Position Paper—Transference-Focused Psychotherapy (TFP) for Narcissistic Personality

Abstract

The authors describe the application of a twice-weekly, exploratory psychotherapy, Transference-Focused Psychotherapy (TFP), to patients with Narcissistic Personality Disorder (NPD). The paper describes the pathology of object relations within which narcissistic pathology can be understood, and how TFP establishes a treatment framework to address narcissistic pathology. An outline of the assessment and treatment protocol is described along with a case example to illustrate the same. The application of TFP to patients with NPD follows from recent research demonstrating the effectiveness of TFP for patients with BPD including some patients with comborbid NPD. Although empirical studies of the efficacy of TFP for NPD are lacking and warranted the authors suggest that, in the absence of any other empirically supported treatment for NPD, TFP may be applied to this challenging patient population.