Treatment using cognitive behavioural therapy for a patient with type II bipolar disorder
Chiara Del Nero, Marco Saettoni, Andrea Gragnani
This article describes the cognitive-behavioural treatment of a patient diagnosed with type II bipolar
disorder and covert narcissistic personality traits. The treatment was oriented around a functionalist
perspective of bipolar disorder, according to which the basic model of mood disorders is grief and griefrelated
processes, and the core feature of depression is the emotional experience of loss. Dysfunctional
interpersonal cycles were also targeted during the treatment using a metacognitive interpersonal
approach.
There are two main reasons for interest in this case. The first one is the role of beliefs, cognitive biases,
rumination and problem-solving attempts in maintaining and exacerbating bipolar symptomatology. The
second one is the contribution of a narcissistic personality to the mood disorder and how it represents
an obstacle to the creation and development of a good therapeutic alliance.
Keywords
Bipolar II disorder treatment, Cognitive therapy, Narcissistic personality disorder,
Therapeutic alliance, Mood disorder.
