Treating Narcissistic Personality Disorders: a case illustration of key clinical contributions from Transference Focused Psychotherapy for psychoanalytic practitioners

Abstract

Narcissistic Personality Disorder (NPD) is complex and difficult to treat. Whilst there is no research based evidence for the specific treatment of NPD, there is an evidence base for psychotherapeutic approaches to Borderline Personality Disorder (BPD) which includes Transference Focused Psychotherapy (TFP). TFP is a contemporary object relations approach which has been developed to treat patients with a Borderline Personality Organization, which includes narcissistic personality structures. TFP therefore stands to contribute to the treatment of NPD. We introduce main tenets of TFP, and how TFP views narcissism. We then present a case illustration to illustrate aspects of TFP which are key clinical contributions in treating NPD. These include assessment of personality organization, the treatment contract, transference, countertransference, use of clarification and interpretation, technical neutrality, therapist centered interpretations, the treatment frame and consideration of the stage of treatment