Anxiety is a debilitating disease. It’s those oppressive thoughts and feelings that become so overwhelming that you can barely function, let alone breathe. It is the persistent over examining of every little detail, analyzing then overanalyzing all incoming data, while constantly checking it for slights or wrongs. It’s that tightness in your chest or gut that makes you feel all twisted up inside. It’s the cause of your heart palpitations and your irritability. It’s the voice in your head that fills you with self-deprecating thoughts and feelings that you can’t shake.

People with Anxiety Disorders cognitively know that their thoughts aren’t rational at times, much like someone with OCD knows that the constant repetition of a behavior impairs their day to day functioning, but they still feel powerless to stop it.

While there is no evidence that I could find to support this theory – I would hazard a guess that most Narcissists suffer from an anxiety disorder in varying degrees.  The Narcissists I council all match the DSM 4 criteria for Generalized Anxiety Disorder, while at the same time match the criteria for Narcissistic Personality Disorder. Comorbidity, which is the existence of one or more additional disorders, that occur concurrently with a primary disorder, is common in the mental health community.

Listening and trying to make sense of the Narcissist’s inner workings led me down this path and I thought it would be helpful to post a few sessions to give some insight into how irrational and out of control the thought process can be for a narcissist.

James is in his early 30’s. He has struggled with relationships all his life. While he claims to want a relationship and a family, his thoughts and behaviors tell a very different story. In a recent therapy session, James discussed a woman he had met on-line. He says he’s been having an awful dry spell of late and hasn’t been able to get a second date from anyone, which has been making him feel very frustrated, lonely and insecure. He claims his sexual kill count is in the three digits and the lack of sexual gratification he’s experienced lately makes him feel worthless. This new woman has gone out with him now on three dates, he won’t however, allow himself to feel optimistic about it. He is preoccupied with the fact that she doesn’t give him enough attention. He complains that she doesn’t text him enough, compliment him enough, or initiate anything. All of this has led him to feel a great deal of anxiety and he wants to break it off, because he’s having difficulty coping with not knowing how she really feels. He seems to be in  a rush to get her to admit that she has feelings for him and only then will he be able to relax.

James: I texted her that I had a really good time after our date and then I said goodnight and she only texts me back ‘night.’ Like what the ‘f’ is that? She never gives me compliments and it takes her forever to get back to me when I text her.

Sav: You have only known her for ten days. She doesn’t even know you. She is still making up her mind about you as she should. Anyone that is throwing themselves at you and declaring to have feelings this early should be a red flag to you. She doesn’t owe you a front row seat in her life yet. It’s healthy for her to take her time to get to know you before investing emotionally in a relationship with you.

James:  I don’t know. She’s probably talking to other guys and not interested in me.

Sav: That’s possible, but that’s dating right? Especially on-line dating – there’s a high turnover.  Or maybe she just wants to get to know you first and she’s taking her time.

James: We have a date tomorrow, but I don’t know how much more of her indifference I can stand. She’s the first girl I’ve gotten a second date from in months and she’s probably thinking of ditching me.

Sav: She wouldn’t keep making plans with you if she wasn’t at least interested. When you date someone this ‘not knowing’ how the other person feels is part of the process. Allow yourself to enjoy it. Enjoy the moment, enjoy the uncertainty. It’s part of the dating experience. And stop trying to rush everything. You should be concerned with how you are feeling about her and stop being so focused on whether or not she likes you.

James went on his date. I received the following text message at 10:00pm that night:

James: It’s over Sav I blew it. She liked me and I blew it.

Sav: What happened?

James: I’m too ashamed really…I’m too embarrassed. I want to hide in a hole.

Sav: What happened?

James: I did my stupid creeper thing and she caught me. Don’t be mad. I’m too sad right now.

Sav: I’m not mad at you. What creeper thing?

James: After the date I text her from a fake phone number.

Sav: You text her pretending to be someone else?

James: Yeah. I feel sick. I want to die.

Sav: What did you say?

James: It doesn’t matter.

Sav: Come on. Let’s hear it.

James: I pretended to be looking for somebody else. A wrong number and I asked her if she was single and she knew it was me. She called me right away and told me she was done.

Sav: From the time I told you to let this unfold naturally to the time you came up with this plan – what was the thought process that led you to think this was a good idea?

James: I don’t know Sav. I’m f**ked. I really am. I feel so shitty right now it’s unbelievable.

Sav: Don’t you notice your pattern here. You always get these compulsive thoughts that keep telling you that they’re not interested and then you become a detective always looking for proof. You’ll cyber stalk them, create phony social media accounts or fake text accounts to spy on them. This isn’t healthy James.

James: I feel sick right now. My head is literally spinning right now.

Sav: What you don’t seem to get is that you never really know what a person thinks of you – even when they say I love you – you still never really know for sure. Your ego is so fragile that you can’t handle not knowing. It is way too important to you.  You have to learn that what other people think of you doesn’t matter – who cares. They either are going to like you, or not like you and there is no sense wrapping yourself up in knots about it. It’s out of your control.

James: It consumes me. I can’t stop thinking about it. I’m a sicko.

Sav: There’s no need for that. You need to find a way to control these compulsive thoughts and you seem to have very weak impulse control too.  Tell me did you think that what you were doing was wrong or unhealthy? Did you think about the consequences at all before you did it?

James: No I didn’t. I really didn’t think she’d know it was me. I feel sick right now. My head is literally spinning from anxiety and shame. I feel like throwing up.

Sav: I want to understand better what drove you to do this?

James: I’m insecure.

Sav: Granted, but lots of insecure people don’t do that. Why did you need proof? Why couldn’t you just wait it out?

James: I don’t know why Sav. I don’t.  I just got it in my head that I had to know and I couldn’t stop myself. I had to figure it out.

The next day James called in sick to work because of his anxiety and left several messages on my voicemail and continued to text me:

Sav: Let’s not get over dramatic James and let’s put this into perspective. You went out on 3 dates in 11 days. This was someone you just met. Sure it was embarrassing and a good learning experience, but don’t blow it out of proportion. This wasn’t a 25 year marriage it was 11 days, 10 of which you spent complaining about how you wanted to break up with her. Chalk it up to a learning experience and move on.

James: I did like her. It was my brain that tricked me. She was fine in retrospect. I have to find a way to fix this.

Sav: I think you should leave it alone, learn from it and spend your time figuring out why you do things like this.

A few hours later:

James: I got her to message me. She said unless you’re going to explain yourself I don’t want to hear from you. So I told her everything and now she said she needs her space and time. I told her I was better than this and that I hope she’ll give me another chance. So that’s where I stand. Who cares it’s over. Maybe I should send her a basket full of goodies as an apology.

Sav: (Does face palm) James she asked you to give her time and to give her space. You have to respect her request. Stop trying to control everything.

I have known James for many years. I am fortunate enough to get to see this side of him. With everyone else he wears his mask of bravado, his armor. I thought it was important to witness a Narcissist’s inner turmoil, the fear and the anxiety that goes on inside of them.  With me, James doesn’t fear exposing his true self like he does with others, but I have seen and tasted his Narcissism in all its dark glory. Not many people get to witness a Narcissist’s truth, their obsessions, their weaknesses and their hopelessness. This is the reality they live in. All of the sensory information that comes in seems to go through an extensive processing filter, where it’s scanned for anything that might be considered harmful to their fragile sense of self. They are over-sensitive, their nerves are over-taxed and while all of this is going on on the inside, they spend every last ounce of energy trying to present a perfect, confident picture to the outside world.

People are always asking me how I know their Narcissist isn’t happier with someone else – here is your answer – their brain doesn’t shut off just because someone else has entered the picture. They have extreme difficulty controlling their thoughts and their emotions. They are constantly on edge, irritable and always fighting their demons.

When we get hurt by a Narcissist we want to believe that they are monsters. It helps us to get through it if we can dehumanize them and make them out to be some kind of evil. The truth is that these are highly sensitive individuals, whose anger and irritability are caused by constantly feeling on edge. They desperately seek to control others, because they have no control over their own lives.

James, along with the other’s I counsel, are constantly asking me to interpret someone else’s behavior, because they honestly don’t know how to perceive it correctly. They get through life by faking it. That is the best they can do.

Your Comments!!!!!!!!!!!!!!!!!!!!

Subscribe to our mailing list and receive our weekly posts right to your inbox.

Image courtesy of  Boians Cho Joo Young at