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Grandiosity or Vulnerability: Schema Therapy Approach for Narcissistic Personality Functioning and Implications on the Therapeutic Relationship

Year 2014, Volume: 1 Issue: 3, 29 - 43, 01.09.2014
https://doi.org/10.31682/ayna.470593

Abstract

Many researchers and clinicians criticized DSM-IV-TR approach to Narcissistic Personality Disorder (NPD) on the grounds that diagnostic criteria focused exclusively on the observable grandiose expressions of the disorder while ignoring the presence of vulnerability themes. As a multifaceted modality, Schema Therapy (ST) employed a similar perspective and claimed that narcissistic individuals used grandiosity promoting behaviors as over-compensatory strategies in an attempt to ward off the underlying painful feelings. Particularly, ST approach draw clinicians’ attention to the Lonely Child mode lying at the core of this disorder in order to guide effective treatment strategies. In this regard, the current paper aimed to provide a conceptualization of NPD integrating both vulnerable and grandiose themes of the disorder from a ST perspective. For this purpose, a schema mode-approach will be applied to a case with subclinical narcissism, and specific implications of alternating grandiose and fragile themes on the therapy relationship will be discussed.

References

  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. Washington DC.
  • Behary, W. (2012). Schema Therapy in Narcissism: A Case Study. In van Vreeswijk,
  • Broersen, J., & Nadort, M. (Eds), The Wiley-Blackwell Handbook of Schema Therapy: Theory, Research and Practice (81-90), John Wiley & Sons Ltd: West Sussex. Behary, W.T. & Dieckmann, E. (2011). Schema Therapy for Narcissism: The Art of Empathic
  • Confrontation, Limit-Setting, and Leverage. The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings and Treatments, John Wiley& Sons: New Jersey. Behary, W.T., Siegel, D., & Young, J. (2013). Disarming the Narcissist: Surviving and Thriving with the Self-Absorbed. New Harbinger Publications: Oakland, CA.
  • Bender, D.S. (2005). The therapeutic alliance in the treatment of personality disorders. Journal of Psychiatric Practice, 11(2), 73–87.
  • Besser, A. & Priel, B. (2010). Grandiose narcissism versus vulnerable narcissism in threatening Situations: Emotional reactions to achievement failure and interpersonal rejection.
  • Journal of Social and Clinical Psychology, 29(8), 874–902. Busman, B.J., Baumeister, R.F.,Baumeister, Thomaes, S., Ryu, E., Begeer, S., & West, S.G. (2009). Looking again, and harder, for a link between low self-esteem and aggression. Journal of Personality, 77(2), 428–446.
  • Bushman, B.J. & Thomaes, S. (2011). When the Narcissistic Ego Deflates, Narcissistic
  • Aggression Deflates. The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings and Treatments, John Wiley& Sons: New Jersey. Gregg, A. & Sedikides, C. (2010). Narcissistic fragility: Rethinking its links to explicit and implicit self-esteem. Self and Identity, 9, 142–161.
  • Horton, R.S. & Sedikides, C. (2009). Narcissistic responding to ego threat: When the status of evaluator matters. Journal of Personality, 77(5), 1493–1525.
  • Johnson, J.G., Cohen, P., Chen, H., Kasen, S., & Brook, J.S. (2006). Parenting behaviors associated with risk for offspring personality disorder during adulthood. Archives of General Psychiatry, 63(5), 579–587.
  • Kealy, D. & Ogrodniczuk, J.S. (2011). Narcissistic interpersonal problems in clinical practice.
  • Harward Review of Psychiatry, 19(6), 290–301. Leahy, R.L. (2007). Schematic Mismatch in the Therapeutic Relationship: A Socio-Cognitive
  • Model. In Gilbert, P. & Leahy, R.L. (Eds). The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies (229-254), Routledge: New York.
  • Levy, K. (2012). Subtypes, dimensions, levels, and mental states in narcissism and narcissistic personality disorder. Journal of Clinical Psychology, 68(8), 886–897.
  • Miller, J.D. & Campbell, W.K. (2008). Comparing clinical and social-personality
  • Conceptualizations of narcissism. Journal of Personality, 76(3), 449–476. Nadort, M., van Genderen, & Behary, W. (2012). Training and Supervision in Schema
  • Therapy. In van Vreeswijk, Broersen, J., & Nadort, M. (Eds), The Wiley-Blackwell Handbook of Schema Therapy:Theory, Research and Practice (81-90), John Wiley & Sons Ltd: West Sussex. Nicolo, G., Carcione, A., Semerari, A., & Dimaggio, G. (2007). Reaching to the covert, fragile
  • Side of patients: The case of narcissistic personality disorder. Journal of Clinical Psychology: In Session, 63(2), 141–152. Perris, P., Fretwell, H., & Shaw, I. (2012). Therapist Self-Care in the Context of Limited
  • Reparenting. In van Vreeswijk, Broersen, J., & Nadort, M. (Eds), The Wiley-Blackwell Handbook of Schema Therapy: Theory, Research and Practice (81-90), John Wiley & Sons Ltd: West Sussex. Pincus, A.L. & Roche, M.J. (2011). Narcissistic Grandiosity and Narcissistic Vulnerability.
  • The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings and Treatments, John Wiley& Sons: New Jersey. Ronningstam, E. (2012). Alliance building and narcissistic personality disorder. Journal of
  • Clinical Psychology, 68(8), 943–953. Rafaeli, E., Bernstein, D.P., & Young, J. (2011). Schema Therapy: The CBT Distinctive
  • Features Series. Routledge: New York. Ronningstam, E. (2011). Narcissistic personality disorder in DSM-V: In support of retaining a significant diagnosis. Journal of Personality Disorders, 25(2), 248–259.
  • Russ, E., Shedler, J., Bradley, R., & Westen, D. (2008). Refining the construct of narcissistic
  • Personality disorder: Diagnostic criteria and subtypes. American Journal of Psychiatry, (11), 1473–1481.
  • Savage, J. (2011). The role of parenting and overindulgence in the development of narcissism and parental illness perceptions of ADHD (Unpublished doctoral dissertation).
  • University of Birmingham: England. South, C.S., Eaton, N.R., & Krueger, R.F. (2012). Narcissism in Official Classification
  • Systems. In Campbell, W.K. & Miller, J.D. (Eds), The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings and Treatments, John Wiley& Sons: New Jersey. Tracy, J.L., Cheng, J.T., Robins, R.W., & Trzesniewski, K.H. (2009). Authentic and hubristic pride: The affective core of self-esteem and narcissism. Self and Identity, 8, 196–213.
  • Vazire, S., & Funder, D. C. (2006). Impulsivity and the self-defeating behavior of narcissists.
  • Personality and Social Psychology Review, 10, 154–165.
  • Young, J., Klosko, J.S., & Weishaar, M.E. (2003). Schema Therapy: A Practitioner’s Guide.
  • The Guilford Press: New York.

Büyüklenmecilik ya da İncinebilirlik: NarsisistikKişilik Örgütlenmesinin Şema Terapi YaklaşımıÇerçevesinde Ele Alınması

Year 2014, Volume: 1 Issue: 3, 29 - 43, 01.09.2014
https://doi.org/10.31682/ayna.470593

Abstract

Birçok araştırmacı ve klinisyen Mental Bozuklukların Tanısal ve Sayımsal El Kitabı-IV-R’nin (DSMIV-R) Narsisistik Kişilik Bozukluğu (NKB)’na olan yaklaşımını tanı kriterlerinin yalnızca büyüklenmeci dışavuruma odaklandığı buna karşın bu psikopatolojinin temelindeki kırılgan temaların varlığını görmezden geldiği gerekçesiyle eleştirmiştir. Çok yönlü bir tedavi yöntemi olarak Şema Terapi (ŞT) de benzer bir bakış açısını benimsemiş ve narsisistik bireylerin büyüklenmeci davranışları altta yatan acı verici duyguları engellemek için aşırı telafi stratejileri olarak sergilediklerini iddaa etmiştir. Etkin tedavi yöntemlerine yön verebilmek için, ŞT yaklaşımı klinisyenlerin dikkatini hastalığın temelinde yatan Yalnız Çocuk moduna çekmiştir. Bu bağlamda, bu makale narsisistik kişilik örüntüsünün hem kırılgan hem de büyüklenmeci temalarının ŞT bakış açısından bütünleştirildiği bir kavramsallaştırma sunmayı hedeflemiştir. Bu amaçla, klinik düzeyde olmayan narsisistik bir vakaya şema mod yaklaşımı uygulanmış ve birbirini izleyerek değişen büyüklenmeci ve kırılgan temaların terapötik ilişki üzerindeki etkileri tartışılmıştır.

References

  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. Washington DC.
  • Behary, W. (2012). Schema Therapy in Narcissism: A Case Study. In van Vreeswijk,
  • Broersen, J., & Nadort, M. (Eds), The Wiley-Blackwell Handbook of Schema Therapy: Theory, Research and Practice (81-90), John Wiley & Sons Ltd: West Sussex. Behary, W.T. & Dieckmann, E. (2011). Schema Therapy for Narcissism: The Art of Empathic
  • Confrontation, Limit-Setting, and Leverage. The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings and Treatments, John Wiley& Sons: New Jersey. Behary, W.T., Siegel, D., & Young, J. (2013). Disarming the Narcissist: Surviving and Thriving with the Self-Absorbed. New Harbinger Publications: Oakland, CA.
  • Bender, D.S. (2005). The therapeutic alliance in the treatment of personality disorders. Journal of Psychiatric Practice, 11(2), 73–87.
  • Besser, A. & Priel, B. (2010). Grandiose narcissism versus vulnerable narcissism in threatening Situations: Emotional reactions to achievement failure and interpersonal rejection.
  • Journal of Social and Clinical Psychology, 29(8), 874–902. Busman, B.J., Baumeister, R.F.,Baumeister, Thomaes, S., Ryu, E., Begeer, S., & West, S.G. (2009). Looking again, and harder, for a link between low self-esteem and aggression. Journal of Personality, 77(2), 428–446.
  • Bushman, B.J. & Thomaes, S. (2011). When the Narcissistic Ego Deflates, Narcissistic
  • Aggression Deflates. The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings and Treatments, John Wiley& Sons: New Jersey. Gregg, A. & Sedikides, C. (2010). Narcissistic fragility: Rethinking its links to explicit and implicit self-esteem. Self and Identity, 9, 142–161.
  • Horton, R.S. & Sedikides, C. (2009). Narcissistic responding to ego threat: When the status of evaluator matters. Journal of Personality, 77(5), 1493–1525.
  • Johnson, J.G., Cohen, P., Chen, H., Kasen, S., & Brook, J.S. (2006). Parenting behaviors associated with risk for offspring personality disorder during adulthood. Archives of General Psychiatry, 63(5), 579–587.
  • Kealy, D. & Ogrodniczuk, J.S. (2011). Narcissistic interpersonal problems in clinical practice.
  • Harward Review of Psychiatry, 19(6), 290–301. Leahy, R.L. (2007). Schematic Mismatch in the Therapeutic Relationship: A Socio-Cognitive
  • Model. In Gilbert, P. & Leahy, R.L. (Eds). The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies (229-254), Routledge: New York.
  • Levy, K. (2012). Subtypes, dimensions, levels, and mental states in narcissism and narcissistic personality disorder. Journal of Clinical Psychology, 68(8), 886–897.
  • Miller, J.D. & Campbell, W.K. (2008). Comparing clinical and social-personality
  • Conceptualizations of narcissism. Journal of Personality, 76(3), 449–476. Nadort, M., van Genderen, & Behary, W. (2012). Training and Supervision in Schema
  • Therapy. In van Vreeswijk, Broersen, J., & Nadort, M. (Eds), The Wiley-Blackwell Handbook of Schema Therapy:Theory, Research and Practice (81-90), John Wiley & Sons Ltd: West Sussex. Nicolo, G., Carcione, A., Semerari, A., & Dimaggio, G. (2007). Reaching to the covert, fragile
  • Side of patients: The case of narcissistic personality disorder. Journal of Clinical Psychology: In Session, 63(2), 141–152. Perris, P., Fretwell, H., & Shaw, I. (2012). Therapist Self-Care in the Context of Limited
  • Reparenting. In van Vreeswijk, Broersen, J., & Nadort, M. (Eds), The Wiley-Blackwell Handbook of Schema Therapy: Theory, Research and Practice (81-90), John Wiley & Sons Ltd: West Sussex. Pincus, A.L. & Roche, M.J. (2011). Narcissistic Grandiosity and Narcissistic Vulnerability.
  • The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings and Treatments, John Wiley& Sons: New Jersey. Ronningstam, E. (2012). Alliance building and narcissistic personality disorder. Journal of
  • Clinical Psychology, 68(8), 943–953. Rafaeli, E., Bernstein, D.P., & Young, J. (2011). Schema Therapy: The CBT Distinctive
  • Features Series. Routledge: New York. Ronningstam, E. (2011). Narcissistic personality disorder in DSM-V: In support of retaining a significant diagnosis. Journal of Personality Disorders, 25(2), 248–259.
  • Russ, E., Shedler, J., Bradley, R., & Westen, D. (2008). Refining the construct of narcissistic
  • Personality disorder: Diagnostic criteria and subtypes. American Journal of Psychiatry, (11), 1473–1481.
  • Savage, J. (2011). The role of parenting and overindulgence in the development of narcissism and parental illness perceptions of ADHD (Unpublished doctoral dissertation).
  • University of Birmingham: England. South, C.S., Eaton, N.R., & Krueger, R.F. (2012). Narcissism in Official Classification
  • Systems. In Campbell, W.K. & Miller, J.D. (Eds), The Handbook of Narcissism and Narcissistic Personality Disorder: Theoretical Approaches, Empirical Findings and Treatments, John Wiley& Sons: New Jersey. Tracy, J.L., Cheng, J.T., Robins, R.W., & Trzesniewski, K.H. (2009). Authentic and hubristic pride: The affective core of self-esteem and narcissism. Self and Identity, 8, 196–213.
  • Vazire, S., & Funder, D. C. (2006). Impulsivity and the self-defeating behavior of narcissists.
  • Personality and Social Psychology Review, 10, 154–165.
  • Young, J., Klosko, J.S., & Weishaar, M.E. (2003). Schema Therapy: A Practitioner’s Guide.
  • The Guilford Press: New York.
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Psychology
Other ID JA73KE64BV
Journal Section Research Article
Authors

Yağmur Ar

Publication Date September 1, 2014
Submission Date August 3, 2014
Published in Issue Year 2014 Volume: 1 Issue: 3

Cite

APA Ar, Y. (2014). Büyüklenmecilik ya da İncinebilirlik: NarsisistikKişilik Örgütlenmesinin Şema Terapi YaklaşımıÇerçevesinde Ele Alınması. AYNA Klinik Psikoloji Dergisi, 1(3), 29-43. https://doi.org/10.31682/ayna.470593