Shirah Vollmer MD

The Musings of Dr. Vollmer

Narcissistic Obstacle

Posted by Dr. Vollmer on December 12, 2011

   Jamie, sixty-one, wants special treatment. I suppose one could say, we all went special treatment. It makes us feel good, and it reminds us of our childhood, when we were the center of attention. Giving up that demand for special treatment is a maturing process. It may also be genetically mediated in that I imagine that certain people are born to be more thoughtful of others. Jamie’s desire for special treatment is manifested in my cancellation policy, forty-eight hours notice. He believes that for him, it should be twenty-four hours notice because he has trouble planning his life, such that he is more vulnerable to calendar issues than other people. As such, I should be, according to him, “more understanding” and change my policy just for him. After all, individual psychotherapy, is individual, and I am able to cater to special needs. On the other hand, the desire to have special treatment, may come from a deep-seated personality issue in which Jamie fears he is ordinary, and as such, he needs special treatment in order to feel some self-esteem. If this is the case, which seems likely to me, then I need to help Jamie understand his need for special treatment. Granted, I could do both. I could change my cancellation policy just for him and help him to see the underlying dynamics behind this request. However, by not granting him special treatment, I then see how he responds to limits and what these limits mean to him. It is a tough call. For now, I am going to keep my policy. It is going to be a bumpy road.

2 Responses to “Narcissistic Obstacle”

  1. Shelly said

    I support your decision, although sometimes it isn’t always possible to plan on the unexpected 48 hours in advance. But if this is a repetitive behavior, then certainly I understand your policy. Don’t we all have a need to feel special at some point? Does this mean that we all have narcissistic tendencies?

    • Shirah said

      In this fictional tale, Jamie wanted me to change my policy for him, not just make an exception for a one-time cancellation. Yes, we all have narcissistic needs. The issue is how we negotiate our narcissisitic needs with the needs and demands of others. This negotiation process is at the heart of all relationships. Jamie, in this example, wanted his narcissistic needs to over ride the frame of my practice. In other words, he felt that he deserved special compensation and the fact that I am sticking to my frame hurts his feelings. His inability to work with my rules, I think, speaks to his fragile sense of himself.

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