Metacognition is the ability to recognize and reflect on the psychological state of oneself and others and apply it to solve difficult problems in social life.
The lack of metacognitive ability is the core feature of narcissistic personality disorder;
Patients with narcissistic personality disorder usually lack awareness of the things that cause their emotional reactions in interpersonal communication. For example, they don't think that the depression of the day may have anything to do with the rejection of the girl they liked the day before.
Such patients are usually very sleepy in emotional language, unable to describe their feelings and emotions clearly and concretely, and their descriptions of emotions are always general.
They always evaluate themselves and others in a rigid and rigid way, and it is difficult to doubt or question their own cognition. This situation is called: low metacognitive discrimination.
Narcissistic personality disorder is difficult to think from the perspective of others, and the same reaction ability is impaired, which they don't know.
Meta-cognitive interpersonal therapy (hereinafter referred to as MIT therapy) holds that lack of self-awareness is the core of meta-cognitive dysfunction of narcissistic personality, so the key goal of treatment is to help visitors understand their real motives and wishes? Instead of pursuing arrogance? Help them live a better life.
At present, MIT has a relatively complete and standardized process, and there are instructions for reference. Let's introduce the basic operation process of MIT.
-MIT operation flow-
It is necessary to establish a consultation relationship with visitors before the main body of MIT therapy is carried out. After that, the treatment subject of MIT is divided into two stages: paving the way and promoting change.
Step 1 stage of establishing consulting relationship
Consulting relationship is to know whether the contact between visitors and others is correct. Adaptability? Important indicators. Through the relationship between counselors and visitors, we can infer the relationship between visitors and others.
Whether the visitors with narcissistic personality have a cooperative and trusting attitude is very important for establishing a consulting relationship. Among the visitors with narcissistic personality, counselors should pay special attention to the negative effects of relationship breakdown, misunderstanding and uncooperative visitors on the counseling effect.
Mit consultants will pay great attention to any damage to the consulting relationship. In the process of consultation, counselors may experience temptation, sometimes challenge or criticism from narcissistic personality visitors. Psychological counselors can use positive expressions, be alert to whether visitors show negative signals, and try to avoid or prepare to repair broken relationships.
At the same time, especially in the stage of establishing consultation relationship, psychological counselors need to avoid questioning the image of others described by visitors, and also avoid challenging the criticism of visitors from the perspective of protection.
On the contrary, consultants can now get to know visitors with curiosity and not evaluate Ta.
When the consultant enters the arrogant fantasy of the visitor without challenge, the consulting relationship is easier to establish.
It is not easy to have feelings for visitors with narcissistic personality.
But consultants need to realize that everyone has great dreams and ambitions in their hearts. Do you have these? Arrogant thoughts are also a feature that many of us have.
Psychological counselors can affirm the experience of visitors on the emotional level. For example, visitors say they want to be a great man or a star, and counselors can say, I find that you have high ambition and pride in some things that have not yet been realized. ?
In addition, counselors can skillfully expose themselves and cultivate a kind of? we? Establishing a relationship with narcissistic personality disorder is also an important skill. For example, when visitors describe themselves as powerless, psychological counselors can express themselves sincerely through self-exposure, and they already feel powerless.
The purpose of this exposure is not to emphasize that the counselor teaches the visitor how to overcome this weakness, but to let the counselor and the visitor discover the imaginary place of both sides, thus creating a connection.
Maturing stage
At this stage, the counselor's main task will be to understand the details of the visitors' important experiences, rather than simply accepting the visitors' too abstract and vague generalizations.
These details will include the exact time, place, people, conversation situation, topic description, and why the visitor described this particular event and the idea behind Ta.
Counselors and visitors will review the details of the event repeatedly until the visitors notice the subjective cognition that has been neglected before.
To like it? Rationalize and summarize events? For narcissistic visitors, tell the truth? This is really a difficult thing.
First of all, the consultant needs to explain to the visitors what the reasons are, such as? The reason why I ask you about the specific description of the event is because the original information of your life experience can help the consultant to better understand your every detail? .
In addition, psychological counselors can also use the events rationally summarized by visitors to guide them to describe the details and feelings of specific events. For example, if the visitor puts himself in a scene and says that Ta wants to be a great man, the consultant can follow up and ask:
What does it feel like to be a leader/general/star (detailed description, nameless feeling)?
What do you think is good?
In your past life, have you ever experienced similar feelings and thoughts (subjective experience) at a certain moment?
Excavating memories is not to let visitors experience the arrogant positive state, but to excavate the contradictory thoughts of visitors:
On the one hand, expectations are considered special and powerful by others;
On the other hand, I always feel rejected by others.
In addition, through this process of repeatedly confirming details and feelings, psychological counselors can help visitors learn to describe their feelings and understand the emotional starting point behind them, thus helping visitors improve their ability to understand their psychological state in narration.
Through this process, psychological counselors also collected enough personal experience information of visitors to discover the key issues of rigid interpersonal relationship cognition.
For example, a tourist once described in detail his experience when he went to the post office to pay the bill:
Before he entered the post office, he felt afraid, afraid of being humiliated, so he felt anxious. His inner activity is:? Can I do it well? Will I be respected and not treated rudely? I can't be indifferent to others, otherwise, I am a useless loser. ?
When he came to the shop assistant, he immediately felt that the man was absent-minded and rude to him. So I visited it and thought: This bastard at the counter doesn't even look me in the eye. Who does he think he is? Who does he think he's dealing with?
This state is short-lived, and then he immediately entered a fragile state: I can't get respect from others, and I can't let others see who I am and my value. He was rude to me because he thought I was an idiot. ?
After discussing this matter in detail with the consultant repeatedly, both parties found that the cognitive model of visitors has the following details and characteristics:
Ta is deeply driven by social status motivation;
Ta needs to be accepted and regarded as a capable, intelligent and valuable person;
Ta believes that the conditions for being recognized and gaining social status are: no mistakes in completing the task;
Ta believes that except those who are extremely excellent and outstanding, others are losers and worthless people.
In addition to the specific information of the above-mentioned repeated inquiries, psychological counselors also need to improve their understanding of the recurring interpersonal relationship patterns.
Psychological counselors can help visitors with narcissistic personality understand that they attribute too many people and events to others' hostility and pursuit of status; I base my good self-feeling on being admired and recognized by others.
We should also help them realize that the reason why they think others will be hostile and hinder the realization of their goals is mostly caused by their own cognitive schema.
Visitors also need to understand that they can't enjoy life, mainly because of their passive and goal-oriented actions, not because of the negative reactions of others.
On the basis of recognizing their own cognitive map, psychological counselors can encourage visitors to formulate strategies to change themselves.
Because the interpersonal relationship model of narcissistic personality disorder visitors is reflected in: it is difficult for them to act according to their own inner wishes. As a consultant, we should advocate independent actions driven by inner desires, and at the same time, we should skillfully discourage the perfectionist standards of visitors and the actions taken by Ta to achieve envy and recognition of others.
In a treatment, the psychological counselor said to the visitors:
Who do you seem to work for? Success? Live.
I feel as if you think that if you fail, others will laugh at you. But when you succeeded, you didn't refute the previous assumption that you were incompetent and clumsy. You usually attribute what you have successfully accomplished to what you can easily accomplish.
I think so, too. It seems that if you try to get in touch with someone you are interested in, you will soon find them unworthy. What do you think of the relationship with others? People don't respect me, either he is stupid or he doesn't have a chance to see me. ?
At this stage, psychological counselors can measure whether the cognitive map of visitors has changed by understanding recent events. If the counselor does not know the psychological information of the visitors at this stage, the treatment may stagnate at this stage.
Step 3 Promote the Change Phase
At this stage, the therapist needs to show the clients with narcissistic personality disorder that their thoughts are not necessarily true, but the situation can be explained from many different angles. For example, the following consultation dialogue:
(hereinafter referred to as the client and the visitor, hereinafter referred to as C; Therapist and consultant, hereinafter referred to as T)
C: I am really angry and decadent. Is this what I should have in my life?
T: Can you explain it again? What don't you want in life?
Archaeologists, and these new friends. I think I'm wasting time that I should have spent on other things.
T: What else? Do you have any other goals to achieve?
No, I don't know! But I was thinking. I don't know if I like it. I feel very dissatisfied, as if there are other things in my life, and I am wasting my life. I went to my colleague's house for dinner last night. The circle is small, but I don't know many of her friends.
T: Do you know them?
C: I didn't even notice them. They only care about themselves and no one looks at them. They look like two assholes. I want to leave for a while?
Why do you want to leave? Didn't you have fun with your friends?
Yes, but that's not important. Those two bastards got into such a circle without doing anything. They only care about themselves. Once I asked them what they had done, and then they gave me a cold answer. They are cold.
T: What did you think at that time?
C: They don't want to take me. Do they look cool?
At this point, the consultant can affirm or encourage the visitors and ask ta to clearly describe the details of the matter. Then you can show it to the visitors and observe the old schema of the visitors yourself? Inferiority, others think that Ta is a strict judge, and ta feels contempt for them? It's activated again.
In the above case, the counselor told the visitor that he felt that the visitor had such an idea and was rejected by that circle, and this idea was particularly strong. With the approval of the visitor, the counselor also pointed out that the attention of the visitor is selective, and the visitor completely ignores his good friend's attention to Ta.
The counselor also explained to the visitors why these two expectations were activated so quickly: it may be that the visitors wanted to be treated as special people, but they didn't get it, and then they felt that they were particularly failed.
After that, the psychological counselor asked the visitors to evaluate the possibility of this situation: getting the attention and special treatment of strangers quickly.
Tourists admit that this is unlikely.
After that, the consultant asked the visitors to think about this problem from other angles:
Only after the visitor reflected did he know that Ta had been thinking about what others would think of him all night and regarded himself as the center of others' thoughts. Ta also realized that Ta had been trying to find fault with each other, perhaps driven by rebellion, but also for harvest? Superior? And then what? Win? The feeling of:
T: When the atmosphere becomes like a game? What do you think? Is it finished? Universal fact? , that is what you think? They want to crowd me out? . Can we think about it, in those two people's? Indifference? Is there any other possible explanation behind the behavior?
C: I didn't expect it at that time. Now that I think about it, it may be because they are not feeling well. We met more people that day, and our circle became more familiar. On the contrary, they are a few unfamiliar people. Honestly, we didn't take care of them?
In addition, at this stage, the consultant should also pay attention to:
Cultivate visitors, right? Healthy self? Contact, connect the deep desire of visitors with some healthy/appropriate new behaviors.
When visitors realize that the pursuit of greatness and status is also the normal demand of normal people, including themselves and therapists. At this time, psychological counselors can encourage visitors to leave Ta's marginal consciousness and establish new and healthier thoughts, feelings and behaviors.
It is possible that the visitor's arrogant fantasy can help Ta find her real desire. For example, a visitor wants to be an officer. In order to realize this wish, Ta must first become a historian, and the major of history makes Ta very excited. In one treatment, the visitor brought Ta's own historical works, and the consultant found that the visitor wrote well, so he encouraged Ta to continue writing.
In this way, tourists gradually learned to turn their exaggerated fantasies into real events.
In addition, in the treatment of MIT, the consultant will also help the visitors to keep enough distance from the old picture (old thinking mode) so as not to let the visitors easily get involved in the previous thinking mode. Instead, we can establish different ways of thinking, think about problems from different angles, and also show various performances in interpersonal relationships.
At the same time, in the later stage of treatment, psychological counselors will help visitors to understand how people think and understand feelings and behaviors in more detail, thus helping visitors to improve their conscious thinking ability, improve their understanding of problems and conflicts caused by non-functional interpersonal behavior patterns, and improve their ability to feel for others.
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