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<p>In psychotherapy narcissistic patients pose a&#xa0;major challenge due to their interpersonal difficulties, which often lead to rejection. Therefore, therapists should possess specific skills to establish a&#xa0;stable therapeutic relationship, particularly by minimizing confrontation and fostering a&#xa0;complementary approach. They should also be able to effectively work with the transference process within the therapeutic relationship. At the core of therapy lies the analysis of the underlying psychodynamics in terms of double self-esteem regulation, which highlights the vulnerable side of narcissism. Based on an individualized case formulation a&#xa0;number of concrete strategies can be derived, such as cognitive restructuring of core beliefs and conditional assumptions, emotion regulation, especially regarding feelings of shame as well as training in cognitive empathy and interactional skills.</p>

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Kognitive Verhaltenstherapie narzisstischer Patient:innen

  • 期刊论文

  • 发表日期：

    2025年11月14日

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  • Claas-Hinrich Lammers

摘要

In psychotherapy narcissistic patients pose a major challenge due to their interpersonal difficulties, which often lead to rejection. Therefore, therapists should possess specific skills to establish a stable therapeutic relationship, particularly by minimizing confrontation and fostering a complementary approach. They should also be able to effectively work with the transference process within the therapeutic relationship. At the core of therapy lies the analysis of the underlying psychodynamics in terms of double self-esteem regulation, which highlights the vulnerable side of narcissism. Based on an individualized case formulation a number of concrete strategies can be derived, such as cognitive restructuring of core beliefs and conditional assumptions, emotion regulation, especially regarding feelings of shame as well as training in cognitive empathy and interactional skills.