The International Journal of Psychosocial Rehabilitation
In the Midst of Winter there was an Eternal Summer: Finding Spirituality
and Hope in Suffering, the Case of Antisocial-Narcissistic Personality.

Oudi Singer, Med, RC

University of Akron

Singer, O.  (2004).  In the Midst of Winter there was an Eternal Summer: Finding Spirituality and Hope in
Suffering, the Case of Antisocial-Narcissistic Personality.
  International Journal of Psychosocial Rehabilitation. 9 (1), 99-106.

The only living organism that fails of being genuine with his own nature is man (Camus, 1956). An animal is fixed to its here-and-now by the senses, but man manages to detach himself, to remember, to sympathize with others, to visualize their states of mind and feelings. However Humans capacity to grasp their selves is only achieved darkly and imperfectly. Suffering is created, until every single atom in men’s feeling becomes a ‘howling of anguish’ (Lem, 1984). Within every men there is a tormented martyr nailed to a cross, said Hesse (Hesse, 1965). Each individual must carry his own burden in the most unique way. Realizing it, is coming from afar, closer to fulfillment, closer to friendships closer to hope, and closer to peace (Camus, 1966; Walsh, 1999; Frankl, 1984). This is a look into Dread, Suffering, struggle and it’s relationship to the spiritual life.

Existential Psychotherapy: Etiological Views and Pathology and the Human Condition
“Midway the journey of this life I was aware that I had strayed into the dark forest, and the right path appeared not anywhere”(Dante, 1947, pp.3). Such journey is the journey of men. Born to the cradle thrown with fear and dread into life of confusion and uncertainty, knowing the only certain factor is death (Kiekegaard, 1944, 1958; Heidegger, 1962). The cause of happiness comes rarely, says the bodhisattva, while stating that the seeds of sufferings are many (Lama, 1994). However he leaves the scholar with a sense of optimism:” yet if I have no pain, I’ll never long for freedom” (Shantideva, 1997, pp.78). The Rabbi followed his eastern sage, lamenting:” the whole heart is a broken heart” (Kotzker Rebbe cited in Wolpe, 1999, pp.7).

The sages valued suffering, pain and illnesses and saw them as communication vessel between the human being and the divine, as well as between individuals and their inner selves (Walsh, 1997; Cooper, 1997; Rumi, 1994). Suffering was another opportunity for men to investigate his life, and his behavior (Walsh, 1999).
In contrast therapists and counselors since the time of Freud over emphasized individual self- interest (Doherty, 1995). Contemporary trends, both psychological and economical highlighted pursuit of happiness and comfort as the main goals of life, overlooking the moral-philosophical arena, in which avoidance of discomfort and narcissism will prevail (Fromm, 1976; Doherty, 1995). 

These is an investigation into the world of dread, fear, and negative emotions in general, as arising out of the existential conflict between the ontological and the epistemological, between human beings and the absurdity of life’s unpleasant occurrences (Shoham, 1987).
A systemic approach will examine the historical-philosophical existentialism, moving towards the practical phenomenology with two anti-social/narcissistic clients and their unique journey towards healing. This is and qualitative attempt to capture the despair, revolt and eventually divine acceptance and surrender by the human spirit.

The Human Condition: the void and the absurd
Existentialism is the title of the set of philosophical ideals that emphasizes the existence of the human being, the lack of meaning and purpose in life, and the solitude of human existence (Kaufmann, 1956; Frankl, 1984) Existentialism maintains existence precedes essence: This implies that the human being has no essence, no essential self, and is no more that what he is (Frankl, 1984; Hesse, 1965; Camus, 1956).

According the existential thought existence is always particular, unique and individual (Hesse, 1965; Camus, 1956). Existentialists are opposed to the view laws explaining human freedom and activity can be formulated. Existence is essential and fundamental: Being cannot be made a topic of objective study. Being is revealed to and felt by the human being through his own experience and his situation (Laing, 1967; Camus, 1956; Frankl, 1984).

Existentialism stresses the risk, the voidness of human reality and admits that the human being is thrown into the world, the world in which pain, frustration, sickness, contempt, malaise and death dominates (Camus, 1956; Kierkegaard, 1944,1958; Kaufmann, 1956). Life has no absolute meaning. In spite of the human's irrational "nostalgia" for unity, for absolutes, for a definite order and meaning to the "not me" of the universe, no such meaning exists in the silent, indifferent universe (Camus, 1956, 1966).

Between this yearning for meaning and eternal verities and the actual condition of the universe there is a gap that can never be filled. The void is a living void. Lack of meaning is elastic by nature all that is relieving, all that helps alleviate the pain, drugs, food, gambling, sex, and possessions. The confrontation of the irrational, longing human heart and the indifferent universe brings about the notion of the absurd (Camus, 1966; Frankl, 1984).

Thrown into the world, the human being is condemned to be free. The human being must take this freedom of being and the responsibility and guilt of his actions (Kiekegaard, 1944, 1958; Camus, 1956; Sartre, 1958; Heidegger, 1962). Humanity's primary distinction, in the view of most existentialists, is the freedom to choose. Existentialists have held that human beings do not have a fixed nature, or essence, as other animals and plants do; each human being makes choices that create his or her own nature (Sartre, 1958; Camus, 1966). Freedom of choice entails commitment and responsibility. Because individuals are free to choose their own path, existentialists have argued, they must accept the risk and responsibility of following their commitment wherever it leads (Camus, 1956, 1966; Sartre, 1958; Comer, 1998).

Where the absurd starts and agony takes over
Existence is of two types: authentic and inauthentic forms of existence. Authentic existence is contrasted with dynamic and is the being-for-itself, rising from the human being's bad faith, by which the human being moves away from the burden of responsibility (Kiekegaard, 1944,1958; Comer, 1998). The inauthentic being-in-itself is characteristically distinctive of things; it is what the human being is diseased with for his failure to see himself as and act according as a free agent and his impotency to reject bad faith. Things are only what they are (Camus, 1956; Sartre, 1958). 

The human being hides himself from freedom by self-deception, acting like a thing, as if he is a passive subject, instead of realizing the authentic being for the human being (Comer, 1998). This self-deception is the root of man’s dysfunctions (Kierkegaard, 1985; Comer, 1998). By trying to avoid, hide, misplace, and blame, individuals moves beyond anxieties into the realms of anger, depression, resentments and guilt (May& Yalom, 1995 1989; May, 1987).

The Defiant nature of man’s Spirit
The defiant power of the human spirit (Frankl, 1965) refers to the human capacity to tap into the spiritual part of the self and rise about the negative effects of situations, illness or the past. Camus referred to the defiant behavior of man towards crises, as the rebellion, which may produces Ill emotions or, if done creatively, may establish a new meaning for the sufferer (Camus, 1956, 1966).

The revolt against the universe, situations, events, traumas, creates more than just ill emotions. It may also produce stress on the value system (Camus, 1956). Virtue and vice are mixed when man lies in the pit of despair (Camus, 1956). As that happens and the client becomes a victim of outside forces, since he fails to be accountable, all is permitted. Deviant behavior may be the outcome of failure to cope with the anxieties, anger, blame or even suicide (Camus, 1956, 1966).

The need for control of the outcomes is another cause for neurotic existence (Hayes, 1997). The client who becomes helpless, since he/she neither has nor control over the trauma or bad circumstances, he or she has no significance in this world. The human being cannot find any purpose in life; his existence is only a contingent fact (Frankl, 1984; Hayes, 1997). His being does not emerge from necessity. If a human being rejects the false pretensions, the illusions of his existence having a meaning, he encounters the absurdity, the futility of life.

The Cry for Meaning: Dread and Anxiety
In a world stripped of its illusions and false pretensions, the human being is an outside, who lives without any meaning. The human being is placed in a hopeless and void situation (Camus, 1966; Frankl, 1984). This limiting reality leads the human being to encounter the absurd in every aspect of being, ranging from routine activities in life to unusual and unconventional circumstances (Camus, 1956, 1966).

All human actions and thoughts develop in the void, in the midst of weariness and frustrations, irrelevancies, the bizarre, unconformities, illusions, and evasions, which make those actions and thoughts absurd. The human attempt to grasp the mechanism and the dynamics of the universe also turns into an absurd confrontation between the human being and his surroundings (Camus, 1956; Sartre, 1958).

Out of the cry for meaning, man’s becomes hopeless, helpless, and meaningless. Those introverted ones may turn the anger and frustration towards self, may become alienated from self and other fall into the world of psychosis (Laing, 1965, 1967). Extroverted beings may revolt outwardly by anti social behavior, or by any others aggressive means (Shoham, 1987; May, 1972).

The client may also feel completely alone. A break in attachment or a conflict in relationship is created. The client now realizes he must depend on self. In this state of aloneness the client starts wondering how will he/she live (Corey, 1996). Aloneness and isolation may result as lack of affective rottenness and interactions of the individual with his environment (Fromm, 1973).  

Hope, Courage, and Healing: The Case of antisocial personality
Facing the absurdity of illness, life and trauma, men becomes helpless and hopeless and may resort extreme measures (Camus, 1965, 1966; May, 1972; Fromm, 1973). Without emotional ties with the world, the extroverted rebel may be in a state of lostness, relationship will become evolved around self only (narcissism), the individual might also try to control, aggressively others in a sadistic way (Fromm, 1973).

Doesn't this make a futile pessimistic chaos of life? Wouldn't suicide, or self-injurious behavior as in addiction be a legitimate way out of a meaningless life? As the individual face the absurd he rebels cognitively and emotionally against God and the world, the options remain open for the rebel: suicide (hurt self)/homicide (hurt others) (Camus, 1966).

In the following section emotional-existential focused therapy will examine beneficial outcomes for 2 individual who chose life long rebellion with alcohol, drugs and aggression which brought about incarceration and grief.  Though the absurd cancels all chances of eternal freedom it magnifies freedom of action (Camus, 1965, 1966).

Brief Literature review of Anti-social personality treatment shows a gloomy, pessimistic view (Comer, 1998).  Approximately quarter of people diagnosed with antisocial personality disorder actually receive treatment for it (Reiger, et al., 1993). Generally most of today’s treatments approaches have a little or no impact of individuals with antisocial personality disorder (Comer, 1998).

The Emotional Life of a Narcissist
Narcissism is an effort to contain the ominous onslaught of stale emotions, repressed rage, a child's injuries. Narcissism Isolates the Narcissist from the pain, and dread of facing reality and allows him to inhabit the fantasyland of ideal God like perfection and brilliance (Vaknin, 2003).

APD affect lacks subtlety, depth, and modulation. Individuals with severe APD appear to live in a pre-socialized emotional world; feelings are experienced in relation to self but not to others (Cleckley, 1982). Such individuals are unable to experience emotions such as gratitude, empathy, sympathy, affection, guilt, or mutual eroticism that depend on the perception of others as whole, real, and meaningful (Cleckley, 1982; Comer, 1998).

Clinical investigations confirm previously discussed reactions to negative emotions of life’s absurdity. Individuals with APD are frequently described as irritable. This irritability is defined as a disposition toward anger and aggression. Here, aggression is the APD behavior intended to inflict discomfort, hurt, harm, injury, or destruction on others (Comer, 1998). Oldham suggests that even if individuals with APD improve later in life, they remain irritable, angry, and tense (Oldham, 1990).
The narcissist's positive emotions come bundled with very negative ones. This is the outcome of frustration and the consequent transformations of aggression. This frustration is connected to the primary caregivers of the narcissist's childhood (Vaknin, 2003). Bundling, and stuffing is far easier than unbundling. The narcissist is unable to evoke his positive feelings without provoking his negative ones. Gradually, he becomes phobic: afraid to feel anything, lest it be accompanied by the fearsome, guilt inducing, anxiety provoking, out of control emotional complements (Vaknin, 2003).

Here are the stories in which courage to feel, opened a new path, a new meaning. The counselors attempts were to move emotions from cognitive schema into an experiential one, allowing the detached individual to become one with the totality of the “the kingdom within”.

The void, the hunger, the destruction, and the hope: The Case of Joe
Joe was born in a barrio, to a father who was in prison and mother whom was a pusher and a drug addict (O.S., Field Notes, May, 2003). Joe adolescents and early adulthood was characterized by anger and hostility toward mother, whom he tried to befriend and love numerous of times, finding himself beat and humiliated. Joe turned his aggression toward self and women in general (O.S., Field Notes, June, 2003)

Joe described his life as a chase after money, women and material possessions, and as long as he was satisfied, he was falsely happy. Joe reported his suffering growing as the void got filled but none in essence existed: relationship with women, turned into a tale of abuse, and then a conflict, Money ran down along with his growing habit to assassinate the self (O.S., Field Notes, May, 2003). The security Joe found in possessions faded away as his addiction ran deeper and deeper into oblivion. “Nothing could satisfy”, said Joe. “I was angry at everybody” (O.S., Field Notes, May, 2003).

Out of desperation and aloneness, Joe turned again to mother, but “she turned me away”, sending him coldly into the street. “When she was desperate, I allowed her to stay with me, she didn’t have to do a thing”, stating with bitter morose (O.S., Field Notes, June, 2003).

After two month of looking at the creation of the void down the passages of childhood, sitting tied to a chair hungry, going to school with wet socks and torn pants, yearning for love, Joe came to realize that he was aimlessly seeking the love, growing up and unable to fulfill his own essence with care towards self, unconditional care (O.S., Field Notes, August, 2003). Client realized that all his life he was living in a wheel chair, using a crutch whether it was alcohol, drugs, women, or possessions. But these did not satisfy the void (O.S., Field Notes, June, 2003).

Throughout the also month of treatment, Joe turn all the efforts and motivations towards self. In the past he was ashamed he couldn’t read, now he decided to engage with school (O.S., Field Notes, May, 2003). Joe came from evening schooling and with tears of joy said:” I’m sitting with older folks, I don’t feel ashamed, I feel good, I felt belonged” (O.S., Field Notes, June, 2003)

Client left treatment and started filling his time with volunteering, helping in hospitals. Joe started working (O.S., Field Notes, September, 2003). Calling me few months later, Joe said:” Thank you, I do today everything I haven’t done, I did not read no I started reading poetry, I went to the show Cats, I always ran to relationship and sex, I don’t even look for it now, I know that if God will allow it will come, today I am somebody, thank you” (O.S., Field Notes, February, 2004).

From Brokenness to Arrogance: Georges’ search for significance
This was his seventh or eighth treatment center. Desperate he entered the session stating his diagnosis clearly:” I’m anti social with narcissistic traits (O.S., Field Notes, September 2002).

George discussed his journey into darkness, reflecting on a conquest. George was summarizing his rise and fall. Snorting cocaine with the rich and famous. Having his own band, touring, and women all around tapping on his shoulder boosting up his ego (O.S., Field Notes, September 2002).

“Can you feel?” I asked at one point. “ You talk greatly and intellectualize your life, but can you live it, love it, and feel it, don’t answer, write in your journal, think about it” (O.S., Field Notes, October 2002). George left my office and returned a day later quietly with sadness saying:” I can’t cry I can’t feel I don’t know how too”. “Tell me about your childhood”, I said (O.S., Field Notes, October 2002).

George started with vivid descriptions of childhood memories, sleeping scared at night, his father, a raging alcoholic, beating up his mother (O.S., Field Notes, October 2002). “One night we heard the anguish screams of my mom, my brother woke me saying:” lets kill him”.” How do you feel I said, don’t think feel, I urged him. Georges’ eyes were red, the closest I saw him in two month to feeling empathy. “I am sad”, he said.” I am angry too” (O.S., Field Notes, October 2002).
Not long after that, George started getting into the childhood he never had, feeling alienated by parents, feeling lonely and sad. Going into description of adolescent and adulthood, George realized that he his anger and rage were developed into a more sophisticated beast: arrogance. “Everything I wanted I got. Money women, power”. “I did not feel empty and lonely no more” (O.S., Field Notes, October/November 2002).

“Now I have nothing”, said George in a mourning tone of voice. The show is over, the crowd is gone, women aren’t clapping, and I’m alone again” (O.S., Field Notes, October 2002). I could see now, three month after, George was tearing. “I am feeling again”, he said.” I don’t like what I feel, but I feel it”. Thank you (O.S., Field Notes, November 2002).

George left treatment successfully after 4 month. He changes his occupation and now he helps transporting the mentally retarded. He called me few months after:” This is king baby”, he said. “I feel humble, the residents teach me to be humble again, I feel like a kid again, all fresh all new, it feels good not to feel good Oudi”, he said (O.S., Field Notes, February 2003).

Emotional wisdom is defines by Greenberg (Greenberg, 2001), as the ability to be aware and express one’s own difficult emotions. Such process can open new doors for the sufferer, such as: greater capacity to make sense of self, improved emotion regulation and the ability to develop better empathy toward others’ feelings. In both cases, patterns of avoidance and escape were created by living hedonistic life. Chasing women, money, and drugs. Avoidance of pain as suggested by scholars will create further grief and pain, and will perpetuate the cycle of maladaptive behaviors (Hayes, 1997; Greenberg, 2001; Walsh, 1999).

Growth and change, as a process, are attained through the mirror of relationships, through the understanding of the contents of his/her own mind, and through observation and not through intellectual analysis or introspective dissection. Man has built in himself images as a fence of security - religious, political, personal. These manifest as symbols, ideas, and beliefs. The burden of these images dominates man's thinking, his relationships, and his daily life. These images are the causes of our problems for they divide man from man (Krishnamurti, 2000). 

In This dyad of the therapeutic dialogue, conditions of deep empathetic and compassionate care are authentically embraced and applied by health practitioners; a climate of change and self-actualization will eventually be created (Laing, 1965, 1967; Rogers, 1951, 1961). By building trust and love, and by encouraging the client to feel and express negative emotions (fear, anger, guilt, shame est.…), the chain of self medicaiding and avoidance in broken (Hayes, 1997; Greenberg, 2001; Walsh, 1999).

Clinical literature shows a high recidivism and high drop out of anti- social clients from treatment (Comer, 1998). However, even due to the limitation of small sample casework analysis, the hope of helping individuals who suffer from emotional frozenness is still somewhat evident. Only through loving relationship, the therapist can help his recipient actualize his lost potential (Frankl, 1984).

Blake’s hope of living in joys’- ‘eternity’s sunrise’ is promised only to those sufferers who break the binds to Joy Itself (Rinpoche, 1994). To embrace and feel the dread, the depression and anger of life is not a curse for the Sufi teacher but a blessing. The old mystic teacher, Jalaluddin Rumi, chose to embrace the ill emotions, seeing negative emotions as a bridge to better life. The supreme style of coping is best illustrated in the guesthouse poem:
            “This being human is a guesthouse
             every morning a new arrival a joy, a            
             depression, a meanness Some momentary
             awareness comes as an unexpected                       
             visitor welcome and entertain them
             all! Even if they're a crowd of sorrows
             who violently sweep your house Empty of
             its furniture Still treat each guest
             honorably, He may be cleaning you out for
             some new delight! The dark  
             thought, the shame, the malice meet them
             at the door laughing and invite them in,  
             be grateful for whoever comes Because
             each has been sent as a guide from the
             beyond”. (Rumi, 1995 cited in Zokav,  


Camus, A. (1956). The Rebel. New York: Vintage Books.

Camus, A. (1966). The Myth of Sisyphus & Other Essays. New York: Random House Inc.

Cleckley, H. (1982).The Mask of Sanity. New York: Mosby Medical Publication.

Comer, R.J. (1998). Abnormal Psychology. New York: W.H. Freeman and Company.

Cooper, D.A. (1997). God is a Verb. New York, N.Y.: Riverhead Books.

Corey, G. (1996). Theory and Practice in Counseling and Psychotherapy. Pacific Grove, CA: Brooks/Cole Publishing.

Dante, A. (1947). The Divine Comedy. New York: The Viking Press.

Doherty, W.J. (1995). Soul searching: Why psychotherapy must promote moral responsibility. New York: Basic Books.

Frankl, V.E. (1984). Man’s Search for Meaning. New York: Simon and Schuster.

Fromm, E. (1973). The Anatomy of Human Destructiveness. Great Britain: Penguin Books.

Fromm, E. (1976). To Have or to Be? New York, N.Y.: Harper and Row Publishers Inc.

Hayes, S. (1997). Acceptance and Commitment Therapy. New York& London: The Guilford Press.

Greenberg, L.S. (2001). Emotion Focused Therapy: Couching Clients Through their Feelings. Washington D.C.: APA Publications.

Heidegger, M. (1967). Being and Time. Great Britain: Basil Blackwell Ltd.

Hesse, H. (1965). Demian: The Story of Emil Sinclair’s Youth. New York: Harper and Row Publishers.

Hogenson, G.B. (1981). Depth psychology, death and the hermeneutic of empathy. Journal of Medical Philosophy, 6, pp. 67-89.

Jordan, J.V. (2000). The role of mutual empathy in relational/cultural therapy. Psychotherapy in Practice, 56,

pp. 1005-1016.

Kaufmann, W. (1956). Existentialism from Dostoevsky to Sartre. Cleveland & New York: The Worlds Publishing Company.

Laing, R.D. (1965). The divided- self. United Kingdom: Penguin Books.

Laing, R.D. (1967). The politics of experience and the bird of paradise. United Kingdom: Penguin Books.

Kierkegaard, S. (1944). The Concept of Dread. Princeton, N.J.: Princeton University Press.  

Kierkekaard, S. (1968). Concluding Unscientific Postscripts. Princeton, New Jersey: Princeton University Press.

Kierkegaard, S. (1956). Purity of the Heart is to Will One Thing. New York: Harper and Row Publishers.

Kierkegaard. S. (1985). Fear and Trembling. London: Penguin Books Ltd.

Krishnamurti, J. (2000). To be human. Boston & London: Shambhala.

Laing, R.D. (1965). The Divided Self. London: Penguin Books Ltd.

Laing, R.D. (1967). The Politics and Experience and the Bird of Paradise. London: Penguin Books Ltd.

Lama, D.L. (1994). A Flash of Lightening in the Dark of Night. Boston& London: Shambhala Publications.

Lem, S. (1984). His Master's Voice. Replica Books.

Rogers, C. (1951). Client-centered therapy. Boston: Houghton Mifflin.

May, R. (1950). The Meaning of Anxiety. New York: Ronald Press.

May, R. (1972). Power and Innocence: A Search for the Sources of Violence. New York: W W Norton & Co Inc.

May, R. (1987). Therapy in Our Day. In J.K. Zeig (Ed.), The Evolution of Psychotherapy. New York: Brunner/Mazel.

May, R., & Yalom, I. (1995). Existential Psychotherapy. In R.J. Corsini & D. Wedding (Eds., Current Psychotherapies(5th Ed.)(Pp. 262-292). Itasca, IL: F.E. Peacock.

Rogers, C. (1951). Client-centered therapy. Boston: Houghton Mifflin.

Rogers, C. (1961). On becoming a person. Boston: Houghton Mifflin.

Rumi, J. (1994). Signs of the Unseen. Vermont: Threshold Books.

Sartre, J.P. (1958). Being and Nothingness: An Essay on Phenomenological Ontology. London: Routleadge.

Shantideva, (1997). The way of the Bodhisattva. Boston & London: Shambhala.

Shoham, S.G. (1987). Israel Studies in Criminology. Sheridan House Inc.

Vaknin, S. (2003). Malignant Self Love: Narcissism Revisited. Narcissus Publications.

Walsh, R. (1999). Essential Spirituality. New York: John Wiley & Sons, Inc.

Wolpe, D.J. (1999). Making Loss Matter: Creating Meaning in Difficult Times. New York, N.Y.: Putnam Pub. Group.

Zokav, G. (2001). The Heart of the Soul: Emotional Awareness. New York: N.Y.: fireside.

Copyright © 2004 Hampstead Psychological Associates, Ltd - A Subsidiary of Southern Development Group, SA.
All Rights Reserved.   A Private Non-Profit Agency for the good of all, published in the UK & Honduras