Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T04:50:21.659Z Has data issue: false hasContentIssue false

Chapter 6 - Narcissistic Personality Disorder

from Part III - Application and Adaptations for Mental Health Presentations

Published online by Cambridge University Press:  18 May 2023

Anthony Bateman ,
Peter Fonagy ,
Chloe Campbell ,
Patrick Luyten  and
Martin Debbané
Anthony Bateman
Affiliation:
Anna Freud National Centre for Children and Families, London
Peter Fonagy
Affiliation:
University College London
Chloe Campbell
Affiliation:
University College London
Patrick Luyten
Affiliation:
University College London
Martin Debbané
Affiliation:
University College London
Get access

Summary

A mentalizing framework for understanding narcissism is outlined, and the resulting modifications of basic mentalization-based treatment (MBT) for narcissistic personality disorder are discussed. Treatment of patients with pathological narcissism requires an emphasis on empathic validation and support of the vulnerable “I-mode.” The dangers of not recognizing low mentalizing in narcissistic functioning are also discussed, as both patient and clinician can fail to recognize pretend mode, which may masquerade as “we-mode.” Together the patient and the therapist may then set up a pretend therapy that can be interminable and that functions only to fuel the mental narcissistic structure. A clinical example of a patient in treatment is used to illustrate the process of treatment.

Keywords

affect focuscounter-relational mentalizinggrandiose narcissism“I-mode”“me-mode”narcissismpretend modethick-skinned narcissismthin-skinned narcissismvulnerable narcissism“we-mode”
Type
Chapter
Information
Cambridge Guide to Mentalization-Based Treatment (MBT) , pp. 155 - 173
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Skodol, AE, Bender, DS, Morey, LC et al. Personality disorder types proposed for DSM-5. J Pers Disord 2011; 25: 136–69.CrossRefGoogle ScholarPubMed
Tyrer, P, Crawford, M, Mulder, R et al. The rationale for the reclassification of personality disorder in the 11th revision of the International Classification of Diseases (ICD-11). Personal Ment Health 2011; 5: 246–59.CrossRefGoogle Scholar
Fonagy, P, Gergely, G, Jurist, E, Target, M. Affect Regulation, Mentalization, and the Development of the Self. New York, NY: Other Press LLC, 2002.Google Scholar
Robinson, EA. Robinson: Poems. Donaldson, S, ed. New York, NY: Everyman’s Library, 2007 (originally published 1897); 33.Google Scholar
James, W. Principles of Psychology. New York, NY: Henry Holt, 1890.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×