The narcissistic personality disorder is characterized by a lack of self-confidence and rejection of one's self inwards, alternating with an exaggerated and extremely pronounced self-confidence outwards.
Hence, such a person is always striving for admiration and acknowledgement, while giving little real attention to other people. She/he has an exaggerated sense of importance, hopes to attain and to earn special status. She/he exhibits exploitative attitudes and a lack of empathy. Delusional disorders with concepts of grandness are within the spectrum of possibilities. Moreover, the afflicted shows a striking sensitivity towards criticism, which often is projected globally, stirring feelings of rage, shame, and humiliation.
The term "personality disorder" by itself is hazy and subject to controversy. It is not just a standardized, empirically validated theory that is missing but likewise a sound therapy for the effective treatment. Furthermore, clients with personality disorders are considered as therapeutically little accessible and difficult on an interaction level.
Prof. Rainer Sachse, psychology professor at the University of Bochum and founder of the "Klärungsorientierte Psychotherapie" (clarification-oriented psychotherapy) and of the dual action regulation model, does not talk about personality disorders anymore, but instead of relationship and interaction disorders.
Herewith the therapist takes on an equally important role, as does the client.
Moreover, he assumes that the forms of relationship, which taken to the extreme lead to the so-called personality disorders, are universal behavior in their milder expression (Sachse, 2006).
For a better understanding of the subject, the present work first discusses the theory of clients with narcissistic personality disorder and subsequently elaborates on the possibilities for intervention. In the light of the model of dual action regulation, central motives, schemata, and strategies of action are pointed out, that are displayed by clients with narcissistic PD. Therapeutic strategies like complementary structuring of relationships, confrontation, schema modifications are being deduced.
Table of Contents
Introduction
Basic concepts
The model of dual action regulation
Therapeutic interventions
Building of a relationship
Complementarity at the motive level
Non-complementarity at the play level
Never regard the client as deficient
Establishing compliance
Appreciation and acknowledgement
Emphasize resources
Normalize
Leave room for self-portrayal
Absolutely appreciate
Dealing with testing
Therapy phase
Confrontation: Identifying a work assignment
Substantial work
Summary
Literature
Objectives and Topics
This work aims to provide a comprehensive understanding of Narcissistic Personality Disorder (NPD) through the lens of the "Model of Dual Action Regulation," specifically detailing therapeutic strategies for effective clinical intervention.
- Theoretical foundation of Narcissistic Personality Disorder
- The Model of Dual Action Regulation in psychotherapy
- Establishing a therapeutic relationship with challenging clients
- Confrontation techniques and work assignment identification
- Addressing dysfunctional schemas and building alternative behaviors
Excerpt from the Book
Never regard the client as deficient
In the context of narcissistic personality disorder complementary acting with regard to the motive level implies that the therapist avoids at all cost to define the client as deficient: The client has no problem, but wants to "make progress", which is perfectly fine. The therapist acknowledges the accomplishments and successes and connotes them in a positive way. Moreover, the therapist competently portrays someone who the client can connect with as a peer and respects. He accepts the client's autonomy and makes offers rather than give instructions.
Example:
T: "Even if you could not give the talk last week – people do know, how incredibly much you have done for the endowment so far."
Summary of Chapters
Introduction: Provides an overview of narcissistic personality disorder, framing it as a relationship and interaction disorder rather than a traditional pathology.
Basic concepts: Discusses how patients often replicate their interaction problems within the therapy setting and resist change due to the ego-syntonic nature of their disorders.
The model of dual action regulation: Introduces the theoretical framework for understanding the interactional motives and the disguised strategies used by clients.
Therapeutic interventions: Details the four-phase therapy process, focusing on building a stable relationship and non-complementary interactions at the play level.
Building of a relationship: Examines specific strategies like establishing compliance, using the "Judo-technique," and providing acknowledgement to build trust.
Therapy phase: Explains the necessity of confrontation in making manipulative strategies transparent and transforming the disorder into something ego-dystonic to create motivation for change.
Summary: Concludes that treating NPD is a tedious, long-term process requiring highly experienced and resilient therapists.
Literature: Lists the academic foundation of the work, including key references by Rainer Sachse.
Keywords
Narcissistic Personality Disorder, Dual Action Regulation, Psychotherapy, Clarification-oriented Psychotherapy, Therapeutic Relationship, Interactional Motives, Schema, Confrontation, Complementarity, Behavioral Therapy, Ego-syntonic, Compliance, Manipulation, Intervention, Psychological Diagnosis.
Frequently Asked Questions
What is the primary focus of this work?
The work focuses on applying the "Model of Dual Action Regulation" to the treatment of patients with narcissistic personality disorder within a clinical psychotherapy setting.
What are the central themes covered?
Key themes include the psychological structure of narcissism, the role of the therapist in managing interactional resistance, and the specific phases of treatment ranging from relationship building to schema modification.
What is the main research question or goal?
The goal is to provide a guide for therapists to effectively handle the specific interactional challenges posed by narcissistic clients and to facilitate meaningful therapeutic change.
Which scientific methodology is utilized?
The work is based on clarification-oriented psychotherapy and cognitive-behavioral foundations, specifically utilizing the model of dual action regulation developed by Prof. Rainer Sachse.
What topics are discussed in the main section?
The main section covers the "four phases of therapy," ranging from building a relationship, identifying work assignments, performing substantial clinical work, and finally transferring new behaviors into the client's daily routine.
Which keywords characterize this work?
The work is characterized by terms such as narcissistic personality disorder, dual action regulation, complementarity, therapeutic resistance, and interactional diagnostics.
What is the "Judo-technique" mentioned in the therapy phase?
It refers to the therapist's strategy of taking advantage of the client's momentum to direct them toward constructive outcomes without arguing or provoking reactance.
Why is confrontation considered a delicate phase in this therapy?
Because personality disorders are ego-syntonic, patients are often unaware of their maladaptive patterns. Premature confrontation can lead to ruptures in the therapeutic alliance, so it must be built on previously established "relationship credit."
- Quote paper
- Pamina Russek (Author), 2011, Behavioral Therapy of Narcissistic Personality Disorder, Munich, GRIN Verlag, https://www.grin.com/document/279727
