CoChat
Sign Up
Cited by 143Personality Disorders and PsychopathologyPsychoanalysis and Psychopathology ResearchPersonality Traits and Psychology

The Almost Untreatable Narcissistic Patient

Kernberg, Otto F.·2007·Journal of the American Psychoanalytic Association
DOI 10.1177/00030651070550020701
Open this paper in CoChat — free account

Abstract

Clinical experience in the Personality Disorders Institute at Weill Cornell Medical College suggests that patients with borderline personality organization and a narcissistic personality disorder have a more serious prognosis than all other personality disorders functioning at the borderline level, and that those who in addition present significant antisocial behavior have an even worse prognosis (Clarkin, Yeomans, and Kernberg 1999; Stone 1990). This negative trend culminates in a group of practically untreatable patients with antisocial personality disorder, who represent the most severe cases of pathological narcissism. There are also patients with severe narcissistic personality disorder, functioning at an overt borderline level with significant antisocial features, but not presenting an antisocial personality disorder proper, who at times respond to treatment, while others do not. These patients are explored here, with a focus on particular psychotherapeutic techniques that have proven helpful, as well as on the limits of these technical approaches.

Integrity signals

Registry

Crossref · 10.1177/00030651070550020701

Cites

18 of 18 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Patients affected by NPD are often considered resistant or even untreatable.

    “Experts have different opinions about the best treatment approach, but patients affected by NPD are often considered resistant or even untreatable (62, 63).”

    From The dark side of empathy in narcissistic personality disorder (2023) · cites this paper as [62]

  • Patients affected by NPD are often considered among the most difficult to be treated.

    “Patients affected by narcissistic personality disorder are often considered among the most difficult to be treated (62, 63).”

    From The dark side of empathy in narcissistic personality disorder (2023) · cites this paper as [62]

  • As a result of a pain-rage-hatred cycle, justification of revenge against the frustrating object is an almost unavoidable consequence.

    “Regarding the ‘vengeful’ node, Kernberg [16], Kernberg [59] describes that as a result of a pain-rage-hatred cycle, justification of revenge against the frustrating object is an almost unavoidable consequence.”

    From Living with pathological narcissism: a qualitative study (2020) · cites this paper as [59]

Cites

Flagged first, then by citations

1 of the 19 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Kernberg, O. F.
Affiliations
NewYork–Presbyterian Hospital (US)
Corresponding author
Kernberg, Otto F.
Venue
Journal of the American Psychoanalytic Association
Publisher
SAGE Publications
Published
2007-06
Volume
55
Issue
2
Pages
503-539
ISSN
  • 0003-0651 (ISSN-L)
  • 1941-2460
DOI
10.1177/00030651070550020701
OpenAlex
W2090114408
Cited by
143
References
19
Citations by year
2026: 9 · 2025: 8 · 2024: 9 · 2023: 8 · 2022: 14 · 2021: 9 · 2020: 8 · 2019: 2 · 2018: 6 · 2017: 7 · 2016: 7 · 2015: 7 · 2014: 8 · 2013: 9 · 2012: 11
FWCI
3.62
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of the American Psychoanalytic Association (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
Keywords
narcissistic personality disorder, borderline personality organization, antisocial personality disorder, pathological narcissism, treatment resistance, psychotherapeutic techniques, prognosis, antisocial behavior, borderline personality disorder
MeSH terms
Adult, Antisocial Personality Disorder, Borderline Personality Disorder, Countertransference, Defense Mechanisms, Female, Humans, Male, Middle Aged, Personality Disorders, Physician-Patient Relations, Prognosis, Psychoanalytic Theory, Psychoanalytic Therapy, Sick Role, Suicide, Attempted, Transference, Psychology, Unconscious, Psychology, Treatment Failure

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review