Narcissistic Patients And New Therapists

Patients that have significant narcissistic personality pathology are challenging to most therapists. Student therapists often find that treating such patients is particularly difficult. Not only do such patients challenge the therapist's conceptualization and empathic skills, but they also evoke strong feelings toward the patient, a phenomenon known as countertransference, which can be personally unnerving. However, countertransference can be used as a tool in better understanding one's patient and how to best intervene with him or her. This book sets out to accomplish three major objectives. First, it describes narcissistic pathology from a psychoanalytic and psychodynamic perspective, which allows therapists to have a meaningful framework from which to think about their patients' problems and work with them. Second, it discusses how countertransference can be understood as a useful therapeutic tool. Third, it presents four case studies from doctoral students in various stages of their clinical training and how they came to understand and work with their patients in therapeutically effective ways by managing and understanding their countertransference reactions. In the end, it is hoped that the reader will see that, while they may be challenging at times, narcissistic patients can be effectively treated if therapists have a meaningful theoretical framework from which to think about their patients and can become comfortable with their own inner lives as they relate to their patients.

Levin examines what therapists can do to help the victims of narcissistic wounds to integrate, mourn, and heal them. He shows the nature of the injuries to each party and considers ways to minimize them, since treatment itself can seem an injury to both patient and therapist.

The definition of narcissism can be a moving target. Is it an excess of self-love? Profound insecurity? Low self-esteem? Too much self-esteem? Because of the multifaceted nature of narcissistic personality disorder (NPD), treating this disorder presents clinicians with a range of wholly unique challenges. Narcissism and Its Discontents recognizes the variable nature of NPD and provides a template for adjusting treatment to the patient rather than shoehorning the patient into a manualized treatment that may prove to be less effectual. This guide offers clinicians strategies, including transference and countertransference, to deal with the complex situations that often arise when treating narcissistic patients, among them, patient entitlement, disengagement, and envy. The authors provide a skillful integration of research and psychoanalytic theory while also addressing psychotherapeutic strategies that are less intensive but also useful--being cognizant of the fact that a majority of patients do not have access to psychoanalysis proper. A chapter on the cultural aspects of narcissism addresses the recent societal fascination with NPD in the discourse on politics and celebrity, particularly in the age of social media. Regardless of the treatment setting--psychoanalysis, psychotherapy, pharmacotherapy, partial hospital, or inpatient--clinicians will find a wealth of approaches to treating a diverse and challenging patient population in Narcissism and Its Discontents.

Filling a crucial gap in the clinical literature, this book provides a contemporary view of pathological narcissism and presents an innovative treatment approach. The preeminent authors explore the special challenges of treating patients--with narcissistic traits or narcissistic personality disorder--who retreat from reality into narcissistic grandiosity, thereby compromising their lives and relationships. Assessment procedures and therapeutic strategies have been adapted from transference-focused psychotherapy (TFP), a manualized, evidence-based treatment for borderline personality disorder. Rich case material illustrates how TFP-N enables the clinician to engage patients more deeply in therapy and help them overcome relationship and behavioral problems at different levels of severity. The volume integrates psychodynamic theory and research with findings from social cognition, attachment, and neurobiology.

Can narcissists and psychopaths be cured? Can their behaviour be modified? How are these mental health disorders diagnosed?

Its previous edition hailed as "the best reference for the majority of practicing psychiatrists" (Doody's Book Reviews) and a book that "more than any other, provides an approach to how to think about psychiatry that integrates both the biological and psychological" (JAMA), The American Psychiatric Publishing Textbook of Psychiatry has been meticulously revised to maintain this preeminence as an accessible and authoritative educational reference and clinical compendium. It combines the strengths of its three editors -- Robert Hales in clinical and community psychiatry, Stuart Yudofsky in neuropsychiatry, and new co-editor Glen Gabbard in psychotherapy -- in recruiting outstanding authors to summarize the latest developments in psychiatry and features 101 contributors, 65 of whom are new to this edition. The book boasts a new interior design, with more figures and color throughout to aid comprehension. Each chapter ends with 5-10 key points, 5-10 recommended readings, and helpful Web sites not only for the clinician but also for patients and family members. The book also includes complimentary access to the full text online. Online benefits include powerful searching, electronic bookmarking, and access by username and password from wherever you have Web access -- especially convenient for times when the print copy of your textbook is not where you are. The online version is accompanied by a downloadable PowerPoint presentation, which contains a wealth of material to enhance classroom presentation, study, and clinical use. Among the improvements to this edition's content: • Of the text's 44 chapters, 23 either feature new topics or have new authors, making this the most completely revised edition yet.• New basic-science chapters on cellular and molecular biology of the neuron and on neuroanatomy for the psychiatrist conveniently distill essential information on the biological foundations of psychiatric disorders for clinicians.• A new chapter on human sexuality and sexual dysfunctions, and another new chapter on treatment of gay, lesbian, bisexual, and transgender patients, equips clinicians to address the entire spectrum of sexual issues and their attendant mental health concerns.• New chapters on nonpharmacological somatic treatments, supportive psychotherapy, and combination psychotherapy and pharmacotherapy augment the section on psychiatric treatments.• A new chapter on the assessment of dangerousness -- an individual's propensity to commit violent acts -- presents helpful guidelines for appropriately evaluating and minimizing the risk of violence in both outpatient and inpatient settings. Why The American Psychiatric Publishing Textbook of Psychiatry will be your first choice among comprehensive psychiatry textbooks: • Complimentary Access to the Full Text Online -- Online benefits include powerful searching, electronic bookmarking, and download to PDA.• PowerPoint Presentation -- Online version is accompanied by a downloadable PowerPoint presentation, which contains a wealth of material to help you enhance classroom presentation, study, and in clinical use. • Self-Assessment -- An interactive online Self-Assessment allows you to assess your knowledge of each chapter, with links back to the textbook when more study is needed.• Summary Points -- Each chapter ends with 5-10 key points, 5-10 recommended readings, and helpful web sites not only for the clinician but also for referral to patients and family members. • Co-Editor Glen O. Gabbard, M.D. -- As the third Co-Editor, Dr. Gabbard adds depth and perspective to psychotherapeutic approaches.• Chapter Authors -- Partnership of senior and junior faculty brings fresh insights tempered by wisdom and experience.• Peer-Reviewed -- Rigorously peer reviewed and updated to reflect the rapidly changing profession. • Disclosure of Interest Statements -- Disclosure from each chapter author assures you that potential biases have been removed.• Comprehensive But Concise -- Inclusion of essential information eases information overload.• Better Layout -- Larger type for text makes book easier to read and color figures are provided throughout the text. It's no wonder that this text has established itself as both a leading scholarly reference and an indispensable clinical resource. The American Psychiatric Publishing Textbook of Psychiatry is a proven teaching tool and an essential component of every practitioner's library.