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

Öz

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.

Anahtar Kelimeler

• narcissism,vulnerability,schema-mode approach,therapy relationship

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

Öz

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.

Anahtar Kelimeler

• narsisizm, incinebilirlik, şema-mod yaklaşımı, terapi ilişkisi

Kaynakça

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