Up Close With Dr. E

Understanding narcissistic personality disorder


I was running late. So, when the railroad crossing gate went down, blocking my path, anger bubbled up.

My car was closest to the train, giving me a front row seat to the concert: clickity-clack, the locomotive blues played by steel wheels grinding upon steel rails. I rammed the car into park, shoved in a CD, tried to relax. But no. The pesky imp in my head ranted, “You’re late, late, late …”

I watched the fog roll in as it cloaked the ground, leached the light and swapped colors for monochrome grey. The world turned unworldly — moving mountains of mist, floating forests. I jumped up; total silence. Where was the train?

At that moment, I doubted my sanity. Had there been a train at all? Did I fall asleep, into a dream? Honk, honk! The car behind me snapped my eerie mood. I headed for the office.

My secretary said, “Doctor, you’re late, late, late, but relax, your first patient was also late.”

First office visit: Mrs. Cindy Maslam was a petite, highly attractive woman who looked 10 years younger than her age of 39. From head-to-toe, she dressed in understated elegance: dark chocolate knee-high boots, matching wide leather belt, long lustrous chestnut hair, crème colored cashmere sweater and black jeans.

Cindy sensed the doctor’s probing mind. Not ready to face him, she kept her eyes downcast and began to summon her courage.

Suddenly, fear flooded her heart. She clasped her hands tighter together — to hide their shaking- and silently prayed: “Dear God, give me the strength to trust this doctor, for without help, I’ll die a prisoner’s death in the dungeon built by my husband.”

With a deep breath, she unclasped her hands, freeing them to quiver like fish out of water. She then raised up her chin and looked directly into the eyes of the doctor.

I began. “Mrs. Maslam, why are your hands shaking?” “Doctor,” she slumped down as she spoke. “If you don’t believe me, then I’m lost.” I listened to her describe a man named Burt, her husband of 12 years. I watched her shoulders shake with fear as she relived lie after lie, betrayal after
betrayal. “Here is a photo.” She handed over her iPhone, which had pictures taken in front of her fancy home on the lake. A tall, strikingly handsome man with blond hair, perfect teeth and ice-blue eyes, towered over Cindy and their identical 10-year-old twin girls, Amber and Carrie.

Tears poured down her cheeks as she told another story: “Two weeks after the twins were born, Burt shook me awake at 2 a.m, in a rage. He screamed, “The twins get one thousand times more love from you than what you give to me, so Cindy, do you want to be only a mother? Fine, I’ll get what I need from Sheila — my beautiful, 22-year-old secretary with a great body, not wrinkled or fat like yours.”

It became clear that Cindy had unknowingly married a wolf dressed in sheep’s clothing. Furthermore, this wolf went by the name of Narcissistic Personality Disorder or NPD.

What is NPD? It is a destructive and dangerous disorder, occurring mostly in men. It has these flaws in personality and character: total self-absorption (“it’s always about me”), chronic habitual lying, extra-marital affairs, gambling, reckless financial schemes, illegal activity, lack of empathy, inability to form healthy relationships due to unbridled greed, and broken commitments.

Cindy reached into her purse, fished out a report and tossed it to me as if it was infected. “It’s a summary of Burt’s affairs, a log of his emails to his harem and the money he stole. I hired a private detective — Burt cashed in the twin’s college savings, money my parents had given them. I am completely broke.”

“Cindy, “I asked, “what prompted you to come today?” She replied, “I feel as if I am trapped in a fog. I am so afraid.”

Conclusion: Mrs. Maslam was a bird, a delicate yellow goldfinch, who, having become caught in the gale force winds of Hurricane Burt, had sustained a broken wing. She would soon mount a successful battle to leave Burt. However, until she had the answers to these questions, she would never be 100% free from Burt, nor would she be able to select and date men who were emotionally healthy:

1.What drew Cindy to Burt? 2. Why did she ignore the warning signs of Burt’s true nature? 3. Why didn’t she seek help sooner? 4. What new skills would she need to stay clear of men with NPD?

The content of this article is for educational purposes only and should not be used as a substitute for treatment by a professional. The characters in this story are not real. Names and details have been changed to protect confidentiality.


1. “Understanding Personality Disorders,” Dr. Shannon, 2011.

2. “Fatal Flaws,” Stuart Yudofsky, 2005.

3. “Cognitive Therapy of Personality Disorders,” Beck, 2007.


Dr. Richard Elghammer contributes his column each week to the Journal Review.


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