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1 results

  • Chapter 6 - Narcissistic Personality Disorder

  • from Part III - Application and Adaptations for Mental Health Presentations
  • Anthony Bateman, Anna Freud National Centre for Children and Families, London, Peter Fonagy, University College London, Chloe Campbell, University College London, Patrick Luyten, University College London, Martin Debbané, University College London
  • Book:
    Cambridge Guide to Mentalization-Based Treatment (MBT)
    Published online:
    18 May 2023
    Print publication:
    01 June 2023, pp 155-173

  • Summary

    A mentalizing framework for understanding narcissism is outlined, and the resulting modifications of basic mentalization-based treatment (MBT) for narcissistic personality disorder are discussed. Treatment of patients with pathological narcissism requires an emphasis on empathic validation and support of the vulnerable “I-mode.” The dangers of not recognizing low mentalizing in narcissistic functioning are also discussed, as both patient and clinician can fail to recognize pretend mode, which may masquerade as “we-mode.” Together the patient and the therapist may then set up a pretend therapy that can be interminable and that functions only to fuel the mental narcissistic structure. A clinical example of a patient in treatment is used to illustrate the process of treatment.