Why is the name of a flower that can be eaten given to the condition Narcissism? Perhaps the ancient Greeks were aware of the concept of healthy narcissism. Narcissism is a necessary component of mental health—echoed centuries later by Rabbi Hillel, “If I am not for myself, who will be for me?”

If not for narcissism, why look in the mirror? Why wear clothes that make us look good, or devote ourselves to our work, or compose a song? Why sing a song or write a book? Why paint a picture?

The adjective pejorative is implied when we say narcissism. Pejorative should be reserved for the pathological narcissist. We all occasionally encounter a pathological narcissist. They usually are men who can be charming and delightful. They often are intelligent and accomplished. Although they can be entertaining, they turn conversations into monologues. They usually are destructive to the people closest to them. An arrogant, overbearing, self-centered, condescending, overconfident, and insulting person is not enjoyable.

They rarely seek psychological treatment. Why bother? They know everything. Why listen to anyone else about anything? They are difficult patients. It is not easy to engage them in therapy.

Let me take a narcissistic moment to tell you about one of my former patients.

Fred was a scientist who had held many high-level jobs. His work was respected and appreciated. He came to see me because once again he had been fired from his job.

We began Fred’s psychoanalysis. After several months I thought I knew enough about him to offer some observations and interpretations. This did not go well. His reaction was silence. Finally, in exasperation, he sat up from the couch, turned around to face me and gave me one of the best pieces of supervision I’ve ever had. He said, “This would go much better If you would just shut up and listen!”

Fortunately, this was easy to do. Fred was knowledgeable about the history of ancient Rome, classical music, especially that of Mozart, Schubert and Beethoven and other subjects that I found interesting. So I listened, and listened and listened. I learned a great deal from Fred.

One day he surprised me. He was telling me about an argument he had with his wife. Once again he turned around, but this time instead of the supervision, he asked me, “What do you think?”

AT LAST! He thought I might have something of value to offer. With these words, he acknowledged that he didn't know everything. It had taken us many months to arrive at this point. He realized that I wasn’t going to criticize him, that I wasn’t going to hurt him, that I was trying to be helpful. And so we were able to continue to work together. If we had not shared a passion for classical music or if it had been earlier in my practice, I probably would have kept making interpretations and observations, which would have been felt by him as attacks. He would have left, which often happens with narcissist patients.

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