The Patient that we Love to Hate: Cognitive Behavioral Treatment of the Narcissistic Personality Disorder (mini workshop)

Abstract

The patient with a narcissistic personality disorder may be among the most difficult patients in the clinician's caseload to treat. They may take more time in therapy, more of the theraapist's energy, and overwhelm the therapist's ability to dea;l with the countertransference. Given their self-serving and demanding style, they are more frequently "sent" to therapy than electing to come for treatment. Thus the morivation for therapy and for change is severely limited. The patient's ability to establish a working therapeutic bond is also limited by the very nature of their disorder. Given all of this they can be treated. The active, directive, structred, and problem oriented facets of Cognitive Behavior Therapy make this model an ideal treatment modality. Helping the patient to examine what is in their best personal interest, the therapy proceeds by examining the patienbt's thoughts, feelings, and behaviors.