The Birth of Sorrow | Part 2: Emotional Life in Neurotic-Level Narcissism

The Birth of Sorrow | Part 2: Emotional Life in Neurotic-Level Narcissism

Author: Mark Ettensohn, Psy.D. May 27, 2025 Duration: 37:43
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.

In Heal NPD, clinical psychologist Mark Ettensohn, Psy.D., offers a nuanced and compassionate exploration of narcissism, moving beyond simplistic labels to examine the underlying psychological structures. This podcast delves into the complexities of narcissistic personality disorder and related traits, providing clarity for those who recognize these patterns in themselves or in their relationships. Dr. Ettensohn draws from his specialized therapeutic practice to discuss the origins of narcissistic adaptations, the impact on interpersonal dynamics, and the realistic pathways toward change and healing. Episodes often break down clinical concepts into accessible language, featuring discussions on empathy, identity, shame, and the challenging process of building healthier self-esteem and relational skills. The tone is educational yet deeply human, aiming to reduce stigma and foster understanding. Whether you are a mental health professional, someone personally affected by NPD, or simply curious about personality psychology, this series provides a rare, expert-guided look into a frequently misunderstood area of human behavior. Tune in for a thoughtful perspective that prioritizes psychological science and the possibility of growth.
Author: Language: English Episodes: 50

Heal NPD
Podcast Episodes
Lisa Taylor-Austin’s Interview with Dr. Ettensohn [not-audio_url] [/not-audio_url]

Duration: 1:12:02
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.c…
Decoding NPD: The Critical Role of Attachment [not-audio_url] [/not-audio_url]

Duration: 22:41
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…
5 Common Misconceptions about NPD [not-audio_url] [/not-audio_url]

Duration: 27:27
In this episode, Dr. Ettensohn addresses 5 common misconceptions about pathological narcissism and NPD: 1. NPD is not a mental illness 2. NPD is not treatable 3. Even if NPD is treatable, actual healing is impossible 4.…
Boundaries, Assertiveness, and NPD [not-audio_url] [/not-audio_url]

Duration: 24:47
In this episode, Dr. Ettensohn discusses the important topic of boundaries. He provides a definition of interpersonal boundaries, discusses the reasons why boundaries are important for mental health and healthy relations…
What Causes Narcissistic Rage? [not-audio_url] [/not-audio_url]

Duration: 19:04
In this episode, Dr. Ettensohn explores the possible causes of narcissistic rage, referencing the work of Ernest S. Wolf, a close collaborator with Heinz Kohut and author of the book 'Treating the Self: Elements of Clini…
Do Narcissists ”Know What They’re Doing?” [not-audio_url] [/not-audio_url]

Duration: 14:47
In this episode, Dr. Ettensohn discusses the topic of self-awareness in NPD. Numerous commenters have shared their belief that narcissists "know what they are doing"...that they are fully aware of the harm caused by thei…
Why Narcissists Lack Empathy [not-audio_url] [/not-audio_url]

Duration: 15:21
In this episode, Dr. Ettensohn outline 4 reasons why empathy may be impaired in pathological narcissism and NPD: 1. Lack of self awareness 2. Objectification of the self and others 3. A 'starvation mindset' 4. Avoidant a…
Illness Anxiety and NPD [not-audio_url] [/not-audio_url]

Duration: 10:35
In this episode, Dr. Ettensohn explores the connection between illness anxiety and pathological narcissism. This episode explores how illness anxiety in NPD can be disguised anxiety about loss of self or psychological di…
A Real Definition of Narcissistic Abuse [not-audio_url] [/not-audio_url]

Duration: 10:20
The term ‘narcissistic abuse’ has been, itself, heavily abused. Is has largely been a pop-psychology term that means different things depending on how and where it is used. It is often used to demonize individuals with p…