Dealing with arrogance and grandiosity in therapy

Grandiosity and arrogance are often linked as characteristics of addiction. Grandiosity and arrogance emanate from low self-esteem. Many addicts and alcoholics use this defence mechanism as a mask to cover up self-loathing and feeling ‘less than’ others. They have ideas of invincibility and superiority. They seek attention and have over inflated egos. They feel the world revolves around them and indeed the world owes them a favour. They are scared of being found out and keep others at arm’s length. The bottom line is that they are also terrified of becoming vulnerable.

In coming into treatment there needs to be honesty and a willingness to change. It is important that the focal therapist forms a therapeutic bond with their patient. This can often involve working with resistance as denial is a large part in the disease of addiction. In the early stages arrogance and grandiosity are blocks to recovery which need to be unpacked, understood and broken. Becoming humble is key. It takes time for the patient to accept change.

In the initial days patients are often in denial about their addiction and they may say “I have nothing in common with these people”. Some alcoholics put themselves on a superior position to a heroin addict because, they say to themselves, alcohol is legal and socially acceptable. Equally a heroin addict feels that they are above someone who drinks. However, it is not long before the same people are sharing stories, recognising that they have the commonality of addiction, taking care of each other, supporting one another and confronting their addiction together. Lifelong friendships are often formed in treatment as the patients share deeply and more about themselves in six weeks than perhaps they have shared with a friend or family member that they have known for a decade or a lifetime.

Removing recovery blocks in addiction counselling

If a patient is willing to be confronted and challenged on being arrogant and grandiose then change can begin. The patient needs to be shown how to gain insight into how these characteristics do not work in their lives.

It is important to look at how these traits play out in active addiction. The patient will often be blaming others for their using, justifying and rationalising why they use. They may feel invincible until they get caught, found out by family, friends or indeed employer. They may have experienced trouble with the police. They need to be prepared to become humble and at the same time realise they can be assertive without behaving in an arrogant manner. It is important that they begin to think about others and how their behaviours affect friends and family in a negative way.

In family sessions the patient must hear - when clean and sober - the impact they have on their family. Equally, the patient needs to acknowledge that they have used arrogance as a defence mechanism. They are often very scared and vulnerable people. They hide behind a big ego whilst the truth is they have very little self-esteem. They do not like themselves and do not allow people to see the real person. They use arrogance to deflect and to ensure people do not get close to them. They see asking for help as a weakness, whereas it is actually a strength to ask for help and to admit that they cannot deal with addiction/alcoholism on their own.  

The first step in dealing with these traits is to admit that they are powerless over their drug of choice and to recognise that their lives are chaotic and unmanageable. It is equally important to use self-esteem building techniques. No addict or alcoholic is a bad person - they have an illness which needs treatment.

I feel residential treatment is key to change. When the addict/alcoholic comes into treatment abstinence is quite easy as the patient is removed from their environment and external issues. However, it is about abstinence plus change, abstinence on its own in my opinion is a ‘dry drunk’ as all that has happened is that they are no longer drinking or using but nothing has changed; behaviours are the same; relationships have not improved; they are still in denial. There’s nothing like having about 30 to 40 addicts living together who can actually spot each other’s blind spots, confront behaviours, challenge manipulation, pride and arrogance.

Patients who undertake psychodynamic group therapy respond well to peer confrontation once they understand that it is their addiction that is being confronted, not their personality. They are given time to reflect and to see things from another addict's perspective who will often have the same symptoms. Over a period of four to six weeks, the denial is broken as the patient needs to face themselves on an hour to hour basis, there is no longer anywhere to run, and they are facing their truth.

I have often said to a patient; “You know only too well the life of addiction, you've tried not to use, you have tried many ways to control it, and you’ve made promises to yourself and family to never use again, you may have had periods of abstinence but the problem lies in that you simply cannot stay stopped without help. You can get your life back, you can discover and rediscover yourself, you can build relationships and most importantly you can have happiness and peace in your life. You've got no idea if it's going to work but you have nothing to lose by giving it a chance as after all your old life will always be waiting for you. You will pick up the misery where you left off and the consequences of using will also be waiting. So, now you have a real choice: the choice to use or the choice to be clean and sober.“