Narcissism

Their posts allow you to fleetingly marvel at a truly remarkable person. In their photos, they are always smiling and apparently having a fantastic time. They take trips to the most exciting exotic locales. They make a point of always supporting the best and latest causes because ‘it’s important to give back’ (and tell the whole world you are doing it).

They are working on yet another glamorous, compliant and wealthy patient (the sort who simply doesn’t exist in your world), whilst all the time raising children, and also starting some hot new business venture or clinical technique. They are fit and show you how they stay so fit (gym selfies, ‘I’ve just run 20km’ selfies, ‘look at the bucket of kale I’m eating’ selfies).

They frequently put up quotes that promote a positive attitude and spiritual values, and can be seen publicly doling out advice. They have several selfies that just happen to capture them staring philosophically at the horizon, pondering how to do more good in the world whilst always being grateful for their incredible achievements to date.
And have no doubt, this is NOT about them. Definitely not about them at all! It is about positivity and helping others.

Ok.

Do you feel helped? Do you feel positive? No, me neither…and neither does anyone else.
After the umpteenth round of seeing these posts, images, and reading their stories, a certain level of disquiet begins to creep in. Instead of feeling helped you may feel unsettled. As a species we are programmed to be envious, so perhaps it is just our own failings, our own infantile envy making our cortisol levels rise and a feeling of inadequacy, perhaps even shame, creeping in.

On some level the utopian life depicted cannot help but stir up our own insecurities?—?“Am I having as good a time? I’ve not pioneered a dental technique, let alone started a family or made my business a huge success.”
The reality is that we are dealing with a deep narcissist.
This person may be a colleague, another GDP or even your patient.

The deep narcissist needs special distinction from the functional and healthy narcissist groups. Everyone looks in the mirror, chooses their clothes, adjusts their make-up and presents themselves to the world as best they can. So, to some degree, we are all narcissists. It is a spectrum we are all on, hopefully towards the healthy end.
Deep narcissists are different. They demand the clicks and likes; they will play either the persecuted victim or react aggressively to criticism. If they play the victim, have no doubt this will be done on a public platform where the subject is them.

They have an inner emptiness and constant need for validation and recognition that must be continually filled by drawing attention from a mass of followers (even if they have to buy some friends and followers to pad their numbers). In real life, we quickly see through such types as frauds?—?they have not accomplished what they boast about; they merely dabble in ventures; they are just as banal and unhappy as everyone else, and hardly spiritual. Their attempts at getting attention are quite desperate. But in the virtual world it is hard to discern this reality. They know how to manufacture the illusion of excitement, achievement and moral purity. They pick a fleeting number of cases that went well and post them relentlessly to a carefully selected audience. The audience are acolytes or team mates. This audience will reliably leverage the power of social proof by paying in clicks to each and every post (they expect the same in return BTW). So the echo chamber becomes self-fulfilling and voices of dissent or contestation then sound petty and ‘negative’. You may be labelled a hater if you point out any flaw or dare to challenge the narcissist’s personal narrative to glory!!!

A contemporary deep narcissist cannot actually harm you. You can probably list a fellow dentist who is a deep narcissist. You may or may not have ever met them, but you see them every day. The only dangers are the insecurities and envy they can stir up in us. It is best to unfriend them, cut them from our news feed, without their knowing, and not subject ourselves to their irritating notions.
Patients can be deep narcissists too.

The deep narcissist patient can cause you untold anxiety, stress and pain. Their narcissism means if you are their dentist you have been cast in their movie. They are the star and you are a supporting act. If you glorify the star and make them a hero you will be cast as a sidekick in the movie and may get some gratitude. If, despite acting in their best interest, you don’t support the rise of this star, you are a villain. The movie villain is a baddie and will get punished for this role.

So what does this mean in real life? A narcissistic patient may have to go to the dentist. This may not fit with their perception of what they, the star, should be doing. So they are angry before they have arrived. Movie stars don’t get toothache, do they?

Who will receive this anger? It’s probably going to be you. And what if you are younger, prettier and inherently more deserving of their self-awarded accolades? Oh dear, well then the fuel gets added to the fire, as there is nothing a narcissist likes less than a bigger and better movie star moving into their field of view, and, worst of all, you don’t act like a spoilt, self-obsessed brat. You will probably be really nice and kind and their self-loathing and emptiness becomes too painful for them, so their anger and resentment is all they can rely on and use.
How many times are you nice to patients only to have them behave irrationally and aggressively in return? Were they a deep narcissist?

Remember: If you aren’t a supporting act who glorifies them, you are the villain!
Worst of all, it is as if your dentistry detracts from them living like a star. The crime? You detract from their aesthetics. And let’s be clear, this doesn’t need to be the aesthetics that they walk in with. It has more to do with how they want to be or feel they deserve to be.

You may take an unsightly set of teeth and give them a huge upgrade in aesthetics. But the deep narcissist’s standards are impossibly high. If it’s not perfection, or doesn’t reflect their personal notion of perfection, it’s failure. If you can’t achieve this singular version of movie-star flawlessness, all you will achieve is failure, disappointment and anger. Who pays a dental bill if those are the three descriptors of the treatment outcome?
Deep narcissists are always looking to reinforce and enhance their position as a leading star. Real life gets in the way, however, and their expectations for your cosmetic enhancements may not immediately lead them to fame and glory. The four veneers you fitted didn’t lead to them scoring a date with the footballer they have been waiting to notice them. The bleaching and composite bonding didn’t make the model start texting back on Instagram.
Reality got in the way. Is this the superstar’s fault? Don’t be silly. If only the dentist had added the three microns of composite they helpfully suggested then the dream would have become real. The shape of the teeth, if done correctly, as helpfully shown in the glossy magazine preoperatively, would have meant they were a sure thing to be scouted by the model agency—and then the glamour, fortune and adulation would have naturally and deservedly come their way.

The key to deep narcissists is to spot them. To learn to see them coming. To detect them with cleverly crafted and prepared questions. You can then manage them with ease. Support them in their delusional role without ever actually getting cast in their movie and allow them to move on. All the while they think of you as an irrelevant cast member, neither here nor there but certainly not someone the star wants to complain about.

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