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What, if any, are the therapeutic techniques/approaches/ ideas that you think might be most effective in this more humble goal of managing narcissistic pathology.I see most of the problems with the therapist, not with his or her narcissistic client.Additionally, CBTs propagate, however subversively and inadvertently, a mechanistic (almost behavioural) view of the psyche. Research also suggests that they are prone to early termination of psychotherapeutic treatments because of the narcissistic wounds they suffer when the therapist will not serve solely as a source of narcissistic supply, but attempts to get beneath this constant need for affirmation.

Are they faking their knowledge, emotions, judgements, opinions, values? Are they intelligent as their academic credentials imply?

Are they reliable: can the narcissist trust their promises and threats? How do they stand in comparison and in relation to the narcissist?

It remains an inert and indifferent piece of “wisdom”, with minor influence on my psyche. Many narcissists report the same process of progression followed by recidivist remission and many therapists refuse to treat narcissists because of the Sisyphean frustration involved.

When I first found out about the Narcissistic Personality Disorder (NPD), I really believed that I could change. This was especially true since my whole world was in shambles. I never said that narcissists cannot CHANGE – only that they cannot HEAL.

That is often the case with narcissists in therapy: They are instantly impressive on first meeting but eventually turn out to be insatiably desirous of so much of this mirroring that they overwhelm the therapist.

Freud suggested that insight is necessary and sufficient for the cure in therapy.2.To what extent does your insight on your narcissism moderate or “cure” or help you to manage your pathological expression of it? Yes, the narcissist’s need for narcissistic supply (the mirroring of his perfect, brilliant, omniscient, and omnipotent False Self) is insatiable and overwhelming.To what extent do you believe that insight is sufficient for the “cure” in your case? He perceives everyone around him – his therapist included and especially – as potential or actual sources of narcissistic supply.It strikes me as cerebral, analytic, and “intellectual”: precisely the traits I admire and which form the dimensions of my self-imputed identity.I feel less threatened when I can avoid directly confronting my emotions. Positive reinforcements, verbal cues, the emphasis on cognition, inner tapes and narratives (the equivalent of programming) all strike a cord within me. Pathologically narcissistic clients, it would seem, often end up being forced into therapy more by a difficult context in which they find themselves (a narcissistic wound, the end of a relationship, court-mandated clients, etc.) than as a result of their soul-searching or awareness that their narcissistic pathology is something that would warrant further understanding.It is a delicate balancing act: not giving the narcissist his “due” is likely to alienate and enrage him (he has a strong sense of entitlement, often incommensurate with his real-life achievements), give him too much supply and he clings and extorts. Regarding (2): Cognitive understanding of the disorder does not constitute a transforming INSIGHT. I did not INTERNALIZE what I have leaned and what I know and understand about my disorder.

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