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The issue of narcissism has found its way into the culture as a popular topic in the realm of intimate relationships, work relationships, and family dynamics. In this episode, we examine the topic from the perspective of what it means to be parented by someone with narcissistic traits.

We begin our exploration with an overview of what narcissism is. We review the criteria in the Diagnostic and Statistical Manual of Mental Disorders that determine whether or not an individual meets the standard to be diagnosed with Narcissistic Personality Disorder. We then discuss where narcissism fits within the spectrum of human development over the lifespan and highlight periods in a normal life where people might be excessively focused on themselves. We will briefly touch on the role narcissism plays in psychopathy and the 'Dark Triad' before examining the root that underlies the very concept of narcissism, the Myth of Narcissus. This first part of our journey brings us to a more useful way to approach the topic of being parented by a narcissist by clarifying its functional definition.

Armed with a working framework, we then turn the conversation toward characteristics that accompany being raised by a narcissistic parent. When a parent is excessively focused on their own needs over the needs of their children, certain patterns emerge. First, we look at typical behaviors that a parent with these traits will engage in as they raise children. All parents will make mistakes during child-raising, but parents with narcissistic behaviors tend to fail at effective parenting in certain predictable ways. We look at seven of the most common ways a narcissistic parent can hamper healthy childhood development. Second, we look at how these typical, maladaptive parenting behaviors can affect an adult who was raised by a narcissistic parent. We discuss several characteristic outcomes we may face in adulthood when one or both of our parents suffered from narcissistic traits and behaviors.

Finally, we turn to consideration of the key domains that are often a focus in psychotherapy with an adult who was raised by a narcissistic parent. These areas represent normal developmental milestones and the key information and skill sets that the adult child of a narcissistic parent may have missed out on. It is encouraging that, as healing begins in any one of these domains, it has a positive effect on all of the other areas. Recovery can be swift and profound as a person learns to incorporate new understanding and an effective set of skills. As an adult, a person can access a rich array of resource materials on how to cope with having been raised narcissistic parent and begin their healing journey on their own or in psychotherapy with a trusted professional.

Even those adults who were exposed to the most toxic levels of narcissistic parenting can learn to navigate life challenges and relationships with more confidence and experience greater freedom and joy in life.

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In this episode we continue the discussion about recent advances in understanding and treating neuroplastic pain. Pain can exist on a spectrum between purely structural and purely neuroplastic, and many types of chronic pain might involve elements of both. We explore different clinical indicators that can point to the role of learning and neuroplasticity in the development of chronic pain. Although there is not currently a reliable survey or measure to definitively distinguish structural pain from neuroplastic pain, the presence of any of these indicators suggests that there may be a significant neuroplastic component to a patient’s pain experience, which likely means that a person would benefit from psychotherapeutic interventions designed to reset the neurophysiological alarm system and help that patient un-learn being in constant pain and discomfort.

Next, we briefly review the role that pain management techniques can play in helping a patient learn to cope with the stress of being in constant pain. Unfortunately, the process of seeking care for chronic pain can strain a person’s support system and their relationships with family, friends, and the medical team that is treating them. Pain management therapies seek to reduce the stress associated with the role of patient and empower the person to advocate for better and more effective support from the important people in their life.

We then turn our attention to pain recovery therapies by discussing the cutting edge of pain psychology, Pain Reprocessing Therapy. We provide an overview of three of the main phases of PRT by discussing the important role of initial psychoeducation, the subsequent training of the patient to engage in somatic tracking, and the management of relapses. Psychoeducation helps the patient understand why they are experiencing chronic pain and provides them with evidence that supports the use of the PRT techniques. Somatic tracking, a technique used in several other mind-body approaches, is a central strategy in PRT. The way it is applied in PRT consists of learning to practice the skills of mindfulness, safety reappraisal, and positive affect induction.

When a patient is trained in these skills and begins to practice them, they typically experience a reduction or cessation of their chronic pain. However, there may be a time when a person experiences a new injury or when their pain returns in some form. Relapses are so common that clinicians have recognized that there are three distinct stages involved. We will examine the stages of relapse and explore how these events can actually be leveraged to reinforce the positive effects of re-training the brain to respond differently to pain signals. Paradoxically, relapse episodes often serve to strengthen the long-term effectiveness of pain recovery techniques.

Exciting new developments in neurophysiology have paved the way for cutting edge psychotherapy techniques that can help you to better manage the effects of chronic pain and in some cases to reduce or eliminate chronic pain entirely.

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Recent developments in the area of neuropsychology have highlighted the role of neuroplasticity in the perception of chronic pain. In this episode we will first examine current research about neuroplasticity and how it relates to the perception of sensations within the body and the interpretation of these sensations as chronic pain. The long-standing neuroscientific principle, “neurons that fire together, wire together,” will be explored in its application to the phenomenon of ongoing pain.

Next, we will take an in-depth look at what pain is. We will discuss the differences between acute and chronic pain and explore what the purpose of pain is in terms of its function in human survival. Contrary to popular belief, there is not one “pain center” in the brain that is responsible for our experience of it. Recent research has highlighted over 40 different regions of the brain involved with sensing, interpreting, and either increasing or decreasing our perceived level of pain. As the acute pain of an injury begins to resolve and becomes chronic pain that persists over time, different regions of the brain become involved. From this recent research we have begun to understand the role that narrative, meaning-making, and attention play in facilitating the persistence of chronic pain. The dramatic case of a worker being injured on a job site will be discussed as it highlights the role of narrative in shaping our experience of pain.

Finally, we will take a look at the pain/fear cycle. We will discuss research that highlights key aspects of the epidemic of chronic back pain, which is the leading cause of disability designations in the United States. We will also briefly touch on several excellent resources that are recommended if you would like to learn more about chronic pain the role of neuroplasticity, and current thinking about effective treatment for chronic pain.

A better understanding of the role neuroplasticity plays in the perception of pain facilitates the effective use of psychological interventions for managing and potentially recovering from chronic pain.

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Recorded and edited at Studio 970West, Grand Junction, CO.

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