In this video, Dr. Ettensohn examines the online narc-abuse ecosystem and explores how content that initially feels validating and supportive can, over time, become thought-constraining and socially isolating for some viewers.

Drawing on clinical experience and established research on high-demand systems, Dr. Ettensohn analyzes the rhetorical patterns commonly used across narc-abuse channels: the elevation of the viewer as a lone truth-seer, the narrowing of acceptable interpretations, the use of loaded psychological language, and the gradual erosion of trust in ordinary relationships. He shows how these dynamics can reshape identity, undermine critical thinking, and foster increasing dependence on content creators rather than encouraging reflection, complexity, or professional consultation.

Throughout the video, Dr. Ettensohn carefully distinguishes between genuine abuse and the expanding, imprecise use of narc-abuse language online. He emphasizes that acknowledging harm and seeking clarity are legitimate and necessary, while also warning that one-size-fits-all narratives can distort meaning, escalate conflict, and contribute to unnecessary social rupture. The focus is not on dismissing people’s pain, but on examining how certain explanatory frameworks operate psychologically and what they may unintentionally cost the people who adopt them.

This video continues Dr. Ettensohn’s clinically grounded effort to bring nuance, rigor, and psychological depth to public conversations about narcissism, offering a perspective that prioritizes complexity, reality testing, and relational context over certainty, moralization, or ideological alignment.

Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact

Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH

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This video continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn with his associates, Deanna Young, Psy.D., and Danté Spencer, M.A.

In this session, the group discusses Empathy and Narcissistic Personality Disorder: From Clinical and Empirical Perspectives (2014), examining the long-standing assumption that narcissistic personality disorder is defined by a lack of empathy. Drawing on the article’s review of empirical findings and clinical case material, the conversation explores empathy as a multidimensional and context-dependent capacity rather than a fixed trait.

Key themes include the distinction between emotional and cognitive empathy, the variability of empathic functioning across grandiose and vulnerable narcissistic states, and the ways shame, threat, and affective overload can disrupt empathic engagement in intimate relationships. The discussion highlights how empathy may appear intact or even robust in some contexts, while collapsing in situations that feel most emotionally consequential.

This video continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn with his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Empathy and Narcissistic Personality Disorder: From Clinical and Empirical Perspectives (2014), examining the long-standing assumption that narcissistic personality disorder is defined by a lack of empathy. Drawing on the article’s review of empirical findings and clinical case material, the conversation explores empathy as a multidimensional and context-dependent capacity rather than a fixed trait. Key themes include the distinction between emotional and cognitive empathy, the variability of empathic functioning across grandiose and vulnerable narcissistic states, and the ways shame, threat, and affective overload can disrupt empathic engagement in intimate relationships. The discussion highlights how empathy may appear intact or even robust in some contexts, while collapsing in situations that feel most emotionally consequential. The seminar also addresses common misunderstandings of neuroimaging findings related to empathy, emphasizing the limits of biological reductionism and the importance of viewing brain-based data as correlates of experience rather than determinants of destiny. Throughout, the group reflects on clinical implications for treatment, including the differentiation between motivation-based and deficit-based empathic disengagement, the role of affect tolerance and reflective capacity, and the relational conditions that support the gradual restoration of empathic availability.

This series is intended for clinicians, trainees, and others interested in a nuanced, non-moralizing understanding of narcissistic personality disorder, empathy, and psychological development.

To learn more about our work, visit www.HealNPD.org

Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact

Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH

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Citation for the article discussed: Baskin-Sommers A, Krusemark E, Ronningstam E. Empathy in narcissistic personality disorder: from clinical and empirical perspectives. Personal Disord. 2014 Jul;5(3):323-33. doi: 10.1037/per0000061. Epub 2014 Feb 10. PMID: 24512457; PMCID: PMC4415495.

Full text link: https://pmc.ncbi.nlm.nih.gov/articles/PMC4415495/

This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. I

n this session, the group discusses a recent meta-analytic review examining suicide-related outcomes in narcissistic personality functioning. The conversation explores why studies using DSM-based diagnoses of Narcissistic Personality Disorder consistently fail to predict suicidal ideation, attempts, or self-injury, while dimensional measures that include vulnerable narcissism show strong and reliable associations with elevated risk.

Themes include the distinction between grandiose and vulnerable self-states, the limitations of trait-based and purely behavioral diagnostic models, and the deeper affective and regulatory structures that define pathological narcissism.

The team examines how shame, identity instability, emotional dysregulation, and collapse of self-esteem stability contribute to suicidality—and how grandiose presentations can mask underlying fragility in ways that obscure clinical risk.

Throughout the seminar, the group reflects on the developmental and relational origins of vulnerable narcissism, emphasizing the role of early emotionally invalidating early environments, contingent self-esteem, and dissociated self-states in shaping defensive functioning.

The discussion also highlights clinical challenges in assessing suicide risk in narcissistic patients, including the role of masking, externalization, and shame-driven withdrawal.

This seminar is designed for clinicians, students, and anyone seeking a nuanced, clinically grounded understanding of narcissistic personality functioning, suicide risk, and the hidden dimensions of vulnerability that are often overlooked in public discourse.

To learn more about our work, visit www.HealNPD.org

Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact

Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH

SUBSCRIBE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8

Citation for the article discussed: Sprio, V., Mirra, L., Madeddu, F., Lopez-Castroman, J., Blasco-Fontecilla, H., Di Pierro, R., & Calati, R. (2024). Can clinical and subclinical forms of narcissism be considered risk factors for suicide-related outcomes? A systematic review. Journal of Psychiatric Research, 172, 307–333. https://doi.org/10.1016/j.jpsychires.2024.02.017 Full text link: https://www.sciencedirect.com/science/article/pii/S0022395624000803

In this episode, Dr. Mark Ettensohn responds to a common question: How can someone with a perfectly normal and mostly happy childhood develop narcissistic personality disorder? The discussion challenges the widespread misconception that narcissism is simply a personality type, a collection of traits, or the result of genetics alone. Dr. Ettensohn explains that pathological narcissism is a disorder of self-esteem regulation and identity formation, not just a pattern of behavior. Drawing on clinical research and developmental theory, he explores how early experiences that appear loving and stable can still leave important parts of the self unseen, unrecognized, or conditionally valued. These subtle, chronic relational injuries, repeated over years rather than occurring as a single traumatic event, can distort the developing self’s capacity to maintain a stable and realistic sense of worth. The episode distinguishes between “popular narcissism,” which focuses on abusive behavior, and clinical narcissism, which reflects an internal system of dysregulated self-esteem. Through metaphor and clinical reflection, Dr. Ettensohn illustrates how a child can grow up in an environment that looks healthy on the surface yet still learn to equate love with performance, value with achievement, and safety with control.

Additional Resources Website: https://healnpd.org Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 BECOME A MEMBER: https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join Article Citations: Vater, A., Ritter, K., Schröder-Abé, M., Schütz, A., Lammers, C.-H., & Roepke, S. (2013). When grandiosity and vulnerability collide: Implicit and explicit self-esteem in narcissistic personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 44(1), 37–47. https://doi.org/10.1016/j.jbtep.2012.07.004 Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400.

This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Narcissistic Personality Disorder: Progress in Understanding and Treatment by Igor Weinberg, Ph.D., and Elsa Ronningstam, Ph.D. The conversation examines recent advances in how clinicians conceptualize and treat narcissistic personality disorder, moving beyond fixed trait models toward a dynamic, relational understanding of the self and its development. Themes include the interplay between grandiose and vulnerable self-states, the interdependence of self-esteem regulation, affect, cognition, empathy, and interpersonal functioning, and the recognition that narcissistic pathology evolves through cumulative disruptions in early attunement and relational safety. The discussion also explores how developmental misattunements - whether through neglect, overindulgence, or inconsistency - shape defensive adaptations and contribute to the oscillation between self-inflation and shame. Throughout the seminar, the team reflects on the therapeutic process of working with narcissistic patients, emphasizing empathy, reflective capacity, and the slow, relational work of rupture and repair that makes genuine transformation possible. This series is designed for clinicians, students, and anyone interested in a nuanced, compassionate understanding of narcissism, personality, and psychological change. To learn more about our work, visit www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH SUBSCRIBE HERE: https://rb.gy/kbhusf LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 BECOME A MEMBER: https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join Citation for the article discussed: Weinberg I, Ronningstam E. Narcissistic Personality Disorder: Progress in Understanding and Treatment. Focus (Am Psychiatr Publ). 2022 Oct;20(4):368-377. doi: 10.1176/appi.focus.20220052. Epub 2022 Oct 25. PMID: 37200887; PMCID: PMC10187400. Full text of the article: https://pmc.ncbi.nlm.nih.gov/articles/PMC10187400/

This episode continues the Heal NPD Seminar Series, featuring Dr. Mark Ettensohn and his associates, Deanna Young, Psy.D., and Danté Spencer, M.A. In this session, the group discusses Principles of Psychodynamic Treatment for Patients with Narcissistic Personality Disorder by Holly Crisp, M.D., and Glen Gabbard, M.D. The conversation explores how psychodynamic clinicians conceptualize and treat narcissistic personality disorder, emphasizing the disorder’s pleomorphic nature - its capacity to take many forms depending on context, stress, and level of personality organization. Themes include the oscillation between grandiose and vulnerable self-states, the role of shame as a central organizing affect, and the therapist’s challenge of moving flexibly along a supportive–interpretive continuum. The group also examines common transference and countertransference dynamics, the integration of Kohut’s and Kernberg’s models, and the transformative role of rupture and repair in the therapeutic process. Through candid discussion, clinical reflection, and moments of humor, the seminar illustrates how empathic attunement, flexibility, and authentic connection form the heart of effective treatment for pathological narcissism. This series is designed for clinicians, students, and anyone interested in a deeper and more nuanced understanding of narcissism, personality, and the process of psychological healing. To learn more about our work, visit www.HealNPD.org. Citation for the article discussed: Crisp H, Gabbard GO. Principles of psychodynamic treatment for patients with narcissistic personality disorder. Journal of Personality Disorders. 2020 Mar;34(Suppl):143-158. doi: 10.1521/pedi.2020.34.supp.143. PMID: 32186987.

In this episode, Dr. Mark Ettensohn challenges one of the most persistent distortions in contemporary discourse on narcissism: the myth of “the narcissist.”

He explains how this cultural archetype, an image of coldness, cruelty, and manipulation, has eclipsed legitimate clinical understanding of Narcissistic Personality Disorder.

Drawing on both the peer-reviewed literature and his clinical experience, Dr. Ettensohn describes how terms like narcissistic abuse, covert narcissism, and narcissistic supply have come to dominate popular psychology despite lacking grounding in peer-reviewed research.

The episode explores how this narrative misleads clinicians, alienates patients, and perpetuates stigma, while offering a more accurate view of pathological narcissism as a defensive structure rooted in shame, vulnerability, and loss.

Dr. Ettensohn argues that it is time to discard the myth of “the narcissist” and replace it with a more compassionate, evidence-based understanding of NPD...one that recognizes both the pain it causes and the suffering it defends against.

Additional Resources

Website: https://healnpd.org

Newsletter: https://healnpd.substack.com

Assessment and therapy inquiries: https://healnpd.org/contact

Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH

Related Links:

In-depth exploration of the DSM NPD construct: https://youtu.be/I2fD65wy48I

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This episode marks the beginning of a new educational series from Heal NPD, featuring Dr. Mark Ettensohn and his associates: Deanna Young, Psy.D. and Danté Spencer, MA.

This series offers a rare window into clinical reasoning and supervision, bringing viewers inside real discussions about theory, diagnosis, and treatment of personality pathology. In this first seminar, the group examines an influential paper by Pincus & Lukowitsky (2010) and explores one of the central challenges in the field: how to define pathological narcissism.

The conversation addresses the criterion problem surrounding narcissism. That is, the lack of a unified construct definition. It traces how this has led to conflicting models and measures of narcissism.

Topics include the distinction between pathological narcissism and NPD, the interplay of grandiosity and vulnerability, the overlap with depression and trauma, and emerging dimensional approaches to understanding personality.

This series is designed for clinicians, students, and anyone interested in a deeper and more integrative understanding of narcissism, personality, and self-regulation.

To learn more about our work, visit www.HealNPD.org

Citation for the article discussed: Pincus, A. L., & Lukowitsky, M. R. (2010). Pathological narcissism and narcissistic personality disorder. Annual Review of Clinical Psychology, 6, 421–446. https://doi.org/10.1146/annurev.clinpsy.121208.131215