scholarly journals Internal Processing in Patients With Pathological Narcissism or Narcissistic Personality Disorder: Implications for Alliance Building and Therapeutic Strategies

2020 ◽  
Vol 34 (Supplement) ◽  
pp. 80-103
Author(s):  
Elsa Ronningstam
Keyword(s):  
Personality Disorder ◽  
Therapeutic Strategies ◽  
Narcissistic Personality Disorder ◽  
Pathological Narcissism ◽  
Narcissistic Personality ◽  
Alliance Building ◽  
Internal Processing

Narcissistic Personality Disorder: The Diagnostic Process

2012 ◽  
pp. 526-548
Author(s):  
Elsa Ronningstam
Keyword(s):  
Personality Disorder ◽  
Diagnosis And Treatment ◽  
Narcissistic Personality Disorder ◽  
Diagnostic Process ◽  
Pathological Narcissism ◽  
Dsm 5 ◽  
The Past ◽  
Narcissistic Personality ◽  
Specific Focus ◽  
Alliance Building

The diagnosis of narcissistic personality disorder (NPD) evolving over the past 40 years within several fields of inquiry—clinical and psychoanalytic as well as psychiatric and empirical—is discussed in this chapter. The inclusion of NPD as a separate personality disorder in the latest proposal of DSM-5 has warranted continuing studies and development of the diagnosis and treatment of pathological narcissism and NPD. Specific focus is on capturing the complexity of narcissistic pathology, identifying narcissistic core traits in the context of regulatory and dynamic variability, and incorporating the functional and phenotypic range of NPD. The diagnostic process, that is, identifying narcissistic traits in a collaborative alliance-building context between patient and clinician, aims at establishing a meaningful diagnosis that can inform patient and relatives and serve to guide treatment. Concluding guidelines for enhancing accuracy and meaningfulness of the NPD diagnosis are proposed.

Transference-Focused Psychotherapy for Pathological Narcissism and Narcissistic Personality Disorder (TFP-N)

2021 ◽  
Vol 49 (2) ◽  
pp. 244-272
Author(s):  
Diana Diamond ◽  
Frank Yeomans ◽  
John R. Keefe
Keyword(s):  
Personality Disorder ◽  
Sense Of Self ◽  
Assessment Process ◽  
Narcissistic Personality Disorder ◽  
Object Relations Theory ◽  
Pathological Narcissism ◽  
Personality Functioning ◽  
Therapeutic Interaction ◽  
Narcissistic Personality ◽  
Transference Focused Psychotherapy

In this article, we provide an overview of transference-focused psychotherapy for patients with pathological narcissism and narcissistic personality disorder (TFP-N). In TFP-N we have modified and refined the tactics and techniques of TFP, an evidence-based treatment for borderline personality disorder, to meet the specific challenges of working with patients with narcissistic personality pathology whose retreat from reality into an illusory grandiosity makes them particularly difficult to engage in treatment. We first describe a model of narcissistic pathology based on considerations of psychological structure stemming from object relations theory. This model provides a unifying understanding of the core structure of narcissistic pathology, the pathological grandiose self, that underlies the impairments in self and interpersonal functioning of those with narcissistic pathology across the levels of personality organization (from high functioning to borderline to malignant). We then delineate the clinical process of working with patients with pathological narcissism and narcissistic personality disorder. Starting with the assessment process, using a detailed clinical example, we guide the reader through the progression of TFP-N as it helps the patient move from the distorted, unintegrated sense of self underlying the narcissistic presentation to the more integrated, realistic sense of self that characterizes healthier personality functioning. In TFP-N the focus on the disturbed interpersonal patterns of relating in the here and now of the therapeutic interaction is the vehicle to diminish grandiosity and improve relatedness, thereby effecting enduring changes in mental representation and real-world functioning.

scholarly journals Current understanding of narcissism and narcissistic personality disorder

2018 ◽  
Vol 24 (5) ◽  
pp. 305-315 ◽  
Author(s):  
Jessica Yakeley
Keyword(s):  
Personality Disorder ◽  
Empirical Studies ◽  
Learning Objectives ◽  
Narcissistic Personality Disorder ◽  
List Type ◽  
Pathological Narcissism ◽  
Know How ◽  
Psychological Therapies ◽  
Narcissistic Personality

SUMMARYThis article reviews historical contributions to the conceptualisation of narcissism and narcissistic personality disorder (NPD), including its evolution as a clinical diagnosis within the DSM classification of mental disorders. It discusses the epidemiology and aetiology of NPD, noting that empirical studies of both are limited. The challenges of managing patients with prominent narcissistic traits are presented, and the psychological therapies specifically designed for the treatment of patients with NPD are summarised.LEARNING OBJECTIVES•Understand different models of narcissism•Understand the epidemiology, comorbidity and theories of aetiology of NPD•Know how to manage and treat patients with pathological narcissism and NPDDECLARATION OF INTERESTNone.

scholarly journals El caso "Pierre". Comentarios al tratamiento de un paciente narcisista

2020 ◽  
Vol 14 (2) ◽  
pp. 412-430
Author(s):  
Fernando García Gil ◽  
◽  
Carlos Rodríguez Sutil ◽  
Keyword(s):  
Personality Disorder ◽  
Self Esteem ◽  
Narcissistic Personality Disorder ◽  
Child Victim ◽  
Pathological Narcissism ◽  
Narcissistic Personality ◽  
Corrective Experience ◽  
The Creation ◽  
The One ◽  
Personality Patterns

We present here a case of a patient with a narcissistic personality disorder. We must take narcissism, like the rest of the personality patterns, as the response of an individual to a context, as the result of a relational matrix (Mitchell). The origin of pathological narcissism is to be found in caregivers who emotionally neglected the child, victim of isolation, on the one hand, and who share and promote narcissistic fantasies of the child, confused with their own fantasies. Dysregulation of narcissism occurs when the child's needs have been ignored, causing severe disturbances in self-esteem or the creation of a great defensive shield (Morrison). At first, our patient could not accept any fault in himself, assuming that the therapist would not accept his faults either. The challenge as therapists is to assume the disability that the patient attributes to us, the incompetence that the patient pursues, without us falling into disaster or in the most absolute hell, which is ultimately what he fears the most. Accepting the faults that the patient displaces in the therapist is a surprise for the patient, it was even a corrective experience in the encounter with himself.

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