Baylor College of Medicine, Houston, Texas.
J Pers Disord. 2020 Mar;34(Suppl):143-158. doi: 10.1521/pedi.2020.34.supp.143.
Narcissistic personality disorder is a pleomorphic entity that requires the psychodynamically oriented therapist to tailor the approach to the characteristics of the individual patient. Psychodynamic principles encompass a broad range of interventions depending on the patient's specific characteristics. The therapist's interventions range from interpretation of the transference to supportive approaches that emphasize empathic validation and direct advice. In the absence of systematic data on these variations, this article attempts to offer clinically based principles. Several themes are emphasized: the experience of shame, the predictable transference-countertransference developments, the role of comorbidity with other personality disorders and traits, and the approach to resistances.
自恋型人格障碍是一种多形态的实体，需要精神动力学导向的治疗师根据个体患者的特点来调整治疗方法。精神动力学原则涵盖了广泛的干预措施，具体取决于患者的具体特征。治疗师的干预措施范围从对移情的解释到强调共情验证和直接建议的支持性方法。由于缺乏关于这些变化的系统数据，本文试图提供基于临床的原则。强调了几个主题：羞耻感的体验、可预测的移情反移情发展、与其他人格障碍和特征的共病关系，以及对阻力的处理。
