Jacobs E H
Department of Psychiatry, Harvard Medical School, Cambridge, MA.
Am J Psychother. 1991 Oct;45(4):483-98. doi: 10.1176/appi.psychotherapy.1991.45.4.483.
Family systems that are characterized by narcissistic deficits are difficult to treat in systemically oriented therapy. Self psychology can help to understand these "narcissistic systems," identify the shortcomings of family therapy when applied to them, and develop methods for treating them. In narcissistic systems, each member uses the others as a selfobject, in a nonreciprocal, i.e., pathological manner. There are characteristic boundary formations, power relationships, expectations of others, and subjective experiences among the members. Narcissistic systems present for treatment in identifiable ways. Because of their narcissistic deficits, these systems have difficulty complying with the demands of family therapy. To treat these families the therapist must become a selfobject to the family. However, functioning as a selfobject is risky for the therapist and the family. In successful therapy, the family is able to modulate its rage and shame, develop realistic goals, and participate in more insight-oriented or directive therapy.
以自恋缺陷为特征的家庭系统在以系统为导向的治疗中很难治疗。自体心理学有助于理解这些“自恋系统”，识别将家庭治疗应用于它们时的不足之处，并开发治疗它们的方法。在自恋系统中，每个成员以非互惠的、即病态的方式将其他成员用作自体客体。成员之间存在着特有的边界形成、权力关系、对他人的期望以及主观体验。自恋系统以可识别的方式呈现以接受治疗。由于其自恋缺陷，这些系统难以遵守家庭治疗的要求。为了治疗这些家庭，治疗师必须成为家庭的自体客体。然而，作为自体客体发挥作用对治疗师和家庭来说都是有风险的。在成功的治疗中，家庭能够调节其愤怒和羞耻感，制定现实的目标，并参与更具洞察导向或指导性的治疗。
