CASE STUDY "Brother John" Narcissistic Personality Disorder Rev. Stephen J. Rossetti, Ph.D., D.Min.

. Brother John is a member of a religious community whose ministry is teaching school. He is an excellent teacher and has inspired many students. He has always had a group of students, usually dependent personalities, "follow" him and he becomes a kind of "guru." He has some friends among the teachers and parents of students. However, the relationships usually last a short time and then end up badly. Whenever a relationship ends, he complains that the other people did not understand him and turned against him. He has long been a divisive member of the community. In the early years, many people were enamored with him. Later, as the conflicts occurred, some people tried to understand and defend him. However, Br. John began to be increasingly negative and critical of the community's leadership and hostile toward many of the members. On the outside, Br. John seems confident and self-assured. However, when he is criticized, he takes it badly and becomes enraged. He then lashes out at the person making the criticism. He has emotionally hurt many members of the community but is oblivious to the hurt he has caused. He criticizes leaders' decisions behind their backs and tries to sow seeds of discontent. He presents himself as someone who would know what to do in leading the community and expects others to follow him. Br. John has felt deeply hurt that his ideas are so "callously" dismissed by others. He believes he should be given a position of leadership in the community. Br. John no longer has any friends in the community. He has begun to gain weight and looks disheveled. His personal hygiene has suffered and he spends most of his time by himself. Whenever he interacts with community members, the members usually feel themselves the brunt of much hostility and aggression.

After many years of his behavior, the community wants something to be done and has sent a delegation to the religious superior. The superior has spoken to Br. John about his behavior, as had the three previous superiors, but there has been no change. Br. John responds, "The community is dysfunctional and they are envious of my success with the students." When Saint Luke Institute LUKENOTES Article 2 confronted by his religious superior, Br. John has mobilized his students and friends who have sent letters and called the superior. What kind of problems does Br. John have? Br. John has a personality disorder called a narcissistic personality. It appears that he also has some aggressive, paranoid, and perhaps self-defeating traits. He also has long standing authority issues which have not been resolved. Br. John has a grandiose sense of himself and gathers dependent students around him that provide him with excessive admiration. This adulation is a dysfunctional attempt to bolster up his fragile ego. It is likely that there have been some early childhood hurts which have led to this damaged self-esteem and buried anger, which surfaces in a rage whenever he is criticized. Br. John manipulates his students and few friends to come to his defense and thus is exploitive of them, another sign of narcissism. Also, he lacks empathy and is not aware of the enormous hurt he causes others, especially those in his community. After many years of conflict and criticism in the community, Br. John has emotionally withdrawn from the community and is showing symptoms of depression. Help for "Brother John" How should the superior and the community deal with him? Any kind of personality disorder tends to be long-standing and difficult to treat. Part of the difficulty is that personality disorders tend to be "ego syntonic," that is, the person with the disorder is not directly distressed by the disorder itself. The person may be distressed by the results of his or her behavior but the disorder itself is not distressing. In this case, Br. John is

not distressed by being a narcissistic personality and projects the blame for his interpersonal problems on others. Thus, Br. John is unlikely to ask for psychotherapy for his narcissism. And if he does end up in therapy, usually at the direction of a superior, he will not see any reason to change his way of relating to others. Therapy goals in such cases need to be concrete and realistic. Br. John does appear to be distressed by his rejection by the community and his lack of receiving the leadership positions to which he feels entitled. As a result, he is suffering from some significant signs of depression. It would be important for the superior to ensure that Br. John is treated for his depressive symptoms. While therapy can assist Br. John with his depression, and perhaps make some limited progress in dealing with his narcissism, a major focus of the superior should be to help the community, and himself, deal with Br. John's presence. It appears that the community has never directly engaged Br. John in his dysfunctional beh