In this Weekly Insight, Dr. Ettensohn examines the rise of moral panic within contemporary discourse about narcissism, particularly how popular online narratives have transformed psychological terms into tools of moral judgment. In this Weekly Insight, Dr. Ettensohn examines the rise of moral panic within contemporary discourse about narcissism, particularly how popular online narratives have transformed psychological terms into tools of moral judgment. Using a recent online interaction as a jumping-off point, the video traces how disagreement is increasingly reframed as harm, and how nuanced discussions of narcissistic personality structure are met with accusations of abuse, gaslighting, or complicity. Drawing on Stanley Cohen’s original criteria for moral panic, and placing current trends alongside historical examples such as witch hunts, McCarthyism, and the Satanic Panic, Dr. Ettensohn contextualizes the intense emotional reactions that now dominate conversations about NPD. The video explores how stigma, stereotypes, and moral binaries are amplified online, creating a culture in which appeals to complexity and humanity have become taboo. It also considers the communal function of scapegoating within current narratives about narcissism. This video offers a clinically grounded, sociologically informed framework for understanding what happens when trauma discourse is overtaken by lurid sensationalism and moral panic, and why the path toward healing lies in reclaiming psychological depth, complexity, and humanization.  

Link to episode 1 in this series, on psychotic-level NPD: https://youtu.be/IoxUCbNUJUE Link to episode 2 in this series, on borderline-level NPD: https://youtu.be/Oz-C503q_9Y Link to part 1 of episode 3 in this series: https://youtu.be/vUsnambadIE This is the third episode of a four-episode series describing the narcissistic personality style across different levels of severity. Due to the length of the material, this episode has been divided into three parts. This is part two. In this part, Dr. Ettensohn explores the emotional consequences of the developmental shift from borderline to neurotic-level personality organization. While borderline-level defenses aim to ward off annihilation through splitting, projection, and omnipotence, neurotic-level functioning introduces new emotional burdens: grief, guilt, and the realization that some losses cannot be undone. Drawing on psychoanalytic theories of the paranoid-schizoid and depressive positions, this episode examines how individuals begin to internalize the reality of separate minds, enduring subjects, and the permanence of emotional injury. These capacities open the door to deeper love, mutuality, and ethical concern—but also to sorrow, remorse, and longing. Dr. Ettensohn also outlines the core developmental conditions that support this shift, including “good enough” relational experiences that enable ambivalence to be tolerated and meaning to be preserved across time. Finally, the episode offers concrete strategies for strengthening neurotic-level integration and functioning, both in therapy and in everyday life. References: Bollas, C. (1987). The shadow of the object: Psychoanalysis of the unthought known. Columbia University Press. Gabbard, G. O., & Wilkinson, S. M. (1994). Management of countertransference with borderline patients. American Psychiatric Publishing. Johnson, S. M. (1987). Characterological change: The hard work miracle. W. W. Norton. Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psychoanalysis, 27, 99–110. Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press. Winnicott, D. W. (1949). Hate in the counter-transference. The International Journal of Psychoanalysis, 30, 69–74. Winnicott, D. W. (1965). The maturational processes and the facilitating environment: Studies in the theory of emotional development. International Universities Press.

Link to episode 1 in this series, on psychotic-level NPD: https://youtu.be/IoxUCbNUJUE Link to episode 2 in this series, on borderline-level NPD: https://youtu.be/Oz-C503q_9Y This is the third episode of a four-episode series describing the narcissistic personality style across different levels of severity. Due to the length of the material, this episode has been divided into three parts. This is part one. In this part, Dr. Ettensohn explores the developmental shift from borderline to neurotic-level personality organization, and how this shift transforms the inner life of individuals with narcissistic traits. Part one serves as a conceptual bridge—reviewing core ideas from earlier episodes while highlighting the emergence of psychological capacities that make neurotic-level functioning possible. These include the ability to maintain a continuous sense of self, to recognize others as enduring subjects, and to experience ambivalence, guilt, and loss without fragmentation. Through the lens of psychoanalytic developmental theory, Dr. Ettensohn illustrates how this shift brings with it new emotional burdens: the capacity to grieve, to feel remorse, and to live with an awareness of history. This part introduces the foundational concepts of subjectivity and historicity, which will be explored in greater depth in parts two and three. References: Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. Yale University Press. Ogden, T. H. (1986). The matrix of the mind: Object relations and the psychoanalytic dialogue. International Universities Press. Ogden, T. H. (1989). The primitive edge of experience. Jason Aronson. Winnicott, D. W. (1965). The maturational processes and the facilitating environment: Studies in the theory of emotional development. International Universities Press.

In this video, Dr. Ettensohn examines the growing claim that Narcissistic Personality Disorder (NPD) is almost entirely genetic, offering a critical, clinically grounded reflection on what the current science actually supports—and where it falls short. He discusses how genetic contributions to personality traits are often misunderstood, and why claims of “hardwired narcissism” oversimplify a profoundly complex developmental process. Drawing from empirical research, neurodevelopmental theory, and clinical observation, Dr. Ettensohn explores how narcissistic pathology emerges not simply from temperament, but from early relational experiences—especially chronic emotional neglect, inconsistent attunement, and conditional regard. He addresses how brain plasticity, diagnostic controversies, and the misunderstood vulnerable core of NPD further complicate the genetic narrative. This video offers a nuanced perspective for anyone seeking to understand NPD beyond reductive models, emphasizing the importance of relational context, developmental history, and psychological depth. References: Brummelman, E., Thomaes, S., Nelemans, S. A., Orobio de Castro, B., Overbeek, G., & Bushman, B. J. (2015). Origins of narcissism in children. Proceedings of the National Academy of Sciences, 112(12), 3659–3662. https://doi.org/10.1073/pnas.1420870112 Chen, Y., Jiang, X., Sun, Y., & Wang, Y. (2023). Neuroanatomical markers of social cognition in neglected adolescents. NeuroImage: Clinical, 38, 103501. https://doi.org/10.1016/j.nicl.2023.103501 Gatz, M., Reynolds, C. A., Fratiglioni, L., Johansson, B., Mortimer, J. A., Berg, S., & Pedersen, N. L. (2006). Role of genes and environments for explaining Alzheimer disease. Archives of General Psychiatry, 63(2), 168–174. https://doi.org/10.1001/archpsyc.63.2.168 Horton, R. S., Bleau, G., & Drwecki, B. (2006). Parenting Narcissus: What are the links between parenting and narcissism? Journal of Personality, 74(2), 345–376. https://doi.org/10.1111/j.1467-6494.2005.00380.x Luo, Y. L. L., Cai, H., & Song, H. (2014). A behavioral genetic study of intrapersonal and interpersonal dimensions of narcissism. PLOS ONE, 9(4), e93403. https://doi.org/10.1371/journal.pone.0093403 Nenadić, I., Lorenz, C., & Gaser, C. (2021). Narcissistic personality traits and prefrontal brain structure. Scientific Reports, 11, 15707. https://doi.org/10.1038/s41598-021-94920-z Otway, L. J., & Vignoles, V. L. (2006). Narcissism and childhood recollections: A quantitative test of psychoanalytic predictions. Personality and Social Psychology Bulletin, 32(1), 104–116. https://doi.org/10.1177/0146167205279907 Schulze, L., Dziobek, I., Vater, A., Heekeren, H. R., Bajbouj, M., Renneberg, B., & Roepke, S. (2013). Gray matter abnormalities in patients with narcissistic personality disorder. Journal of Psychiatric Research, 47(10), 1363–1369. https://doi.org/10.1016/j.jpsychires.2013.05.017 Skodol, A. E. (2012). The revision of personality disorder diagnosis in DSM-5: What’s new? Current Psychiatry Reports, 14(1), 39–43. https://doi.org/10.1007/s11920-011-0243-2

In this Weekly Insight, Dr. Ettensohn shares an adapted preview from his upcoming video on narcissism at the neurotic level of personality organization. He reflects on what it means to move toward psychological integration, emotional complexity, and the capacity for self-reflection - especially for those doing this work without a therapist. Drawing from clinical understanding and developmental theory, Dr. Ettensohn discusses how self-acceptance, mindfulness, and the capacity to tolerate imperfection are crucial aspects of healing. He emphasizes the importance of allowing history to be real, recognizing and managing splitting, and loosening rigid self-perceptions that often emerge from narcissistic defenses. Using metaphor, lived experience, and grounded strategies, he shows how healing becomes possible even outside the therapeutic relationship when we begin to relate to ourselves differently.

In this Weekly Insight, Dr. Ettensohn explores the nature of grandiosity in pathological narcissism and Narcissistic Personality Disorder (NPD), emphasizing that grandiose self-states are distortions that mask underlying vulnerability. He examines how these states emerge, why they are so compelling, and how they become self-reinforcing through positive feedback loops. Dr. Ettensohn also discusses the hidden instability beneath grandiosity, the interpersonal consequences of maintaining a distorted self-image, and the trauma-based origins of grandiose narcissistic armor. Drawing on the work of Ernst Wolf and real-world examples, he offers a compassionate yet clear-eyed look at how grandiosity functions as both protection and prison—and how growth is possible even after years of wearing the armor.

In this Weekly Insight, Dr. Ettensohn explores the deep existential conflict at the heart of pathological narcissism and NPD: the fear of being ordinary. Drawing from a recent presentation by psychiatrist and psychoanalyst Dr. Salman Akhtar, he examines how the pressure to be extraordinary—instilled early in life—becomes a defining and isolating feature of the narcissistic identity. Dr. Ettensohn discusses the paradox of extraordinariness: how the very thing that promises acceptance and recognition instead fosters loneliness and disconnection. He explores why admiration and envy are poor substitutes for love and how healing involves letting go of an identity built on standing apart—so that real connection can finally become possible.

In this weekly insight, Dr. Ettensohn addresses the common misconception that individuals with Narcissistic Personality Disorder (NPD) never seek therapy—and the even more misleading idea that simply wondering whether you have NPD means that you don’t. This episode explores the origins of these myths, explaining how they stem from a misunderstanding of personality disorders and the role of insight. While NPD often involves rigid, maladaptive patterns of thinking and an egosyntonic sense of grandiosity, it also frequently includes periodic self-esteem collapses, during which individuals experience deep distress, depression, and anxiety. It is in these moments that many people with NPD seek therapy—contrary to the popular belief that they never do. Dr. Ettensohn discusses how online narratives about NPD have distorted public understanding of the disorder, reinforcing harmful stereotypes that discourage those who need help from reaching out. Drawing from clinical experience and current research, he provides a more nuanced and accurate view of why individuals with NPD do, in fact, pursue treatment.

The "Weekly Insights" series is for paid members of Dr. Ettensohn's Heal NPD Youtube channel. In the short-term, Dr. Ettensohn is posting all even-numbered episodes free of charge. If you would like access to the full series, please follow this link:  https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join In this weekly insight, Dr. Ettensohn explores how cycles of narcissistic wounding and dehumanization develop and perpetuate across relationships and even generations. He discusses the origins of pathological narcissism, the defenses formed in response to early emotional injuries, and how these patterns manifest in adult relationships as narcissistic abuse. The discussion also highlights how those impacted by these dynamics may unknowingly adopt similar patterns of anger, projection, and polarized thinking, perpetuating the cycle. Breaking free from these patterns requires leaning into complexity, embracing nuance, and recognizing the shared humanity in all involved.

The "Weekly Insights" series is for paid members of Dr. Ettensohn's Heal NPD Youtube channel. In the short-term, Dr. Ettensohn is posting all even-numbered episodes free of charge. If you would like access to the full series, please follow this link:  https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join In this weekly insight, Dr. Ettensohn discusses the limitations of polarized or dichotomous thinking, particularly when it comes to self-experience. Inspired by viewer responses to a previous episode on the false self, Dr. Ettensohn discusses why concepts like “true” and “false” self can be misleading when taken too literally. Our internal experiences are complex, layered, and dynamic—identity, thought, feeling, and behavior are not static or easily divided into “good” and “bad” categories. Psychological health involves learning to tolerate and even appreciate this ambiguity rather than striving for certainty.

The "Weekly Insights" series is for paid members of Dr. Ettensohn's Heal NPD Youtube channel. In the short-term, Dr. Ettensohn is posting all even-numbered episodes free of charge. If you would like access to the full series, please follow this link:  https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join What’s the difference between healthy self-love and pathological narcissism? In this week's episode of Weekly insights, Dr. Ettensohn discusses key differences, with recommendations for healing.

The "Weekly Insights" series is for paid members of Dr. Ettensohn's Heal NPD Youtube channel. In the short-term, Dr. Ettensohn is posting all even-numbered episodes free of charge. If you would like access to the full series, please follow this link:  https://www.youtube.com/channel/UCHeT5kujD1JqHRAi-x8xD-w/join In this episode of the members-only "Weekly Insights" series, Dr. Ettensohn reflects on the positives and negatives of gratitude as a therapy intervention, noting the potential for unintended enactments of invalidation or 'pressure to perform' in the therapy relationship. Things like gratitude journals invite us to reflect on the things that are good in our lives. But they can also reinforce inauthenticity when someone has been raised in an emotionally invalidating environment.

In this episode, Dr. Ettensohn explores the insights of Alice Miller regarding  emotional abandonment and narcissistic use of the child, focusing on how these early dynamics shape pathological narcissism and Narcissistic Personality Disorder (NPD). Drawing from Miller’s groundbreaking work, Dr. Ettensohn examines how a child growing up in a narcissogenic environment learns to adapt by creating a false self—a facade designed to secure love and avoid rejection in a world where their authentic self is not welcome. The episode explores the function of grandiosity as a defense mechanism—an unconscious strategy to deny the pain of unmet emotional needs—and its counterpart, depression (narcissistic vulnerability), which turns the pain inward. Both defenses serve to protect the individual from confronting a devastating loss: the realization that the love and support they needed was not available. The episode offers a compassionate exploration of how this tragic loss gives rise to the false self, a defense that becomes both a survival strategy and a prison. Through relatable metaphors and clinical insight, Dr. Ettensohn describes the psychological toll of living behind this mask and the challenges of reconnecting with the buried authentic self. Though the loss cannot be undone, healing is possible. By grieving the past and clearing away the defenses, it is possible to rediscover the vibrant, authentic self that has always been there, waiting to emerge. References: Miller, A. (1979) Depression and Grandiosity as Related Forms of Narcissistic Disturbances. International Review of Psychoanalysis 6:61-76 Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8   VISIT THE WEBSITE: https://www.healnpd.org

In this episode, Dr. Ettensohn draws on psychodynamic dimensional models of personality development to describe narcissism and NPD at the borderline level. Characterized by identity diffusion, blurred boundaries, and disrupted internal experience, borderline personality organization represents an "in between" level where the perceptions of the self and others float in and out of clear focus. This episode reviews the important concepts of personality style vs. organization, helping the viewer to understand what a personality disorder actually is and why all personality disorders share common features. It discusses the developmental arrests thought to underlie borderline organization and describes common defense mechanisms that characterize this level of object relations. Borderline-level NPD is then discussed using these concepts. The episode concludes with a discussion of treatment.   References: Berney, S., de Roten, Y., Beretta, V., Kramer, U., & Despland, J.-N. (2014). Identifying psychotic defenses in a clinical interview. Journal of Clinical Psychology, 70(5), 428–439. Clarkin, J. F., Cain, N. M., & Lenzenweger, M. F. (2018). Advances in transference-focused psychotherapy derived from the study of borderline personality disorder: Clinical insights with a focus mechanism. Current Opinion in Psychology, 21, 80-85. http://dx.doi.org/10.1016/j.copsyc.2017.09.008 Di Giuseppe, M., & Perry, J. C. (2021). The hierarchy of defense mechanisms: Assessing defensive functioning with the Defense Mechanisms Rating Scales Q-Sort. Frontiers in Psychology, 12:718440 https://doi.org/10.3389/fpsyg.2021.718440 Kernberg, O. F. (1970). Factors in the psychoanalytic treatment of narcissistic personalities. Journal of the American Psychoanalytic Association, 18, 51- 85. Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven: Yale University Press. Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). New York: Guilford Press. McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press. Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH   LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org   *A note about the title: The title is a partial quote from BPD specialist Marsha Linehan, describing borderline personality disorder. I am aware of her original intent to describe that specific patient population. I also use the quote in the video to describe the emotional vulnerabilities that necessitate splitting. Although she was describing BPD specifically, I feel the quote also works for borderline organization in general. The intense emotional vulnerabilities and exposure to unprocessed experience reflect the absence of moderating internal capacities - "skin" so to speak.

Dr. Mark Ettensohn answers questions and responds to viewer comments in a livestream broadcast from 7-25-24. 

In this episode, Dr. Ettensohn draws on psychodynamic dimensional models of personality development to describe narcissism and NPD at the psychotic level. Characterized by compromised reality testing, symbiotic object relations, low integration between parts of the self, and the use of reality-distorting defense mechanisms, psychotic-level NPD represents both the least developmentally mature and most severe form of the disorder. This episode explains the spectrum of personality development, from psychotic to healthy. It then explains the psychotic personality organization in detail, providing descriptions of specific defense mechanisms utilized at this level. Finally, psychotic-level NPD is described.   Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life here: https://amzn.to/3nG9FgH   LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 VISIT THE WEBSITE: https://www.healnpd.org   Cited References: Berney, S., de Roten, Y., Beretta, V., Kramer, U., & Despland, J.-N. (2014). Identifying psychotic defenses in a clinical interview. Journal of Clinical Psychology, 70(5), 428–439. Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven: Yale University Press. McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press.

Dr. Mark Ettensohn answers questions and responds to viewer comments in a livestream broadcast from 4-26-24. 

Dr. Ettensohn answers listener questions and responds to comments in a livestream broadcast from 3-14-24. 

This episode is the audio from an on-camera interview between licensed psychotherapist Lisa Taylor-Austin and Dr. Ettensohn. The video of this interview can be viewed on Lisa's youTube channel here: https://www.youtube.com/@LisaTaylor-Austin   This audio recording is posted with Lisa's permission. This discussion covers numerous topics, from treating pathological narcissism, the diagnostic criteria for NPD, variation in narcissistic pathologies between siblings raised in the same family system, the use of defenses like splitting, and the ever-present stigma surrounding NPD.

   Lisa runs the Taylor-Austin Group. Learn more at their website: https://thetayloraustingroup.com/

In this episode, Dr. Ettensohn draws heavily on his own research concerning pathological narcissism and attachment patterns, using attachment theory as a lens to focus explanatory power onto the often confusing dynamics of NPD. Beginning with a general overview of Bartholomew's four-prototype model of adult attachment, Dr. Ettensohn identifies the most common attachment patterns of individuals with NPD. He describes the relevant research on the development of these patterns and draws parallels with descriptions of early care deficits thought to cause pathological narcissism. 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 VISIT THE WEBSITE: https://www.healnpd.org Cited References: Bartholomew, K. (1990). Avoidance of intimacy: An attachment perspective. Journal of Social and Personal Relationships, 7(2), 147-178. Bartholomew. K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61(2), 226-244. Bennett, C. S. (2006). Attachment theory and research applied to the conceptualization and treatment of pathological narcissism. Clinical Social Work Journal, 34(1), 45-60. Blatt, S. J., & Levy, K. N. (2003). Attachment theory, psychoanalysis, personality development, and psychopathology. Psychoanalytic Inquiry, 23, 104-152. Bowlby, J. (1973). Attachment and loss: Volume 2: Separation. New York: Basic Books. Connors, M. E. (1997). The renunciation of love: Dismissive attachment and its treatment. Psychoanalytic Psychology, 14, 475-493. Dickinson, K. A., & Pincus, A. L. (2003). Interpersonal analysis of grandiose and vulnerable narcissism. Journal of Personality Disorders, 17(3), 188-207. Ettensohn, M.D. (2011). The relational roots of narcissism: Exploring relationships between attachment style, acceptance by parents and peers, and measures of grandiose and vulnerable narcissism. (Doctoral dissertation). Retrieved from Dissertations and Theses: Full Text. (Publicaiton No. AAT 3515488). Gabbard, G.O. (1989). Two subtypes of narcissistic personality disorder. Bulletin of the Menninger Clinic, 53, 527-532. Holdren, M. (2004). Causal attributions among overt and covert narcissism subtypes for hypothetical, retrospective, and prospective events. (Doctoral dissertation). Retrieved from Dissertations & Theses: Full Text. (Publication No. AAT 3146467). Kernberg, O. F. (1970). Factors in the psychoanalytic treatment of narcissistic personalities. Journal of the American Psychoanalytic Association, 18, 51-85. Kobak, R. R., & Sceery, A. (1988). Attachment in late adolescence: Working models, affect regulation, and representations of self and others. Child Development, 59, 135-146. Main, M., & Stadtman, J. (1981). Infant response to rejection of physical contact by the mother. Journal of the American Academy of child Psychiatry, 20, 292-307. Otway, L.J., Vignoles, V.L. (2006). Narcissism and childhood recollections: A quantitative test of psychoanalytic predictions. Personality and Social Psychology Bulletin, 32(1), 104-1116. Pistole, C. M. (1995). Adult attachment style and narcissistic vulnerability. Psychoanalytic Psychology, 12(1), 115-126. Scroufe, L. A., Waters, E. (1977). Heart rate as a convergent measure in clinical and developmental research. Merrill Palmer Quarterly, 23, 3-25. Smolewska, K., & Dion, K. L. (2005). Narcissism and adult attachment: A multivariate approach. Self and Identity, 4, 59-68.