Many people are justifiably pessimistic when it comes to the narcissistic patient.

Family members who’ve given up on him lament, “He’s been an egomaniac for decades. Why would he suddenly change now?” Even therapists will throw up their hands and say, “There’s no working with someone like that. I don’t want to waste my time.”

But Angry Lawyer had actually done some good work since becoming one of my regular patients. The first time I met him, when he barged into my office practically breaking down the door, was already a full six months ago, and much to my surprise, he hasn’t given up — even though I half expect him to slam the door behind him on his way out for good.

Has he become a changed man? Not exactly. Angry Lawyer is still quick to respond to any slight he perceives and has quite an unpleasant temper. That being said, there is definitely progress.

While not everyone responds well to ultimatums, Angry Lawyer’s wife’s threat to divorce him prior to our initial meeting served as a good catalyst for some serious introspection. While it wasn’t enough to make him own up to all of his challenging personality traits, the fear of embarrassment had motivated him to delve into his past, and together we began to explore how he’d gotten to this point.

Here was a grown man who was still hurting from his youth as the only son of a high-powered businessman who could never quite live up to his father’s standards or expectations. And then, upon his father’s untimely death in an auto accident, the bochur destined to become Angry Lawyer had become filled with rage: Now he would never be able to please his father — that opportunity had been ripped away from him by a drunk driver. And with this as a backdrop, Angry Lawyer went to war with the world — fighting everyone in his personal life and suing everyone in his professional life — for not giving him the unconditional love he desperately desired but, in fact, had no idea how to receive.

As the weeks went on, his insight grew and his tolerance for those who’d slighted him became increasingly noticeable. He had reached a temporary truce with his wife and had even noticed a positive effect on his high blood pressure during the last checkup with his family doctor.

And then, all the work seemed to unravel as he began to notice he wasn’t seeing very well. His vision was becoming steadily blurrier. The half year of personal growth was demolished with rage directed at his optometrist for “missing the signs of what is obviously macular degeneration,” and soon his wife was back to threatening a divorce over his angry outbursts.

But Hashem cared for Angry Lawyer and for the hapless optometrist who decided to send him for an ophthalmological checkup “just to make sure everything’s fine,” but who, according to his patient, “carelessly missed the diagnosis that any first-month optometry student would have seen.” As opposed to degenerative vision impairment, Angry Lawyer, who had been wearing contact lenses for years, was simply in need of multifocals. And yet he was furious.

“How could they drive me crazy like that? Any drugstore clerk should have known I just needed new glasses!” he screamed.

“Perhaps, but aren’t you able to just breathe a sigh of relief that you’re healthy?” I countered.

“That half-wit eye doctor shouldn’t be practicing in such a nice office. He doesn’t belong treating cows in Wyoming. What if I really had a degenerative condition? I would have sued him out of business!”

“Maybe he thought you were going to sue him if he didn’t give you a referral for the ophthalmologist?” I offered.

That seemed to hit home as he grumbled, “I should sue him anyway.”

“We need to help you see a better side of things. You’ve got to relax a bit.”

“Yeah, yeah, you’re right,” he muttered noncommittally.

“You know,” I told him, “I’ll never forget the time a cop banged on my door at 4:15 a.m. It just so happened that I was half awake making a bottle for my baby. But boy, was I scared hearing someone yelling outside my house.”

“What happened?” Angry Lawyer asked, his curiosity getting the better of his temper.

“What happened was the cop kept yelling for me to open up and eventually I did, when I saw his badge through the peephole. Apparently there had been reports of a break-in in our community and the police had found someone suspicious on our street. The young man was claiming that he was a neighborhood kid but didn’t have any identification to prove it, so they had him handcuffed and facedown on the street. They were looking for someone to corroborate the story and I happened to be the only house on the block with my downstairs lights on so they’d knocked. As it turned out, it was just Ovadia Mizrachi, a neighbor’s kid who worked in a bakery and left the house at the crack of dawn every day.”

“You must have been furious for the near heart attack they’d given you!”

“Not really,” I admitted. “Actually, I was pretty relieved, thinking how amazing it was that they’d found a suspicious person who turned out to be Ovadia Mizrachi instead of a marauding terrorist, chas v’shalom.”

“Well!” he said, and then nodded quietly. “I guess that is better.”

“For sure! Look, if I had a bottle of Arak in my office I’d make a l’chayim with you,” I offered with a big smile on my face. “So how about instead, I’ll pour you a shot glass of seltzer and we’ll call it Arak?”

“Why? What’s to celebrate?”

“A l’chayim in honor of your good news! This time it’s pretty obvious, but you’ve got to really work hard to find the tov in everything you experience as opposed to the massive personal insult and crime against humanity that you often feel.”

Angry Lawyer grinned and took the makeshift l’chayim, raising his glass.

“To multifocals and bakers, Dr. Freedman!”

There was certainly more work to be done, but when I saw how Angry Lawyer was finally able to calm down, I knew he could do better than most therapists and family members of hopeless narcissistic personalities could have imagined.

Identifying details have been changed to protect the privacy of patients, their families, and all other parties.

Originally featured in Mishpacha, Issue 748. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in The Old City or hiking the hills outside of Jerusalem.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.