The Narcissistic Family: Diagnosis and Treatment (Part II)

In my last post, I reviewed the narcissistic family model originated by authors Stephanie Donaldson-Pressman and Robert M. Pressman in their book, The Narcissistic Family: Diagnosis and Treatment. I promised to review the author's model of recovery and recommendations for improvement.

The key to recovering from a narcissistic family and thereby improving one's adult self is acceptance. To move on, the adult survivor must accept the full reality of their childhood and the effects that their experiences had on their development, which includes who they are today. In doing so, they must acknowledge two things: First, that they were not responsible for the events of their childhood, and second that they must take full responsibility now. The point of acceptance, the authors note, is not to place blame on parents or caregivers, but for the individual to acknowledge reality, which encompasses taking accountability for positive change today.

Fives stages of recovery are outlined in the book. The stages are outlined in the context of a therapeutic relationship. As such, they are designed for facilitation by a therapist. Nevertheless, I believe the concept of each is helpful to the casual self-help reader.

Stage One: Revisiting
The first step toward recovery is revisiting the reality of childhood. In doing this, the individual is encouraged to accept that as a child, they never had control. They are also encouraged, as adults, to give up any fantasy they might harbor of somehow creating an ideal family of origin.

Stage Two: Mourning the Loss of the Fantasy
In this stage, the individual mourns the reality perceived from stage one—that they never had, and cannot create, an ideal family of origin. The authors comment that many individuals return home for family events like Christmas or weddings believing that "this time it will work out." The purpose of this stage is to remove pointless hope for the fantasy family, which frees emotional energy for the here and now.

Stage Three: Recognition
Here, the individual acknowledges the vestiges of being raised in a narcissistic family. They come to an understanding of particular personality traits or behavioral patterns (i.e. people pleasing) and must accept that, although the traits are dysfunctional now, they did help them to survive throughout childhood.

Stage Four: Evaluation
This stage flows from the traits recognized in stage three. The individual assesses their current selves, which includes the personality and behavioral traits they now exhibit and decides which to keep and which to change. Traits to be changed tend to include those that have proved dysfunctional for the adult.

Stage Five: Responsibility for Change
The final stage is the actual implementation of change. The individual takes responsibility for themselves and works to replace dysfunctional behaviors with more functional ones.

In the book, each step is explained thoroughly with helpful techniques and case examples designed to assist the individual along the way. What follows are more tips and case examples used to illustrate areas of dysfunction common to adults from narcissistic families. Below are a few examples.

Area of dysfunction: Problems with assertiveness, including identifying and communicating feelings to others:

As a result of their upbringing, these individuals may have difficulty identifying their feelings or even buried them altogether. Thus, they have difficulty discussing them and their wants and needs with others. The authors suggest a simple exercise commonly used to teach effective communication skills called, "I feel/I want." So, instead of slamming doors when your husband failed to make plans for your birthday, for example, state, "Joe, I felt hurt when you did not make dinner reservations for my birthday. I want you to do that now (next year)."

Area of dysfunction: Problems with setting boundaries:

Many individuals from narcissistic families are uncomfortable setting boundaries for fear of disappointing others. To overcome these tendencies and gain more personal control the individual must learn to live with some disapproval. The authors lay out eight rules for learning how to set boundaries with others. Here are a few:

• "Correction, appropriately expressed, is not destructive, hurtful, or shame-inducing."
• "One's needs cannot always be met by others, but they can always be appropriately articulated to others."
• "Feelings do not need justification—one always has a right to one's feelings."

If you like these tips for self-improvement, I suggest you check out The Narcissistic Family: Diagnosis and Treatment. You will find more detailed strategies for dealing with issues I briefly addressed above and also information on those I have not addressed here including, decision making, deferment of gratification, building trust, and improving intimacy, sex, and friendships.