Heal NPD

Épisodes

• The Birth of Sorrow | Part 3: Conflict and Defense In Neurotic-Level Narcissism 03.06.2026 43min

  This is the third part of a three-part exploration of narcissistic personality style at the neurotic level of personality organization. In this episode, Dr. Ettensohn examines the defensive architecture of neurotic-level narcissism, including the characteristic defenses that allow individuals to manage conflict, preserve relationships, and maintain self-esteem without resorting to the identity fragmentation or reality distortion seen at more severe levels of personality organization. Drawing on the Defense Mechanisms Rating Scale (DMRS), this episode explores obsessional defenses such as isolation of affect, intellectualization, and undoing, as well as neurotic defenses including repression, reaction formation, and displacement. Through clinical examples, personal reflections, and portrayals from film and literature, Dr. Ettensohn illustrates how these defenses shape emotional experience, interpersonal relationships, and the therapeutic process. The episode also examines how narcissistic concerns manifest at the neurotic level, including struggles with self-worth, dependency, vulnerability, perfectionism, and grief. Particular attention is given to transference, countertransference, and the unique opportunities and challenges that emerge in psychotherapy with neurotic-level narcissistic personalities. While neurotic-level functioning represents a profound developmental achievement, it also introduces new emotional realities. As the capacity for integration grows, so too does the capacity to experience loss, guilt, limitation, and sorrow. The movement toward greater psychological health is not the elimination of suffering, but the ability to bear it without abandoning oneself or others. Additional ResourcesWebsite: https://healnpd.orgNewsletter: https://healnpd.substack.com Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpumLISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpcaLISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 BECOME A MEMBER: https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join About Heal NPDHeal NPD is a clinical practice specializing in the assessment and treatment of pathological narcissism, narcissistic personality disorder, and related personality difficulties. We offer comprehensive diagnostic assessments, individual psychotherapy, and consultations for partners and family members. Learn more or inquire about services: https://healnpd.org
• Internal Absence: Emptiness in NPD 26.05.2026 15min

  Dr. Mark Ettensohn examines the experience of emptiness in narcissistic personality disorder and other forms of personality pathology. Rather than approaching personality disorders as collections of traits or behaviors, the episode frames them as disturbances in identity. Dr. Ettensohn outlines how the sense of self is constructed through early relational experience and how disruptions in that process can lead to unstable, fragmented, or underdeveloped self-experience. The discussion focuses on the role of dissociation and splitting in shaping identity, and how different self-states may become organized around incompatible relational experiences. In this context, emptiness is not simply a feeling, but reflects aspects of the self that were never fully recognized, mirrored, or integrated in development. Dr. Ettensohn also addresses a common misunderstanding in public discourse, where narcissism is equated with observable traits such as arrogance or entitlement. He explains why these descriptions capture only one part of a broader system involving both grandiose and vulnerable states, and how focusing solely on behavior obscures the underlying psychological structure. The episode concludes with a discussion of clinical implications, emphasizing why treatments that focus only on behavior often fall short, and why effective work with narcissistic pathology requires attention to identity, relational process, and the integration of dissociated aspects of self-experience. Additional ResourcesWebsite: https://healnpd.orgNewsletter: https://healnpd.substack.com Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpumLISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpcaLISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8   About Heal NPDHeal NPD is a clinical practice specializing in the assessment and treatment of pathological narcissism, narcissistic personality disorder, and related personality difficulties. We offer comprehensive diagnostic assessments, individual psychotherapy, and consultations for partners and family members. Learn more or inquire about services: https://healnpd.org
• Living with Pathological Narcissism: What Loved Ones Reveal 26.05.2026 58min

  This episode continues the Heal NPD Seminar Series with Dr. Mark Ettensohn, joined by his associates Deanna Young, Psy.D., and Danté Spencer, Ph.D. In this session, the group discusses the paper “Living with Pathological Narcissism: A Qualitative Study” (Day et al., 2020), which examines narcissistic personality pathology from the perspective of partners and family members. Unlike most research on narcissism, this study does not rely on self-report or clinician ratings. Instead, it draws on qualitative descriptions from over 400 individuals in close relationships with someone exhibiting high levels of pathological narcissistic traits. These accounts provide a window into how narcissism is experienced interpersonally, particularly in intimate and long-term relationships. The discussion focuses on the study’s central finding: that pathological narcissism is best understood as a system characterized by the co-occurrence of grandiosity and vulnerability. Loved ones described patterns of entitlement, arrogance, and need for admiration alongside insecurity, hypersensitivity, emotional instability, and chronic feelings of emptiness. In the majority of cases, these features were not separate “types,” but fluctuating states within the same individual. The group explores how these findings challenge common assumptions about narcissism, including the tendency to equate it with overt grandiosity or interpersonal abusiveness. Particular attention is given to the limitations of DSM-based models, which emphasize observable traits while underrepresenting the internal dysregulation and vulnerability that define the disorder. The conversation also examines broader relational and developmental themes, including: The oscillation between grandiose and vulnerable self-states The role of dissociation and splitting in personality organization The impact of early attachment trauma and “empathic failures” How narcissistic dynamics are expressed and amplified within close relationships The tendency for polarized, dehumanizing narratives to emerge in response to relational injury Finally, the group discusses the concept of “narcissistic abuse,” noting that while experiences of harm in these relationships are real and often significant, the term itself is not a well-defined clinical construct. The discussion emphasizes the importance of distinguishing between lived experience and explanatory frameworks, and of maintaining a nuanced, non-reductive understanding of personality pathology. Key themes include: Pathological narcissism as a dysregulated self-state system The interdependence of grandiosity and vulnerability Limitations of categorical and trait-based models of narcissism The relational expression of personality pathology The role of trauma, attachment, and development in narcissistic adaptation Clinical implications for assessment, formulation, and treatment This series is intended for clinicians, trainees, and viewers seeking a nuanced, clinically grounded understanding of narcissism beyond popular discourse. To learn more about our work, visit:www.HealNPD.org Additional Resources:Newsletter: https://healnpd.substack.comAssessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life:https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpumLISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpcaLISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 Citation:Day, N. J. S., Townsend, M. L., & Grenyer, B. F. S. (2020). Living with pathological narcissism: A qualitative study. Borderline Personality Disorder and Emotion Dysregulation, 7(19).  Full Text Link: https://pmc.ncbi.nlm.nih.gov/articles... About Heal NPDHeal NPD is a clinical practice specializing in the assessment and treatment of pathological narcissism, narcissistic personality disorder, and related personality difficulties. We offer comprehensive diagnostic assessments, individual psychotherapy
• The DSM's New Model of Personality Disorders: The Good, The Bad, and What's Missing 26.05.2026 58min

  This episode continues the Heal NPD Seminar Series with Dr. Mark Ettensohn, joined by his associates Deanna Young, Psy.D., and Danté Spencer, Ph.D. In this session, the group examines the Alternative DSM-5 Model for Personality Disorders (AMPD), a dimensional framework introduced in Section III of the DSM-5 and retained in DSM-5-TR. The model was developed in response to longstanding limitations of the traditional categorical system, including diagnostic overlap, heterogeneity within disorders, and the absence of a clear framework for assessing severity. The discussion focuses on the two core components of the model. The first, Level of Personality Functioning (Criterion A), assesses impairments in identity, self-direction, empathy, and intimacy. This portion of the model reflects a structural approach to personality and aligns with psychodynamic and developmental perspectives on personality organization. The second component, Criterion B, introduces a trait-based system organized around five domains: negative affectivity, detachment, antagonism, disinhibition, and psychoticism. These traits are derived from dimensional personality research and represent an effort to describe maladaptive personality features in a standardized way. The group explores the strengths of this combined model, as well as its limitations. Particular attention is given to the tension between structural and trait-based approaches, and to the question of whether personality pathology can be adequately captured through trait descriptions alone. Using narcissistic personality disorder as a focal example, the discussion examines how the model emphasizes grandiosity and attention-seeking traits while underrepresenting vulnerability, shame, and fluctuations in self-state. The conversation highlights the importance of understanding pathological narcissism as a system of self-esteem regulation rather than a fixed set of traits. Key themes include: The shift from categorical to dimensional models of personality disorder The distinction between personality functioning (structure) and personality traits (style) Limitations of trait-based approaches in capturing dynamic, state-based phenomena The role of self-esteem regulation, vulnerability, and oscillation in narcissistic pathology Clinical implications for diagnosis, formulation, and treatment Throughout, the discussion situates the AMPD as a meaningful step forward in personality disorder classification, while also identifying areas where the model remains conceptually limited. The session emphasizes the value of structural and developmentally informed approaches in understanding personality pathology. This series is intended for clinicians, trainees, and viewers seeking a nuanced, non-moralizing understanding of narcissism and personality disorders. To learn more about our work, visit:www.HealNPD.org Additional Resources:Newsletter: https://healnpd.substack.comAssessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life:https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpumLISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpcaLISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 Citation: American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Link to alternative model:   https://psychiatryonline.org/doi/10.1... About Heal NPDHeal NPD is a clinical practice specializing in the assessment and treatment of pathological narcissism, narcissistic personality disorder, and related personality difficulties. We offer comprehensive diagnostic assessments, individual psychotherapy, and consultations for partners and family members. Learn more or inquire about services: https://healnpd.org
• Narcissism Is Not a Moral Category 26.05.2026 13min

  Dr. Mark Ettensohn examines a growing tendency in public discourse to treat narcissism as a moral category rather than as a psychological construct.   The episode explores why this shift occurs and how misunderstandings about the nature of mental illness contribute to it. While many people intuitively apply a medical model to psychological conditions, most forms of mental illness do not operate in simple cause-and-effect ways.   Instead, psychological disorders are identified through patterns of thoughts, emotions, perceptions, and behaviors that emerge statistically across populations.   Dr. Ettensohn discusses how online discussions about narcissism often move from specific interpersonal conflicts to sweeping claims about an entire category of people. In this process, personality traits, clinical constructs, anecdotal experiences, and moral judgments frequently become conflated.   Drawing on both psychological science and his clinical experience conducting diagnostic assessments for narcissistic personality disorder, Dr. Ettensohn explains why diagnosing personality pathology requires careful evaluation and why many individuals labeled “narcissists” in everyday discourse may not have any significant narcissistic pathology at all.   The episode concludes by distinguishing several different ways narcissism is commonly understood, and why treating it as a moral category ultimately obscures more than it reveals.   Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH   LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8   About Heal NPD: Heal NPD is a clinical practice specializing in the assessment and treatment of pathological narcissism, narcissistic personality disorder, and related personality difficulties. We offer comprehensive diagnostic assessments, individual psychotherapy, and consultations for partners and family members.   Learn more or inquire about services: https://healnpd.org
• Accountability Without Dehumanization 26.05.2026 15min

  Dr. Mark Ettensohn addresses a question that frequently arises in discussions of narcissism and abuse: Is it possible to maintain accountability without dehumanizing? Can someone preserve firm boundaries without abandoning empathy? Dr. Ettensohn clarifies a distinction he often sees misunderstood. When he speaks about compassion toward pathological narcissism or narcissistic personality disorder, he is referring to a cultural and societal stance, not advising individuals to remain in unsafe or harmful relationships. He emphasizes that safety must always come first. If someone is being harmed, the primary question is not whether the other person “knew what they were doing,” but whether the situation is safe and what steps are necessary to ensure protection. The episode explores the gray area between total innocence and calculated malice. Dr. Ettensohn discusses how dissociation and shifting self states can impair consistent self-awareness in personality disorders, while also making clear that impaired awareness is not the same as blamelessness. He examines how behavior driven by triggered trauma states may later be rationalized from a different organizing center of experience, and why this dynamic is often misinterpreted as deliberate manipulation. Finally, the discussion turns to boundaries. Dr. Ettensohn distinguishes kindness from niceness and empathy from permissiveness, arguing that the most empathic stance can sometimes be a firm refusal of access. The episode concludes by asserting that accountability does not require demonization, and that it is possible to reject harmful behavior without reducing a person to a monster. Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8   About Heal NPD: Heal NPD is a clinical practice specializing in the assessment and treatment of pathological narcissism, narcissistic personality disorder, and related personality difficulties. We offer comprehensive diagnostic assessments, individual psychotherapy, and consultations for partners and family members. Learn more or inquire about services: https://healnpd.org
• 2025 Study: Narcissism Does Not Predict Abuse 26.05.2026 53min

  This episode continues the Heal NPD Seminar Series with Dr. Mark Ettensohn, joined by his associates Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group examines a recent empirical study titled Coercive Control and Intimate Partner Violence: Relationship with Personality Disorder Severity and Pathological Narcissism (2025). The discussion responds directly to common claims in online discourse that narcissism inherently causes abuse, and asks a more precise question: What does the data actually show about the relationship between narcissism, personality dysfunction, abuse, and coercive control? The study reviewed draws on informant reports from long-term partners and family members of individuals perceived as highly narcissistic. Importantly, narcissism was rated by loved ones rather than self-reported, addressing a frequent critique of prior research. The findings showed no significant association between overall pathological narcissism and abuse, and only weak associations with coercive control. In contrast, overall personality disorder severity showed stronger and more consistent relationships with both abuse and coercive control, but these associations were still mostly weak. The group explores what this means clinically, emphasizing the distinction between personality style (such as narcissistic features) and personality organization or severity. The discussion clarifies why certain narcissistic subcomponents, such as exploitative behavior, entitlement-related rage, and grandiose fantasy, show limited associations with specific forms of harm, while many other narcissistic features do not. Key themes include: The difference between episodic abuse and chronic coercive control Why collapsing abuse into a single personality label is misleading The role of personality severity and impaired functioning across diagnoses The limits of trait-based and moralized explanations of harm Clinical implications for assessment, treatment, and stigma reduction Throughout, the conversation situates abuse as a highly overdetermined phenomenon influenced by many overlapping factors, rather than the inevitable outcome of narcissism or any single diagnosis. The session concludes by emphasizing the importance of dimensional, developmentally informed models of personality over reductive and stigmatizing narratives. This series is intended for clinicians, trainees, and viewers seeking a nuanced, non-moralizing understanding of narcissism, personality disorder severity, and relational harm. To learn more about our work, visit: www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH   LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 Article Cited and Discussed: Day, N. J. S., Kealy, D., Biberdzic, M., Green, A., Denmeade, G., & Grenyer, B. F. S. (2025). Coercive control and intimate partner violence: Relationship with personality disorder severity and pathological narcissism. Personality and Mental Health, 19, e70038. Full text link: https://onlinelibrary.wiley.com/doi/p...
• The Ethics of Narc-Abuse Content: Why 'It Helps' Isn't Enough 09.01.2026 13min

  In this episode, Dr. Mark Ettensohn examines a common defense of online “narcissistic abuse” content: the claim that, even if imperfect or inaccurate, it ultimately helps people leave harmful relationships. Rather than focusing on whether such content feels validating or empowering, Dr. Ettensohn explores the ethical and psychological implications of justifying misinformation, stigma, and moralized diagnostic narratives on the basis of perceived outcomes. He argues that this form of reasoning relies on a utilitarian logic that is fundamentally incompatible with responsible mental health communication. The discussion addresses why narc abuse frameworks often feel compelling to people in distress, how diagnostic language becomes moralized and expanded beyond its clinical meaning, and how this process reshapes viewers’ understanding of themselves, others, and psychology itself. Dr. Ettensohn distinguishes between recognizing real harm and adopting explanatory models that flatten psychological complexity, foreclose on nuance, and encourage rigid, adversarial interpretations of relational experience. The episode also clarifies common misunderstandings about pathological narcissism, emphasizing that narcissism is not synonymous with abusive behavior and that even when narcissistic pathology is present, it does not explain behavior in a deterministic or morally absolute way. Drawing on clinical ethics, developmental theory, and real-world examples, Dr. Ettensohn outlines why anger and moral clarity can be mobilizing without requiring diagnostic distortion or dehumanization. This video concludes with a reflection on boundaries in public mental health discourse and the importance of maintaining accuracy, restraint, and humanization when discussing stigmatized conditions. Referenced video:    • From Validation to Isolation: The Narc-Abu...   Additional Resources Website: https://healnpd.orgNewsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH   LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8
• From Validation to Isolation: The Narc-Abuse Pipeline 19.12.2025 31min

  In this video, Dr. Ettensohn examines the online narc-abuse ecosystem and explores how content that initially feels validating and supportive can, over time, become thought-constraining and socially isolating for some viewers. Drawing on clinical experience and established research on high-demand systems, Dr. Ettensohn analyzes the rhetorical patterns commonly used across narc-abuse channels: the elevation of the viewer as a lone truth-seer, the narrowing of acceptable interpretations, the use of loaded psychological language, and the gradual erosion of trust in ordinary relationships. He shows how these dynamics can reshape identity, undermine critical thinking, and foster increasing dependence on content creators rather than encouraging reflection, complexity, or professional consultation. Throughout the video, Dr. Ettensohn carefully distinguishes between genuine abuse and the expanding, imprecise use of narc-abuse language online. He emphasizes that acknowledging harm and seeking clarity are legitimate and necessary, while also warning that one-size-fits-all narratives can distort meaning, escalate conflict, and contribute to unnecessary social rupture. The focus is not on dismissing people’s pain, but on examining how certain explanatory frameworks operate psychologically and what they may unintentionally cost the people who adopt them. This video continues Dr. Ettensohn’s clinically grounded effort to bring nuance, rigor, and psychological depth to public conversations about narcissism, offering a perspective that prioritizes complexity, reality testing, and relational context over certainty, moralization, or ideological alignment. Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 
• Understanding Empathy in Narcissistic Personality Disorder 19.12.2025 1h 1min

  This video continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn with his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Empathy and Narcissistic Personality Disorder: From Clinical and Empirical Perspectives (2014), examining the long-standing assumption that narcissistic personality disorder is defined by a lack of empathy. Drawing on the article’s review of empirical findings and clinical case material, the conversation explores empathy as a multidimensional and context-dependent capacity rather than a fixed trait. Key themes include the distinction between emotional and cognitive empathy, the variability of empathic functioning across grandiose and vulnerable narcissistic states, and the ways shame, threat, and affective overload can disrupt empathic engagement in intimate relationships. The discussion highlights how empathy may appear intact or even robust in some contexts, while collapsing in situations that feel most emotionally consequential. This video continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn with his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Empathy and Narcissistic Personality Disorder: From Clinical and Empirical Perspectives (2014), examining the long-standing assumption that narcissistic personality disorder is defined by a lack of empathy. Drawing on the article’s review of empirical findings and clinical case material, the conversation explores empathy as a multidimensional and context-dependent capacity rather than a fixed trait. Key themes include the distinction between emotional and cognitive empathy, the variability of empathic functioning across grandiose and vulnerable narcissistic states, and the ways shame, threat, and affective overload can disrupt empathic engagement in intimate relationships. The discussion highlights how empathy may appear intact or even robust in some contexts, while collapsing in situations that feel most emotionally consequential. The seminar also addresses common misunderstandings of neuroimaging findings related to empathy, emphasizing the limits of biological reductionism and the importance of viewing brain-based data as correlates of experience rather than determinants of destiny. Throughout, the group reflects on clinical implications for treatment, including the differentiation between motivation-based and deficit-based empathic disengagement, the role of affect tolerance and reflective capacity, and the relational conditions that support the gradual restoration of empathic availability. This series is intended for clinicians, trainees, and others interested in a nuanced, non-moralizing understanding of narcissistic personality disorder, empathy, and psychological development. To learn more about our work, visit www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 Citation for the article discussed: Baskin-Sommers A, Krusemark E, Ronningstam E. Empathy in narcissistic personality disorder: from clinical and empirical perspectives. Personal Disord. 2014 Jul;5(3):323-33. doi: 10.1037/per0000061. Epub 2014 Feb 10. PMID: 24512457; PMCID: PMC4415495. Full text link: https://pmc.ncbi.nlm.nih.gov/articles/PMC4415495/
• Narcissism and Suicide Risk: The Hidden Side of NPD 20.11.2025 1h 6min

  This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. I n this session, the group discusses a recent meta-analytic review examining suicide-related outcomes in narcissistic personality functioning. The conversation explores why studies using DSM-based diagnoses of Narcissistic Personality Disorder consistently fail to predict suicidal ideation, attempts, or self-injury, while dimensional measures that include vulnerable narcissism show strong and reliable associations with elevated risk. Themes include the distinction between grandiose and vulnerable self-states, the limitations of trait-based and purely behavioral diagnostic models, and the deeper affective and regulatory structures that define pathological narcissism. The team examines how shame, identity instability, emotional dysregulation, and collapse of self-esteem stability contribute to suicidality—and how grandiose presentations can mask underlying fragility in ways that obscure clinical risk. Throughout the seminar, the group reflects on the developmental and relational origins of vulnerable narcissism, emphasizing the role of early emotionally invalidating early environments, contingent self-esteem, and dissociated self-states in shaping defensive functioning. The discussion also highlights clinical challenges in assessing suicide risk in narcissistic patients, including the role of masking, externalization, and shame-driven withdrawal. This seminar is designed for clinicians, students, and anyone seeking a nuanced, clinically grounded understanding of narcissistic personality functioning, suicide risk, and the hidden dimensions of vulnerability that are often overlooked in public discourse. To learn more about our work, visit www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH   SUBSCRIBE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8    Citation for the article discussed: Sprio, V., Mirra, L., Madeddu, F., Lopez-Castroman, J., Blasco-Fontecilla, H., Di Pierro, R., & Calati, R. (2024). Can clinical and subclinical forms of narcissism be considered risk factors for suicide-related outcomes? A systematic review. Journal of Psychiatric Research, 172, 307–333. https://doi.org/10.1016/j.jpsychires.2024.02.017 Full text link: https://www.sciencedirect.com/science/article/pii/S0022395624000803
• What About Narcissists Who Had a Happy Childhood? 07.11.2025 14min

  In this episode, Dr. Mark Ettensohn responds to a common question: How can someone with a perfectly normal and mostly happy childhood develop narcissistic personality disorder? The discussion challenges the widespread misconception that narcissism is simply a personality type, a collection of traits, or the result of genetics alone. Dr. Ettensohn explains that pathological narcissism is a disorder of self-esteem regulation and identity formation, not just a pattern of behavior. Drawing on clinical research and developmental theory, he explores how early experiences that appear loving and stable can still leave important parts of the self unseen, unrecognized, or conditionally valued. These subtle, chronic relational injuries, repeated over years rather than occurring as a single traumatic event, can distort the developing self’s capacity to maintain a stable and realistic sense of worth. The episode distinguishes between “popular narcissism,” which focuses on abusive behavior, and clinical narcissism, which reflects an internal system of dysregulated self-esteem. Through metaphor and clinical reflection, Dr. Ettensohn illustrates how a child can grow up in an environment that looks healthy on the surface yet still learn to equate love with performance, value with achievement, and safety with control. Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 BECOME A MEMBER: https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join Article Citations: Vater, A., Ritter, K., Schröder-Abé, M., Schütz, A., Lammers, C.-H., & Roepke, S. (2013). When grandiosity and vulnerability collide: Implicit and explicit self-esteem in narcissistic personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 44(1), 37–47. https://doi.org/10.1016/j.jbtep.2012.07.004 Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400.
• Seminar Series 3: Beyond Traits - The Relational roots of NPD 06.11.2025 53min

  This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Narcissistic Personality Disorder: Progress in Understanding and Treatment by Igor Weinberg, Ph.D., and Elsa Ronningstam, Ph.D. The conversation examines recent advances in how clinicians conceptualize and treat narcissistic personality disorder, moving beyond fixed trait models toward a dynamic, relational understanding of the self and its development. Themes include the interplay between grandiose and vulnerable self-states, the interdependence of self-esteem regulation, affect, cognition, empathy, and interpersonal functioning, and the recognition that narcissistic pathology evolves through cumulative disruptions in early attunement and relational safety. The discussion also explores how developmental misattunements - whether through neglect, overindulgence, or inconsistency - shape defensive adaptations and contribute to the oscillation between self-inflation and shame. Throughout the seminar, the team reflects on the therapeutic process of working with narcissistic patients, emphasizing empathy, reflective capacity, and the slow, relational work of rupture and repair that makes genuine transformation possible. This series is designed for clinicians, students, and anyone interested in a nuanced, compassionate understanding of narcissism, personality, and psychological change. To learn more about our work, visit www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 BECOME A MEMBER: https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join Citation for the article discussed: Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400. Full text of the article: https://pmc.ncbi.nlm.nih.gov/articles/PMC10187400/
• Seminar Series 2: Rupture and Repair - Principles of Treatment for NPD 21.10.2025 59min

  This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Principles of Psychodynamic Treatment for Patients with Narcissistic Personality Disorder by Holly Crisp, M.D., and Glen Gabbard, M.D. The conversation explores how psychodynamic clinicians conceptualize and treat narcissistic personality disorder, emphasizing the disorder’s pleomorphic nature - its capacity to take many forms depending on context, stress, and level of personality organization. Themes include the oscillation between grandiose and vulnerable self-states, the role of shame as a central organizing affect, and the therapist’s challenge of moving flexibly along a supportive–interpretive continuum. The group also examines common transference and countertransference dynamics, the integration of Kohut’s and Kernberg’s models, and the transformative role of rupture and repair in the therapeutic process. Through candid discussion, clinical reflection, and moments of humor, the seminar illustrates how empathic attunement, flexibility, and authentic connection form the heart of effective treatment for pathological narcissism. This series is designed for clinicians, students, and anyone interested in a deeper and more nuanced understanding of narcissism, personality, and the process of psychological healing. To learn more about our work, visit www.HealNPD.org. Citation for the article discussed: Crisp H, Gabbard GO. Principles of psychodynamic treatment for patients with narcissistic personality disorder. Journal of Personality Disorders. 2020 Mar;34(Suppl):143-158. doi: 10.1521/pedi.2020.34.supp.143. PMID: 32186987.
• It's Time We Discarded The Myth of "The Narcissist" 17.10.2025 17min

  In this episode, Dr. Mark Ettensohn challenges one of the most persistent distortions in contemporary discourse on narcissism: the myth of “the narcissist.” He explains how this cultural archetype, an image of coldness, cruelty, and manipulation, has eclipsed legitimate clinical understanding of Narcissistic Personality Disorder. Drawing on both the peer-reviewed literature and his clinical experience, Dr. Ettensohn describes how terms like narcissistic abuse, covert narcissism, and narcissistic supply have come to dominate popular psychology despite lacking grounding in peer-reviewed research. The episode explores how this narrative misleads clinicians, alienates patients, and perpetuates stigma, while offering a more accurate view of pathological narcissism as a defensive structure rooted in shame, vulnerability, and loss. Dr. Ettensohn argues that it is time to discard the myth of “the narcissist” and replace it with a more compassionate, evidence-based understanding of NPD...one that recognizes both the pain it causes and the suffering it defends against. Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact   Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH   Related Links: In-depth exploration of the DSM NPD construct: https://youtu.be/I2fD65wy48I   SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8
• Seminar Series 1: Defining Pathological Narcissism - The Criterion Problem 09.10.2025 53min

  This episode marks the beginning of a new educational series from Heal NPD, featuring Dr. Mark Ettensohn and his associates: Deanna Young, Psy.D. and Danté Spencer, MA. This series offers a rare window into clinical reasoning and supervision, bringing viewers inside real discussions about theory, diagnosis, and treatment of personality pathology. In this first seminar, the group examines an influential paper by Pincus & Lukowitsky (2010) and explores one of the central challenges in the field: how to define pathological narcissism. The conversation addresses the criterion problem surrounding narcissism. That is, the lack of a unified construct definition. It traces how this has led to conflicting models and measures of narcissism. Topics include the distinction between pathological narcissism and NPD, the interplay of grandiosity and vulnerability, the overlap with depression and trauma, and emerging dimensional approaches to understanding personality. This series is designed for clinicians, students, and anyone interested in a deeper and more integrative understanding of narcissism, personality, and self-regulation. To learn more about our work, visit www.HealNPD.org Citation for the article discussed: Pincus, A. L., & Lukowitsky, M. R. (2010). Pathological narcissism and narcissistic personality disorder. Annual Review of Clinical Psychology, 6, 421–446. https://doi.org/10.1146/annurev.clinpsy.121208.131215
• From Ideal to Real: Lessons From My Father 28.08.2025 7min

  Dr. Ettensohn reflects on the recent loss of his father. Drawing on both clinical theory and personal experience, he explores how children internalize idealized images of caregivers as a source of safety and reassurance during times of vulnerability. This episode examines how these idealizations can provide stability but also carry developmental costs if they are never gradually tempered by ordinary disappointments and the recognition of parental imperfection. Dr. Ettensohn situates this dynamic within the broader context of self-psychology, showing how therapy can become a place where idealized projections are worked through and reclaimed in more realistic form. With psychological nuance and openness, he shares how this process unfolded in his own relationship with his father, moving from idealization toward a fuller recognition of imperfection, accountability, and authentic connection. The goal, as he frames it, is not to reject or diminish the idealized parent, but to integrate those images into a more grounded sense of self and relationship. Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org
• Dissociation is Key: Linking Splitting, DID, BPD, and NPD 28.08.2025 9min

  Dr. Ettensohn expands on his recent episode exploring splitting as a dissociative process. Drawing from clinical experience and developmental theory, he addresses a common question: What’s the difference between splitting, identity diffusion, and Dissociative Identity Disorder (DID)? Rather than viewing these as separate diagnostic constructs, Dr. Ettensohn presents them as points along a continuum of dissociation. They represent defensive adaptations to overwhelming early experience. He explains why the traditional boundaries between “personality disorders” and “dissociative disorders” may be more fluid than we think. This episode continues Dr. Ettensohn’s unique, trauma-informed reframing of narcissistic personality dynamics, offering psychological depth without jargon and compassion without minimization. Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org
• What If Splitting Is Dissociation? A New Way to Understand Narcissism 28.08.2025 13min

  In this episode, Dr. Ettensohn offers a groundbreaking perspective on one of the most misunderstood features of pathological narcissism: splitting. Drawing from the work of Philip Bromberg and his own clinical practice, Dr. Ettensohn reframes splitting not as black-and-white thinking, but as a dissociative process rooted in early relational trauma. Rather than treating splitting as a rigid symptom, this episode explores how dissociated self-states form when conflicting emotional truths, such as shame, longing, idealization, and rage, cannot safely coexist. What looks like instability or contradiction is actually a protective adaptation. Dr. Ettensohn shows how these self-states develop as compartmentalized responses to unmanageable experience, and how they survive into adulthood, shaping identity, memory, and relationships. Through clear explanation and compassionate framing, he illustrates how healing involves standing in the spaces between self-states, without collapsing into any one of them. Whether you live with these experiences yourself or work with people who do, this video offers a radically humanizing and clinically grounded way to understand dissociation, narcissism, and the divided self.   References: Bromberg, P. M. (1996). Standing in the spaces: The multiplicity of self and the psychoanalytic relationship. Contemporary Psychoanalysis, 32(4), 509–535.   Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8   VISIT THE WEBSITE: https://www.healnpd.org
• Signs You're Trapped in a False Self 28.08.2025 8min

  In this Weekly Insight, Dr. Ettensohn explores subtle signs of false self experiencing. Drawing from clinical work and developmental theory, he reflects on how early relational demands can lead individuals to organize their identity around performance, compliance, or emotional suppression. The episode examines how precocious self-monitoring, idealized emotional states, and internalized expectations often become automatic, forming a false self that feels necessary for connection but ultimately leaves authentic self experience obscured. Dr. Ettensohn situates the false self as a broad survival strategy shaped by narcissogenic environments. With compassion and psychological nuance, he offers signs that may indicate someone is operating from a false self, and encourages viewers to reflect gently on moments of disconnection, exhaustion, or rigid self-presentation. The goal, as he frames it, is not to attack or dismantle these protective structures, but to begin noticing them and allowing more space for what is real. LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org