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Bullying, abuse and narcissistic behaviours between caring professionals:

An organisational perspective.

You probably think this article’s about you!

Don’t you! Don’t you!

by Jimmy Judge

I had some dreams, they were clouds in my coffee –

Clouds in my coffee and -

You’re so vain. You probably think this song is about you

(Simon, 1972)


We are all familiar with how bullying and abuse can occur between therapist and client, or between supervisor and supervisee. In this article, I want to focus on bullying and abuse within the caring profession, and between therapists, tutors, students, and managers. I wish to take a look at how this plays out in organisational settings, and to highlight the insidious nature of narcissism and abusive behaviour when it is perpetrated by psychotherapists and healthcare professionals towards each other. This phenomenon is seldom spoken about openly, due to the impact of collective gaslighting, and/or the fear of negative repercussions on the individual for breaching this omerta or code of silence. I want to bring this painful subject to the surface of our collective consciousness, and provoke a conversation/debate about this professional taboo, that has cast a long and silent shadow upon the caring profession.

I first noticed and experienced this kind of abuse when I began working as an addiction counsellor in the mid-80s. Looking back, you could say that I was a little naïve in my belief that we were all doing the work for the same altruistic reasons; we all wanted to help and support those that struggled in life. I mistakenly thought that we all shared a deep desire to be real, honest, and self-reflective, and to remain open to our own inner processes/needs, and to whatever working with troubled human beings would inevitably trigger and evoke in us. I really did believe that everyone was on the same page with these fundamental requirements. Well…did I get a rude awakening!

This is where it gets a little tricky as phrases like ‘gaslighting’ were not yet in use. I didn’t know what to call it when I saw (or felt) something unfolding in front of me/at me/through me; where a colleague or a manager would deny or disown what had just taken place in a staff meeting. They would then rationalise or justify their bad behaviour by suggesting that the problem was with me – that it was ‘my stuff’ (a commonly used phrase by therapists who disown their own faults and discredit the other). It is really insidious because even when we have been hurt or abused, what we do with this, or how we manage ourselves - which may include the triggering of other abuses and feeling-patterns synonymous with such abuses - is indeed ‘our own stuff’, so to speak. However, narcissistic therapists, tutors, supervisors and managers exploit the living daylights out of this complex process.

Elephants and sycophants
So, let’s develop this a little further. The kind of abuse highlighted here falls under the umbrella of the Cluster B personality type (yes, delightful beings, who can be attracted into the caring profession). This group according to the DSM (American Psychiatric Association, 2013), is made up of:

• Antisocial personality disorder (also referred to as psycho/sociopathology)

• Borderline personality disorder

• Histrionic personality disorder

• Narcissistic personality disorder

These classifications tend to be on a spectrum, and their traits can overlap considerably. I am using them simply as a framework to give us a clinical understanding of what I am describing.

I really get a kick out of the term: ‘elephant in the living room’. It is a surreal and powerful image to describe the unspoken, the hidden, the taboo, the secrets, lies, and shame in our households and psyches. There are many unnamed ‘elephants’ in the psychotherapy ‘living room’. Now, I really like elephants; those enormous, powerful, gentle and enigmatic creatures. It’s funny that they’ve become a symbol to describe what we fear, avoid, ignore or shun. I first came across the phrase back in the mid-80s when I was doing group therapy with children from dysfunctional families, where there was alcoholism or drug addiction with one or both parents in the family. We used this brilliant workbook called, The Elephant in the Living Room (Hastings and Typpo, 1984). Designed for children, it had this comical picture of a big elephant in a standard living room; an awkward, embarrassed and out of place looking elephant.

I want to burst out laughing at the concept of an elephant feeling ‘embarrassed’. It cracks me up! I want to say to them, ‘Look, I know this is really uncomfortable for you and you would rather be somewhere else. Let’s keep talking about this and I’m sure we can work out a solution that’s good for everyone, okay?’

I imagine them replying with, ‘Yes, please do. I don’t belong here and I feel really self-conscious and would welcome any kind of resolution!’ The elephant has no room to move in this living room; all the furniture has been knocked over or smashed and broken. And the room is full of elephant shit! The whiff is overwhelming. The elephant is stamping around, trumpeting his ‘heffalump’ brains out! It’s very, very loud!

‘What’s that racket? My god, what’s that smell? Oh my god, there’s a big fucking elephant in the living room!’ That’s what you would say, right? Does anyone say that though? Amazingly, no; not a word… not a whisper.

‘Shhh…what was that? Was that the sound of an eggshell crunching under my very carefully placed foot? Did she hear it? Did he see me? How do elephants feel about crunching eggshells?’

‘What do you mean elephant? What on earth are you talking about? Are you mad? Imagine saying such a thing! We don’t like your kind around here! You’re a troublemaker, that’s what you are! Why can’t you just shut up; stop this absurd nonsense, and revere our amazing leader/manager/tutor like everyone else?’ It is important that I stress that no elephants were harmed in the writing of this article!

It’s high time that you found,
The same people who you use on your way up,
You might meet up with on your way back down

(Little Feat, 1973)

Narcissists and their flying monkeys
The obsequious and sycophantic behaviour of narcissists is presented under the euphemism of respect and decency. Narcissism has been classified into several subgroups by the DSM-5, which are merely different ways to express an underlying self-absorption, ego-mania, grandiosity and entitlement. These are:

• The overt narcissist

• The covert narcissist (also known as the shy, timid or stealth narcissist)

• The communal or altruistic narcissist

• The malevolent narcissist

(American Psychiatric Association, 2013)

I won’t discuss each narcissistic type in great detail because much has already been written about them but I do want to clarify that, when I refer here to narcissists and Cluster B personality types, I am talking about therapists, psychologists, social workers, and so forth – not clients. The types that tend to show up in psychotherapy settings (i.e. therapeutic workplaces, organisations, training institutes, etc.) are the covert narcissists, combined with the communal/altruistic breed. You can see why the caring profession would attract them.

They usually present as slightly timid, ‘victimy’ and fragile, and yet if you pay attention, you can sense the underlying unease and rage. It’s almost imperceptible, but it’s there. You will know it’s there if you ever challenge them, question them, or ask them to explain themselves or be accountable; that is, if you get that far. I say this because the covert narcissistic therapist will have recruited a group of helpers, often referred to as flying monkeys, as known from The Wizard of Oz (Baum, 1939); these are an interesting little gang.

Flying monkeys may also be covert narcissists themselves who are subservient to the main one. The flying monkeys gather around them, cover for them, and protect them from exposure or transparency. They do their bidding, gather information, laugh at their unfunny jokes, praise them when they’re not worthy of praise, and tell them that they’re ‘amazing’, and ‘such a talented therapist or tutor’ and so forth. Flying monkeys will attribute qualities to them that they simply do not possess.

This performance plays out regularly in workplace settings (i.e. any setting where therapists/healthcare workers gather together). The covert narcissist is, in fact, quite vicious beneath the quasi-altruistic, overly-concerned, cloying, saccharine façade. If you get past the flying monkeys and call the narcissist out on their abusive behaviours (which they have usually inflicted with an audience present, in order to add a dollop or two of shame and humiliation), if you name it, watch the mask slip. Watch the lip curl. Notice that plastic smile changing into a scowl. Look closely, and you will feel and see the almost imperceptible tremble of volcanic rage. Here’s the twist though – do they let the mask drop fully and let fly with apoplectic rage in front of everyone? No. They’d be found out then, wouldn’t they? No, what they do instead is even more despicable – they drop into victim mode. The waterworks are turned on full power. They ‘break down’ and everyone rushes to their rescue, while throwing you dagger-looks that say: ‘How could you hurt this beautiful, delicate, caring person?’ The flying monkeys might even turn on you and attack you for upsetting their beloved leader. So there’s the classic narcissistic blame shift performed in a group. The big weapon is shaming you for daring to speak the truth. The narcissist gets rewarded with tea, sympathy, secret meetings where wage increases and extra time off to recover after ‘you know what’ are negotiated surreptitiously. You’re left on your own, isolated from the group, shunned for this terrible deed of honesty…and the band plays on….

The greatest trick the devil ever pulled off,

Was to convince us he didn’t exist

(McQuarrie, 1995)


Narcissistic abusers in therapeutic workplace settings are the worst kind, as you’re generally not expecting to encounter them, so you don’t see them coming, which adds to your sense of shock and trauma. They sometimes come quietly, or maybe they arrive with power and gusto. They might even be bearing gifts. But make no mistake about it, they are among us in this profession. As with many issues we meet in our client work, the first and all-important step is acknowledging and admitting that something exists and that something is murky.

Ann O’Connell, a highly regarded and respected psychotherapist in the field of addiction and addiction treatment in Ireland, states that, “The narcissistic therapist is the ultimate wolf in sheep’s clothing” (O’Connell, 2019). She goes on to explain that the healing professions are not immune to having cluster

B personality types, and they can provide the perfect hiding place for narcissists, as these professions are “littered with vulnerable people looking for help, kindness and support” giving “predatory types a captive audience to prey upon”.

In addition, O’Connell’s considerable knowledge and expertise in trauma and traumarelated issues provide another layer to this state of affairs. She states that:

The image of therapists from this personality type, who wear ill-fitting masks of sincerity and altruism, and exercising control and power, is a very emotive construct; and the use of gaslighting, in order to invalidate or terrorise clients or colleagues who are in a lesser role in an organisation, creates all of the conditions for trauma, and re-traumatising individuals who come into contact with them. There is a difference between an illequipped therapist and a narcissistic personality type. It brings with it a level of toxicity that is wrapped neatly in a thin veneer of malicious intent and malice aforethought; thus enabling abusive behaviour, for nefarious reasons, to go unchecked, in order to scaffold and solidify the foundations that support their own character disorders.

(O’Connell, 2019)

Shhh…did you see the light flicker?
Singer/songwriter/poet, the late, and very great, Leonard Cohen told us that, ‘everybody knows’:

Everybody knows that the dice were loaded. Everybody rolls with their fingers crossed.
Everybody knows that the war is over. Everybody knows the good guys lost.
Everybody knows the fight was fixed. The poor stay poor and the rich get rich.
That’s how it goes – everybody knows.

(Cohen, 1988)

You’re right, Lenny. Everybody does know, but not everybody says that they know. Not everybody talks about it, writes about it, or sings songs about it. It is often unspoken, silenced, gagged and suppressed. Collusion with the lie is rewarded, while naming and living the truth is punishable by rejection, shaming, abandoning and ostracising the culprit who dares to be real and is caught red-handed: “showing feelings of an almost human nature…this will not do.” (Pink Floyd, 1979).

‘What was that? Did the light just flicker on and off there?’

‘No. I didn’t see anything. Nobody else saw anything. Are you sure you’re okay? You haven’t been yourself lately. Maybe you might need some time out. You’ve been working so hard lately.’

Ladies and gentlemen, welcome to the weird, wonderful and disorienting world of narcissistic ‘gaslighting’. This is a term taken from the 1944 film Gaslight (Hamilton, 1944), where the narcissistic husband makes his vulnerable partner doubt her perceptions and actual sanity.

This is a favourite ploy of the narcissists in the caring profession. They use their knowledge and awareness of the human psyche, along with the unsavoury ability to recognise and exploit uncertainty, confusion and vulnerability. The key element to this tactic is to make the target doubt themselves, and their perception of what is happening or has happened. This is crazymaking at its worst, as it can make you feel that you’re going mad. It’s a nasty, cowardly and deceptive trait, often carried out in plain sight where others may collude with, and support, the gaslighting stance. It usually involves the person behaving badly, being disrespectful or abusive to you (in a meeting for example). When you challenge this, or enquire as to what just happened, they tell you that you must have imagined it – it wasn’t like that at all – that you have got the problem. They twist the whole thing to make it look like you did something wrong.

Have you ever ended up apologising to somebody who has just bullied or abused you? Where you’re left dizzy, nauseous, reeling, shaking and confused? Deep down, you are hurt and angry because you know you’ve just been ‘done over’. That, my friends, is gaslighting. This may be combined with what is referred to as ‘word salad’; the person throws in confusing and unrelated statements to discombobulate you and throw you further off-balance. This usually happens when you get close to tilting their narcissistic mask sidewards.

I saw a werewolf drinking a pina colada at Trader Vic’s.
His hair was perfect.

(Zevon, 1978)

This brilliant and surreal line from the late, great singer/songwriter Warren Zevon, captures perfectly the duplicitous nature of the covert narcissistic type. Here is a werewolf sitting in a respectable establishment, drinking a pina colada, not to mention his perfect hairstyle!
Don’t be fooled, people. As the song says:

You better stay away from him, he’ll rip your lungs out Jim! I’d like to meet his tailor.

(Zevon, 1978)

The covert narcissist would ‘rip your lungs out’, only they’d be smiling at the time, pretending to all-and-sundry that they really cared about you. These people have no scruples when it comes down to it. They will steal your ideas, set you up to be attacked in meetings, then have the gall to try and comfort you afterwards. You can smell and feel their narcissistic presence as they feign concern and attempt to embrace you, while minutes earlier, they plunged a dagger between your shoulder blades! They are so conceited and self-obsessed that they will become histrionic and ‘affected’ by the damage they have just caused, while diverting all the attention back on to them, as you lie bleeding to death!

They are very good at using therapeutic language to exploit open, vulnerable and oblivious therapists, tutors or students. They scrutinise the staff group, class, fellow students etc. targeting the brightest, most talented in the pack – as these are a threat to them. Why? Because the covert narcissist not only lacks class and integrity, they are also devoid of any real flair or talent.

Thankfully, these narcissists are in the minority but they are there; posturing, spying, plotting and scheming, while outwardly presenting a ‘butter wouldn’t melt in my mouth’ look. They are not all as blatant, arrogant and vainglorious; some come smiling, fawning, promising, seducing, and intoxicating you with their short-lived charms and charisma. Hang around a bit longer though and you may find that lurking beneath that ever so sweet, overhelpful exterior is the same grandiose, arrogant, entitled, malicious, raging narcissist that we’ve come to know (and love!) in their more overt and brash counterpart.


Snap out of it baby,

People are jealous of you.

They smile to your face but behind your back they hiss.

What’s a sweetheart like you doing in a dump like this?

(Dylan, 1983)

I am very happy to say that there are many fine therapists, psychologists, care workers etc. who approach their work from a place of deep integrity, respect and a genuine desire to support clients with care and compassion. They also strive to treat their colleagues/peers/students with the same dignity and positive regard. However, I think there can be a collective shock or denial about these Cluster B types that exist in the caring professions. Ignore it at your peril, because they are represented in this setting as they are in all walks of life. Our first step is to acknowledge and accept that they do exist. This is what we would tell our clients, right? So we cannot be precious and exhibit such double standards within our own profession. We need to be prepared to do anything that we ask a client to do, or to go where we suggest they go in themselves. We must be authentic and mirror this genuineness to our clients, peers, and colleagues alike.

My hope is that this article will generate conversations about this challenging phenomenon; that it will give people permission to talk about it – particularly if you have been a casualty of such abusive behaviours in your work as a therapist. Maybe you’re a student going through this, or a tutor or manager experiencing the ‘gaslighting’ crazy-making effects of this dark behaviour. Whoever you are, you are not alone and you are most definitely not going mad. Do not doubt your perception, intuition or gut feeling. It’s usually right about something. The irony with this kind of behaviour is that it mirrors what our clients bring to us daily, whether that’s sexual, psychological, emotional, spiritual abuses; or bullying, exploitation, addiction, or other dysfunctions. Either way, we need to be really open to explore the ‘shadow side’ of our profession, which is a direct reflection of the dark underbelly of living that our clients show us regularly and hope to heal from.

Jimmy Judge is a psychotherapist, group therapist, group facilitator, trainer, writer and supervisor, with a private practice in Dublin. He has a special interest in working with social exclusion, stigma, and people living on the margins of society. He specialises in trauma, addiction, somatic work, and exploring recovery through the creative arts.


American Psychiatric Association (2013). Diagnostic & statistical manual of mental disorders, 5th Edition: DSM-5. Arlington, VA.

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Cohen, L. (1988). Everybody knows [Song]. On I’m your man. Columbia.

Dylan, B. (1983). Sweetheart like you [Song]. On Infidels. Columbia.

Hamilton, P. (1944). Gaslight [Film]. Metro-Goldwyn-Mayer.

Hastings, J. and Typpo. M. (1984). The Elephant in the Living Room. Hazeldene.

Little Feat (1973). On your way down [Song]. On Dixie Chicken. Warner Brothers.

Milne, A. A. (1926). Winnie-the-Pooh. Methuen & Co., Ltd.

McQuarrie, C. (Director). (1995). The Usual Suspects [Film]. Gramercy Pictures.

O’Connell, A. (2019). The Crooked Mask. Unpublished essay.

Pink Floyd. (1979). The trial [Song]. On The Wall. Harvest Columbia.

Simon, C. (1972). You’re so vain [Song]. On No Secrets. Elektra Records.

Zevon, W. (1978). Werewolves of London [Song]. On Excitable Boy. Asylum Records

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