Institute of Psychotherapy and General Psychiatry Services, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Department of Psychology, University of Windsor, Windsor, ON, Canada.
Clin Psychol Psychother. 2018 Mar;25(2):272-282. doi: 10.1002/cpp.2160. Epub 2017 Dec 19.
This process-outcome study aims at exploring the role of shame, self-compassion, and specific therapeutic interventions in psychotherapy for patients with narcissistic personality disorder (NPD). This exploratory study included a total of N = 17 patients with NPD undergoing long-term clarification-oriented psychotherapy. Their mean age was 39 years, and 10 were male. On average, treatments were 64 sessions long (range between 45 and 99). Sessions 25 and 36 were rated using the Classification of Affective Meaning States and the Process-Content-Relationship Scale. Outcome was assessed using the Symptom Check List-90 and Beck Depression Inventory-II. Between Sessions 25 and 36, a small decrease in the frequency of shame was found (d = .30). In Session 36, the presence of self-compassion was linked with a set of specific therapist interventions (process-guidance and treatment of behaviour-underlying assumptions; 51% of variance explained and adjusted). This study points to the possible central role of shame in the therapeutic process of patients with NPD. Hypothetically, one way of resolving shame is, for the patient, to access underlying self-compassion.
这项过程-结果研究旨在探索羞耻感、自我同情以及特定治疗干预措施在自恋型人格障碍（NPD）患者心理治疗中的作用。这项探索性研究共纳入 17 名接受长期澄清导向心理治疗的 NPD 患者。他们的平均年龄为 39 岁，其中 10 名男性。治疗平均时长为 64 个疗程（45-99 个疗程不等）。第 25 次和第 36 次治疗使用情感意义状态分类和过程-内容-关系量表进行评估。使用症状检查表-90 和贝克抑郁量表-Ⅱ评估结果。在第 25 次和第 36 次治疗之间，发现羞耻感的频率略有下降（d=0.30）。在第 36 次治疗中，自我同情的存在与一系列特定的治疗师干预措施有关（过程指导和行为底层假设的治疗；解释和调整后的方差为 51%）。这项研究指出了羞耻感在 NPD 患者治疗过程中的可能核心作用。从理论上讲，患者缓解羞耻感的一种方式是接触潜在的自我同情。
