Narcissistic Personality Disorder
Mrs. N’s case study is an informative illustration of patients with narcissistic personality disorders (NPD). NPD is a mental condition where individuals have an inflated sense of importance, high levels of insecurity, and a distorted self-image. Mrs. N, conforming to the description of NPD, is presented as overly aggressive, needy, and with a high sense of personal adequacy.
The problem description of Mrs. N is a complex one that demands a professional approach to discern her symptoms from those of bipolar, depressive, and anxiety disorders. Her outbursts and anger are established to be chronic rather than periodic in manic episodes in bipolar disorder. The therapist also disqualifies depressive and anxiety disorder from the information that, even though she has elevated or irritable moods, the feelings are not long-lasting. Besides, the attitudes varied, and she had long extended periods without a bad temper. The therapist uses Kernberg’s structural interviews to diagnose and develop psychotherapy goals collaboratively with the patient. Mrs. N’s NPD diagnosis is established from her perception of superior intelligence, impoverished view of others, lack of empathy, and defensiveness to inconsequential attitudes from others.
In line with evidence-based intervention, the therapist adopts Transference-Focused Therapy (TFP) in treating Mrs. N. This intervention is effective in addressing the patient’s narcissistic concerns where NPD patients idealize and critic their therapist simultaneously. Additionally, the article recommends analyst-centered therapy where therapists allow patients to hold a distorted view of them, not to reinforce the misrepresentation but offer an alternative perspective to facilitate the integration of her feelings.
The TFP model was useful as the patient was presented with a psychological rationale of the intervention while the contract setting allowed her to understand the expectations. Her prognosis was favorable with improved relationships, controlled emotions, quitting of marijuana use, and reduced alcohol consumption.
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