The "inability to do" is one of the narratives at the core of some people. It shows up as a constant drive to achieve, to prove one’s worth by doing without pause. This inner dialogue is more than a quiet self-doubt: it is a loud statement of one’s supposed shortcomings. In polyvagal terms it is linked to a highly aroused sympathetic system (the branch of the autonomic nervous system that prepares the body for action, for fight or flight). A second system is also involved: the connection system, governed by the ventral vagus (the branch of the vagus nerve that supports calm and social contact), because to measure one’s results a person needs to connect with others.

Consider John, a CEO who, despite major accomplishments, privately struggles with the fear of being incapable. He is driven by a False Core belief (in the Enneagram work of some authors, the original mistaken conviction about oneself) that keeps repeating: "You cannot do." In public he is a model of success and productivity. Alone in his office, he feels a deep emptiness that no amount of doing seems to fill.

This "inability to do" is a subjective experience, often unrelated to objective reality. It is an illusion of incompetence that people like John keep chasing. The False Self (the identity built to compensate for the False Core) responds by taking on the role of the overachiever, a tireless worker who never does enough. It is a performance: an urgent request for validation addressed to a world that treats achievement as the main measure of worth.

This compensating behaviour is rooted in vanity: attention to how one is seen rather than to how one feels. It is a form of self-deception, in which people like John perform not for their own satisfaction but for the gaze of an audience they feel is always watching. The price is a disconnection from the body: personal comfort and well-being are neglected for the sake of appearance.

We regard this "inability to do" as a concept: an idea people use to justify their constant striving. It works as a closed system that does not take in external feedback, and the subjective feeling of not doing enough becomes a self-fulfilling prophecy.

The paradox of this inner struggle is that it often leads to an impostor complex (the feeling of not deserving one’s own success). People like John feel like actors in their own lives and cannot take in their achievements. Success feels like a costume that never quite fits, and they fear that someone will see through the façade and expose the "emptiness" inside.

For those caught in the False Core–False Self dynamic, healing begins by recognizing that this inner narrative is an illusion. It means removing the layers of performance to reveal the authentic self, free from the compulsion to do. It means finding balance and recognizing the spaciousness of one’s essence, without labelling it as emptiness or inadequacy.

Healing comes from being more rather than doing more: from contacting the stillness within and recognizing that worth is inherent, not earned. As people like John follow this path, they discover that achievement does not nourish the soul; it distracts from the simplicity of just being. In our practice we support this shift by stimulating the person’s inner force, starting from the body.

Healthy and Unhealthy Levels

Of course, we need to distinguish between balanced types and unhealthy types.

Looking at narcissistic traits through polyvagal theory helps us see the physiological basis of personality and behaviour. In a Type Three of the Enneagram (the personality model with nine types), often described as hard-working and self-assured, the sympathetic nervous system is engaged in a balanced way. This balance supports readiness and action, and with them a sense of assurance and productivity.

When this balance tips into the extreme, the picture changes. The high sympathetic arousal of the grandiose, narcissistic Type Three reflects an overactivation of the body’s fight-or-flight response. The person is in hyperarousal, always "on", driven to do more, achieve more and be seen as more, often at the expense of deeper social connections and emotional well-being.

The inhibitory system (Behavioral Inhibition System, BIS: according to some authors, the system that acts as a brake on excitation) works only moderately and cannot counter the strong sympathetic drive of this extreme state. As a result the person may show high RSA reactivity (respiratory sinus arrhythmia: the natural variation of heart rate with breathing), but it is not used effectively for emotional regulation, and vagal tone (the calming influence of the vagus nerve on the heart) remains moderate. The vagus nerve, which slows the heart and supports social engagement, is not activated optimally, and this activation is crucial for building and maintaining social bonds.

The avoidant attachment style (a tendency to keep emotional distance in relationships) seen in unhealthy Type Threes can therefore be understood as a result of this physiological dysregulation. These people may put work and achievement before relationships not only out of psychological preference, but because of an underlying physiological state that favours mobilization and task execution over social engagement and relaxation. This state is also reflected in their RSA reactivity which, while moderate, does not help them return to calm and connection after stress.

In polyvagal terms, a Type Three moving from health to imbalance passes from a dynamic, well-regulated system to one in which the sympathetic drive overrides the social engagement system. The focus shifts to individual achievement, and relationships lose value. At work this can appear as a relentless pursuit of success, often admired, with a hidden cost to the person’s relational and emotional life. We saw this pattern in the bodies of the people we work with (posture, breathing, the pace of their gestures) long before it had a polyvagal interpretation; the theory now describes the shift as a change of autonomic state. The shift is physiological as well as psychological, so it calls for a change in the body’s response to the world, not only in mindset.

How are narcissism and polyvagal theory connected? At the centre of this study are overt and covert narcissism and their relation to emotional regulation, an area crucial for psychological health and social adjustment. The key lies in respiratory sinus arrhythmia (RSA) reactivity: it reflects the intervals between heartbeats and is a clear indicator of physiological regulation.

OVERT: in its overt form, narcissism often correlates with traits considered positive, such as self-esteem and extraversion.

COVERT: covert narcissism tends to go together with internalizing symptoms (difficulties turned inward), such as anxiety and a tendency towards negative emotional reactivity. The fact that narcissism is associated with both positive and negative outcomes has puzzled researchers for years.

RSA

Central to this picture is RSA reactivity: the heart’s rhythmic response to breathing, which gives us a window onto our inner regulatory mechanisms.

The study of RSA adds a new layer to this puzzle. RSA, especially its reactivity to stress, has been proposed as a physiological correlate of emotion regulation. Studies show that high resting RSA is associated with better emotional control, while a marked RSA decrease during stress may act as a protective factor.

People with overt narcissism may have fewer difficulties regulating their emotions, while those with covert narcissism may struggle more. The study also shows that stress-induced RSA reactivity can moderate the effect of covert narcissism on these difficulties: a greater RSA decrease under stress may protect against the impact of covert narcissism.

Consider Jake, a person with overt narcissistic tendencies, often perceived as confident and charming. His high self-esteem and outgoing nature make him the centre of the party and suggest a positive outlook, often linked to a robust resting RSA. Everyday stress does not easily lower his mood: his RSA reactivity helps him handle emotional waves with skill, and he is less exposed to emotional turbulence.

Emily, by contrast, embodies covert narcissism. She carries a quiet anxiety and a sensitivity that often overwhelms her. Her inner world is full of emotional reactivity, doubt and self-criticism. Here RSA reactivity becomes decisive: for Emily, a marked RSA decrease under stress could act as a buffer, softening her inner turmoil and offering a degree of emotional protection.

This study offers a more detailed understanding of narcissistic personality and highlights the role of physiological responses in mental health. It suggests that RSA reactivity is both a marker of emotion regulation and a possible moderator in the relationship between narcissism and emotional well-being. (source https://www.sciencedirect.com/science/article/abs/pii/S030105111530020X)

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Research notes

A selection of peer-reviewed studies on polyvagal theory and vagal function that offer a scientific reading of the topics discussed in this article.

Edelstein RS, Yim IS, Quas JA (2010). Narcissism predicts heightened cortisol reactivity to a psychosocial stressor in men. Journal of Research in Personality, 44(5), 565-572. Among men exposed to an evaluative laboratory stressor, higher narcissism scores predicted greater cortisol reactivity and larger increases in negative affect; no such link was found in women. https://doi.org/10.1016/j.jrp.2010.06.008

Cheng JT, Tracy JL, Miller GE (2013). Are narcissists hardy or vulnerable? The role of narcissism in the production of stress-related biomarkers in response to emotional distress. Emotion, 13(6), 1004-1011. Over three days, women high in narcissism showed higher cortisol and alpha-amylase output when they experienced negative emotions, consistent with a 'fragile ego' account of heightened physiological sensitivity. https://doi.org/10.1037/a0034410

Zhang H, Wang Z, et al. (2015). Associations between narcissism and emotion regulation difficulties: respiratory sinus arrhythmia reactivity as a moderator. Biological Psychology, 110, 1-11. In 227 students, covert narcissism was associated with greater emotion regulation difficulties, and the degree of vagal (RSA) reactivity during a stressful task moderated this association. https://doi.org/10.1016/j.biopsycho.2015.06.014