Heal NPD

From Ideal to Real: Lessons From My Father

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.
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Dissociation is Key: Linking Splitting, DID, BPD, and NPD

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

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

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

What Narcissism Isn't: Clearing Up the Confusion

In this Weekly Insight, Dr. Ettensohn addresses widespread misconceptions about narcissism by clarifying what the term does not mean. Drawing on clinical examples and years of engagement with public discourse, he explores how the label “narcissist” has become a cultural catch-all for behaviors that are often common, non-pathological, and only proximally related to Narcissistic Personality Disorder (NPD). This episode examines how actions such as setting a boundary, avoiding emotional intimacy, or disagreeing with someone’s interpretation of events are frequently misread as narcissistic - especially when filtered through shame, hurt, or interpersonal conflict. Dr. Ettensohn distinguishes these behaviors from the psychological structure of narcissism, which involves instability in self-esteem regulation and associated interpersonal strategies. He also addresses the growing tendency to conflate narcissism with abuse, control, gaslighting, or moral failure, arguing that these associations undermine both clinical clarity and compassion. Misusing the term “narcissism” can lead to stigmatization, inhibit treatment-seeking, and reinforce rigid victim-abuser narratives that obscure the mutual complexity of relational harm. This Weekly Insight is a call for greater nuance, clinical integrity, and psychological humility. By understanding what narcissism isn’t, we create more space to see what it is, and how it might be worked with more constructively in both cultural discourse and clinical care. 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

Live with Dr. Ettensohn 6-12-25

Join Dr. Mark Ettensohn from Heal NPD for a live broadcast answering questions and responding to viewer comments.

Do Narcissists *Really* Lack Empathy?

What does it mean to say that narcissists lack empathy?
In this Weekly Insight, Dr. Ettensohn challenges the common assumption that low empathy is a fixed trait in narcissistic personality disorder (NPD).
Drawing from psychoanalytic theory and clinical observation, he explores how empathy in NPD often collapses in response to internal threat, and how this collapse is due to defenses rather than intrinsic empathy deficits. The episode identifies three core processes that disrupt empathic functioning in NPD: paranoid anxiety, dissociated self-states, and shame-driven defenses against dependency.
These processes help explain the inconsistency, withdrawal, and emotional detachment often seen in narcissistic dynamics.
Whether you identify with narcissistic traits or have been affected by them in others, this video invites a more psychologically informed and humanistic understanding of how empathy functions under distress.
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
 
Works Cited:
Miller, A. (2008). The drama of the gifted child: The search for the true self (Rev. ed., R. Mannheim, Trans.). Basic Books. (Original work published 1979)
 
 

Weekly Insights: Is Narcissism the New Moral Panic?

In this Weekly Insight, Dr. Ettensohn examines the rise of moral panic within contemporary discourse about narcissism, particularly how popular online narratives have transformed psychological terms into tools of moral judgment.
In this Weekly Insight, Dr. Ettensohn examines the rise of moral panic within contemporary discourse about narcissism, particularly how popular online narratives have transformed psychological terms into tools of moral judgment. Using a recent online interaction as a jumping-off point, the video traces how disagreement is increasingly reframed as harm, and how nuanced discussions of narcissistic personality structure are met with accusations of abuse, gaslighting, or complicity. Drawing on Stanley Cohen’s original criteria for moral panic, and placing current trends alongside historical examples such as witch hunts, McCarthyism, and the Satanic Panic, Dr. Ettensohn contextualizes the intense emotional reactions that now dominate conversations about NPD.
The video explores how stigma, stereotypes, and moral binaries are amplified online, creating a culture in which appeals to complexity and humanity have become taboo. It also considers the communal function of scapegoating within current narratives about narcissism.
This video offers a clinically grounded, sociologically informed framework for understanding what happens when trauma discourse is overtaken by lurid sensationalism and moral panic, and why the path toward healing lies in reclaiming psychological depth, complexity, and humanization.
 

The Birth of Sorrow | Part 2: Emotional Life in Neurotic-Level Narcissism

Link to episode 1 in this series, on psychotic-level NPD: https://youtu.be/IoxUCbNUJUE
Link to episode 2 in this series, on borderline-level NPD: https://youtu.be/Oz-C503q_9Y
Link to part 1 of episode 3 in this series: https://youtu.be/vUsnambadIE
This is the third episode of a four-episode series describing the narcissistic personality style across different levels of severity. Due to the length of the material, this episode has been divided into three parts. This is part two.
In this part, Dr. Ettensohn explores the emotional consequences of the developmental shift from borderline to neurotic-level personality organization. While borderline-level defenses aim to ward off annihilation through splitting, projection, and omnipotence, neurotic-level functioning introduces new emotional burdens: grief, guilt, and the realization that some losses cannot be undone.
Drawing on psychoanalytic theories of the paranoid-schizoid and depressive positions, this episode examines how individuals begin to internalize the reality of separate minds, enduring subjects, and the permanence of emotional injury. These capacities open the door to deeper love, mutuality, and ethical concern—but also to sorrow, remorse, and longing.
Dr. Ettensohn also outlines the core developmental conditions that support this shift, including “good enough” relational experiences that enable ambivalence to be tolerated and meaning to be preserved across time.
Finally, the episode offers concrete strategies for strengthening neurotic-level integration and functioning, both in therapy and in everyday life.
References:
Bollas, C. (1987). The shadow of the object: Psychoanalysis of the unthought known. Columbia University Press.
Gabbard, G. O., & Wilkinson, S. M. (1994). Management of countertransference with borderline patients. American Psychiatric Publishing.
Johnson, S. M. (1987). Characterological change: The hard work miracle. W. W. Norton.
Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psychoanalysis, 27, 99–110.
Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.
Winnicott, D. W. (1949). Hate in the counter-transference. The International Journal of Psychoanalysis, 30, 69–74.
Winnicott, D. W. (1965). The maturational processes and the facilitating environment: Studies in the theory of emotional development. International Universities Press.

The Birth of Sorrow | Part 1: Crossing into Neurotic-Level Narcissism

Link to episode 1 in this series, on psychotic-level NPD: https://youtu.be/IoxUCbNUJUE
Link to episode 2 in this series, on borderline-level NPD: https://youtu.be/Oz-C503q_9Y
This is the third episode of a four-episode series describing the narcissistic personality style across different levels of severity. Due to the length of the material, this episode has been divided into three parts. This is part one.
In this part, Dr. Ettensohn explores the developmental shift from borderline to neurotic-level personality organization, and how this shift transforms the inner life of individuals with narcissistic traits.
Part one serves as a conceptual bridge—reviewing core ideas from earlier episodes while highlighting the emergence of psychological capacities that make neurotic-level functioning possible. These include the ability to maintain a continuous sense of self, to recognize others as enduring subjects, and to experience ambivalence, guilt, and loss without fragmentation.
Through the lens of psychoanalytic developmental theory, Dr. Ettensohn illustrates how this shift brings with it new emotional burdens: the capacity to grieve, to feel remorse, and to live with an awareness of history.
This part introduces the foundational concepts of subjectivity and historicity, which will be explored in greater depth in parts two and three.
References:
Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. Yale University Press.
Ogden, T. H. (1986). The matrix of the mind: Object relations and the psychoanalytic dialogue. International Universities Press.
Ogden, T. H. (1989). The primitive edge of experience. Jason Aronson.
Winnicott, D. W. (1965). The maturational processes and the facilitating environment: Studies in the theory of emotional development. International Universities Press.