Principles of Psychodynamic Treatment for Patients With Narcissistic Personality Disorder.

doi:10.1521/pedi.2020.34.supp.143

Paper

Principles of Psychodynamic Treatment for Patients With Narcissistic Personality Disorder.

Published Mar 1, 2020 · Holly Crisp, G. Gabbard

Journal of personality disorders

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17

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Abstract

Narcissistic personality disorder is a pleomorphic entity that requires the psychodynamically oriented therapist to tailor the approach to the characteristics of the individual patient. Psychodynamic principles encompass a broad range of interventions depending on the patient's specific characteristics. The therapist's interventions range from interpretation of the transference to supportive approaches that emphasize empathic validation and direct advice. In the absence of systematic data on these variations, this article attempts to offer clinically based principles. Several themes are emphasized: the experience of shame, the predictable transference-countertransference developments, the role of comorbidity with other personality disorders and traits, and the approach to resistances.

Study Snapshot

Key takeawayPsychodynamic treatment for narcissistic personality disorder should tailor interventions to the patient's specific characteristics, emphasizing empathic validation and direct advice.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Paper

Principles of Psychodynamic Treatment for Patients With Narcissistic Personality Disorder.

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References

Citations

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The ICD-11 dimensional model effectively captures gender differences in narcissistic presentations, potentially reducing gender stereotype influences in clinical conceptualization.

Can Patients With Narcissistic Personality Disorder Change? A Case Series

Psychotherapy can lead to improvements in patients with narcissistic personality disorder after 2.5 to 5 years, leading to better psychosocial functioning.

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The ICD-11 framework effectively captures both grandiose and vulnerable narcissism, identifying common core elements and distinct differences in their clinical presentations.

Two-Wave Stability of Grandiose and Vulnerable Narcissism During Adolescence

Narcissistic grandiosity remains stable during adolescence, while narcissistic vulnerability shows a mild increase, with empathy playing a crucial role in shaping these developmental trajectories.

Therapist reactions to patient personality: A pilot study of clinicians’ emotional and neural responses using three clinical vignettes from in treatment series

Therapists show distinct criticized/devalued and sexualized reactions to patients with different personality disorders, and their memory processes can accurately predict which patient they observed during an EEG task.

The concept of Narcissistic Personality Disorder–Three levels of analysis for interdisciplinary integration

The core-deficit-model of NPD integrates macro, meso, and micro levels of analysis to better understand deficient empathy as the core of narcissistic personality disorder.