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Assessment of dysfunctional interpersonal schemas, avoidance of intimacy and lack of agency as key issues for treating narcissism: A commentary on Ronningstam's narcissistic personality disorder
Author(s) -
Dimaggio Giancarlo
Publication year - 2011
Publication title -
personality and mental health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 22
eISSN - 1932-863X
pISSN - 1932-8621
DOI - 10.1002/pmh.173
Subject(s) - psychology , narcissistic personality disorder , narcissism , psychotherapist , dysfunctional family , agency (philosophy) , interpersonal communication , borderline personality disorder , personality , sense of agency , personality disorders , social psychology , clinical psychology , epistemology , philosophy
Ronningstam's compelling description of a patient with severe co‐occurrent narcissistic personality disorder and alcohol abuse is effective at proposing hypotheses about how to handle such patients' tendency to leave treatment prematurely. I suggest here that in order to have a more effective therapy and reduce the high drop‐out risk typical of these patients, (1) a careful assessment of internalized relational patterns is needed, in particular in order to detect any problem they have as regards intimacy with the therapist; (2) it is likely that fostering a premature sense of interpersonal connection with the therapist and of the need to be cured may trigger patients' tendency to withdraw from therapy; and (3) targeting an impaired sense of agency could be a first‐line therapy with such patients. Copyright © 2011 John Wiley & Sons, Ltd.