’d received at least six phone calls from the same number in the last 20 minutes, and by the time I was free to call back, I’d received another two.

“Don’t you answer the phone, Dr. Freedman?!” a frustrated man on the other end practically demanded.

My patients know that the kinds of emergencies that can’t wait a half an hour are best solved in the emergency room. “Are you one of my patients?” I asked.

“No. And I’m not going to be.”

Okay, so I decided I wasn’t going to take it personally when he abruptly hung up the phone.

Five minutes later he called again. Whether or not he wanted to be my patient, I figured the guy was in need of some sort of help and I answered with as pleasant a tone as I could muster.

“Hi, this is Dr. Freedman.”

“Are you ready to talk now, Dr. Freedman?” came the same aggressive, I-own-the-world voice.

“Absolutely. How can I help you, sir?”

“I need to talk to you. I heard about you through a friend, and thought maybe you could be of service. I need you to fix up my situation!” he started to yell. “My wife gave me one last chance before she kicks me out — and that’ll ruin everything for the kids, my career, and the community, too. You gotta help me out!”

I’ve written previously about my patient whom I called “Angry Doc”; this fellow seemed to be a classic “Angry Lawyer.” We set a time for later that week and Angry Lawyer sent me a dozen e-mails in the meantime describing his various trials and tribulations — which gave me a bit of insight into his world of profound narcissism. There was: “No one seems to notice that I’m the only person in the room who understands how to handle this situation!” Or, “My wife and kids don’t respect a single thing that I have to say, so of course I have to yell!” And “Of course I’m angry because they’re all a bunch of morons!”

And with this introduction, I was looking forward to meeting my new patient.

Actually, I was impressed with the fact that Angry Lawyer was seeking help. Because while most people associate narcissism with an inflated sense of superiority, it’s not actually the root of this personality disorder. The underlying issue is an overarching resistance to feeling vulnerable or being in a vulnerable position with anyone, and that’s why a narcissist actually lives in a state of constant anxiety. Seeking help is a sign of a crack in the armor, an indication that something has touched him in a way that has upset the shell he’s created.

I was running a bit late that particular afternoon. A long-term patient had just lost his closest sibling to a sudden fatal heart attack and needed some extra support, and our session ran about six minutes over. Even as we were wrapping up, I heard loud grumblings in the waiting room and could only imagine who it was.

The truth is, I was about to finish the appointment, go out to meet him, apologize for running overtime, and offer to make up the time to him — letting him know that if he were in crisis, I’d give him the extra time he needed as well.

But I didn’t have a chance. Angry Lawyer took the initiative and began banging on the door.

When I opened it up a crack to let him know I was finishing up, he beat me to the punch. “You know you’re six minutes late, Dr. Freedman!”

“I do. Forgive me. I’ll be done in a minute.”

“I can’t promise to forgive you for wasting my time, Dr. Freedman,” he remarked rather snidely.

A few moments later I finished with my patient, and before I could blink, Angry Lawyer was already in my office and even took the liberty of examining my licenses and certifications on the walls.

“You look smart on paper, Dr. Freedman, but you should know better than to keep a new client waiting. That’s not how you keep a good business going strong and it’s definitely not respectful of your client’s time and money.”

This was the exact type of behavior that was ruining Angry Lawyer’s relationships at home and life in general.

“Sir,” I said. “Let’s just say that these sorts of comments are rapidly demolishing any chance you have of saving your relationship with your wife or having any meaningful interpersonal relationships.”

“Whoa! You diagnosed me that quickly?” he responded sarcastically. “How’d you figure that out?”

“It’s not neurosurgery, just common sense. You’re on such a powerful narcissistic trip that you don’t have any time for anyone else.”

“Of course I do! I give plenty of tzedakah and I’m known as a baal chesed in the community.”

“I don’t doubt it,” I told him, “but the complete lack of respect you display to others is ruining whatever good name you’ve created for yourself.”

“I don’t need to pay you to hear this kind of abuse, you know,” he responded angrily.

“Then feel free to leave, sir, but I’m not going to sit here and let you bang on my door and chase away my other patients and then strut around like you own the place,” I said calmly.

“And why not?” he tested me.

“Because that wouldn’t help you in the least bit. Look, you can leave now and I’ll catch up on my e-mails. But if you’re actually concerned about not getting kicked out of your house then we need to talk about respecting other people.”

A fellow like this would never feel like he was honored enough. Because of his buried fears, his ego became a black hole that seemed like it could never be satiated. He continued, “So I should let everyone walk all over me and talk to me with the chutzpah you’re talking to me right now?”

“Maybe it’s better than walking all over everyone else?”

Angry Lawyer looked like he was about to explode and answered me in a voice laced with profound rage. “Do you think that I need to hear this kind of narishkeit from a kid like you? I was busy running this town when you were waiting for your upsheren!”

“You have to hear it from me,” I said in my calmest voice. “You have to listen to me because you haven’t listened to your wife, your rav, your friends, your family, your associates, or frankly anyone else here in Olam Hazeh. You have to listen to me because if you don’t you’ll wind up shamed in the community you’ve helped created when you get thrown out of your house as a result of your vicious narcissism. You can be on the warpath for kavod, but when it translates into gaavah, all you’ll end up with is the tremendous bushah of everyone saying, ‘Angry Lawyer’s wife kicked him out because he was an insufferable baal gaavah.’ ”

Angry Lawyer looked defeated as he slumped down in his chair. His internal hurricane seemed to settle and I thought I even detected the hint of a smile.

“You’re tough,” he said. “Tough, tough, tough, Dr. Freedman. You’d probably make a good Angry Psychiatrist.”

Originally featured in Mishpacha, Issue 724. 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.