Narcissism - Treatment Modalities and Therapies - Part I

Written by Sam Vaknin


Continued from page 1

Sometimes, these therapies are divided to expressive versus supportive, but I regard this division as misleading.

Expressive means uncovering (making conscious)repparttar patient's conflicts and studying his or her defences and resistances. The analyst interpretsrepparttar 126201 conflict in view ofrepparttar 126202 new knowledge gained and guidesrepparttar 126203 therapy towards a resolution ofrepparttar 126204 conflict. The conflict, in other words, is "interpreted away" through insight andrepparttar 126205 change inrepparttar 126206 patient motivated by his/her insights.

The supportive therapies seek to strengthenrepparttar 126207 Ego. Their premise is that a strong Ego can cope better (and later on, alone) with external (situational) or internal (instinctual, related to drives) pressures. Supportive therapies seek to increaserepparttar 126208 patient's ability to REPRESS conflicts (rather than bring them torepparttar 126209 surface of consciousness).

Whenrepparttar 126210 patient's painful conflicts are suppressed,repparttar 126211 attendant dysphorias and symptoms vanish or are ameliorated. This is somewhat reminiscent of behaviourism (the main aim is to change behaviour and to relieve symptoms). It usually makes no use of insight or interpretation (though there are exceptions).

Group Therapies

Narcissists are notoriously unsuitable for collaborative efforts of any kind, let alone group therapy. They immediately size up others as potential Sources of Narcissistic Supply or as potential competitors. They idealiserepparttar 126212 first (suppliers) and devaluerepparttar 126213 latter (competitors). This, obviously, is not very conducive to group therapy.

Moreover,repparttar 126214 dynamic ofrepparttar 126215 group is bound to reflectrepparttar 126216 interactions of its members. Narcissists are individualists. They regard coalitions with disdain and contempt. The need to resort to team work, to adhere to group rules, to succumb to a moderator, and to honour and respectrepparttar 126217 other members as equals is perceived by them to be humiliating and degrading (a contemptible weakness). Thus, a group containing one or more narcissists is likely to fluctuate between short-term, very small size, coalitions (based on "superiority" and contempt) and narcissistic outbreaks (acting outs) of rage and coercion.

Can Narcissism be Cured?

Adult narcissists can rarely be "cured", though some scholars think otherwise. Still,repparttar 126218 earlierrepparttar 126219 therapeutic intervention,repparttar 126220 betterrepparttar 126221 prognosis. A correct diagnosis and a proper mix of treatment modalities in early adolescence guarantees success without relapse in anywhere between one third and one halfrepparttar 126222 cases. Additionally, ageing moderates or even vanquishes some antisocial behaviours.

In their seminal tome, "Personality Disorders in Modern Life" (New York, John Wiley & Sons, 2000), Theodore Millon and Roger Davis write (p. 308):

"Most narcissists strongly resist psychotherapy. For those who choose to remain in therapy, there are several pitfalls that are difficult to avoid ... Interpretation and even general assessment are often difficult to accomplish..."

The third edition ofrepparttar 126223 "Oxford Textbook of Psychiatry" (Oxford, Oxford University Press, reprinted 2000), cautions (p. 128):

"... (P)eople cannot change their natures, but can only change their situations. There has been some progress in finding ways of effecting small changes in disorders of personality, but management still consists largely of helpingrepparttar 126224 person to find a way of life that conflicts less with his character ... Whatever treatment is used, aims should be modest and considerable time should be allowed to achieve them."

(continued)

Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .

Visit Sam's Web site at http://samvak.tripod.com




Narcissism, Substance Abuse, and Reckless Behaviours

Written by Sam Vaknin


Continued from page 1

Thus, there is no point in treatingrepparttar dependence and recklessness ofrepparttar 126200 narcissist without first treatingrepparttar 126201 underlying personality disorder. The narcissist's addictions serve deeply ingrained emotional needs. They intermesh seamlessly withrepparttar 126202 pathological structure of his disorganised personality, with his character faults, and primitive defence mechanisms.

Techniques such as "12 steps" may prove more efficacious in treatingrepparttar 126203 narcissist's grandiosity, rigidity, sense of entitlement, exploitativeness, and lack of empathy. This is because as opposed to traditional treatment modalities repparttar 126204 emphasis is on tacklingrepparttar 126205 narcissist's psychological makeup, rather than on behaviour modification.

The narcissist's overwhelming need to feel omnipotent and superior can be co-opted inrepparttar 126206 therapeutic process. Overcoming an addictive behaviour can be truthfully presented byrepparttar 126207 therapist as a rare and impressive feat, worthy ofrepparttar 126208 narcissist's unique mettle.

Narcissists fall for these transparent pitches surprisingly often. But this approach can backfire. Shouldrepparttar 126209 narcissist relapse an almost certain occurrence he will feel ashamed to admit his fallibility, need for emotional sustenance, and impotence. He is likely to avoid treatment altogether and convince himself that now, having succeeded once to get rid of his addiction, he is self-sufficient and omniscient.

First published in my "Narcissistic Personality Disorder" Topic Page on Suite 101

Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .

Visit Sam's Web site at http://samvak.tripod.com




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