As a couple therapist, the question I sometimes get is, ”Is my problem serious enough to warrant a therapist?”
I like to address this question in this article.
There are 3 key reasons why you’d want to see a couples therapist/relationship coach
When you have issues in the relationship that you’ve tried to solve but you’re unable to.
When you want to do a health check for your relationship
When you’d like to enhance your relationship
Prevention is better than cure and this applies to relationship as well. If you’re in a committed relationship and not married yet, nothing should stop you from finding ways to strengthen your romantic competence.
The majority of couples that I see now in my clinic are those with troubled marriage or also known as ‘relationship recovery’. Increasingly, I have more couples who decided to seek help and they are in under category 2 and 3. It’s highly encouraging for me to see this trend as younger couples are less affected by the stigma of seeking help.
In enhancing your relationship, what you can expect is the identification of possible conflict areas, assessment of your communication and conflict management skills, emotional regulation skills as well as the strength of your relationship. The former framework of therapy is based on looking at the problems and trying to fix them. What was missing is how to focus on what is good in the relationship and magnify and fortify those strength? This is equally important and it’s also more positive.
For ‘relationship recovery process’, the types of cases that I see include infidelity, being stuck in conflicts, poor emotional regulation which leads to avoidance of conflict and rebuilding trust and commitment.
There is a certain transition in life where relationship coaching or therapy is highly recommended. This is as follows:
Pre-marital: Before you make the lifelong commitment, you want to be ensured that your chances at staying married is as high as possible. You want to know what the non-negotiables are and learn skills that make the process of integrating your life smoother.
Transitioning to parenthood: While bringing a baby into a family is a happy occasion, it brings about a lot of stresses to the marriage. 2/3 or 67% of couples who transition to parenthood suffer a decline in their satisfaction of marriage. Help and support is available foryou to learn how you can mediate this and continue to keep the spark in the marriage alive.
Couples who have suffered child lost or have unsuccessful attempts at assisted reproduction.
Couples who are planning to adopt: You will want to know what are the expectations that you have of each other and what sort of rituals of connection you can establish so that you don’t lose sight of your own relationship.
When you have a child with special needs either physical, intellectual or mental: This additional stress could make or break the marriage and often times, couples place so much focus on the child that he/she ends up neglecting the partner. What you want to cultivate is the mindset “we against the world” rather than “I am alone in this marriage”.
Empty nest: There is an increase in marital break-ups at this stage because they have waited for their young children to grow up. The many years of emotional disconnection and busyness of life in caring for the children may have caused neglect to the marriage but it is possible to breathe a new lease of life to the marriage so that you can enjoy your golden years meaningfully.
Ultimately, relationship is hard work. You will need to consistently invest in it just like how you would a plant. You will need to Create an environment that’s conducive for the relationship to thrive; learn the skills that can help you connect better with your significant other and be intentional in what you want in the relationship.
Happily-ever-after is an ideal that many believe and pursue and numerous studies have suggested that the key to happiness lies in a thriving marriage. I am also convinced that when couples come together and decide to get married, they do not have the thought of a divorce on the horizon.
To many, marriage is not a frivolous decision but one where he or she has deliberated and decided to entrust oneself to the other legally. Imagine the horror when shortly after the wedding bells, you discover that your spouse turned out to be someone that you don’t recognise and ends up hurting you so deeply that you wonder how you even got to this point: being romanced to being discarded. This is what it is like to be in a relationship with a narcissist.
Let’s explore the traits of a narcissist.
The following are the 9 official criteria for Narcissistic Personality Disorder (NPD):
grandiose sense of self-importance
preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
believes they’re special, unique and can only be understood by, or should associate with, other special or high-status people or institutions
need for excessive admiration
sense of entitlement
interpersonally exploitative behaviour
lack of empathy
envy of others or a belief that others are envious of them
demonstration of arrogant and haughty behaviours or attitudes
In essence, a narcissist has an excessive sense of self-importance over and above the needs of others. There is a sense of grandiosity and arrogance; and a lack of ability to empathise and experience reciprocity within intimate relationships. They are typically charming and charismatic. The early stages of the relationship are almost always exhilarating, romantic, powerful and intense. Love-bombing is a tactic where NPD makes you feel so special and loved that you can’t help but fall deeper in love with him or her. Most narcissists only reveal their true colours when they are in conflict. And when you no longer serve their needs, they discard you from their lives or make it a living hell for you.
Imagine the adverse and trauma that one experiences when you wake up one day and realises that the love you’ve received is not real and permanent.
The following are the lasting psychological and emotional impact of being in a relationship with a person with NPD:
“I don’t know what is real anymore.” Survivors of persons with NPD have the inability to trust their own judgment. Because gaslighting is a key feature in this toxic relationship, they lose touch with what is the reality. Gaslighting is defined as a form of manipulation, emotional and psychological abuse that results in a slow dismantling of a victim’s self-trust and judgment.
“It is all my fault. Everything I do is wrong. I trigger him/her. I deserve his/her anger.” Because a person with NPD will never assume responsibility for anything (they believe they do no wrong), they turn it around and project their emotions on the survivor. The survivor is the one who is over-sensitive and would ask irritating questions that trigger them to react. The consequence of this is that the survivors feel powerless and start to blame themselves for not being good enough for their partner.
“I am worthless and deserve nothing From the constant criticizing and undermining from a person with NPD, the survivors begin to accept the narrative that they are the problem and suffer from low self-esteem. They may start to withdraw from their family and friends who are concerned and question the relationship. They also hide their partner’s behaviour and lie about it.
“I am going crazy” This is related to point #1. Because a person with NPD constantly lie and intentionally say things that make the survivors question their reality, they start to think that they are crazy for having those questions. They feel confused and lost all the time.
“I don’t know. I can’t decide. It will be wrong anyway.” They have great difficulty in making decisions because they start to believe that they can’t do anything right. This is the message that is drummed into them persistently and this could extend into other aspects of life, such as in their work.
One of the common frustrations that my clients, who have survived persons with NPD, have often expressed: ‘how is it possible that they missed the warning signs’. Because of the suffering that they have been through, they have asked for the warning signs to be shared so that more can be aware and watch out for them in their relationships.
Self-centeredness They believe that the world revolves around them. They are not able to empathise and therefore can only see from their point of view. When things do not go their way, they get very upset and may threaten to end the relationship. Everything is on their terms. For example, my client shared that when they were dating, the partner dictated when to meet according to his schedule. Not knowing better, she accommodated. That is a red flag. Also, when they no longer have use of the partner, they have no qualms to simply discard them by being emotionally unavailable, refusing to communicate and abandoning the partner.
Frequent threats and emotional blackmail If you feel like you are perpetually walking on eggshells not knowing when your partner will explode on you, chances are he/she has NPD. Threats and emotional blackmail are their tools to control and get you to submit to their wants. E.g., Go ahead and leave, I never needed you anyway. I’ll tell everyone what a mean person you are.”
They act entitled and rules don’t apply to them. They believe that their needs are more important than their partner’s. There will be no reciprocal gestures unless there is an ulterior motive to get what he or she wants. Because of the self-importance and arrogance, they believe that they can do as they please as long as they don’t get caught. They deserve special treatments.
Obsessive focus on the external This applies to how they dress and carry themselves. Typically they are attractive, have material possessions and are of certain social status. They appear to be an excellent “catch”. They will go all out to inflate their status and standing. Another client told me that her husband, a covert narcissist, was charming and social. His real self only surfaced when they were on their own and when he felt threatened by her. This creates problems as people may not believe her when she tells her challenges.
They are master manipulators and schemers. The key emotions that you feel when you’re with a narcissist are guilt, shame and confusion. The hallmark of a person with NPD is the inability and unwillingness to take responsibility for any action and word. Consequently, they project their emotions onto the survivors and make them feel guilty and responsible. They can also be verbally abusive and are good liars. They scheme and twist the words of the survivors to their advantage. They have no issue in making their partners the bad guy and spread rumours that paint themselves as the victim. The bottom line is this: they need to make themselves feel good at the expense of everything and everyone. When they don’t get what they want, they will withdraw either physically and /or emotionally from the partner. They may give the silent treatment, be passive-aggressive, stonewall and/or ignore the partner. At the end of it, the partner will accept the blame and promise to not upset them next time.
They are hot, then cold. When they want something, they will go all out to get it. As such, in the early stages of the relationship or when they are on a mission to keep you under their control. They will pull out all the stops to make you feel wanted, admired and loved. One moment, you could be the most important person in their lives and in the next, when you don’t agree with them on something, it could be a trivial matter, you would become a worthless person that is undeserving of his/her respect and love. The switch from hot to cold is unnerving and they will make the survivors think that the problem lies with them.
In spite of the detrimental impacts of being in a relationship with a narcissist, the good news is that it is possible to heal from it. I have supported and seen my clients live a meaningful and flourishing life following the breakup with a narcissist. Though the journey may not be easy, if one is willing to work with a professional to go deeper and understand the pattern of relationships in their lives, they can find healing and freedom.
What are the steps to heal?
Educate yourself on NPD and accept that it is a disorder. Know that you are not alone and you are not the problem. Raise awareness for it. The World Narcissistic Abuse Awareness Day is on 1 June. Get involved and when you are ready, share your story. You can empower and help others by sharing your experience courageously.
Get professional help as dealing with trauma can be complicated. Learn to connect the past to the present; typically, the dynamics between the person with NPD and the survivor is one that the latter is familiar with. It is not uncommon that upon the realization that the partner has NPD, the survivor can see that a family member could be one as well. Those who persist in such toxic relationships are usually accustomed to such dynamics from childhood.
Practice boundaries – physical and emotional. Have zero contact or keep it to a minimum should you share the care of the children. The survivors are usually empathic and attuned to the feelings of others. Be mindful not to take on feelings that are not yours. Have clarity on what is your responsibility and discard those that are not yours.
Build a strong foundation – focus on one’s strengths and resilience, in ending the relationship and working through the issues. Find meaning in it by rewriting the narrative.
Forgive and work on self-love. Self-compassion is a critical component in recovering. Learn to take good care of yourself – physical, emotional, psychological, spiritual, social.
Pay attention to your body as trauma is stored in your body. Practice mindfulness to bring yourself to the present moment when you’re triggered by difficult memories. The triggers will still be there, and the healing process will be imperfect and a work-in-progress.
Focus on the good – that is in you; the work that you have put in to heal and maintain your well-being by learning new skills and maintaining good habits. Celebrate quick wins when you are able to enforce boundaries or not take on responsibility for how others are feeling.
Embrace a healthy relationship. After being in a toxic relationship for a long time, being in a healthy relationship can feel weird and scary. You aren’t sure what to make of it. The lure to get back to what is familiar albeit negative for you is high. Be aware of it and put measures in place so that you can recalibrate when you feel threatened.
Let’s remember that significant relationships in our lives will impact our mental well-being. Even as we focus on the benefits of positive relationships and promote it, we also need to provide support for those who have been through traumatic and toxic relationships. The key is to remember that relationships should enhance your lives and motivate you to be a better version of yourself. When there are disempowerment and manipulation in the relationship, it is not healthy, and you can make the decision to get out of it.
Strong social connections are vital to our mental and physical wellbeing – they help us navigate stressors and give us the courage to overcome the challenges that we face. Positive relationshipsare pivotal for an individual’s happiness, productivity, and form the foundation of a person’s support system. As such, we must not take these relationships for granted. Instead, we need to learn how to continue building and maintaining such positive relationships with others.
As an overall guideline, a good way to start is for us to adopt the “Above and Below the Line” thinking. Has someone ever told you in the heat of an argument that you have “crossed the line”? In every domain of life, there’s a line, and we all intuitively know where “the line” exists. In any given moment, we are either living Above the Line or Below the Line.
When we are “below the line”, we are constantly angry, closed, and looking for blame and excuses. When we are operating out of fear, we withdraw from our connections, which causes us to become estranged from others, and pull ourselves back emotionally. In such cases, try gathering the courage to connect with what you’re afraid of. Although this could turn out in both good and bad ways, it will be worth a shot. At least you will then be able to confront the grip of toxic fear and bring forth behaviours and beliefs that are above the line. Anger, on the other hand, causes us to blame others or the situation we’re in, while at the same time creating excuses for ourselves. At times, we can even move into a state of denial. In order for us to start living “above the line”, we need to be more mindful of our emotional state. This could mean being more sensitive to the context and perspective of others or the situation. When we are “above the line”, we are operating out of love, understanding, and appreciation in order to tackle anger and take ownership of what’s happening. Acknowledge that pushing the blame on others continually will wear you out, and will eventually take a toll on your relationship. Moreover, remind yourself to be less prideful and try giving others credit instead. Focus on gratitude for those around you, and start showing appreciation for their contributions and positive impact on your life.
When we choose to live “below the line”, we fall victim to the biases that influence our perception, thereby impacting our relationships in a negative way. Such biases may include:
Egocentric behaviour often stems from inadequate awareness of the self. This becomes limiting in the sense that we become embedded in our own point of view rather than attempting to understand the perspective of the other person. Egocentrism can often lead to feelings of anger and frustration, and severely impacts our capacity to deal with others in an appropriate manner.
Fundamental Attribution Error
Fundamental Attribution Error is the tendency to explain others’ behaviour and actions based on internal factors. This means having a cognitive bias to assume that someone’s behaviour is dependent on the personality of that person. When we overemphasise personal characteristics and qualities and choose to ignore situational factors when judging someone else’s behaviour, we become increasingly narrow-minded, making it difficult for us to resolve situations in an efficacious manner. For example, if a road user cuts into our path while driving, our initial thought might be that the driver is a “jerk”, or someone who is highly impatient. However, we fail to consider the possibility that the driver could have been rushing a passenger to the hospital.
Naive realism is the tendency to believe that we view everything around us objectively and those other individuals who disagree with our viewpoint must be uninformed, irrational, or biased. This also causes us to be self-righteous and narrow-minded.
Confirmation bias describes the tendency of individuals to seek evidence that confirms and reiterates a previously held view. A classic example of this is the belief that women are poor drivers compared to men. We pay particular attention to the gender of such poor drivers and cherry-pick evidence that reinforces the idea of the poor motor skills of women.
As much as possible, we should try staying away from living “under the line”. When we fall victim to such biases, our perceptions become clouded, causing us to be incapable of handling our social connections well and in a healthy manner. Try staying away from negative emotions, and be more open-minded and understanding of the other party and the situation at hand.
So, how can we make the shift and start living “above the line”? Instead of living in fear, anger and pride, try living in courage, faith and love. Gather the courage to improve yourself, and take tiny steps every day. Reflect on the personal qualities and weaknesses that you think you need to work on and make the effort to change. If someone gives you constructive feedback, take it! Focus on self-improvement and don’t let pride and arrogance overcome you. Have faith in yourself and in the relationships you share with others. Believe that relationships can be worked on and salvaged, even if they are on the rocks. Lastly, give and spread love. Love will bring out the greatness in yourself, and the best in others. Show the people around you that you genuinely care for them, and that you appreciate their presence. Positivity will certainly go a long way and bring individuals closer together.
Above all else, perhaps you could ask yourself a simple question when tackling any situation in a relationship: Is your intention to help or to hurt? If you are willing to take the step to be more mindful of your intentions, then you’re already on the road to building and maintaining positive relationships. The more you practice, the better you’ll get. On the other hand, should you require any further guidance, don’t be afraid to reach out to us.
“I forgive you.” while on the surface seems to be an innocuous word and easy to say. But in reality, it’s one of the most difficult words to express in our human language. A few years ago, a middle-aged man angrily dragged his 13-year-old son to our clinic, it turned out that Mr Zhang (pseudonym) had discovered his son hiding in a corner of his room smoking, and slapped the boy hard in a fit of anger. Even after being scolded the boy was recalcitrant and didn’t even feel remorseful. In her efforts to appease the situation at home, his wife suggested bringing the son to see a counsellor.
On that day, I happened to walk past the therapy room. I could only hear the loud arguments between the father & son, and loud sobbings of the mom. Just as I stepped into my office, my office phone rang. It was an urgent call from my colleague, the therapist, who alerted that the situation was getting a bit out of hand, and asked for my assistance in the therapy room. Upon arriving at the scene, I could hear the son’s angry retort, “You’ve never loved me since young, why are you trying to control me now? All you’ve ever done was scolding me. So what if I behave myself? Would you even notice?”
It took more than an hour to calm all parties down. After which, I carefully interviewed both Mr Zhang and his son, and I finally got to the root of why the situation had become so tense between father and son.
It wasn’t the 13-year-old boy who had caused the breakdown in their relationship. The issues stem from painful experiences when Mr Zhang was growing up. Mr Zhang had grown up with an abusive father who was not only alcoholic and chain-smoked, who often vented his anger on his wife and children. As a result, Mr Zhang made a vow from young to never touch alcohol and cigarettes. Unfortunately, his demeanour also became very stern with hardly any smile on his face and had high expectations with his own children. Why did it become like this? It was because he had never forgiven his own father. The deeply buried hurts had made him prone to irritability, and thus he didn’t know how to praise or encourage his own child, and only knew strict discipline as his way of bringing up his child. Moreover, his biggest worry had been over his child coming into contact with alcohol and tobacco.
Mrs Zhang explained, her husband was a good man, but was a man of few words, and was not good in expressing his feelings. She knew that he really cares about the child, but it was a pity that communication was poor between the father and son. As a result of a craving for his father’s love and experiencing scolding and punishment from young, the boy had grown to become more rebellious in recent years.
In fact, Mr Zhang’s father had quit smoking and drinking for many years. However, as a result of the poor relationship between Mr Zhang and his father coupled with a break in communications for more than a decade. Mr Zhang couldn’t come to terms with my conclusion initially. But for the sake of his own son, he finally agreed to receive counselling. After several months, he finally understood the root cause. He asked me, “I’ve finally understood that the root cause of my frustrations was the unresolved anger and hatred towards my own father, but what should I do after so many years?”
Fortunately, one day his mother decided to visit their grandson together with his father. Although he felt embarrassed initially, Mr Zhang struck up his courage, squarely faced his dad and said: “I forgive you.” This simple yet miraculous sentence seemed to untie the knots of anger and hurts between Mr Zhang and his father. From that day onwards, Mr Zhang began to smile more frequently face and he could finally express his love fully to his son.As a result, his son stopped being rebellious. Not only did he stop smoking, but also paid more attention to his studies.
As a psychiatrist, I’m truly happy for this family and admire Mr Zhang’s courage in forgiving his own father. They continued with counselling for some time, and finally mended their father and son relationship that was formerly broken.
Therefore, forgiving others is also giving ourselves a chance to receive complete healing.