella: that I'm punishing, I'm not humiliating this woman or punishing her.
I'm just saying I can't participate in this kind of relationship. Right. You know, it's like a, a, a, it's like the parent who gets so frustrated with their child and timeout doesn't work, you know? Mm-hmm. And the child doesn't listen or they run out. You know, at some point you may have to say, if you don't knock it off, I'm going to take a timeout.
Put yourself in timeout. Right. You know, instead of trying to control, instead of trying to control your child. So I'm not trying to control this mother. I'm just saying this is the boundary. This is where I'm comfortable.
Gordon Brewer: Yeah. Right. Yeah. Oh boy. Well this is just great stuff and I, again, I've got, I guess we need to be mindful of our time, but, and I'm sure Anthony, I'm already thinking out, I'm thinking out loud here, but I'm thinking we might wanna continue this conversation even more.
Yeah. Beyond this, beyond this episode I know we will do we will have available for people the. The recording that Anthony and I did mm-hmm. Together for his podcast and, and links to his YouTube channel and that sort of thing. And we'll have those in the show notes and that sort of thing. But Anthony, tell folks how they can get in touch with you and where they can find your work.
Sure. And just to
Anthony Mazzella: keep it very simple, it's just dr mazzella.com is my website and if anybody goes to the website, everything is there. You know, the podcast is there. The YouTube videos, I put out a lot of written content as well. You know, like little blogs about all different issues related to personality disorders and narcissism in
Gordon Brewer: particular.
Awesome. And again, like I mentioned, we'll have links here in the show notes and show summary for people to access that easily. So well, Anthony, thanks again for being on this particular episode and I, I know for sure we'll be having more conversations here in the future. I, I look forward to it. Thank you, Gordon.
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