Obsessive-compulsive disorder (OCD) is a mental health condition characterised by, as its name suggests, obsessions and compulsions. It should, however, be noted that official psychiatric diagnosis differentiates if from obsessive-compulsive personality disorder (OCPD), which regardless of its name is not characterised by actual obsessions and compulsions. OCD is anxiety based condition, which can be successfully attended to in psychotherapy or counselling. When faced with OCD in a therapy room, the condition itself is not hard to diagnose and differentiate from other conditions, however, people presenting with OCD will sometimes tend to hide their symptoms from the therapist due to the sense of shame.
A corporate executive that spent half of her life chasing her career, getting one promotion after the other and moving up the corporate ladder, only to find out—usually in her thirties—that she in fact never achieved what she wanted, whilst her life is slipping by. She wakes up anxious, not knowing what she is doing, where she is going and slightly doubting that she knows what she wants to achieve. She cannot take pleasure in fruits of her hard work although she can afford to. She sees younger generation as competition and starts wondering how long she can keep this up. And what then? When? She can no longer relate to the little girl that sat on her daddy’s shoulders, pulling his hair as they walked through the zoo.
In therapy room this topic is likely to come up at some point. And it will usually come up in many forms. From questions like “Will therapy make me happy?” to statements from the client that therapy is making them feel more sad or depressed or even claiming therapy is making things worse for them in general. Any therapist working with wide variety and number of clients will get used to these questions and allegations. But, even though, this might not be something new to the therapist, it is very much new to the client.
Narcissism and narcissistic personality disorder seem to be quite latent personality presentations—they are not commonly presented in therapy as the core presenting problem that a client will present when they come in for treatment. Often times, hence, narcissistic personality disorder is undiagnosed, which goes even more so for narcissism in general.
Narcissism by nature of the personality structure manifestation makes it hard for a narcissist to engage in authentic and intimate relationships. People who engage in a relationship with a narcissist will often be subject to the lack of connection, empathy and intimacy. They may find themselves under fire of allegations that they are too controlling and smothering. Even though these accusations will be part of narcissist’s distorted reality, there will often also be some pathology related to why someone gets involved with a narcissist in the first place. Usually such pathology will be unconscious.
Development of narcissism tends to start early in life and is often mistaken for confidence. In addition, today’s society often incubates narcissism and narcissists as a virtue, rather than pathology. But that doesn’t mean that the pain a narcissist will go through will be any less once they break. And there is also the pain of their partners in the relationships they form—even though they are not capable of sustaining a true intimate and healthy relationship. So, what causes someone to be a narcissist?
Is narcissist a modern day standard and is narcissism on the rise in cosmopolitan world today? At least the latter is often a question and the answer is also simple. But I guess the straightforward answer would not really be enough. The next question is why is that so, why is it happening and why?
A therapist will often be faced with a question of what the difference between sadness and depression is and what low mood is then. This will either come up in therapy room as client is making progress beating depression or dealing with any other issue and trying to evaluate progress, or it will come up as a question before a client even comes in for the first session of psychotherapy or counselling.