Chip on the shoulder: Pathogenic beliefs and relational tests in a case of narcissistic personality disorder
Marzia Albanese, Andrea Gragnani
This article describes the case formulation and treatment of a patient with narcissistic personality disorder and major depression. The treatment was designed to address pathogenic themes and beliefs that emerged in both the patient’s life history and interactions with the therapist. Particular attention has been given to the relational processes arising during psychotherapeutic sessions, highlighting typical difficulties that can be encountered by the therapist with narcissistic patients. It is reported how these obstacles were effectively overcome using an integration of standard cognitive-behavioural therapy and control-mastery theory, ultimately favouring awareness and restructuring of pathogenic beliefs.
Keywords
CBT, Narcissism, Therapeutic alliance, Control-mastery theory, Relational tests.
