Wow. Thanks for that article. I react very much like Michael, with my T's. I've made very similar comments to my T's.
I was especially impressed with this paragraph.
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Patients with NPD suffer a great deal. Kohut describes the depression and anxiety that a narcissistic patient may feel as “the deepest anxiety a man can experience.”6 NPD has also been described to be as overwhelming as the fear of death.6 The torment narcissistic patients suffer should never be discounted. Furthermore, these patients can and do present a risk. They feel less than human when they encounter even minor failures and, in order to regain a sense of unity within themselves, they act in ways that seem narcissistic to others, including suicide.
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and this one ..
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Although providing therapy to a patient such as Michael who has NPD can prove challenging, it is also rewarding. Through growth in therapy, Michael ultimately found some relief, fleeting at first, from his depression and anxiety and learned ways to change some of his behaviors in a lasting way. As therapy progressed, Michael began to find some sense of unity, giving him a more durable peace within himself that was usually able to sustain him.
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Maybe some in the field do get NPD's. And it's always encouraging to hear stories of people making progress.
I like the fact that Michael wasn't portrayed as a demon that everyone needed to avoid, but rather as basically a man with issues that wanted help. Sure, he struggled, and caused problems, but he also had some insights and desire to change. It is interesting and rather sad that he never followed through on his desire to connect with his children. Maybe, as he got help, he got better in that area, also.
I just noticed that there is an editor's note in the
pdf version that makes it clear that "All cases presented in the series 'Psychotherapy Rounds' are composites constructed to illustrate teaching and learning points, and are not meant to represent actual persons in treatment."