Transference-Focused Psychotherapy for Narcissistic Personality Disorder: An Object Relations Approach

Summary & key facts

This paper explains how transference-focused psychotherapy (TFP) was adapted for people with narcissistic personality disorder (TFP-N). TFP is a psychodynamic therapy originally validated for borderline personality disorder. TFP-N keeps core parts of TFP, adds specific changes for narcissistic traits, and focuses on using the therapist–patient relationship in the present to change distorted self- and other-images and improve real-world functioning in relationships and work.

Key facts:

• Transference-focused psychotherapy (TFP) is an empirically validated psychodynamic treatment for borderline personality disorder (BPD).
• The authors adapted TFP into a version for narcissistic personality disorder (called TFP-N) to address people with NPD or narcissistic traits.
• TFP-N retains core elements of TFP, including a contracting phase and an interpretive process.
• TFP-N focuses on identifying and modifying maladaptive mental representations of self and others that are thought to underlie emotional and behavioral dysregulation.
• The major goal of TFP-N is to work on disturbed interpersonal patterns in the here-and-now of therapy to produce enduring changes in personality organization and real-world areas such as love and work.

Abstract

Transference-focused psychotherapy (TFP) is an empirically validated psychodynamic psychotherapy for borderline personality disorder (BPD), based on object relations theory, that has clinical utility for individuals with narcissistic personality disorder (NPD). Given the effectiveness of TFP for patients with BPD, including a number of patients with comorbid NPD, we have adapted the tactics and techniques of TFP with specific modifications for patients with NPD or narcissistic traits. TFP for NPD (TFP-N) retains core elements of the treatment, including a contracting phase and an interpretive process designed to identify and modify maladaptive mental representations of self and others that underlie the affect and behavioral dysregulation in those with personality disorders including NPD. The major goal of TFP-N is the focus on disturbed interpersonal patterns of relating in the here-and-now of the therapeutic interaction as a vehicle to effect enduring changes in personality organization and real-world changes in the areas of love and work.

Topics

Personality Disorders and Psychopathology Psychotherapy Techniques and Applications Transactional Analysis in Psychotherapy

Categories

Clinical Psychology Psychology Social Sciences

Tags

Borderline personality disorder Clinical psychology Narcissistic personality disorder Object relations theory Personality Personality disorders Psychoanalytic theory Psychodynamic psychotherapy Psychodynamics Psychology Psychotherapist Social psychology