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Saturday, March 26, 2022

What is Sexual Narcissism? Part 2: A Clinical Vignette

In Part 1 of this topic, I gave a definition, described the characteristics of this dynamic, and distinguished sexual narcissism from Narcissistic Personality Disorder (NPD).  In this article, I'm providing a clinical vignette to illustrate how the dynamics of sexual narcissism can play out in a relationship.

What is Sexual Narcissism?

What Are the Telltale Signs of a Sexual Narcissist?
As a brief recap, the following behaviors usually characterize sexual narcissists (see Part 1 for a more detailed description):
  • Charming During the Initial Phase of a Relationship: Sexual narcissists like the thrill of the chase, so during the initial stage of a relationship they're often charming until they get what they want. 
  • Grandiose Behavior With Underlying Low Self Esteem: Although their behavior is grandiose with regard to their perception of their sexual prowess, they often have an underlying sense of low self esteem.  
  • A Focus on the Physical Over the Emotional: Their primary focus is on having sex--not establishing an emotional connection.  
  • A Lack of Empathy For Their Partner: Their partner exists to please them.  They often don't see their partner as having their own needs and wants. 
  • Negative Reactions If They Don't Get What They Want: They might get angry, critical, sarcastic or passive aggressive when they don't get what they want from their partner.
  • Put Down Their Partner: In order to feel superior or manipulate their partner into doing what they want, a sexual narcissist will often belittle their partner by calling their partner names or putting them down in other ways.
  • Treat Their Partner Poorly After Sex: After sex, they usually don't engage in cuddling or being affectionate with their partner. 
  • Infidelity: The sexual narcissist is often unfaithful.  Once the thrill of the chase is over, they want to find the next person to pursue sexually because this is what they most enjoy--the sexual conquest.  They're often not concerned about whether their behavior will hurt their partner.

Clinical Vignette:
The following clinical vignette is based on a composite of many cases with all identifying information removed to protect confidentiality:

At the point when Carol sought help in therapy, she had asked her husband, Mike, to move out of their home due to his cheating.  

She explained to her therapist that throughout their courtship and 10 year marriage, she had discovered numerous incidents of his infidelity.  Each time she confronted him about it, she believed his promises not to do it again.  He seemed genuinely remorseful--until the next time.  Then, the cycle would begin again--as if he had never promised to change his behavior (see my article: Broken Promises).

The last straw occurred for Carol when she found out that Mike was having an affair with a casual acquaintance of theirs, Ann. Hoping to end Carol and Mike's marriage, Ann sent Carol a video of Mike and Ann having sex.

At first, Carol wasn't sure what she was seeing.  Then, when she realized she was looking at a video of Mike and Ann having sex, Carol was crushed.  

At first, as he usually did, Mike denied any involvement with Ann, but when Carol showed him the video, he was silent.  

Not being able to deny it anymore, he told Carol that he had sex with Ann once, and he wasn't aware that she was videotaping them.  Then, he went into a rage blaming Ann for being seductive and manipulative and for sending this video to hurt Carol and destroy their marriage.

Carol recognized his pattern of not taking responsibility for his actions, and she told him to move out that night.  In response, Mike begged Carol to allow him to stay so they could work things out.  He even agreed to attend couples therapy--something he refused to do when Carol had suggested it many times before.

Believing Mike was sincere, Carol allowed him to stay with the understanding they would attend couples therapy.  But a week later when she made an appointment with a couples therapist, Carol was disappointed and hurt to discover that Mike refused to go.  She realized that his offer to go to couples therapy was just another manipulation, so she packed his bags and insisted that he move out.  Reluctantly, he went.

Carol told her therapist she realized throughout their marriage she had been trying to get their relationship back to how it was during the initial stage of their courtship when they were in college and he was trying to persuade her to go out with him.  He was charming, funny and seemingly thoughtful.  But, at the time, she was in a committed relationship so she politely rejected Mike's offers to take her out.  

At first, she thought Mike would be dissuaded from pursuing her when he found out she was in a relationship with someone else but, as she looked back on it, she realized, if anything, Mike became even more persistent.  

When her boyfriend ended their relationship to return to his prior girlfriend, Carol was so heartbroken that when Mike approached her again for a date, she agreed to go out with him--even though her friends on campus told her he was a "player," also known as a womanizer (see my article: Understanding the Underlying Emotional Dynamics of Men Who Are Players).

She  reasoned to herself that he was attractive and funny, she was flattered by his attention, and she wanted a distraction from her heartbreak.

Initially, Carol thought she would only go out with Mike once or twice and it would help her to forget about her breakup.  But Mike was so charming and attentive that she kept seeing him.  At that point, she thought he was fun and exciting, and when she was with him, she didn't think about her ex.

Six months into their relationship, Carol found out through the grapevine that Mike had lied to her.  Not only was he secretly seeing other women on campus, he was also having an affair with an older woman in his hometown whenever he went home for a visit.

At first, Mike denied that he was cheating on her, but when Carol confronted him with photos posted on social media by the women he was seeing, he blamed her for his infidelity.  

He told her that she was neglecting him and spending too much time studying and participating in college activities.  He also blamed her for not meeting his sexual needs.  He told her that if she spent more time with him, he wouldn't need to see other women.

In retrospect, Carol told her therapist, this was the start of allowing Mike to manipulate her and blame her for their problems, which continued into their marriage.  

A month after their marital separation, Carol was ready to work on herself in therapy.  She stopped taking Mike's increasingly panicked calls or reading his text messages because she knew she had to put herself first and work on herself.

Through her work in therapy, Carol learned how her family history contributed to her problems.  She saw many of Mike's narcissistic and manipulative characteristics in her father, who also had multiple affairs, which her mother passively endured.  

Over the next year, she worked through her traumatic childhood history with EMDR therapy as well as the trauma she endured in her relationship with Mike (see my article:  How Does EMDR Therapy Work: EMDR and the Brain).

During that time, Carol continued to block Mike from calling or sending email or text messages to her.  But eight months into their separation, he sent her a letter where he said he was devastated by their separation.  For the first time in their relationship, he said, he felt genuinely remorseful and he wanted to change, so he was attending individual therapy.

Initially, Carol didn't believe Mike.  He had lied to her so many times before so she didn't see any reason to believe him now.  At the time, she was consulting with an attorney to begin divorce proceedings.  

Carol was also feeling much better about herself and she didn't want to endure any more emotional abuse from Mike.  But at the end of his letter he asked her to come to one of his sessions to meet his therapist, and Carol was curious:  Was it possible for Mike to change?

After she discussed this with her therapist, Carol agreed to attend one session with Mike and his therapist.  It was awkward, at first, to see Mike in his therapist's reception area after having no contact with him for so long.

During the session, Mike's therapist explained that he had been treating Mike for sexual narcissism, and he explained how sexual narcissism is related but different from Narcissistic Personality Disorder, NPD (see my article: What is Sexual Narcissism - Part 1).

Mike's therapist also talked about the progress Mike had made in coping with his sexually compulsive and impulsive behavior.  In addition, at the start of therapy, he sent Mike for a psychological evaluation to rule out Attention Deficit Hyperactivity Disorder (ADHD), which is often related to sexual compulsivity and other impulsive behavior, and the tests revealed no ADHD.

He suggested that they attend Emotionally Focused Therapy (EFT) for couples to see if they could work out their problems in couples therapy (see my articles: What is EFT Couples Therapy? and How EFT Couples Therapy Can Improve Your Relationship).

After being hurt and disappointed so many times, Carol wasn't convinced that Mike could change.  She talked about whether or not to attend couples therapy in her own individual therapy.  

One the one hand, she didn't want to set herself up for another disappointment.  One the other hand, she sensed that Mike was brought down so low by their separation that he just might be motivated to take responsibility and work on changing his behavior (see my article: Developing Internal Motivation to Change).

A few weeks later, after much consideration, Carol agreed to attend EFT couples therapy with Mike as they both continued to attend their own individual therapy (see my article: What Happens During the Initial Stage of EFT Couples Therapy?).

Several months into couples therapy, Carol felt they had made enough progress to move back in together for a trial period of six months.

There were times during this period when Mike slipped into parts of his old behavior, like blaming Carol for his mistakes instead of taking responsibility, but he quickly realized the error in his thinking and took responsibility. He also stopped cheating.

As part of their agreement to move back in together, Carol had full access to Mike's email, texts, social media and computer files.  She found no evidence of infidelity and, although she was leery at first, she was beginning to trust Mike again.

Their progress in their individual and couples therapy was gradual, but they both believed their relationship was now better than it had ever been (see my article: Progress in Therapy Isn't Linear).

A year after they completed couples therapy, they received a follow up call from their couples therapist, which was agreed upon during their couples therapy, and they were still doing well.

Sexual narcissism exists on a continuum.  

Some people have more of a problem than others, and many people with this problem are unwilling to get help.

A person who is in a relationship with a sexual narcissist often, unknowingly, colludes with their partner's behavior because of their own psychological history.  As illustrated in the vignette above, Carol was primed for this relationship due the family dynamics in her childhood home with a father who was sexually narcissistic and a mother who passively endured his behavior.

For some sexual narcissists, the motivation to change their behavior comes when they have endured the loss of a relationship.  Then, they're willing to do the necessary work to change.  Even then, they have to be vigilant so they don't slip back into old behavior patterns.

Other sexual narcissists say they'll change (and maybe even believe it at the time when they say it), but once they have what they want again, they're no longer motivated to work on themselves.  

Anyone with a partner who is a sexual narcissist has to let go of whatever denial they're holding onto about their partner and their relationship, see their part in the dynamic, and decide for themselves if they're willing to try couples therapy to work out their problems.

Although the vignette above is about a man who is a sexual narcissist, women can also be sexually narcissistic.  

Also, be aware that the dynamics of sexual narcissism can play out differently in different relationships.  The example given above is just one manifestation of this problem.

Getting Help in Therapy
Whether you're the person who is in a relationship with a sexual narcissist or you see these traits in yourself, you can benefit from working with a licensed mental health professional.

Individual and couples work for sexual narcissism is neither quick nor easy, so you both need to be motivated to do the work.

Doing nothing won't change anything, so if you're struggling on your own, seek help from a licensed psychotherapist.  

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during regular business hours or email me.