"Help! I Think My Loved One Is a Narcissist." (with Dr. Alexandra Repke)

"My husband is a narcissist." It's one of the most common things families say when they call for help. But is it true narcissism, or something else entirely?

In this episode, Drew sits down with Dr. Alexandra Repke, a licensed psychologist who specializes in personality disorders and their overlap with addiction. Recorded live at the Hope for Healing conference by Lit Path, this conversation unpacks the blind spot that keeps some people stuck no matter how much treatment they get.

Dr. Repke explains the difference between a personality issue and a true personality disorder, why trauma treatment can actually make a personality disorder worse, and what's really underneath narcissism and borderline personality disorder. Most importantly, she pushes back on the idea that these diagnoses are hopeless. With the right treatment, real change is possible.

In this conversation:

· Personality as your psychological toolkit

· Personality issues vs. personality disorders

· Why some people don't get better in treatment

· Narcissism as a lack of access to equality

· Borderline as a cage of extremes

· What families should do next, and what makes things worse

· Why treatment takes 12 to 18 months, and why there's real hope

This is also the final episode of the Valiant Living Podcast. Starting next episode we become the Loving Leverage Podcast. Same show, same feed, sharper focus on the families, partners, and parents who love someone struggling with addiction. Michael Dinneen joins Drew next time to unpack what Loving Leverage means.

Learn more about Dr. Repke's work at repkepsychologicalservices.com

If you or someone you love is struggling with addiction, you don’t have to face it alone.

Valiant Living helps men and their families move from crisis to stability through clinically driven care, community, and hope.

Learn more about our programs at www.valiantliving.com
or call us confidentially at (720) 796-6885 to speak with someone who can help.

Transcript

Podcast Rebrand And Loving Leverage

SPEAKER_02 0:00

Well, hey everyone. Welcome back to another episode of the Valiant Living Podcast. My name is Drew Powell. I get to work as a recovery advocate and an alumnus of the Valiant Living program. And before we jump in with today's guest, I want to let you know about some exciting updates we have to the podcast. We are officially rebranding our podcast, and it's going to be starting on the very next episode. We're now going to be calling it the Loving Leverage Podcast. And here's why we decided to do this. We're really, as a program, starting to really focus our efforts and our energies towards supporting and helping the families, the partners, the parents of the addict. And here's what we believe deeply. It's really like a core belief of ours is that the only thing stronger than addiction is love. And whether you have love for yourself yet or someone else loves you enough to set some boundaries, which is what the loving leverage is, that's really the only thing that's going to motivate you to get the help that you need, whether that's a spouse, whether that's kids, whether it's finally believing that you deserve to get better, whatever it is, there's there's loving leverage in your life that's going to be the thing that helps you get healthy and get well. So, same types of conversations. We're going to be having some great guests on, but we're going to be talking through what is what is the love in your life that you can leverage to get healthy and to get healing. And so super excited about that. Michael Denine's going to be joining us on the next episode just to kind of unpack what all that means. But same channel, you don't have to do anything different. It's going to be published to you just like you've been used to getting your episodes. But I don't want you to freak out when you see Loving Leverage podcast that is kicking off in the next episode. But today, man, I have an incredible conversation with Dr. Alexander Repke. We actually met each other at a conference. We were at the Hope for Healing conference by Lit Path just last month. We met and hit it off, and I was like, man, we have got to have a conversation about this. And so right there at the conference, uh, Lit Path was so gracious to offer a studio, and we sat down and had this conversation, and it blew me away. I gotta be honest with you. I mean, it just kind of blew my mind in some really powerful ways. And we talk a lot about personality disorder. If you've been around addicts much at all, you hear words like borderline and narcissism and all these things, obsessive, compulsive, you hear these things thrown out, and sometimes they can be misused and mislabeled. It's easy for you to say, man, you know, my husband is such a narcissist, or she's got narcissistic tendencies, but what does that actually mean? So we do a deep dive into that with Dr. Repke, and it is fascinating. My family actually sat in the room while we recorded, and they were doing all they could not to point their finger at me when she came up with some stuff. So, anyways, I really hope that you enjoy this episode with Dr. Repke. So let's jump in.

Meeting Dr. Repke At Lit Path

SPEAKER_02 2:56

Welcome to the Valiant Living Podcast.

SPEAKER_00 2:58

Thank you.

SPEAKER_02 2:59

This is this is fun because we literally just met yesterday.

SPEAKER_00 3:01

Yep, less than 24 hours.

SPEAKER_02 3:03

We're less than 24-hour old friends, and um we're here at the Hope for Healing conference by Lit Path, which is super fun. Um, but we met, we started talking, and I was like, man, it would be so cool if you jump on a podcast, tell us a little bit about what you do. So welcome, glad you're here. Thank you. Good to know you. Really incredible the work that you do with people. Thank you. So talk a little bit about just your story and how did you get into this and a little bit about what you do.

SPEAKER_00 3:29

Yeah, so I I kind of fell into it, if you will. It was never my um, it was never my goal to say, oh, someday I'm gonna work with people with sexual addiction, personality disorders, a little bit of criminology and trauma mixed in there.

SPEAKER_02 3:41

Like not every little girl's dream.

SPEAKER_00 3:42

No, that's not how it started. Um, but I was fortunate enough to be in a program that encouraged you to try different things. Okay, which I'm very grateful for because this radically deviated from my original plan. And being in that program, I had the opportunity to go to a residential setting where I was working with folks with sexual addiction and saw very quickly that a lot of folks could get healing, but there is a certain subset of person that was I wouldn't say they were resistant to healing, it's just the same techniques were not working on them.

SPEAKER_01 4:17

Interesting. Okay.

SPEAKER_00 4:18

And that's when the personality disorder piece came out and really captured my attention.

SPEAKER_01 4:24

Yes.

SPEAKER_00 4:24

So it's not to say that everyone who isn't healing has a personality disorder. That's not what I'm saying. But what I am saying is oh, somebody's they're doing all the things, they're getting the best treatment possible. Right. And they're still not healing, they're still not connecting to other people, to their recovery. Right. I wonder.

SPEAKER_02 4:44

Right. Yeah. Well,

Personality As A Psychological Toolkit

SPEAKER_02 4:46

let's just maybe start with just a baseline because one of the reasons why I wanted to have you on this podcast is because we we see this a lot at Valiant. Um, we also see a lot of terms thrown around quite a bit. Um but just so we have a baseline understanding, can you describe just from your own words what is what is personality? Just let's start there.

SPEAKER_00 5:06

Great question. Because if you ask, firstly, if you ask 10 different clinicians, you're gonna get 10 different answers. Um I'm actually gonna take mine from Dr. Gregory Lester, who is seen to be on the forefront, if you will, of the psychology and um personality field. Your personality is simply your psychological toolkit.

SPEAKER_01 5:25

Okay.

SPEAKER_00 5:26

And so what that means is in any given situation, what tools do you have to reach for to maneuver through that situation?

SPEAKER_02 5:35

Interesting.

SPEAKER_00 5:36

And let's give you an example of a tool.

SPEAKER_02 5:37

Okay.

SPEAKER_00 5:38

Um let's say a tool is trust. Do you have the ability to reach into that toolkit and not just reach for trust, but have access to the gradient of trust, right? So each attribute exists on a gradient or a spectrum. Okay. For trust, you have mistrust over here, trust over here. What tools do you have to reach in and get each part of that gradient?

SPEAKER_02 6:02

Very interesting. So here's a question that came up from as you're talking is personality, is it does that is it change over time, or is it kind of like I I don't know if it's like a nature versus nurture, but one thing that my wife, actually, she's actually in the studio audience, so that's why I say my wife is over there, but people are like She's here, yeah. She's here, try to trust you. But one thing that we've talked about before is for me in recovery, there's so much of my personality, or maybe I'm even using that word wrong, and you can course correct me, that has evolved or maybe even changed because of a survival skill that I need to show up. Like, for instance, I've historically been a very like outgoing personality, but as I've gotten older and got into recovery, I've actually embraced a lot more of how I used to show up as a child, which was more introverted, more quiet. But because of the settings I lived in, I was kind of developed this survival skill that became like almost who I am. Right. And recently I've almost feel like I'm going through a bit of a personality change where I'm like, I don't, I don't actually feel like yesterday, all day long, I went home, I was exhausted. I'm like, I don't naturally want to be around people anymore like I used to. Am I using personality in the right context? Does it change?

SPEAKER_00 7:16

I think it can. I think possibly though, maybe you're returning to baseline, and maybe that part of you was always there, and it was the environment that was necessitating you being more jovial, etc. But now that things have calmed down a different way, maybe your authentic personality was always, uh, I like people and I'm okay.

SPEAKER_02 7:33

Interesting.

SPEAKER_00 7:33

I'm okay being by myself.

SPEAKER_02 7:34

It's almost a returning back to what was more natural with that.

SPEAKER_00 7:39

I look at personality, your preferences is typically a little bit more set in nature. And based on circumstance, different things, volume can be turned up or turned down.

SPEAKER_02 7:48

Okay. Interesting. That's helpful. All

Personality Issues Versus Disorders

SPEAKER_02 7:51

right. So now when we talk personality disorder, if we kind of have a baseline for personality, what does that mean? And what do you see there? Because, you know, I I'm not sure what percentage of the population has an actual disorder, but how would you define that?

SPEAKER_00 8:05

Well, we'll take one step backwards, actually. So we did personality, so that's your psychological toolkit. So what tools do you have to reach for? And then I differentiate between a personality issue and a personality disorder.

SPEAKER_02 8:18

Okay, I haven't heard that before.

SPEAKER_00 8:19

So a personality issue, let's say the gradient for trust is on a scale of zero to ten, zero being no trust whatsoever, and ten being I completely wholeheartedly trust this person. Somebody with a personality issue, they technically have access to each one of the pieces along that gradient. Technically have access to it.

SPEAKER_01 8:39

Okay.

SPEAKER_00 8:40

But for some reason, they're limiting their tool belt. Maybe they're limiting their tool belt because of trauma, maybe it's the circumstance.

SPEAKER_02 8:48

Okay.

SPEAKER_00 8:49

They technically could reach for these other tools.

SPEAKER_02 8:52

They have access to them.

SPEAKER_00 8:53

They have access, but in general, they're not reaching for them.

SPEAKER_02 8:54

They're not reaching for them.

SPEAKER_00 8:56

So that's that's a personality issue, if you will.

SPEAKER_01 8:59

Okay.

SPEAKER_00 9:00

And then the personality disorder piece, and and this is where this is where I get sad. Um because to be clear, when it comes to a personality disorder, I believe you are born with it.

SPEAKER_01 9:12

Okay.

SPEAKER_00 9:12

And we'll talk a little bit more about that later. I know that oftentimes it's associated with trauma. Um somebody with a personality disorder, they lack access to the other side of the coin, essentially. So trust versus mistrust. Um, that person would not have access to trust. And without that, that other side of the coin, they lose access to the gradient in between. And so they have one tool in their tool belt, mistrust. And that is actually what paranoid personality disorder is. Okay. Those are folks that are born without the ability to trust.

SPEAKER_02 9:53

Okay. So that tool would you say it's it's not even in their toolkit?

SPEAKER_00 9:57

It's not even in their toolkit. There's not the neuropathway. It is not they are born without the ability. They do not have that wiring.

SPEAKER_02 10:04

Just because I'm I can't can't cure my curiosity around this. Can we just jump into that whole when you say born with it? Because I'm super curious about that because I have heard a lot about trauma and shaping, whatever. But talk a little bit more about that. So it's possible that someone could be born without the tool of, let's just go with your example, of trust that's just not there.

SPEAKER_00 10:25

Correct.

SPEAKER_02 10:26

Correct.

SPEAKER_00 10:26

So I mean, there's a couple of things that have me saying that. Firstly, I I feel like I'm um incidentally uh marketing for Dr. Gregory Lester's support circle. Yeah, shout out to him. This is sponsored by please look up his stuff. Um but if you look at the different research, if you look at twin studies, if you look at um how we've treated personality disorders and the fact that the treatment doesn't work in the same ways that we'd expect. Um I guess a big thing for me is when it comes to trauma. If we treat the trauma, you would expect the personality issues to decrease. But for some people, that doesn't work. It actually makes it worse and inflamed. Why is that? It's because the trauma is not the issue. The personality disorder precedes the trauma. A true personality disorder precedes the trauma. And so what I have found is clinicians will hear personality disorder, let's treat the trauma. If they're working with somebody with a true personality disorder, that person gets worse.

SPEAKER_02 11:29

Interesting.

SPEAKER_00 11:30

So there's there's that piece. Actually, that's one of the litmus tests I use when I'm testing people.

SPEAKER_01 11:35

Yeah.

SPEAKER_00 11:36

Because typically, if folks find their way to my door, it's not pretty.

SPEAKER_01 11:39

Yeah.

unknown 11:40

Right.

SPEAKER_00 11:40

I think I joked with you the other day. Um someday a patient's gonna graduate on a raw t-shirt that says 33rd therapist. Yes, right. Right.

SPEAKER_02 11:47

By the time they get to you, they've tried everything else. It's not working.

SPEAKER_00 11:50

Right. It's not great. Um the trauma treatment makes it worse for folks with personality disorders.

SPEAKER_02 11:57

So, how do you address the disorders from from birth then? Like how, like, because it feels like okay, well, if it's a lot of people. Without the trauma, what do you do? Yeah.

SPEAKER_00 12:04

Um,

Mirror Work And Unpleasant Boundaries

SPEAKER_00 12:05

it is a very impolite conversation with the person in therapy. So essentially, my job in therapy with someone with a personality disorder is I I mean, I'm warm, I'm kind, and whoo, I am holding a mirror. I'm holding a mirror the whole time. I'm basically chasing you around with a mirror the whole time. Hey, you said that to me in that tone of voice. That doesn't work well for me and my boundaries. Hey, did you notice that you just tried to draw attention to something over there instead of focusing on yourself here? That's not going to help you. It is constant and consistent. Um I've heard it likened to climbing out of hell on a metal ladder.

SPEAKER_01 12:41

Wow.

SPEAKER_00 12:42

Is imagine being faced with a mirror where you're seeing all your blemishes, all your pores, and like we're just we're poking.

SPEAKER_02 12:50

So is it possible for someone with that that's not more of that tool to gain access to the tool? Okay.

SPEAKER_00 12:57

Nine, and this is this is important for nine out of ten of the personality disorders.

SPEAKER_02 13:02

Okay.

SPEAKER_00 13:02

So there are ten personality disorders in total. Some are more well known than others, right? Of course, you have narcissism. A lot of people recognize that one.

SPEAKER_02 13:09

That's a go-to for a lot of people, yeah.

SPEAKER_00 13:11

Borderline personality disorder is one people can often recognize. Obsessive-compulsive personality has some familiarity. And then there's some lesser known ones, schizotipal, schizoid, like never heard of those. Ones that people typically don't hear about. Um, and in general, my experience in the field has been folks with sexual addiction, the personality disorders I have seen most commonly associated with them is narcissism or borderline.

SPEAKER_02 13:37

Okay. I have people that I'm thinking of that I've I've candidly thought, is there a solu like is there a solution for them? Because it feels like they're like they'll go to treatment, they'll do all the stuff, they'll do the therapy, and it's just like it's almost like there's this massive blind spot that I've thought to myself, is there hope that they would ever change? Because this person again, I'm I'm diagnosed and I shouldn't because I don't know, but it's say they have a personality disorder, it almost feels like with this person's personality, they're just always gonna always gonna be this way. But you're saying if they get to the right person who holds up a mirror and is blunt with them, that there is hope that they can see it, change it, and access the tools they need to show up in the world more connected and in a in a nutshell, yes.

SPEAKER_00 14:31

I mean, obviously there's some fine-tuning per person and what that looks like. And there's another thing called a treatment frame, if you will, that's really important for folks with a personality disorder. So a treatment frame is a series of unpleasant boundaries.

SPEAKER_01 14:44

Okay.

SPEAKER_00 14:44

So for example, um, if you have a personality disorder and you're working with me, oftentimes I'll say, okay, if you're late, late to session, what we're gonna do is for every minute you're late, we're gonna double that. We're just gonna stare at each other.

SPEAKER_02 14:59

That's the worst.

SPEAKER_00 15:00

In silence.

SPEAKER_02 15:02

That's the worst.

SPEAKER_00 15:04

Bless his heart. Somebody the other day showed up five minutes late and he knows he knows the treatment frame. And I was like, you know what this means. Ten minutes, and obviously, it's painful for multiple reasons. I was gonna say it's awful for you.

SPEAKER_02 15:14

That's a lose-lose. You just hold the hold the space though.

SPEAKER_00 15:18

Yeah, well, financially, but it's so interesting. What I've actually found in those moments is oftentimes towards the end of however many minutes we have, there's there's tears in their eyes.

SPEAKER_02 15:26

Interesting.

SPEAKER_00 15:27

Because I we hold eye contact.

SPEAKER_02 15:30

Yeah. And so again, but it's an aggressive type treatment.

SPEAKER_00 15:35

Yeah. Buckets of cold water.

SPEAKER_02 15:41

Okay.

SPEAKER_00 15:42

Whole time. Buckets of cold water, done with warmth, but buckets of cold water.

SPEAKER_02 15:45

It's actually pretty hopeful as you're sharing. Because like I I know that I've and and maybe there's some some people listening or watching that are that know someone in their life. It could be a spouse, a son, a daughter, I mean, and they're thinking what I've thought. Like, is can we ever get through to them? Like, is it ever gonna and what I'm hearing you say is yes, there is hope for them.

SPEAKER_00 16:06

There is so much hope. And that's one of the misconceptions about personality disorders that really frustrates me. It's this, I don't know, this aura of hopelessness.

SPEAKER_01 16:14

Yeah.

SPEAKER_00 16:14

I have I have seen it work time and time again.

SPEAKER_01 16:17

Yeah.

SPEAKER_00 16:17

Hundred percent no. Right. I wish. Right. Um, but I have seen it work time and time again. True healing takes place. Um the other day I have I have a patient who came in, narcissistic personality disorder, and we worked for about a year, and it was hard work, and he put so much effort in. It was unpleasant, and he would drag himself to sessions and almost dread it, but he's like, I'm gonna do this and chase him around with a mirror. Um the other day, the spouse came in and she looked at me and said something along the lines of, he's not a narcissist anymore. He can be a jerk, right, but he's not he's not the still a human.

SPEAKER_02 16:53

Right.

SPEAKER_00 16:53

Still human, but not the same man he was. So yeah, there's super rewarding. There's a lot of hope. Yes.

SPEAKER_02 16:59

And you have to get, and I'm not just trying to like plug you in what you're doing, but in general, you you have to get with the right people that know how to like I've talked to even a lot of people at this conference who have had I want to be careful I say this, but there there's just a spectrum of skill sets in therapy and in this world. And you've got to get with the right people that know how to really treat a specific thing. Right. Because, like you said, someone with really great intentions, a therapist or a clinician with great intentions can accidentally make it worse doing the things that they know to do that works for the majority of people. Right. And so it really you really owe it to yourself to do the research to find the people out there that specialize in something like this so that healing can be possible.

SPEAKER_00 17:41

Yes. Although frustratingly enough, what I have found is a lot of people don't even know like this is even a possibility, or maybe why treatment is stalling out and what is even a personality disorder specialist, and how do I find one?

SPEAKER_01 17:53

Totally.

SPEAKER_00 17:53

So it I wish, I wish it was more accessible and people knew more about these resources.

SPEAKER_02 18:00

Yeah, yeah, me too. Well,

Addiction, Disconnection, And Relapse Risk

SPEAKER_02 18:02

let's talk a little bit about um specifically addiction and personality disorder, and like what do you see in that space? Because you know a lot of the guys that are coming into our program, they're coming in for process addiction, substance addiction of some sort. Um, and a we see a lot of coexisting patterns and behaviors between the two. And your experience, why do you think that shows up so frequently and help us understand the connection between addiction and personality disorder?

SPEAKER_00 18:28

So for a true personality disorder, um, addiction plus personality disorder, you can treat the addiction all you want. I'm not betting on your recovery.

SPEAKER_02 18:38

Interesting.

SPEAKER_00 18:39

And that's it's a strong statement.

SPEAKER_02 18:40

No, it makes sense though, yeah.

SPEAKER_00 18:48

A personality disorder quite literally impedes you from having connection with other human beings. Gotcha. That's what personality disorders do. And so without that, I you might you might get sober for a little bit. I don't expect it to stay.

SPEAKER_02 19:02

Wow. I would be curious about the the relapse rates around people that have the personality disorder. Like it's gotta be so high.

SPEAKER_00 19:12

I would love to know that kind of data. Um unfortunately, as far as I know, that hasn't been collected because they'd have to know they have personality disorder. And at that point, hopefully they're getting treatment for that.

SPEAKER_02 19:21

But yeah, and how do you diagnose it, by the way? Like the the like the issue versus and when you say issue, is that similar to personality trait, or is that a different okay?

SPEAKER_00 19:29

Yeah, it's basically saying you have a trait, it's it's not saying you lack access to the whole thing, right? Like you can you can trust, but you're keeping it over here for some reason. Um I mean, diagnostic-wise, I take it really seriously because I don't want to put a label on somebody that is not that's not befitting to them. There's uh objective psychological testing that I give folks. And then very importantly, I am looking at their childhood and collateral contacts. Because if you're born with a personality disorder, these these issues didn't just magically appear when you started using, they just magically appear when you got married and started having marital problems. They've they've been there the whole time. Okay. And so I am seeking evidence. Have they been there the whole time?

SPEAKER_02 20:14

Gotcha. So for the for the clinicians that are listening right now, if someone's coming into their practice or even to their treatment center and they're showing up with compulsive sexual behavior, addiction, alcohol, whatever, what are some of the the things they can ask to kind of understand is there a deeper issue going on here? Because as I'm sitting here thinking, someone could go through 30, 60, 90 days of of treatment, yeah, but if they're not actually getting to the core and diagnose it, so is is there I don't know, is there triggers or is there clues?

SPEAKER_00 20:44

Yes.

SPEAKER_02 20:45

Okay.

SPEAKER_00 20:45

So clue would be hey, before the addiction started or before the um the more heavy parts of your addiction, how are you relating to people?

SPEAKER_02 20:53

Okay.

SPEAKER_00 20:53

How how are your friendships? How are your connections? That that's a big piece that I look at.

SPEAKER_01 20:59

Yeah.

SPEAKER_00 20:59

Um, so I think again, looking outside getting to know the person outside of their addiction is so important for the clinician.

SPEAKER_01 21:05

Okay.

SPEAKER_00 21:06

The addiction is often the loudest thing in the room, though. And so those types of questions aren't things we often think to ask in those moments because we're so focused on getting to know the addiction, but personality is at play. We want to see was that present before who were they outside of the addiction?

SPEAKER_02 21:21

So it's almost like we we kind of need to zoom out a little bit first and get a a fuller picture of what's going on before we just kind of dive in and treat the addiction that they presented when they showed up. Or potentially even because a lot of the guys that come to our program, you know, you'll be surprised to hear this, but they don't just walk in our front door and say, Hey, I need 90 days of treatment. It's usually a mother or a spouse or someone who's calling saying they need help. And usually they're calling with a um non clinical diagnosis from a family member of you know I see this a lot. Yeah, my husband needs treatment and he's a narcissist or whatever, and so I think Just we owe it to the client we're serving and ourselves to be able to zoom out and say, okay, well, let's let's kind of look at this from 50,000 foot before we dive into the actual diagnosis of the treatment.

SPEAKER_00 22:11

I've heard a lot of people, I say a lot of people, a lot of betrayed partners, and reasonably so um make the assumption my husband is a narcissist. And I say reasonably so because an active addiction, you have to have some narcissism about you to do what you're doing, right? You're lacking empathy for the other person. You're you have a sense of grandiosity there. Like there are some narcissistic traits to sustain addiction.

SPEAKER_02 22:36

Interesting.

SPEAKER_00 22:36

But does that mean they're an actual clinical narcissist? Not necessarily.

SPEAKER_01 22:41

Yep. Yep.

SPEAKER_00 22:42

And statistically speaking, probably not. It's only 1% of the general population that we could put or ascribe that diagnostic label to.

SPEAKER_02 22:51

So let's go there because I you know, I I spent 20 years in um in church ministry, and I've always thought like there has to be some again, you please correct me if this is, but there has to be some narcissism or ego for someone to even want to get on a stage and do like what get what's what who volunteers to say I'll I'll stand in front of people every week and whatever. So there's gotta be something that at least says I'll do that, you know.

Narcissism As Lack Of Equality

SPEAKER_02 23:19

But because we hear, and I we don't have time to go through all 10, but I want to hit I want to hit a couple of the more you know prevalent ones, and narcissism is probably the we hear the most. Yes. How do we know the difference between a narcissist, someone who's showing up with narcissistic traits or tendencies? Like, do you have some working definitions that would be helpful for us around narcissism?

SPEAKER_00 23:41

Yeah. Um, so a narcissist at their core lacks access to equality.

unknown 23:47

Okay.

SPEAKER_00 23:49

Meaning they cannot see the person sitting across from them as an equal.

SPEAKER_02 23:53

Okay.

SPEAKER_00 23:54

Now, originally when I was going through some additional education about narcissism, I thought that what they would lack would be empathy. I was like, oh, that's gonna be what they lack. They do lack empathy, but they lack it because they lack a quality. How can you have empathy for somebody who you don't consider to be an equal?

SPEAKER_02 24:12

Okay, so is that across the board? So across the board, a narcissist has trouble seeing the person across from them equally. So it could be empathy, but it could be it could be other things as well.

SPEAKER_00 24:23

It could be all the other traits listed in the DSM, the diagnostic statistical manual by which we don't.

SPEAKER_02 24:29

It doesn't have to be just one. It could be but for whatever that trait is, they they don't see themselves as equal with that person.

SPEAKER_00 24:35

Correct. They put themselves above. And then there's other nuances with narcissism. Um something helpful is to look at where the word comes from.

SPEAKER_01 24:43

Okay.

SPEAKER_00 24:43

I'm gonna butcher it, so forgive me. That's fine. Um Greek mythology. Everyone's favorite stories originate there.

SPEAKER_01 24:49

Right.

SPEAKER_00 24:49

Uh man named Narcissus, very handsome, very smart. Uh I think a god falls in love with him. Maybe he rejects her. It's something happened with love. Okay. And he's cursed to fall in love with his image. And so he walks down to go get some water, I believe, looks in the pool of water, sees himself, and falls in love. And what that means is he's not eating, he's not drinking, he's just staring at himself. And I believe eventually he dies if I follow the story correctly. But what we often miss in that story is narcissist didn't fall in love with himself. He fell in love with the image of himself.

SPEAKER_02 25:29

Wow.

SPEAKER_00 25:30

Those are two different things.

SPEAKER_02 25:32

Yeah.

SPEAKER_00 25:32

So a narcissist actually does not love himself. He is in love with this image that he has spent his life curating.

SPEAKER_02 25:40

Interesting. And so it's not actually true self-love.

SPEAKER_00 25:44

No. No.

SPEAKER_02 25:45

It's it's love of the image he's projected.

SPEAKER_00 25:47

Right.

SPEAKER_02 25:48

Okay.

SPEAKER_00 25:48

Because I mean, think I think about uh in in the here and now, when people take selfies, right, they're taking it at a certain angle, certain lighting, there's filters.

SPEAKER_02 25:58

Duck lips or whatever, is that still a thing? I don't know. I hope not.

SPEAKER_00 26:02

Um the image they produce, it's technically them, but it's not really.

SPEAKER_01 26:09

Yeah.

SPEAKER_00 26:09

Right? And so just looking at the difference or the disparity between true self, like who we are in 3D, sure, um, versus this curated image you've produced, there's there's a there's a difference there. And so for a narcissist, if they feel like their image is being attacked, or you are giving them criticism or critique or constructive feedback on anything that maps onto this perfectly curated image that they worship.

SPEAKER_02 26:35

Right. Right.

SPEAKER_00 26:37

That hits. That's a raw nerve.

SPEAKER_02 26:39

Yeah, yeah. I mean, that it makes a lot of that makes a lot of sense to me. But now, how would that be different from just a trait? Like someone who shows up with some narcissistic traits, but they're not technically a narcissist.

SPEAKER_00 26:51

I mean, it depends it's awesome. You ask a question, we're like, well, it depends.

SPEAKER_01 26:56

Right, right, right.

SPEAKER_00 26:57

It depends. Um, somebody with traits of narcissism, they can care about their image. Like we we I think most people to some degree care about their image. It's it's healthy, that's normal. There's a health and a normality to it. The narcissist, a true narcissist, just takes it to the whole other extreme where they worship it and that is them. There is not a tolerance for that. Yeah. And so, actually, in terms of suicidality, people have asked before, well, narcissists wouldn't complete suicide, they love themselves. I actually think that narcissists are at the most risk for suicidality when they finally recognize the gap between image and self.

SPEAKER_02 27:38

And so as a clinician, I'm alive to that, the chasm that exists between the two.

SPEAKER_00 27:42

When they realize the gap, because they spend their whole life dismissing that there's a gap, when they actually come to terms with the fact that there's a gap, as a clinician, you need to be aware and you need to be careful. Interesting. Yeah.

SPEAKER_02 27:54

What would you say to the families, the parents of spouses listening or watching right now, that would be the most helpful thing around trying to understand if their loved one is a narcissist or have narcissistic behavior? Like if someone's listening right now and is like, man, I I don't know. I see a lot of these things showing up, but I don't know. What what would be the most helpful thing you could share with them around this?

SPEAKER_00 28:18

Helpful thing would be don't get lost on the Reddit rabbit hole, firstly. Solid advice. Please don't do it.

SPEAKER_02 28:23

Across the board, good advice.

SPEAKER_00 28:25

Again, it's has this always been the case? Has there always been something blocking connection? Is this true of them outside of the addiction? And if so, get curious and go to a mental health clinician.

SPEAKER_01 28:37

Yeah.

SPEAKER_00 28:38

Be empowered to ask these questions. Hey, could this be something more than trauma? Could this be more some more something more than addiction? Is this maybe personality?

SPEAKER_02 28:47

Right.

SPEAKER_00 28:47

Get curious.

SPEAKER_02 28:48

Yeah. Ask. I love that because I think getting an expert involved to really help identify what is actually going on.

SPEAKER_01 28:55

Right.

SPEAKER_02 28:55

Feels like that would be more kind even to the person trying to understand so that you're not, you know, creating a story that may not be helpful or whatever else. Right. Yeah. Yeah.

SPEAKER_00 29:08

Something I'll add to the narcissism piece. I want to tell a story of a former patient. Um, he was a physician, very smart, very talented, uh, came into residential treatment, and he was a narcissist clinically, diagnosably. And that meant that he just had this death grip on his image. And we were working, I believe, with his medical board or medical providers. Um, and they just want him to get honest. Like, get honest, like what was going on? How was your, I think it was a substance addiction for him, how was that impacting you and your work? Get honest. We want to work with you. We want you back in the field practicing, assuming you get treatment.

SPEAKER_01 29:48

Right.

SPEAKER_00 29:49

He had the hardest time getting honest. I mean, we're talking hair follicules later, polygraphs later, like all of these things. And it was because he just did not want to let go of his image.

SPEAKER_02 30:01

That's tough. Right. We we definitely see that in certain professions more than others as well. A lot of the professions where there is some sort of identity or some sort of public-facing thing or hierarchy. It could be C-suite, it could be athlete, could be performer, it could be doctor, lawyer, training, whatever. There's it seems like there's certain fields that tend to lend itself towards a perception that needs to be, you know, maintained. And over time, we just see it get to where it can be so unhealthy and damaging when someone starts believing that's that's who they are. Right. You know? Can we go

Borderline As A Cage Of Extremes

SPEAKER_02 30:40

can we talk about borderline just for a minute? Okay, because that's probably the second to narcissism. We hear narcissism, we hear borderline. Unpack that for us. What's your definition of that and how do we start to recognize that?

SPEAKER_00 30:50

So for borderline personality disorder, the trait you do not have access to is proportionality.

SPEAKER_02 30:56

Okay. What does that mean?

SPEAKER_00 30:57

So when we think of proportionality, I mean let's let's go by the antonym first. All, nothing, everything, nobody, everybody. That's extreme. Yes. Proportionality is sometimes, maybe, some people. There's there's a temperance there.

SPEAKER_02 31:15

Gosh, I catch myself doing that all the time.

SPEAKER_00 31:17

All the time.

SPEAKER_02 31:18

See? I got you're the worst. Yeah, that's I do that. That's that's something I do. Like, I literally let my family's laughing in the background right now. I I'm I try to catch myself because I was like, I told Jamie yesterday, there's all these people that want to meet you at the conference. And then I had to stop and say, Yeah, I talked to three people that wanted to meet. Like, it wasn't that many. But in my mind, I've just gone, yeah. And you I just did it talking to you. That's crazy.

SPEAKER_00 31:42

Yeah, it's it's a cage of extremes.

SPEAKER_02 31:44

And actually, if I could ask Do I have borderline personality disorder? Is that what I'm saying?

SPEAKER_00 31:48

I don't know. Can't formally diagnose no comments from my family in the background, please. Um, but what I would what I would love people to I'm shame spiraling. What I'd love people to take away, one of the takeaways I'd love people to have from this podcast is when you think of a personality disorder, think of a cage.

SPEAKER_01 32:06

Okay.

SPEAKER_00 32:06

They did not ask to be in this. Imagine living in a cage where you do not have access to proportionality, and everything really seems everything all the time. Nobody.

SPEAKER_02 32:19

Like it's is it just like feel big?

SPEAKER_00 32:21

Like everything's just a big feeling, a big it's because the opposite of proportionality is intensity.

SPEAKER_02 32:27

Okay.

SPEAKER_00 32:28

And so that's that's the cage they live in.

SPEAKER_02 32:31

Yeah.

SPEAKER_00 32:32

There's no rest in that cage. There's no rest and there's no connection. Um ten personality disorders, the ones that could they can all probably all of them can move me to towards tears at some point, but borderline, you just live with your nervous system on fire. It's a horrible way to live.

SPEAKER_02 32:51

It is. Yeah. Man, I mean, I you've just thinking through that is is super powerful. And I'm I'd love to hear your connection with addiction into borderline. It almost like the story kind of writes itself, it seems like. If someone's like an all-or-nothing type personality, then even just being able to live with themselves, the anxiety, the pain, the nervous system, you would have to numb just to survive the intensity of the big feelings, it seems like.

SPEAKER_00 33:17

Yes. And sometimes when those folks come to me for treatment, um, they and the spouse will look at me with wide eyes when I say, okay, we're gonna manage the addiction, we're gonna treat the personality. I'm not gonna, I'm not even really gonna try to treat the addiction right now. I'm gonna go, I'm gonna go for the root, which is the personality. Their nervous system is on fire. They keep reaching for this. We're gonna focus on the personality and manage the addiction, manage being, we're gonna put some barriers in place, we're gonna do some of that stuff, but the deep processing stuff, not yet. We're gonna focus over here first.

SPEAKER_02 33:49

Wow. That's so good. That's so helpful. Let's

Why Treatment Takes 12 To 18 Months

SPEAKER_02 33:52

talk a little bit. You mentioned this earlier and I want to go back to it, but in recovery.

SPEAKER_01 33:55

Yeah.

SPEAKER_02 33:57

As someone starts to get healthy, so they start getting in maybe 30, 60, 90 days, how do you see, especially with these personality disorders, how do you see them start to show up or even change? So I think one thing that we've seen a lot of, so we'll we'll have guys come and stay with us 90 days, sometimes longer. They leave one way, and not that 30 to 90 days is gonna you're gonna be a like we always say you're we're just trying to get you back to the starting line so that you can begin the work and the healing and get regulated, all this stuff. But it can be a almost a shock to the system as someone has been presenting a certain way for so long, and then they come home and there's certain things that they're more aware of and all that kind of thing. So, how would you describe the changes that can happen in a person as they enter into recovery with these personality disorders?

SPEAKER_00 34:49

It's a good question. I think what I'll say to start with is personality disorder treatment. I say tip, again, I always get a little scared to say typically. Right. Um when I approximate, it's 12 to 18 months of intensive treatment.

SPEAKER_02 35:04

Wow. Because this is this is a long road.

SPEAKER_00 35:09

And in some ways, if we're looking at addiction, I really believe the betrayed partner is owed informed consent about this. Like this is a personality disorder. This is how long it would take to treat if treatment's successful, because there are no guarantees, lots of hope. No guarantees. I think that's something people need to be aware of.

SPEAKER_02 35:27

Well, the interesting thing about borderline is uh, as you're saying that, is it it would be really easy for someone, and I should say this as a question, because I don't want this to be true, but this is what I'm thinking.

SPEAKER_01 35:37

Okay.

SPEAKER_02 35:38

Say they're they leave and they're an all or nothing type, yeah, they're gonna go from okay, now I'm I o I'm aware that I have a need or a problem to I'm all better.

SPEAKER_00 35:48

Yeah.

SPEAKER_02 35:49

Like they can't you know what I'm saying? It's like it would lend itself to that. So I think it's important what you just said for the the the longevity of the process and giving yourself the grace to say it's okay that it might take me a little longer than what I want to get towards the growth and the healing that I need.

SPEAKER_00 36:06

Because we're trying to give you access to a tool you've never had.

SPEAKER_02 36:09

Right. Right.

SPEAKER_00 36:10

We're building something.

SPEAKER_02 36:12

Yeah. What what gives you hope today? Because I think there was a a a period of time and it's maybe a while where personality disorders seemed like they were almost untreatable.

SPEAKER_00 36:23

Yeah. People didn't want to touch them with a 10-foot pole. Really? Yeah.

SPEAKER_02 36:26

Is that stigma changing a little bit? And what what have you seen even in the time that you've been doing this work as far as the changes and the growth and and what we know now about these personality disorders?

SPEAKER_00 36:36

I mean, I would like the stigma to continue to decrease. I would like there to be more of a spirit of hope. Um, for example, I had a I had a patient inquiry the other day, and this gentleman is terrified to go through the evaluative process with me because he's so scared to be diagnosed with a personality disorder.

SPEAKER_02 36:52

Scared of what he might what might show up.

SPEAKER_00 36:54

He's he's afraid it's a death sentence because of everything. I say, look, everything. Um, because of the reputation of personality disorders.

SPEAKER_01 37:04

Right.

SPEAKER_00 37:04

There is so much hope. And I think that some clinicians are starting to see that, especially as this different type of treatment is being administered as opposed to just trauma treatment, which inflames this different type of very interactive, interpersonal, psychodynamic treatment, it can be really effective.

SPEAKER_02 37:22

Yeah, that's good.

What Families Should Do Next

SPEAKER_02 37:24

What should families do? So if they're someone's listening right now and they believe maybe their spouse or their child or family member may have both an addiction and a personality disorder, what would be the healthiest way to respond, like in this moment? What I should say this, what helps or what maybe unintentionally makes things worse?

SPEAKER_00 37:43

Yes. So a couple things. Um, for the family, first I would want them to internally recognize that if there is a personality disorder at play, the lack of connection you have had with this person isn't on you. They cannot connect. If there's a personality disorder at play, that imp the personality disorder impedes connection. So I'd want them to rest in that to start with. Um what I wouldn't do is go to the person and say, hey, pretty sure you're a narcissist. Let's get you in and get you checked out.

SPEAKER_02 38:10

That's not gonna go over well.

SPEAKER_00 38:12

Especially if the person is a narcissist. Right, right, right, right. Not gonna go over well. Um I would take, I would take a spirit of curiosity in general. That seems to be an effective way for families to communicate with folks with personality disorders, a spirit of curiosity. Say, hey, listening to this podcast, hearing some things, would you mind listening to it? Curious if we should try to find somebody just to check, just to check things out, to rule things out. Maybe it is, maybe it's not. It would give me some peace and assurance to know.

SPEAKER_02 38:41

Yeah. Super man, this has been awesome, super helpful. I I'd love for you just to kind of close out with just I don't know, and maybe this is my personality where I'm always wanting to reframe everything, but just a message of hope for like the the people that are listening who might have just been told they have a personality disorder or or a loved one has a personality disorder. And because even in this whole conversation, at least what I'm taking away from it, and and maybe this is newer for a lot of people too, is there is a path. Like there is a a way towards connection, all those things. And so I'd love for you just to kind of give your final thought on on what's the hope.

SPEAKER_00 39:22

Yeah,

Clarity, Hope, And Closing Notes

SPEAKER_00 39:23

my my final thoughts would be it's worth getting clarity. If if you are wondering what if, maybe it's worth getting clarity. And truly, I have seen, I have seen, I I don't even want to say miracles, I've seen treatment work the way it's intended to work. People get better, people can connect. There's been beautiful redemption stories, story after story after story I've seen. And it's a painful process to get there. It's a lengthy process to get there. You need to know that going into it. But there's there's a lot of hope here.

SPEAKER_02 39:59

Man, wasn't that so good? I told you, I mean, I just I've already gone back and listened to that one several times because there's so much good stuff in there. Dr. Reppy, thank you so much for jumping on and joining us. Uh, we'll link to your work. I want people to get connected with you and the great stuff that you're doing. And so just so grateful for who you are and for the work that you're doing. Well, for the last time, signing off as the Valiant Living Podcast. Join us next time with Michael Danin for the Loving Leverage podcast. We're super excited for the future of this podcast. Have some great guests coming on in the near future. I don't want to spoil it, but we've got Jeff Hatch coming on. We got Ian Brown coming on out of Austin, out of Jeff is in the in the Pacific Northwest. Just some incredible, incredible guests, just trying to bring value to your life. And so, for the last time you've been listening to the Valiant Living podcast, thanks for joining us.