CIIS Public Programs Podcast

transcript

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This is the CIIS Public Programs Podcast featuring talks and conversations recorded live by the Public Programs Department of California Institute of Integral Studies, a non-profit University in San Francisco. To find out more about CIIS, and public programs like this one, visit our website ciis.edu and connect with us on social media @ciispubprograms.  

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Elizabeth: Hi Ramani, thank you so much for being here with us today. It's my absolute pleasure Elizabeth. It's a real honor thank you.   Well I had so much fun reading your book which ironically matches your shirt perfectly. 

Ramani: It does – yes. I favor red these days, so yes thank you. [laughter]  Elizabeth: Well there are so many things that I can't wait to hear from you about, but I thought I would start by just asking you how you got into this field of study. What inspired you to dive so deep into the world of narcissism?  Ramani: You know I tumbled into it in many ways. Basically, a student had approached me who was working at one of our clinical research sites and was commenting on how some of the patients coming into the clinic were sort of demanding all the attention of everyone there and I’d never thought of it.  

I thought this is interesting these kinds of high conflict personalities probably put a real drain on health care systems and that gave that that tiny seed became went on to about 10 years of grants from the National Institute of Health looking at personality disorders and health. But at the same time in my private practice I was also hearing people coming in with stories mostly about intimate relationships, but also about family relationships, where the same themes kept coming up over and over again, invalidation and manipulation and lots of confusion, and I find myself sort of they would be so overwhelmed that would be taking my notes and they say could you drop some of that into a quick email to me and I would you know I would just send it to them I’m writing the same email over and over again that slowly became Should I Stay or Should I Go.  

And then we had an election in 2016. Then this word that I was sort of quietly working with you know in this backwater of academia was now everyone was talking about it and then I got angry. And I think the anger is really what put me into this full-on because what I was seeing is this was it was this wasn't just husbands and wives and husbands and husbands and wives and wives arguing with each other, this was about the loss of human potential. This was about lifetimes of people feeling silenced because they had been so minimized and trivialized and dismissed. This was cutting across cultures and that was sort of where I almost had had it and so I thought people need to understand this. It's not being taught in grad school therapists didn't understand it nobody knew where to turn there was sort of this strange kind of underground of narcissism information and that's when I went all in. So ultimately what really propelled me over the wall was anger as it does with many things in life so that's what happened yes. 

Elizabeth: Well fair enough and this is a timely conversation then as our collective global anger actually rises but before we go there let's get on the same page about what you mean by narcissism. Are we talking clinical are we talking personality disorder are we talking traits of behavior..? Help us all orient together.  Ramani: Narcissism is a pattern you know that's the best way I can put it and a lot of people really take umbrage at this word…it feels very clinical to them and if you take a riff on sort of the work of Dr. Alan Francis who's really written brilliantly about mental health and especially he actually was one of the architects of the diagnosis of narcissistic personality disorder. You know, he's like “we really have to be very careful on how we medicalize things” and in this case the word narcissism is risky because here we start to medicalize meanness, we medicalize spitefulness, and vindictiveness but the word is simply a pattern that refers to things like lack of empathy, entitlement, grandiosity, a person who chronically seeks out validation and admiration, a sense of arrogance, control.  

A person who cannot cope with frustration or disappointment and when faced with those situations they tend to lash out at other people. There's a lot of rage, there's a sensitivity to criticism, there's a real hypocrisy I can say things to you can't say things to me. I can break the rules, but you have to follow the rules. But all of this which a lot of people can sometimes misread as tremendous confidence or bravado is a shell around a very insecure core. And that insecure core is incredibly vulnerable and the more vulnerable that core feels the more antagonistic the narcissist becomes. And I even tell people like if you don't like the word narcissist I run into that a lot with clinicians as I’d imagine you'd understand that a lot because I’m like “oh I don't want to diagnose someone I haven't met” and I’ll even use acronyms I’ll say like okay let's use the word CAVE let's try that conflictual, antagonistic, vulnerable, entitled, and dysregulated.  

So I’m always trying to figure out the workaround you know I talk about it in terms of being difficult being toxic you know it all kind of ends up at the same destination which is a pattern that is not only good for the person who possesses it's definitely not good for the people who are exposed to it, and yet it is something and I don't know what your experience was Elizabeth, but in graduate school I don't think I heard the word narcissism once. I didn't get any formal training in personality disorders, it was only when I was in supervision, that maybe a supervisor would talk about it, but it wasn't talked about. And that to me is already an oversight in the field.  

 Elizabeth: It has certainly gone out of vogue, right? [Ramani: Yes] When we want to look at manualized 12-session therapies, narcissism is not something we know how to even meaningfully speak about and you know [Ramani: Mhm] I hear your concern about stigmatizing or being unkind but I also hear the power of naming a pattern. Naming something that is present and actually impacting people all day long every day.  Ramani: Yeah absolutely I think that where I’ve gotten frustrated and—just to almost give some historical context to this—you I’m sure you've heard of this is this idea of the Goldwater Rule. This was something that had come out from the American Psychiatric Association as almost like an ethical stance that one should never diagnose a person that they have not evaluated. Now first of all narcissism as a term is not a diagnosis…it would be if you and I were sitting together at a table and we saw someone else on the other side of the table who was worried, worried, worried. We'd say “golly that person seems anxious” we wouldn't call that diagnosing them you know, so to me narcissistic is an adjective like that but when the Goldwater Rule came along everyone got very fussy about ever using any kind of a clinical term, least of all one that stigmatized like narcissism.  

So, when 2016 happened and the conversation turned to what is happening, what is going on, what is this person's behavior. Some people were peddling out that word and then all of a sudden it turned into this big discussion of the Goldwater Rule, and we shouldn't diagnose people we haven't met. And the reason I really got frustrated by that was a lot of people were very confused about what they were witnessing day in and day out on the news and on Twitter and all of that by giving people a framework they could at least understand what they were seeing, and that's really my only goal by giving people a framework at a minimum I can tell them this is what you're going to expect, this is how it's going to go down, and for many people they're saying I feel in so much more control of this toxic relationship now that I know what's coming…ironically exactly the same things are coming that were always coming, but now they know they're coming. It's very different it's like finally turning on a weather forecast you're like “ah this rain thing can be predicted”. And so it was very similar that people are saying oh thank you for giving me this kind of a road map and that's really what it becomes with any of these sort of high conflict personality styles you can sort of predict how it's going to go and I think that has tremendous importance for workplace issues, for family issues, for couples issues, and just for people to generally go through the world.  Elizabeth: Makes sense. Well while we're clearing up common myths and misperceptions you started to speak to the difference between healthy self-esteem and narcissism. And that narcissism is not typically what it appears, can you say just a little bit more about that?  

Ramani: Absolutely. So a lot of people have viewed narcissism as this inflated self-esteem it's actually not and even in fact when you look at the newer the DSM-5, which is a diagnostic and statistical manual of mental disorder, sort of our diagnostic bible, which I don't even like calling it that sort of what we've been given to diagnose with is that the DSM-5 now refers to narcissism as variable and vulnerable self-esteem. It's a big difference. This is not self-esteem that's overly inflated it is inaccurate it is distorted it is misperceived it is vulnerable and its variable. Healthy self-esteem is observed in a person who has a strong sense of self who knows who they are across situations that they can sort of not feel a sense of threat by every interpersonal interaction that doesn't go their way. There's a big difference there's a stability to healthy self-esteem, there's an incredible instability in the self-esteem we observe in narcissism.   Elizabeth: Thank you yeah makes a lot of sense and is so resonant with what any clinician has observed I think when admitted to the inner world of someone whose behavior aligns with narcissism. So, I appreciate that.   Ramani: Absolutely and I do also think Elizabeth is that many times at first blush a person's first past with a narcissist is very grandiose and larger than life and they tend to hold court and everyone at the party's listening to them and their stories are better than anyone else's. It's very easy to sort of get lost in that vortex and wonder why is that person making so much noise, why do they feel the need to hold court. I think we are so immediately oriented to that person who has so much charm and charisma that we assume that they're doing it right, rather than wondering what might they be compensating for. It's just it's a paradigm shift.  Elizabeth: Absolutely. Well let's talk more about that. If this is truly toxic, then why don't we immediately recognize it as toxic just the way you'd recognize a toxic environment or a chemical that you'd say, “I want nothing to do with that”. How is it that we are so seduced and so taken in by this pattern?  Ramani: The cynic in me would say that the people who make the rules and run the media have really put out this image of the narcissist as this great thing to win over. I do think that we are taught at a relatively early age that charm, and charisma, and confidence are all great things, that these are wonderful things to look for. And in fact we are a very extrovert-biased culture…we think extroverts are healthier and in fact many people…you know in fact I have a graduate student working on this right now on her thesis and we're sort of frustrated because her and I are both introverts and having this moment where the extroverts come out better on almost all the mental health indicators. And what I had to explain to her I said, listen the extroverts are treated better by society, you know and so we are very biased to the person who's the life of the party, and we assume that the person who's the wallflower or sort of sticking to the corner that they're somehow lacking. And I do think that we are now especially in the last 20 years, Elizabeth, I think this has sort of spread like an accelerant on a fire with social media and other things like reality television, where we really do sort of celebrate shamelessness and attention seeking and all of that.  

But these patterns have been here for a long time. And when we take it take away from the sort of the grandiose piece of it, narcissism is also very much about domination and control. And so, these people were natural leaders well the natural leader also had most of the food most of the property was probably the one functioning better even in a tribe or a village. So, I think that this has always been the case that to the degree that there's a human alpha they're probably a narcissist. And that's who we're taught to value, follow, lead or may simply have had more than us and so I think that this is a story that's been sold to us so it does go back to this issue of why don't we teach this and I think that it feels uncomfortable because again it is such a massive paradigm shift and I don't think people understand it.  

I think we are very much in this, I hope it's something we end up talking about, we're very much there's a culture and I think a world of where we talk about the benefit of the doubt and giving people second chances and always forgiving without exception and I think what that does is it paints people into a corner, where they say this is this pattern's making me uncomfortable and someone else will weigh in and say maybe you need to give them the benefit of the doubt. And people are easily talked out of their sort of instinctual feel of “this does not feel comfortable”.  

People who are narcissistic read the room better than many other people because they have to. They need the validation of the people in the room simply to survive. It may matter less to the rest of us so reading the room becomes less important but by reading the room they know how to work their way through the room and I think that we really do need to learn though that a person who lacks empathy and is entitled and is grandiose and is not self-reflective. This is not healthy, and that we have to get out of the sort of benefit of the doubt mindset. 

Elizabeth: It's such a paradox because even with this insight we can tell that someone whose behavior is narcissistic is not actually having a great time, right? [Ramani: No.] They may in the moment, but they are they are suffering profoundly on the inside. [Ramani: Precisely.] And yet compassion and endless forgiveness and benefit of the doubt is not necessarily the road to health for anybody involved. 

Ramani: Well and there to wit is the challenge right because it is literally like walking on a razor's edge and the hardest thing for me has been to talk about this pattern as toxic but in the same breath to tell people please also be compassionate. I’d love to illustrate this by a story that literally has happened to me in the last 12 hours because it really affected me profoundly in a way I didn't think it would.  

Last night we found out that the president got coronavirus. Okay my politics would probably be very clear to anyone knowing that I study narcissism and I’m not particularly fond of what the Trump Presidency has created for our country. And when I found out it was 10 o'clock last night that he had gotten the virus, I was gleeful. I was happy. And for a moment I even put out a mean-spirited tweet I quickly took it back, but I was happy, I was gleeful that another human being got sick. I went to sleep I woke up and I felt absolutely awful. And the reason I felt awful was I still don't like his Presidency I still wouldn't vote for him, but in fact he is a human being and what has happened to me that I have sunk to that level of incivility and participated in an interchange that I don't think is right that I think is contributing to a larger problem.  

And I think that what has happened, and the reason I wrote Don't You Know Who I Am is that we have gotten to a point where this sort of toxic human interchange has become so modal and so normalized that without thinking we are very quickly sliding into it and when I really took some time this morning to think about it I thought the lesson for me there is I remain sort of indifferent to him. You know I’m not going to monitor his health status that's his business. But the desire to sort of get caught up in that made me reflect on things like how unjust I feel things are right now how unheard and how helpless I feel things are right now and how that led me to want to lash out. And if that's happening to me I know it's happening to many other people. So how could I step back and that the compassionate stance here was to not say anything. Yes, you know Schadenfreude, that sort of pleasure we might get out of a person's misery, it's very human it's I don't think the Germans would have come up with a word for it if it wasn't a human thing. But I didn't like what I’d become people would say “come on he deserved it” but that's a slippery slope.  

So, my attitude would be though let's bring him down to just being an ordinary citizen who's just sort of this really kind of mean-spirited, vindictive, kind of a person. I would say you need to set a boundary and get distance from this because it's not healthy for you to spend time with it. So rather than “hahaha” make fun of him for being sick and I realized how much I felt the injustice and the helplessness had pushed me into this toxic space and I had to take responsibility for that. It's not right for me you know to say something…it doesn't model a healthy behavior for my kids it doesn't model a healthy behavior for the world and so that moment of incivility taught me how sort of how far we've fallen is that we're all doing this right now and I can sense that we're all sort of on the edge of our seat so it's how can we all also take individual responsibility but that means how do you have compassion for somebody who's hurting you but also give yourself permission to distance yourself from the relationship.  

That cognitive dissonance, and cognitive dissonance is this idea as you well know, Elizabeth that the mind cannot maintain opposing thoughts simultaneously, so we craft justifications to make it all fit. The classical tale of that is sour grapes, right? So, we're kind of living in a sour grapes world right now we're trying to make the pieces fit. In this one they're not going to fit you can compassionately let someone go because they're hurting you.  

Elizabeth: Wow you said so much there. First, I just hear the contagiousness [Ramani: Yes, mhm.] the normalizing and the outrage fatigue and then the enactment that we all get caught into. And I hear again another impossible paradox of when someone beloved and dear to us is hurting us or is displaying these traits we can feel compassion for them and the wish that it would be different, and still need, to set boundaries to get distance to protect ourselves rather than waiting for imagining something that will change. 

Ramani: That's exactly right and I think that many people interact with narcissists. They interact with them as the person they wish they were rather than the person they are. And then what happens is the person they wish they were doesn't exist, so they keep getting frustrated that what's coming back at them is so hurtful. And so that's where I say this is what you're dealing with and so I really talk a lot about a concept called radical acceptance. This is it and I am sorry for whatever backstory they have that got them to this place it is not your responsibility to fix them or change them. And to let go of that responsibility but to do so with grace and not from a place of vindictiveness because then you're it's really it's like what is the old adage goes it's like swallowing poison and hoping that the other person dies, you know, it just it's not worth it for you but again it goes back to that word I was using Elizabeth which is justice.  

People feel that these relationships are inherently unjust, and the human brain doesn't do well with injustice, it was it was wired for justice, it was wired for sort of things you know kind of being balanced. We don't do well with hypocrisy we don't do well with injustice in fact that's a lot of Jonathan Haight’s work is on that and it's really fascinating because that's not what this brain does well so when we're faced with multiple injustices systemic injustices, injustice is all the way from the top you know levels of the government all the way into our day-to-day lives in our homes we start to snap and so people want justice and so they'll often stay in these relationships and want that justice delivered to which I say you know you kind of you're wasting a lot of life wasting the best justice here is that you set the boundaries or you get out of the relationship and then proceed to live a healthier life that's the justice but people often want something bad to happen to the narcissist that it won't feel right until that happens and that's the piece that I try to help people let go of.  

Elizabeth: In your book you speak about dealing with a narcissistic partner but also those folks that we didn't choose. A parent, a child, a family member where setting boundaries is heartbreaking and very challenging at times. A co-parent…  Ramani: Absolutely. It is it is a bit, uh you have to understand, it's also very intergenerational and sort of the tragic legacy of having a narcissistic parent or parents is that it really does leave the person honestly either committed to a lifetime of anxiety, a feeling that they're not enough a feeling that they can't even regulate themselves well, so there may often be struggles with alcohol or drugs or food, or just feeling they were never given that because they really weren't seen the narcissistic parent makes it about themselves in fact when the even when the child goes to the parent and says “mommy I feel sad” the mommy's response might be “well now I feel sad” and you're like “oh no, no, no, no” and so the child learns that their emotional value in the world is not only not valued, but it is that the parent is the only one who gets to corner that market which can really lead to a sort of a repetition of those cycles in adulthood and choosing partners that re-perpetuate those cycles and then yet another generation of children may come from that growing up with at least one narcissistic parent and the beat sort of goes on. 

And so these are legacy issues that really stick with people and that's also the heartbreak because you almost want to get to people before they choose their partner right? This is why I always think this would be such a key issue to teach about in high schools, that teenagers really need to understand this the entire sort of rom-com Disney princess you know kind of hegemony that has been pushed on especially women of looking for the prince waiting to be rescued these are really actually dangerous stories to tell and they really do become almost internalized sorts of mythologies that can also nascently push people to choose partners that are actually either narcissistic or domineering or controlling or “Beauty and the Beast is my favorite, and hey, let's find a rageful person who's going to control me and isolate me from the world and then I’m going to dance around with him and he's going to come around because of my love…”  

Just that one story, that mythology of “I will rescue someone with my love” I don't even want to think about how many lives have been destroyed over that myth. 

Elizabeth: Right. You know, you speak so clearly about confidence charisma and charm as things that are pink flags, magenta flags…things that we ought to really be paying attention to…that they sometimes coexist with humility [Ramani: Right.] and kindness…all kinds of other things, but not always.  Ramani: I would say not often and so, I would say when you meet someone trying charming and charismatic don't just run away, but spend the time peering behind the curtain. Look at their capacity for empathy, for closeness, for reciprocity. Are they capable of doing the dance of conversation? How do they regulate themselves when there might be a moment of disappointment or stress or interruption? 

Listen, I mean I’ve heard thousands of stories and worked with hundreds of clients on these issues and would almost say without exception in the intimate relationship space, most people said, “in the first month I knew something was off”. And these are people who've been married for 40 years [Elizabeth: Wow…] I mean these are not like new dating relationships they'll say “in the first month I knew, however, I was 30 uh you know and no one else was around…I didn't think I deserved better…” or “I thought this was normal” and all the justifications you hear but in many cases it was that after that first sort of charismatic spark the rest of it became very clear and I think that it's really instead of getting dazzled by the charisma and the charm it's about hunting for the intimacy and the uh empathy. And that's not what we teach people to look for. 

Elizabeth: It's not. Well, I’m so excited to hear later about your recommendations about education and how we would inoculate a cohort, right? [Ramani: Mhm, mhm…] a generation against narcissism both in expressing it themselves and then falling prey to it in another way. [Ramani: Right.] But I want to go back…you mentioned emotion regulation [Ramani: Yes.] like something happens and then how do people handle themselves can you say a little bit more about how emotion regulation is related to this whole phenomenon?  

Ramani: Mhm..so people with narcissistic personality styles or these more difficult personality styles… emotional dysregulation, trouble managing their emotions, is one of the sort of leading characteristics we see. So, a very quick ramping up into rage, blaming and lashing out at other people when there's a point of disappointment, when something goes wrong…very quick to say this is everybody else's fault and getting angry at everybody else.   

So this dysregulation is also associated with impulsivity, there's a lot of acting out, doing things without thinking in essence and because of that many times people with narcissistic personalities can hold a lot of power because people start walking on eggshells they're so terrified of upsetting this person that they end up enabling them and that regulation issue is actually considered to be most likely a sort of a social and developmental issue. That they say you know, “I would…” they being I, the royal…that they, and you know this as a psychologist, that much of the work of parenting is fostering empathy, regulation, self-soothing, and emotional vocabularies in our child. Multiplication will figure itself out okay, but that stuff you get one crack at that one. 

And so that idea of teaching the child to self-soothe, to experience disappointment even if it's something as little as playing a board game with a child. They lose, the child wants to throw a tantrum, and the parent then walking them through that landscape… many, many times adults who became narcissistic in childhood...those regulatory issues were already starting to come out. Whether it was impulsive rage, acting out at siblings, we see it and you'll see that sometimes in a family system there will be multiple children and only one is narcissistic and the others are well put together and they will often have a recollection even as children the sibling that went on to grow into the narcissistic adult was not as well-regulated, would act out a little bit more often, did have more sort of unsettling anger, and then so that implies that there might be a temperamental style associated with this too a sort of underlying temperament that may be more fragile that may be more sensitive but all of that said this really does come down to not being given that opportunity to learn to self-soothe in childhood, which then turns into an inability to self-soothe in adulthood. 

So, whereas the one-year-old can get a pacifier 40-year olds can't really get pacifiers but they sort of do. It might be drugs, it might be alcohol, it might be spending money, and then when the pacifier falls out of their mouth they start screaming and yelling and throwing adult tantrums which we see quite often in our world of grown people, grown adults throwing tantrums. 

 Elizabeth: Wow. So, yes…what I think I’m understanding is that when someone who displays this pattern has difficulty self-soothing or self-regulating rather than calling on internal resources to do that and continuing to be kind, they regulate using other people [Ramani: Yes.] so by making other people insecure—we would call this projective identification if we were in a dynamics class—but they actually create in others the experience that they are having and in such it's a consumptive way [Ramani” Precisely.] of engaging with other humans. 

Ramani: Precisely. You said it so eloquently, it's exactly what it is and in fact, a lot of Freud’s early work on projective identification did actually tie into sort of talking about these personality styles, frankly. So the idea of projective identification creating the chaos in the world that they are experiencing within is sort of a signature move of narcissism which is actually a way we could derive some compassion for them. Not enable them, not embolden them, but actually have some compassion saying “do you see this chaos this person is creating? They are a mess inside, this is like they're throwing up on us”. Okay, so this, this ickiness is inside of them but, I do not want you to sit here and put up with it, see? It's the but that is the issue so a lot of times like “they're suffering, they're struggling” and they put a period at the end of that sentence that period is not gonna—this is a compound sentence—[laughter]and so you really have to go on further and say and you know what, they're not three, they're 43 and if they can't figure it out you're not going to teach them how to regulate. They are an adult they can go get the help, therapy, whatever it is they need to get this under wraps. But a lot of people feel like “well…they had a tough start in life…well…they, you know, their dad abandoned the family or mom abandoned the family, or it was traumatic” I said I get all of that and my heart aches for that person and that does not qualify you to be their punching bag. 

And again it's like an outsourcing of emotional regulation it's really what it is for the rest of us the entire system is internalized I always say it's like a building with a scaffold, that's what a narcissist is, all of their regulatory abilities are all sort of outside the building. They're supposed to be inside the building and that's why we always see them and some of that regulation happens through grandiosity and entitlement “I’m so great, look how great I am! I’m the greatest!” that's regulation because if they keep saying they're great, then they are.  

Elizabeth: And that external regulation is fine for a therapist who gets paid for their time to help you regulate. It's not fine as a demand on the people around them. 

Ramani: That's exactly right. And yet that those are the people who bear the brunt of it and so…and listen, the literature is very clear, narcissistic individuals or people with narcissistic styles or even full-on narcissistic personality disorder are almost 60 percent more likely to drop out of therapy so just when you turn up the heat on a client with this personality style is exactly when they're going to stop coming. 

Elizabeth: Right. Because it's ego syntonic right? If they're not experiencing it as a problem, if other people are experiencing the problem, [Ramani: Mhm.] the motivation to really work on this is probably intermittent at best. 

Ramani: Yeah, it's intermittent, and I know what I’ve seen because I’ve actually, I would estimate probably a third of my clinical practice has been narcissistic clients, I mean the only way you're going to learn it is to sort of actually be present with it. And what you'll see is that typically what has brought them into therapy was a relationship failure, a workplace issue, or something sort of problematic like a lawsuit or something that would actually cause public shame.  

Those are the three primary reasons narcissistic individuals will come into therapy, that it is a regulatory issue, and in many ways they've often burned all the bridges they've had…they talked to every friend and everyone and nobody wants to hear it anymore or they're given an ultimatum. A partner will say “you either get therapy, or I’m out of here”. 

Elizabeth: Got it. Got it. You know, you're bringing to mind a little tiny story that I want to share. [Ramani: Mhm.] This happened so recently I uh…a dear friend and I were speaking about a third individual and I found myself saying to my friend “oh you've got to pick your battles with him don't, you know, don’t bother bringing this up…don't…you know, don't go there” I was really coaching her to hold back and she took my advice. And then a few days later she called me and said “Liz, you know, I’ve thought about this, and while pick your battles may be good advice, it's also a sign that that person has made it so unpleasant to be challenged, right? [Ramani: Yep.] …has made it so punishingly difficult to raise anything with them this is not a healthy system” [Ramani: No, it’s not.] …she said “you know in a healthy system, you raise things and it gets resolved or it doesn't, but it's not a trauma for anybody involved and nobody's terrified of it”.  

Ramani: That's exactly it. You nailed it right there is… when I wrote the book Should I Stay or Should I Go it would have been very easy to write a book that was called Go. [laughter] But the fact is about 50 percent of people stay in these relationships and their reasons are incredibly valid: culture, money, children, fear, age…I mean myriad reasons and as far as I’m concerned no one's reason to stay was judgeable. You know that this is what they felt was right [Elizabeth: Mhm.] they also didn't understand what they were dealing with.  

So when I put together that section of the book what I said to them was you know, to stay in this relationship you can't really share anything…you can't share good news because they will minimize it and trivialize it…you can't share bad news because they'll either mock or humiliate you or minimize it again, so you're really only stuck with the weather…can you bring in the mail…did they change the trash day because it's a four day week…like that's it. You cannot be vulnerable, you have to be, you're again, you're being very careful…like you said it's choose your battles to the point that it's no longer an authentic relationship. And people say “well this isn't an authentic relationship anymore” I said “exactly, it never was, you were never able to be yourself because you were so fearful of their reactions” and that's often a wake-up call for people who say “okay I’m out”.  

You know but they almost needed to see that this now it's working there were no more the bouts of rage and all of that but there was nothing there they weren't speaking about anything there was no more relationship left. And if anything when they stopped giving the narcissist the fight, the bait, or anything, the narcissistic partner would get very angry at them because it was almost like “well we used to be able to fight and this is where I would kind of basically get my energy out you're not even giving me that” and so, for many people it was a wake-up call but not for all, and some people interestingly said “now I figured this out…” and I’ve seen different relationships take different paths with this very sort of neutral sort of nothing stance because they didn't want to split up homes or you know assets or they had issues with children whatever the reasons were…but that's it…there isn't a lot of there there…and to me that is a lot of enabling, but what's interesting, I frame it differently if you know what you're dealing with and it's very intentional then, it may not be enabling as much as “I am not going to put myself in the line of fire anymore now that I understand how this works”.  

But many people become very sad because there are three things that keep a narcissistic relationship together: hope, fear…actually four…hope, fear, guilt, and lack of information. So hope that it's gonna get better, fear of being alone, or the uncertainty of the future, guilt actually that if I leave this narcissist they are not going to be able to take care of themselves, and then finally lack of information because people don't understand these patterns really are not amenable to change. So, the idea of “I’m going to stay here and I’m going to try it this way and try it that way I’m going to shift strategies…” over and over to see if the narcissistic person will change…they're not going to.  

So, then it really comes down to radical acceptance that if I stay in this, this is this is it. This is what it is… and some people go on, Elizabeth and they end up focusing on their careers…they focus on their friendships and some when they're not with very controlling narcissistic partners they almost kind of carve out a life for themselves. I hate to say more than a few have gone on to have extramarital affairs saying “at least I want to feel touched and connected to again” and you know, I completely understood why that was…so they just felt like “it was the first time I had felt connected to a human being in 25 years”. So, people find their workarounds you know, and that's very personal. 

Elizabeth: Wow, thank you. You know, I want to go back to something you said earlier when you were talking about how narcissism emerges in in a family [Ramani: Mhm.] and you use the words domination and control [Ramani: Yes.] which perk up my ears around gender [Ramani: Correct.] and how boys and girls are socialized differently and I wonder if you could speak to how that whole thing happens.  

Ramani: So I think that you know, the issue around gender and narcissism is actually a really sort of interesting…a bit of a third rail [Elizabeth: Mm…Mhm.] I even I think and I made the error often to say well, this is a very male part a very male pattern, but then when I break down how many people have come into therapy and said they had narcissistic mothers, I’m like well clearly there's a critical mass of women who are narcissistic if this many people have this toxic sort of, um,  difficult mothers.  

That said, you're absolutely right about the socialization process. It is more prevalent in men, there's no two ways about it, and part of that is socialization part, how we shame emotion in the development of boys. We teach them that emotion is weak, that it is ridiculous, they are often humiliated for it or worse if they attempt to share emotion… that is rendered on the play yard with their male peers, that is sometimes reinforced by teachers, it is certainly reinforced by parents. We don't cultivate emotional development and emotional vocabularies in boys the same way we do in girls, we do not give permission to it.  

Then we also foster that sense of domination, which is partly done by society, where we do still put forth a very authoritarian, a very patriarchal kind of a model which is sort of delivered as a given. So that's definitely going to play to the gender hierarchies, the idea that men need to dominate and control if they don't they're not doing it right even, that what we see about classroom behavior…how teachers engage male students compared to female students even in the earliest, earliest grades so it is a socialization that comes up, up, up, and up…continued as late as grad school. 

I mean, I’m sure you've been in professional meetings where you see that play out [laughter] and domination control and male hierarchies…I’m thinking how is it I’m in a room full of psychologists and I’m almost looking around like…anyone else seeing this? It's everywhere and so, I do think though, that where we do men and boys such a disservice is by shaming emotion, shaming vulnerability because I think right there you say “what would the curriculum look like?” it would be that, but the problem is Elizabeth, is the schools could do it but you've got to get the families on board. You can only do so much at school and then throw them back, and can you imagine that child is sent back into a household where all of that emotional training is then degraded by mother or father, I mean it could be either gendered parent that could humiliate them for that… so this is a much bigger societal conversation I think the schools are a place to begin, but if you don't get that buy-in at home, if anything that child—especially a male child—could learn to be contemptuous of delivery of emotion and vulnerability and that's sort of where we are right now is still that that sort of sense of male strength being viewed as contempt for emotion.  

Elizabeth: It puts youth in such a bind where they have emotions right, [Ramani: Yes, mhm.] they're not going to stop having emotions, but then they have contempt for their emotions [Ramani: Correct.] which requires a convoluting, an inverting and then an externalizing of that emotion in ways that are socially acceptable but absolutely toxic. 

Ramani: Correct. 100 percent toxic and that right there is so much of the conversation and with each passing year the other thing that would be part of such a curriculum, because if the core of this is insecurity, really the answer is to stop rendering insecure people. How do we create a world full of people who feel comfortable in their own skin? To me that actually starts going into a very interesting sociological angle…secure people don't buy stuff like, “I’d be fine with this one shirt, I would wash it every time and maybe I’d have a second shirt, and I’m good to go. I don't need 25 shirts” you know?”  

I wouldn't fall for the insecurity of I want what they have, I need what they have, and so those kinds of again…this isn't just about let's play Chutes and Ladders and then I’ll deal with you losing…this is a much bigger conversation about how do we raise secure people and how do we maintain them as secure adults?  

I’m a college professor at California State University of Los Angeles and it comes up all the time with the students who say you know social media is destroying us. We even we know we shouldn't be doing this and yet we compare ourselves to others, and look at the lives of others, and always assume that what they're doing is better…somebody always has more. All of this fosters this sense of insecurity, which is where the lashing out comes from, but when that comes from early childhood and then just gets reinforced all the way into adulthood, that's where you really run into a mess and what better way to protect against that insecurity than to just walk around saying you're the king or queen of the hill? 

Elizabeth: Part of what I hear you saying here is that secure people are not profitable.  

Ramani: Oh, they're not at all.  

Elizabeth: Right, and that they have powerful interests tied up in people being insecure and being in a consumeristic pattern to try to maintain a fragile sense of okay-ness. 

Ramani: Mhm, keep people insecure and you'll be able to control them, and you know, I know that's a very cynical thing to say but it's very honest and  if we would even view it through a lens of a cult, an organization that might coax people in, keep them under the control of a very strong leader, the commonality amongst those members is a desire to belong and often a sense of insecurity that then is replaced by somebody who they identify with telling them “no you're fantastic”. Right, so that becomes the tool, and then it becomes a tool of control…but secure people don't consume as much, secure people just sort of quietly kind of and authentically go through the world…secure people probably aren't that much on social media, they may look at it to get a recipe for an apple pie, but they're certainly not getting into the weeds with it. 

 And so, it is the answer, I mean if there was one answer, somebody said you had a magic wand you could do one thing, I’d say I’d want to make everyone in the world feel more secure. If people felt more secure, there would be no reason for one person to have 150 billion dollars while most of the rest of the people have next to nothing…there would be no need for that because you'd say “oh I got more than enough so how's about we start spreading this out to everyone?” you know it's that sense power, dominance, and control which is reinforced by these societal systems…to me these systems are narcissistic -  they lack empathy ,they're entitled, they're grandiose, they're arrogant, they're validation seeking…that's a system doing that so we're all in relationships with narcissists.  

People might be walking right now “my mom and dad are great, my partner's great, my friends are great” no, you're in a relationship with a narcissist and it's called the world at large.  

Elizabeth: Well I love that we can have this conversation, that we are not just assessing or diagnosing an individual the way the DSM kind of draws little lines around the individual [Ramani:Mhm.] but opening our conversation to communities, systems entire societies, and you know, the phenomenon of gaslighting [Ramani: Mmm…] has gained recognition in recent years thankfully, but what I what I start to think about is marginalized groups who have been gaslit collectively [Ramani: Absolutely.] for hundreds of years. 

Ramani: It's so interesting to me that the word gaslight has such an interesting history. I’m sure many may know this, but if not…there was a play that came out in the 1930s and then that got followed up with the 1944 American film starring Charles Boyer and Ingrid Bergman, and if you haven't seen it you gotta see it, because I cannot believe in 1944 such a prescient film was put out there. But when you really look at the film Gaslight it's not just somebody who's fooling around with the lights..gaslighting is a grooming process and the grooming process is predicated that the gas lighter either has expertise or authority or trust and with that power it's not just about confusing their victim it's about gaining their consent…so as though they're signing on to this process and then completely are under the control of the gaslighter, and you're absolutely right then does that not describe what societies do?  

We know what's better for you, we got you…because that's every colonized culture in the world...we know what's better for you, you're backwards let us come in and fix it. That's gaslighting. All colonization was on the basis of gaslighting, and yet we didn't have the word until recently…I don't know what people called it prior to the 1930s, to be honest with you…I’ve always wondered you know, because honestly the word narcissism wasn't used in the world of people and mental health until 1910 when Otto Rank used it for the first time. Up till then it was a myth about the young man who was cursed to have to stare at his reflection, but it is very much a societal phenomenon, and it is how you can keep control and maintain marginalization in marginalized groups, by gaslighting them. When you're gaslit Elizabeth, you're confused, and when you're confused you're inefficient, you're off balance, you're full of self-doubt, and you're constantly trying to make up ground like maybe this is me, and maybe I am the one who's losing my mind, and I don't even know where to turn anymore and then you isolate. [Elizabeth: Mhm.] 

The only antidote to gaslighting is to hold on to your reality for dear life and say it's an interesting version of events, but I’m good over here like, I got me, you know…if only you know Ingrid Bergman had said “no I know I put my necklace in the in the bag, I know it”. But we're all taught to have that sense of self-doubt, like well no maybe you are the one who's wrong…think about how many times that we say, how many times we even ask people the question, are you sure? That's like a mini gaslight [Elizabeth: Hmm…] they said they're not hungry, they're not hungry. Not are you sure they're not hungry.  

So we do it…we do micro gaslights all day long without even thinking about it, but these macro gaslights aren't just person to person, they're society to person, and they are a way to ensure that a marginalized or an oppressed group cannot climb over the wall and when we are seeing really painful reckonings on race, as we have this year, it is an attempt to push past that gaslight and look at the amount of pushback there's been.  

Elizabeth: I mean, it's messaging baked into the fabric of our country right? Life, liberty, and the pursuit of happiness…equal opportunity, all men are created equal [Ramani: Mhm…] that's the messaging [Ramani: Mhm] and no wonder people feel crazy, like that is not my experience.  

Ramani: Exactly. Exactly, and so it does, it slowly...it destroys a person from the from the inside out... and so it's very interesting because, I’m going to sort of be a bit of a Gaslight spoiler here, but what ends up saving Ingrid Bergman’s character is that one other human being bears witness. One other person steps in and says, “you know I think something funky is going on here” and this is where all of us need to remember when we see someone who is gaslighted, whether it's at a meeting, whether it's a friend of ours, do not stay silent. [Elizabeth: Mmm.] Go up to them and say “I just saw that happen, are you okay?” because a person will say “that was real?” and say “yeah it was”…if enough of us did that for each other, you have no idea how much healing would take place.  

I can say this as a woman of color, is that I have been in meetings, and I one of the most profound anti-gaslighting experiences I had was relatively recent and I was on a Zoom call with multiple people, and something had happened that was really not right, and I let it go…I thought “well maybe I misread the situation”…I gaslighted myself…it's very clever, right? And that night I got an email from an African-American woman in the group and she said “I am so hurt. I’m in so much pain after watching what you've gone through.” and I have to tell you I just cried and cried when I read the email because I didn't feel crazy. I feel always I have this little debt to her because in a moment where I was gonna go to bed convinced I was wrong, and I felt so deflated, I felt I had let this group down..she said what was done to you was so wrong…the profundity of that email we all have the capacity to pay attention and un-gaslight the people around us. 

Elizabeth: Thank you for sharing that. Yeah, I think we have all been there. Been rescued in a sense [Ramani: Yeah.] by somebody who had the courage to speak up, whether it was about race, about power, about gender, about something teeny but noticeable. 

Ramani: Yes. Yes, and to check in and say “I saw that” maybe that's all you do, you don't do anything more, you can't fix it, but you can say I saw it. Again, that was the clincher in the film too, somebody said I saw it, and then you see what happens to her character once she feels that “I’m being seen” and when we see this in the relational space, for example in the domestic violence space, gaslighting is universal… it's in 100 percent of domestic violence cases…you'll see gaslighting…that entire campaign of isolation that the perpetrator will place on the victim in the domestic violence situation means that the gaslighting can go on without anyone addressing it, and this also elevates to another interesting issue around culture because another phenomenon that I’ve talked about is…I call it gaslighting by tribe…it's when multiple people gaslight you, so this can happen in a family system… so let's say there's a narcissistic mother or father who is mistreating someone in the family system…and the person who's being gaslighted saying “can you believe she said that?” and everyone's saying “stop making such a big deal about it, it's not that big a deal”…like let it go she only wants what's good for you [Elizabeth: Mmm.] So now, multiple people are doing this, the family is closing ranks you know, and because it may be that family loyalty sort of is more important than having someone bear witness in that family, and in the most tragic cases, and I’m sure you know a lot about this, Elizabeth, is when there are cases of abuse within a family…when there's sexual abuse happening in a family, [Elizabeth: Of course.] how many times that that is gaslighted by a family, and we know that the children who have the best outcomes after they've had that violation of trust are the children who had somebody who was willing to bear witness.  

This is the antidote, and as long as we're being gaslighted by a country, we need someone to say this is not okay, this is what is being done to you, and it means you have to be comfortable with your own reality and back to the idea of a curriculum, that's what needs to happen for kids - your reality is valid not “Johnny didn't mean it” or “Give Mary another chance” or “Give Joey the benefit of the doubt”. We have to teach kids that's not okay, in fact I remember even when I had small children saying, to them “you are never to treat your classmates with disrespect ever, but you never have to feel compelled that you have to play with someone” I wanted them to know that they could feel that they could set a boundary and not be forced into some sort of amicable playful encounter that they have to enjoy. I said it's okay to say “I’m going to keep playing my game by myself” but it's never okay to disrespect. I was trying to teach them even at that young age how to walk the razor's edge. 

Elizabeth: I love this. Okay, so let's imagine that our country wakes up tomorrow with renewed conscience and insight and says, Ramani the trillions of dollars that are buried in millionaires pockets is now going to you, and your task, your invitation is to inoculate our society against this pandemic, shall we say…whether it's educating young children, changing social media, changing the culture of executive leadership…what are some of the things that you would put in place?  

Ramani: Number one above all else, I would ensure safe spaces for children and protect children from trauma. I think the traumatic exposures that children go through, that not only put them at risk for choosing harmful relationships in adulthood, that it also engenders people who issue harm and have these kinds of high conflict personality styles. I would then say in schools, like at this point they got calculators…can we just let go of the adding and the subtracting and maybe the long division…like we're good! [laugher] But can we build in structured curricula from preschool on where, and all the way through high school, drop the AP classes teach…them empathy, teach them compassion, teach them emotional regulation, but not in a stigmatized way. What we do now with a dysregulated kid is we label them, we punish them, we humiliate them instead of really working on ways where we do frustrate them and then help them come back off that frustration like really like you do in your work you're very experiential kind of work I mean I think that that's actually the most profound powerful form of doing any kind of therapeutic intervention is do it in the moment don't talk about it like it's happening but do it like feel it and then talk about it but we need much more innovative curricula around really doing emotional regulation we need to bring the parents…schools cannot be siloed anymore it cannot be you go to school and then you go home we have to make parents partners in the schools…we know that honestly since time immemorial, and this really hit a really rough patch during the Nixon Presidency, where he really held back a lot of money that was starting to go towards more sort of social development programs saying those are issues of the family it's always been sort of a conservative stance on family issues need to stay in the family which is code for we don't want to spend money on these programs.  

And so that idea of creating family/school partnerships, making these communities almost like it's an extension of the home and vice versa and the home is an extension of the educational space that we have to sort of break down some of those walls and see the schools as the profound social spaces that they can really be.  

I think we've got to teach kids very young how they're being manipulated by media…you know, I once taught a graduate class on media psych, and I was teaching my students by the end of the semester it was like how many tens of thousands of ways they had been manipulated by Facebook and advertisers and a lot of them said “I feel like I’ve just come out of the fog”…you know “I fell for all of it”… I said “of course you did - nobody taught you at a very young age” but you know there's such a fear of…we don't want to turn our kids into cynics…I’m a big fan of turning our kids into cynics, a really big fan because I still think they'll be able to see the joy in a butterfly. 

And then I think we need to make mental health as regular as pediatrician exams. They should be with a developmental psychologist or child psychologist we should be getting physicals, the way people get physicals, they should be in a therapist office at least once a year…therapy should be much more readily available it should not be a luxury product I think if we have that there might be more of a likelihood to be able to talk about feeling and talk about these issues together. I think we have to revamp how we talk about leadership  you know, I think that we have to start pushing into leadership the people who literally don't want to be in leadership because they don't want the headache of leadership because I think people…there's good research showing that people who are more narcissistic actually are the ones who tend to push for leadership…so there's a lot of work we need to do, but if I had to put it all in one place, it would be to protect children from trauma. 

Elizabeth: Thank you. I really appreciate that. I am having a moment of compassion for anybody out there who's listening who's going “oh my God, I’ve been a jerk, I’ve lashed out, I’ve had moments where I didn't disclose the whole truth of what was going on for me”…what would you say to someone who's out there thinking, “oh man, am I a narcissist?”  

Ramani: Moments aren't my concern. Persistence and pervasiveness are. Okay so, patterns are persistent. They're there more often than not…we all have moments; we have all yelled at somebody in Starbucks because we didn't get enough sleep. The right thing to do is go back and say, “I am so sorry, I should I should not have taken that out on you”. You know, we have the capacity to do that, whenever we're not graceful we can then go back and walk in grace it's always possible…and so I think that what we're looking for are people who are contemptuous of other human beings, who view other human beings as conveniences in an instrumental utilitarian way…and how we manage ourselves after the fallout of our moments, we're all going to have moments, but how do you talk about the moment afterward, how do you approach someone, are you willing to take responsibility for it, are you willing to take ownership and say “I was out of line and I am so profoundly sorry”…and “you don't even have to accept that apology, I am sorry I did that to you, and that's that”…you know it's really, it's ownership… 

I think that probably most of the people watching this aren't narcissistic [laughter] they would have gotten bored in the fifth minute…but I get that question a lot, you know, what if I am a narcissist? And so I break it down for them, and they'll say “no…I’ve probably got too much empathy”…but we're also in a culture that is so interesting and back the points you'd raised about gender and oppression and marginalized groups is that I’m amazed at how many people, where when all they do is take care of themselves a little, they think they're being selfish [Elizabeth: Mmm.] and that's part of a socialization process of that idea of like it's okay to take care of you, but a lot of people, particularly women have often gotten that message that there's something somehow selfish if you are…you know at one point saying this evening I’m going to do something for myself, and sadly if they do have a difficult person in their life they'll often jump on that and say “you're being awfully selfish doing what you need for yourself”…so I do think that there's people out there who “oh my gosh today I actually decided to just put my kids in front of the TV and have a glass of wine, or I read a book”…I’m like you rock on sister, good for you, you need to do that from time to time versus like I feel like I’m a narcissist and no, no, no… you know occasionally caring for yourself is not narcissistic, it's necessary. 

Elizabeth: I’m appreciating your grace and your humanity as you speak about all this and I wonder if there's anything else that I didn't ask about or that we haven't touched on yet that you want to name? 

Ramani: You know, as I said, there's a term I use in in my book, I call it tend to your own garden, which is this idea that many people want to fix other people's messes like “I don't like this, I don’t like that…” like I said I did not conduct myself well when I heard that the person who is currently the president United States got sick, I could have just said “I just need to be indifferent to this and not speak negatively about it”… we can all find a hundred small ways a day that we can be more civil let…someone go ahead of us in a line, let someone go ahead of us in a line of cars, say please, thank you, and ask a cashier how their day was…take an extra minute in an email to check in on how someone's feeling or how are you doing instead of like yeah sure, yeah, done…and you know we're all guilty of it in this very quick pressured culture, and so I just want to tell people attend to your own garden. Find five ways each day that you could have been more civil, or empathic, or kind because the odds are then that somebody may end up paying that forward and like I said the final piece, if I had a trillion dollars is how could I help everyone become more secure…is how can you foster that security in other people? Listen to them, care about them, be interested in them…it is amazing how many people out there don't feel seen or heard and so if we could see and hear each other more, I honestly think that you can even be with someone who has different views than you and still be able to hold space for each other. 

Elizabeth:  Thank you, I love that. It's not rocket science, it's not fancy gold standard psychotherapy…it’s human kindness, paying attention, showing up. Well, thank you – this has been such a delight.  

Ramani: My pleasure, thank you. 

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Thank you for listening to the CIIS Public Programs Podcast. Our talks and conversations are presented live in San Francisco, California. Podcast production is supervised by Kirstin Van Cleef at CIIS Public Programs. Audio production is supervised by Lyle Barrere at Desired Effect.  

The CIIS Public Programs team includes Kyle DeMedio, Alex Elliot, Emlyn Guiney, Jason McArthur, and Patty Pforte. If you liked what you heard, please subscribe wherever you find podcasts, visit our website ciis.edu, and connect with us on social media @ciispubprograms.  

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