Okay, so this morning's therapy session was big.  


I was struggling with this idea of "moral anxiety" recently, where I was scrutinizing every decision I have ever made, and racking my brain on ethical dilemmas in the present, no matter how small. I had been struggling with relationships, often times pursuing people who I actually did not find very attractive, and trying to prop up miserable relationships for far longer than I needed too. I would be beating myself up over how I haven't always been in close contact with my family, how my relationship with my sister is not as close as I thought it was, how I have told constant lies to try and appear more honorable and stable than I actually am.   


Then I decided to open way up. I have difficulty dealing with judgement, and will try to hide real problems even from my therapist as I am afraid he would think less of me. But today I just said "Honestly I think deep down I believe I am, or should be, better than other people". This is a pretty arrogant statement, right? I recently watched an interview with Ijeoma Oluo on her book "Mediocre: The Dangerous Legacy of White Male America", where she says she got the title from a tweet that read "Lord give me the confidence of a mediocre white man". As a white man who is very confident, I made sure to look towards my actual accomplishments, what impacts I've actually made. I know this, I am pretty average, though I tell myself I won't be for long because, well, I'm better than everybody else. My future is brighter, or it ought to be, and if not, it's a huge failure. She also talked about academic jargon, and how that has been used to prop up dumb ideas as genius. I have been told I speak very formally (I joke that I learned English by watching Frasier), and when I was in improv, I was the guy who loved to use big words and reference the Hapsburg dynasty.   


So this suddenly brings in a form of narcissism that I wasn't too familiar with identifying before. Narcissism is Kim Jung Un saying he is a god right? Narcissism is that member of your family who could never do any wrong, and when they did they blamed others, right?  


My therapist had me take a peak at Heinz Hokut and his "Self Psychology" as a way to approach my issue with identity. My observation is that this is a more covert narcissism, one that is more depressive than angry. This narcissism is an inward judgement, a harsh superego that tells you that you are worse than everybody else. One that says you should be better than everyone else, yet you see every mistake you have done and you can't move past it. So you try and compensate by being as empathetic as you can be, by looking to do good deeds, trying to be a perfectionist in anyway so as to get feedback from others that you are in fact the best there is, yet this emptiness cannot be filled as you find yourself only talking about yourself and putting other people off from wanting to give you such praise.   


This is another interesting piece of this kind of narcissism- it can actually lead to greater empathy. Psychologist Don Carveth talks about how a sadist tends to be more empathetic, because when they inflict pain, they get their kicks from knowing what that pain feels like. It's not that they don't understand, but rather they don't care. So they can empathize, but they don't sympathize. In a similar way, a narcissist may be very empathetic as they are looking for signs of praise constantly. The problem is, what they are looking for is a mirror to see themselves in that is kind, and not doing good acts because they care about others.

In therapy for self psychology, this is seen as the patient not making any judgements on the therapist, no poking or prodding or attacking, but rather them just talking about themselves, and their own angst. Traditional psychologists in a Freudian structure might get frustrated by this as they don't seem to be giving any outward discussion to work with, no discussion on relationships to others in an outward sense. A self psychologist instead only offers praise, listens and empathizes. They understand the patient is not trying to ask for answers, but rather is needing the therapist to act as a mirror for them, to give them the attention that they desperately missed from their parents.   


You can probably tell from up above that this psychoanalytic view of narcissism allows it to be divorced from a moral judgement. It is often in a Judeo-Christian based culture that selfishness should be punished, and selflessness is the virtue. A narcissist may be a model citizen, doing tons of good and being a very kind human, but doing so in attempt to assure themselves that they are not only good, but better than the average bear. When they get feedback that they are honest moral people, they get a huge rush of elation that can be euphoric. When that feedback runs out because the highs became too high, it can come crashing down into self loathing over the smallest pinprick to the ego. People with Narcissistic personality disorder can even find themselves suicidal due to this, as they can only think of how awful they must be, and believe everyone is looking at them.  


This heightened ego, this mood elation, then the mood drop sounds so familiar to someone with bipolar, right? I'm still having trouble parsing the two apart, at least after learning about this 'other' form of narcissism, and it seems the two can have similar treatments.   


Here are some resources:  
[Narcissism, a psychodynamic perspective (7:49)](https://www.youtube.com/watch?v=shiskiiJf5Y)

[Bipolar vs Narcissism (has info contrary to what I understand from 'Self Psychology')](https://www.verywellhealth.com/bipolar-disorder-vs-narcissistic-personality-disorder-5210087)

[Heinz Kohut lecture from Don Carveth (1:05:36)](https://www.youtube.com/watch?v=Sgoruh5dz3k)

[Heinz Kohut Wiki](https://en.wikipedia.org/wiki/Heinz_Kohut)  


I felt very seen by all this, and as someone who craves approval, it's difficult to talk to people about being a narcissist since it is seen as being an awful person. Anyone else have thoughts to this?