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Cited by 8Personality Disorders and PsychopathologyPersonality Traits and PsychologyPsychoanalysis and Psychopathology Research

Building hope for treatment of narcissistic personality disorder

Open access
Weinberg, Igor·2024·Journal of Clinical Psychology
DOI 10.1002/jclp.23598
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Abstract

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Registry

Crossref · 10.1002/jclp.23598

Cites

71 of 71 references verified0 citation errors · 0 not checkable

Statistics

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  • Despite high dropout rates of 63-64%, psychodynamic therapies remain the conventional treatment for PN, with long-term individual psychotherapy as the cornerstone.

    “Despite high dropout rates of 63-64% (70) psychodynamic therapies remain the conventional treatment for PN, with long-term individual psychotherapy as the cornerstone (71).”

    From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [70]

    Citation (71) follows the treatment claim, while the dropout figure has a separate citation (70). In “New directions for treatment of NPD” (page unavailable), Weinberg includes psychoanalytically oriented and transference-focused psychotherapy among treatments for NPD. Our copy does not establish that psychodynamic therapies remain the conventional treatment or that long-term individual psychotherapy is the cornerstone. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • Managing ruptures and enactments through gentle confrontation is essential for maintaining engagement in therapy, with therapist availability as stabilizing factor.

    “Weinberg (70) emphasizes that managing ruptures and enactments through gentle confrontation is essential for maintaining engagement in therapy, with the therapist’s availability serving as a stabilizing factor.”

    From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [70]

    In “New directions for treatment of NPD” (page unavailable), Weinberg describes a therapist raising the possibility of premature departure, working through the patient’s wish to leave, and responding without retaliation to angry criticism. This supports addressing relationship difficulties to sustain engagement. The copy does not describe gentle confrontation as essential or identify therapist availability as a stabilizing factor. (LLM, conf=0.83)

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  • Narcissistic patients' tendency to seek external validation and avoid deep emotional engagement could lead them to focus on the intensity and sensational aspects of the experience rather than genuine connection and self-reflection, resulting in idealization of the medicine or viewing it as a quick fix.

    “Narcissistic patients’ tendency to seek external validation and avoid deep emotional engagement could lead them to focus on the intensity and sensational aspects of the experience rather than its potential for genuine connection and self-reflection (70), resulting in an idealization of the medicine or viewing it as a quick fix.”

    From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [70]

    Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.

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  • Patients with PN frequently misinterpret therapist interventions, perceiving constructive feedback as criticism, leading to oppositional reactions or emotional withdrawal.

    “Patients with PN frequently misinterpret therapist interventions, often perceiving constructive feedback as criticism, leading to oppositional reactions or emotional withdrawal (70, 128, 154).”

    From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [70]

    The “Challenges in treatment of NPD” section (page unavailable) describes patients dismissing therapist interventions and reports paranoid reactions toward therapists. “New directions for treatment of NPD” (page unavailable) also mentions withdrawal and retaliation among possible treatment dynamics. The paper does not establish that patients frequently mistake constructive feedback for criticism or that this specifically leads to oppositional reactions or emotional withdrawal. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Narcissistic patients often seek admiration that becomes expectation, idealize the therapist then devalue them when validation goes unmet, and treat the therapist as a passive sounding board, undermining mutuality.

    “These dynamics often materialize with narcissistic patients seeking admiration that quickly becomes expectation, idealizing the therapist only to later devalue them when their need for validation goes unmet, and treating the therapist as a passive sounding board, undermining any sense of mutuality (70, 71, 154).”

    From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [70]

    The “Challenges in treatment of NPD” section (page not provided) describes seeking self-affirmation, mutual idealization, and devaluation of the therapist as obstacles to treatment. It does not say that admiration becomes expectation, that idealization turns to devaluation when validation is unmet, or that patients treat the therapist as a passive sounding board. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Cites

Flagged first, then by citations

11 of the 82 references couldn’t be matched to a known paper.

Research works printed but not linked: 12

  1. Diamond, D., Yeomans, F.E., Stern, B.L., & Kernberg, O.F. (2022). Treating Pathological Narcissism with Transference-Focused Psychotherapy. New York: Guilford Press.
  2. Freud, S. (1914). On narcissism. In J. Stretchey (Ed. And trans.). The standard editionof the complete psychological works of Sigmind Freud (Vol XIV, pp.66-102). London, England: Hogarth Press.
  3. Gamache D, Savard C, Lemelin S, et al: Premature termination of psychotherapy in patients with borderline personality disorder. Journal of Nervous and Mejntal Disease 2018; 206: 231-238
  4. Guile JM, Mbekou V, Lageix P: Child and parent variables associated with treatment response in narcissistic youths: the role of self-blame and shame. Canadian Child and Adolescent Psychiatric Review 2004; 13:81-85
  5. Kantrowitz, J. L. (2020). The role of the patient-therapist match in the process and outcome of psychoana- lysis. New York: Routledge.
  6. Kohut, H. (1971). Analysis of the self. Madison, CT: International Universities Press.
  7. Morrison, A. (1993). Shame. The underside of narcissism. New York: Routledge.
  8. Steiner, J. (1993). Psychic retreats. London: Routledge.
  9. Wampold, B. E., & Imel, Z. (2015). The great psychotherapy debate. New York: Routledge.
  10. Weinberg I, Ronningstam E: Dos and donts in treatments of patients with NPD. Journal of Personality Disorders 2020; 34 (Suppl): 122-142
  11. Weinberg I, Ronningstam E, Gunderson J: Can Patients with Narcissistic Personality Disorder Change? Case series. Under Review Weinberg, I., Ronningstam, E. Interventions in effective psychotherapies of narcissistic personality disorder. Unpublished manuscript.
  12. Weinberg I, Finch EF, Choi-Kain L: Implementation of Good Psychiatric Management for Narcissistic per- sonality disorder. Good enough or not good enough? GPM approach to other personality disorders, in Good Psychiatric Management for Borderline Personality Disorder. A practical guide. Edited by Choi-Kain, L.W., & Gunderson, J.G. Washington, DC: American Psychiatric Publishing, 2019, pp. 253-280.

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Authors
Weinberg, I.
Affiliations
McLean Hospital (US)
Corresponding author
Weinberg, Igor
ORCID
Weinberg, Igor
Venue
Journal of Clinical Psychology
Publisher
Wiley
Published
2023-10-10
Volume
80
Issue
4
Pages
721-732
ISSN
  • 0021-9762 (ISSN-L)
  • 1097-4679
DOI
10.1002/jclp.23598
OpenAlex
W4387473288
Cited by
8
References
82
Citations by year
2026: 1 · 2025: 4 · 2024: 2 · 2023: 1
FWCI
2.33
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
narcissistic personality disorder, treatment, hope
MeSH terms
Narcissistic Personality Disorder, Humans, Narcissism, Personality Disorders

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