Populist narratives of “Narcissistic Abuse”: a help or hindrance to psychotherapeutic practice?

Abstract

The recent explosion of populist narratives around ‘narcissistic abuse’ on social media has prompted millions to seek answers in online self-help communities. Many are advised to enter personal therapy. This paper asks whether consuming such narratives supports or hinders subsequent psychodynamic treatment. To address this, the social media discourses are critiqued through a psychodynamic lens, contrasting them with psychodynamic aims. The author conceptualises patients' relationship difficulties as stemming from internalised traumatic relational patterns. The theories of Fairbairn and Ferenczi are reprised. Case material illustrates the challenges that arise when these patients enter therapy armed with preconceived diagnoses, seeking confirmation of online-informed hypotheses. Those clinging rigidly to simplistic social media narratives often struggle to engage deeply in treatment. The author argues that adherence to reductive formulas should concern psychotherapists given the expansion of social media self-help. It is suggested the field would benefit from psychotherapists publicly addressing the risks of simplistic narratives and highlighting psychodynamic complexity. Modelling nuanced thinking may counteract the confirmation bias patients encounter online.