Another conditional assumption of power is the belief of exemption from normal rules and laws, even the laws of science and nature. Risk is viewed as remote, minimal, or easily managed. The patient may dismiss or actively distort evidence indicating risk, even when overwhelming, because of the firm belief in being the “exception.” “I’m special; I can get away with it,” where the “it” may be smoking, drinking, reckless driving, spending, overeating, substance abuse, emotional abuse, even sexual abuse or physical harm. The fallacy of this exception will not be casually accepted. “This can’t be happening to me,” is the refrain when exception fails. When faced with an unremitting loss, perhaps as in a life- threatening illness, the patient with NPD may persist in believing that he or she will not have to cope but will be excepted from the emotional stresses experienced by other, “lesser” individuals. Other normal expectations such as compromising in a marriage may be resisted or resented, based on the belief that “it should be easy for me, and I should not have to make that effort.”

The narcissistic patient also assumes as a condition of power that “other people should satisfy my needs,” and that “no one’s needs should interfere with my own.” Thus, he or she is apt to approach any number of situations feeling automatically entitled to personal gratification. From simple examples such as hogging the best seat, biggest steak, or choice bedroom; dominating entire conversations with personal concerns; commanding excessive portions of a family budget; or relentlessly demanding an outrageous inheritance claim, the assertion of his or her needs seems to lack the constraint of consideration for others. If others fail to satisfy the narcissist’s “needs,” including the need to look good, or be free from inconvenience, then others “deserve to be punished.”

Narcissistic individuals can be quite judgmental, opinionated, and forceful in communication, because they believe that superior people have superior judgment. Cognitive processes, however, are characterized by categorical, black-and-white reasoning, striking confirmatory biases, arbitrary inferences, and generalizations to others. The opinions or judgments of others are easily dismissed, no matter what the person’s exper- tise. On the other hand, when the narcissist does seek input, it is typically important that their consultant have some claim to superiority. Interestingly, other “superior” people arbitrarily know what is right, even if the matter at hand is far afield from their expertise (e.g., a social celebrity can give financial advice—without any financial credentials). Out of their vehement certainty of judgment, boundary violations of all sorts may occur, as narcissists are quite comfortable taking control and dictating orders (“I know what’s right for them”) but quite uncomfortable accepting influence from others. Narcissists are puzzled or down- right angry when others do not obsequiously follow their direction. To be challenged or proved wrong can literally undo their sense of personal esteem and worth.

The belief about the importance of appearances will frequently, although not always, extend to those whom the patient views as an exten- sion of him- or herself (e.g., spouse, child): thus the assumption, “My child (spouse) has to make me look good.” Perplexing double binds may arise out of this view for significant others. If they fail to perform in an admirable way (according to the narcissist), they may be ridiculed, punished, or tormented. If they succeed in admirable performance and challenge or surpass the narcissist, they may be ridiculed, punished, or tormented.

Amanda and Lewis arrived at their marital therapy session in a private limousine, courtesy of Amanda’s parents, who always wanted the best for her. Marital tension was focused on Amanda’s growing dissatisfaction with Lewis, and his “unwillingness” to please her. It seems that at 42, his hair was thinning and receding, and he was getting a bit flabby in the middle, although as a sports professional, he remained physically well toned. Slim Amanda proudly pointed out that at size 1, she was the same size as she had been at age 16. Lewis’s unwillingness to please her involved his reluctance to undergo hair implants which, she reasoned, would ensure that he retained some hair as the natural process of thinning progressed. “I just can’t be married to a flabby, bald guy,” she complained. “It would make me look bad.”

When failed expectations or dreams are the presenting problem, it may be that ruminative comparisons, minimization of the necessity of effort, and contempt or dismissal of partial results stem from similar rigid expectations for superlative achievement. Further, the NPD patient may be minimizing or denying some exploitive or aggressive actions that have impaired their advancement.

Scott, an investment broker terminated from his third firm, complained that “this shouldn’t be happening to me.” He ruminated con- stantly about the success he “deserved,” and angrily compared himself to former classmates now in business, noting that “their successes just grind at me.” He expected to be earning “at least” a $1 million salary, and he did not see that the complaints about his sexual harassment of employees should have anything to do with his lost positions. Scott accepted the idea that it probably was not in his best interest to constantly measure his potential against the past successes of others. More grudgingly, he explored the viability of expecting a $1 million contract with a “prestige” firm despite repeated (and well-substantiated) claims of sexual harassment and other unprofessional conduct. Most difficult but crucial was exploration of the meaning of his expected success and modifying the beliefs about the worthlessness of alternative goals.

Avoidant patients may engage in wishful thinking about their future. They may believe that one day the perfect relationship or perfect job will effortlessly arise from out of the blue. In fact, they often do not believe they will be able to reach their goals through their own efforts: “One day I’ll wake up and everything will be fine,” “I can’t improve my life by myself,” “Things may get better, but it won’t be through my own efforts.”

Shapiro, although not presenting a comprehensive theory of OCPD, discussed what he saw as three of its primary characteristics. The first characteristic was a rigid, intense, sharply focused style of thinking. Shapiro found compulsives to have a “stimulus-bound” quality to their cognition, comparable in certain ways to that of brain-damaged people. By this, he meant that they are continually attentive and concentrating and rarely seem to just let their attention wander. Thus, they tend to be good at detailed, technical tasks, but are poor at discerning more global, impressionistic qualities of things, such as the tone of a social gathering. Shapiro referred to compulsives as having “active inattention.” They are easily distracted and disturbed by new information or external events outside their narrow range of focus, and they actively attempt to keep this distraction from occurring. As another consequence of this, they are rarely surprised.

The second characteristic Shapiro discussed is the distortion in the obsessive–compulsive’s sense of autonomy. Unlike normal self-direction based on volition and choice, the compulsive deliberately and purposefully self-directs each action. Thus, the compulsive exerts a continuous willful pressure and direction on himself as if by an “overseer” and even exerts “an effort to direct his own wants and emotions at will” (Shapiro, 1965, pp. 36–37). The fundamental aspect of the compulsive’s experience is the thought, “I should.” Compulsives experience any relaxation of deliberateness or purposeful activity as improper and unsafe. They invoke morality, logic, social custom, propriety, family rules, and past behavior in similar situations to establish what the “should” is in a given situation, and then act accordingly.