Therapists Normal Narcissism: Part III

Assuming that most therapists have had their primitive, childlike narcissistic needs met while growing up, they still have certain mature mirroring and idealizing needs that at least some of their clients should gratify if they are to find their work interesting and rewarding.  These needs are, of course, different for different therapists.  But here are some of the ones I think are pretty universal.

  1. The need for their clients to grow emotionally and to realize that  they, as their therapist, are instrumental in that  growth.   For example, I received an email awhile ago from an ex-client who, although not in treatment for more than a few months, expressed gratitude for what she got from working with me.  She became a health professional herself and spoke of the years she has spent feeling competent in taking care of her own patients, husband and children.  I felt a sense of pride and well-being when reading  this email .  It fulfilled some of my mirroring needs.

  2. The need to feel appreciated by their clients.   This is similar to the above.  I can imagine a situation, however, where the therapist sees a client growing but the client doesn’t say to the therapist that he or she is growing as a result of  the therapist’s efforts as well as his or her own efforts.    The client letting the therapist know directly that he or she sees the therapist as partly contributing to the client’s growth would be an added dimension to the therapist’s feelings of value.  

  3. The need for their clients to like them.   Again, this is similar to my first two points, but is a bit different in that clients can feel appreciative of the therapist, but not show, that they are fond of the therapist.    I have had clients who were in therapy with other therapists and said that they liked them as people, but that they didn’t help them grow.  So this can be a separate need.  I don’t think I have had a client who attributed  growth to a previous therapist that he or she actively disliked!

  4. The need for their clients to be interesting, even exciting.  I must admit that I feel energized, even look forward to, clients who lead interesting lives and are emotionally expressive in the way they function in session.  I of course don’t require them to be that way, but like it when they are.

  5. The need for their clients to arrive for their sessions on time and to keep regular appointments.   I get a feeling of security and grounding from this type of client.   The client who is continually very late. cancels frequently or changes her or his appointment time around a lot, can lead to slight feelings of insecurity in me.  I am also deprived of doing my most effective work with them.  The positive feelings  I get with a stable client can be subsumed under the idealizing need category.

  6. The need for clients to be up-to-date in their payments of their fee.  Again, this provides me a feeling of safety and support, an idealizing need.   After all, one reason I am a psychologist is because it is a relatively well-paid profession that provides many rewards, among them, financial.

  7. The need to feel helpful and caring toward clients.   This is probably the most important maturely narcissistic need for a therapist:   the opportunity to interact in an emotionally intimate way with people from all walks of life,  and to be able to care deeply for them.  Without this caring for their clients, even loving them, the psychotherapy enterprise can be, at times,  boring and frustrating and, with some disturbed, chaotic clients, very draining.

  8. Although I enjoy working with the people who have a growth mindset and lead exciting, successful lives, I have had many clients through the years who were not capable, either because of age, degree of intelligence, ill health or having limited resources, of significant change.  The therapy was supportive rather than growth-oriented, but I cared very much for them and even felt honored that they allowed me to  participate in a limited way in their  difficult lives.

The need to recognize  oneself as part of the community of psychotherapists.  This is another, perhaps most important, idealizing need:  feeling part of something outside the self that is bigger, stronger and ultimately more important than the self.    For me, it’s being a member of various professional organizations:  Oregon Psychological Association, American Psychological Association, International Gestalt Therapy Association and the American Mental Health Alliance, Oregon Chapter.  Although I don’t see any of these organizations as perfect, my membership in them helps me to feel grounded, supported  and connected to like-minded people who have the same commitment to making the world a somewhat better place through our work.  Without that feeling, I would experience a sense of isolation, loneliness and unimportance.