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Narcissism and Its Discontents

Diagnostic Dilemmas and Treatment Strategies With Narcissistic Patients

Glen O. Gabbard, M.D., and Holly Crisp-Han, M.D.

  • ISBN 978-1-61537-127-3
  • Item #37127
Hear the voices behind the most prominent psychiatric scholarship. Listen to Psychiatry Unbound.

Dr. Laura Roberts, M.D. unwraps Narcissism with Glen O. Gabbard, M.D., and Holly Crisp-Han, M.D. authors of the book Narcissism and Its Discontents.

Description

The definition of narcissism can be a moving target. Is it an excess of self-love? Profound insecurity? Low self-esteem? Too much self-esteem? Because of the multifaceted nature of narcissistic personality disorder (NPD), treating this disorder presents clinicians with a range of wholly unique challenges.

Narcissism and Its Discontents recognizes the variable nature of NPD and provides a template for adjusting treatment to the patient rather than shoehorning the patient into a manualized treatment that may prove to be less effectual.

This guide offers clinicians strategies, including transference and countertransference, to deal with the complex situations that often arise when treating narcissistic patients, among them, patient entitlement, disengagement, and envy. The authors provide a skillful integration of research and psychoanalytic theory while also addressing psychotherapeutic strategies that are less intensive but also useful—being cognizant of the fact that a majority of patients do not have access to psychoanalysis proper.

A chapter on the cultural aspects of narcissism addresses the recent societal fascination with NPD in the discourse on politics and celebrity, particularly in the age of social media. Regardless of the treatment setting—psychoanalysis, psychotherapy, pharmacotherapy, partial hospital, or inpatient—clinicians will find a wealth of approaches to treating a diverse and challenging patient population in Narcissism and Its Discontents.

Contents

About the Authors
Preface
Part I: Diagnostic Dilemmas
Chapter 1. Narcissism and Its Discontents
Chapter 2. The Cultural Context of Narcissism
Chapter 3. Modes of Relatedness
Part II: Treatment Strategies
Chapter 4. Beginning the Treatment
Chapter 5. Transference and Countertransference
Chapter 6. Tailoring the Treatment to the Patient
Chapter 7. Specific Treatment Strategies
Chapter 8. Termination
Index

About the Authors

Glen O. Gabbard, M.D., is Clinical Professor of Psychiatry at Baylor College of Medicine in Houston, Texas. He is also Training and Supervising Analyst at the Center for Psychoanalytic Studies in Houston. He is in the full-time private practice of psychiatry, psychoanalysis, and psychotherapy.

Holly Crisp, M.D., is Clinical Associate Professor at Baylor College of Medicine in Houston, Texas. She is on the faculty at the Center for Psychoanalytic Studies in Houston. She is in the full-time private practice of psychiatry, psychoanalysis, and psychotherapy.

This is an excellent, comprehensive, and timely contribution that can help clinicians integrate the accumulated scholarly, clinical, and empirical accounts on narcissism and its pathology. In this masterfully organized and written book, Drs. Gabbard and Crisp present a balanced summary of intersubjective psychodynamic and psychoanalytic treatment of narcissistic patients, with uniquely thoughtful and guiding descriptions and clinical illustrations of numerous specific challenges that psychotherapists can face. Informative and educational, it is a remarkably engaging resource for clinicians and psychotherapists in all stages of their careers.—Elsa Ronningstam, Ph.D., Associate Professor (PT), Harvard Medical School, Boston, Massachusetts, and Clinical Psychologist, McLean Hospital, Belmont, Massachusetts


In this marvelous new book, Narcissism and Its Discontents, Gabbard and Crisp help us understand the many faces of narcissism in the context of an upheaval of social change. Then they invite us to sit at their sides while they, master clinicians, show us how to reach and help those whose narcissism has led them from success to great peril. And how to do so with compassion, even when the going gets rough. Take a seat. You won’t regret it.—John M. Oldham, M.D., Professor of Psychiatry, Barbara and Corbin Robertson Jr. Endowed Chair for Personality Disorders, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas


Compassionate, clear, and wise, this book reflects perspectives that can come only from extensive clinical experience, combined with both illustrative vignettes and elegant prose. Clinicians will find it as absorbing to read as it is instructive to their practices.—John G. Gunderson, M.D., Professor of Psychiatry, Harvard Medical School, Boston, Massachusetts, and Director, BPD Center for Treatment, Research and Training, McLean Hospital, Belmont, Massachusetts


This book is a gift to the profession; it should be the template for all clinical monographs. It’s a great read, hard to put down, while at the same time comprehensive, authoritative, and miraculously concise. The book is as wise as it is practical, from a general appreciation of narcissistic concerns to the bruising interactions of the clinical moment. Above all, Gabbard and Crisp offer vignettes previewing what the therapist is likely to meet and feel at every stage of the treatment and what responses may be helpful, always based on an understanding of what is at stake for the patient. The clinical section is a tour de force of expert supervision-by-text. This book will strengthen the hand of the experienced therapist, and its clear, phenomenological explanations and striking clinical vignettes will instill resilience in the beginner.—Lawrence Friedman, M.D., Clinical Professor of Psychiatry at the Weill-Cornell Medical College and member of the Faculty of the Institute for Psychoanalytic Education affiliated with the New York University Medical Center

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