Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia.
BMC Psychiatry. 2022 Jan 10;22(1):30. doi: 10.1186/s12888-021-03660-x.
Pathological narcissism is a severe mental health condition that includes disturbances in interpersonal functioning. Interpersonal difficulties by those affected include aggressive, domineering, cold and coercive behaviours which often result in strong negative reactions from others. We sought to examine the moment-to-moment patterns that emerge within close relationships between intimate partners and family members.
Participants (N = 15) were romantic partners (73.3%) and family members (26.6%) in a close and long-term relationship (+ 10 years) with an individual with pathological narcissism. Participants told verbatim relationship narratives involving five narrative interactions with their relative with pathological narcissism and five narrative interactions with others. Transcripts were coded using the using Core Conflictual Relationship Theme method. Participants also completed three versions of the Relationship Questionnaire, reporting on 1. their relationship style 'in general', 2. their relationship style 'with their relative' and 3. the relationship style of their relative.
A total of 133 relationship episodes were analysed, comprising 783 components (wishes, responses of others and responses of self). While the identified wishes (e.g., for love, for support) were consistent between relative and non-relative narratives, there was significantly higher disharmony and lower harmony in narratives involving relatives with pathological narcissism. Described disharmony in these relationships involved the relative's rejecting, subjugating and attacking behaviours, and participants rejecting and withdrawing behaviours. There was a prominent deactivation of participants attachment system when interacting with their relative with pathological narcissism, endorsing predominately dismissing relationship styles. Individuals with pathological narcissism were similarly rated as predominately dismissing.
Together, these results reflect the cycles of interpersonal dysfunction for individuals with pathological narcissism and their partners and family members. Treatment implications point to the risk of therapists withdrawing and dismissing a patient with high pathological narcissism in the countertransference. Strategies to monitor and manage these core relational themes in treatment remain a challenge.
病态自恋是一种严重的心理健康状况，包括人际关系功能障碍。受影响者的人际关系困难包括攻击性、支配性、冷漠和强制性行为，这些行为往往会引起他人的强烈负面反应。我们试图研究亲密伴侣和家庭成员之间的亲密关系中出现的瞬间模式。
参与者（N=15）是与病态自恋者有亲密且长期关系（+10 年）的浪漫伴侣（73.3%）和家庭成员（26.6%）。参与者逐字讲述涉及与病态自恋亲属的五次互动和与他人的五次互动的关系叙述。使用核心冲突关系主题方法对转录本进行编码。参与者还完成了三种版本的关系问卷，报告了 1.他们的关系风格“一般”，2.他们与亲属的关系风格，以及 3.亲属的关系风格。
总共分析了 133 个关系情节，包括 783 个成分（愿望、他人的回应和自我的回应）。虽然识别出的愿望（例如，爱、支持）在亲属和非亲属叙述中是一致的，但涉及病态自恋亲属的叙述中存在明显更高的不和谐和更低的和谐。这些关系中描述的不和谐涉及亲属的拒绝、屈从和攻击行为，以及参与者的拒绝和退缩行为。当与病态自恋亲属互动时，参与者的依恋系统明显失活，支持主要是回避的关系风格。病态自恋个体也被评为主要回避。
总的来说，这些结果反映了病态自恋个体及其伴侣和家庭成员的人际功能障碍循环。治疗意义表明，治疗师在反移情中可能会对高病态自恋患者产生回避和忽视。在治疗中监测和管理这些核心关系主题的策略仍然是一个挑战。
