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I was just recently working on rage with my therapist. I don’t express it much but it’s frequently “there”. You don’t have to be a psychopath for narcissistic rage to be an issue. According to my therapist it’s a defense for sad, diminished feelings of loss. And if you have accumulated feelings like that from childhood and/or even a specific trauma, the inability to tolerate loss and “diminishment” can still be with you as an adult.
You mentioned “pharmacologic intervention” but do you see a therapist or counselor also? I have a diagnosis of PDNOS (in addition to DDNOS but that’s another story) and had a lot of ineffective therapy before I got to my current therapist. So I guess I would advise going a little slow with any counselor you might try. Getting to the underlying original hurts can be painful, but this stuff probably isn’t going to go away without help.
Like I said, it doesn’t mean you’re a psychopath, though it may feel like it (I know). Real psychopaths don’t care. And if you think you may have another personality disorder – many therapists still don’t diagnose them. In my experience those are some who are also least likely to be able to handle them well.
Good luck!!
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