Treatment of the false self (narcissistic defenses)

by Michael Etts, LCSW-C

Personal change is difficult when one is still locked in the original mold (like this plastic airplane model)

For those with a false self, the family of origin mold remains intact and new relationships are appended to it.

Rules of the false self family

  •  Exhibit socially desirable traits (appearance, money, athleticism, intelligence, etc) to bolster the family image and hero status will be awarded
  •  Failing to bolster the family image or identifying flaws in the dominant parent will result in the assignment of scapegoat status
  •  Do not question the family consensual reality that the family unit is “special” “gifted” “lucky” or in other ways superior.
  •  Feelings and emotional intimacy are discouraged except “positive” feelings like being happy. This contributes to the myth of the “happy family” that is believed and presented to outsiders. This happy facade is often considered evidence of the family superiority. Empathy, compassion, sadness and warmth are all compromised, especially for those outside the family of origin.
  •  Dependency and attachment needs are disowned and denied. Guilt, power, money, etc are used to control family members to assure that dependency and attachment needs are met. In accordance with this, saying “no” or setting boundaries is reserved for the dominant parent (and to a lesser degree, the subordinate parent).
  •  The self esteem that does exist is entirely conditional and is based on feeling “better than” others. This requires almost constant judgment of others, both within the family and those outside the family. This explains the main function of the scapegoat. They are to assume an inferior role and thus enable a superior role for the remaining family members.
  •  In the more troubled false self families, children are largely objectified, related to as sources of gratification for the dominant parent’s needs. In a sense, children are seen as vending machines. Something that one goes to to get something, without the need for reciprocity. The idea that children are thinking, feeling beings with their own needs, is not acknowledged. This becomes the relational style of the hero.

Recovery from the false self family

  •  Encourage recognition that the rigid attachment to the family of origin and its rules is dysfunctional.
  •  Following this, recognizing the costs of conditional self esteem and facilitating the development unconditional self esteem. This is a critical second step, as the person will have to let go of a self definition that sees them as valuable only when they meet certain criteria. This step is generally not possible until a person can acknowledge their unconditional worth, regardless of traits they once considered essential to their worth.
  •  Conditional self esteem is a tight rope with nothing between the person and the hard ground below. Only unconditional self esteem can provide a soft landing and allow them to get off the tight rope.

Treatment plan for the false self (emotionally numbed)

  •  Develop unconditional self esteem and begin dismantling conditional self-esteem. Raise awareness of judgmental thoughts directed at the self and others
  •  Develop or enhance trust - create emotional safety through consistent, appropriate responses to emotional expression. Creating emotional safety will enable the eventual acknowledgement and display of vulnerability.
  •  Enhance or teach interpersonal boundaries while identifying areas of entitlement
  •  Develop empathy for others using personal pain as a reference
  •  Raise awareness of emotional invalidation of the self. Follow with raising awareness of emotional invalidation of others
  •  Raise awareness of the disowned/unacknowledged feelings of "not being good enough” and connect to projecting that onto others.
  •  Raise awareness of disowned/unacknowledged abandonment and intimacy fears and normalize basic attachment needs and the need for emotional intimacy
  •  Raise awareness of disowned/unacknowledged dependency needs and normalize relationship interdependence
  •  Raise awareness of primary attachment to family of origin and secondary attachment to nuclear family. Explain the negatives of this arrangement and address relationship issues in the nuclear family (e.g., enhance/create emotional safety)
  •  Raise awareness that being positive or always “looking on the bright side” is not an asset when it is accompanied by impaired ability to feel sadness, empathy, warmth and compassion
  •  If anger is an issue, use standard anger management treatments with one addition. Educate that emotional pain does not create an entitlement to express anger in an aggressive, inappropriate manner.


False self - a persona or mask consisting of emotions (or lack of) and behaviors developed to meet the needs of the original caretaker.

Trigger - a current incident that is reminiscent of a prior emotional injury, which results in a disproportionate and intense emotional response.

True self - the spontaneous expression of emotion and individuality