Self psychology and family therapy.

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.