Narcissistic Interpersonal Problems in Clinical Practice
Abstract
Pathological narcissism is associated with significant interpersonal problems, which are unlikely to be acknowledged by narcissistic patients as clinical issues. Although a substantial clinical and theoretical literature deals with narcissism, a succinct overview of core narcissistic interpersonal problems is lacking, particularly in terms of their presentation in clinical settings. This article provides a descriptive overview of the major types of interpersonal problems associated with pathological narcissism: dominance, vindictiveness, and intrusiveness. We outline how these problems can manifest in patients' relations with others and in treatment situations. Clinical vignettes are provided to highlight the presentation of narcissistic interpersonal dysfunction in various types of clinical encounters, and to facilitate discussion of treatment implications.
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NPD is associated with dominance, vindictiveness, and intrusiveness.
“NPD is associated with dominance, vindictiveness, and intrusiveness (41).”
From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [41]
Interpersonal dysfunction is a well-documented aspect of pathological narcissism.
“Interpersonal dysfunction is a well‐documented aspect of pathological narcissism (Byrne & O'Brien, 2014; Grenyer, 2013; Kealy & Ogrodniczuk, 2011)”
From Pathological narcissism: An analysis of interpersonal dysfunction within intimate relationships (2022) · cites this paper as Kealy & Ogrodniczuk, 2011
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- Authors
- Kealy, D., & Ogrodniczuk, J. S.
- Affiliations
- University of British Columbia (CA)
- Corresponding author
- Kealy, David
- Venue
- Harvard Review of Psychiatry
- Published
- 2011-11-22
- Volume
- 19
- Issue
- 6
- Pages
- 290-301
- ISSN
- 1067-3229 (ISSN-L)
- OpenAlex
- W2136695739
- Cited by
- 41
- References
- 48
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 1 · 2019: 4 · 2018: 4 · 2017: 2 · 2015: 3 · 2014: 1 · 2013: 2 · 2012: 1
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Harvard Review of Psychiatry (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
- pathological narcissism, narcissistic personality disorder, interpersonal problems, dominance, vindictiveness, intrusiveness, patient-clinician relationship
- MeSH terms
- Adult, Countertransference, Empathy, Humans, Interpersonal Relations, Male, Middle Aged, Narcissism, Personality Disorders, Psychotherapy, Psychotherapy, Group, Psychotherapeutic Processes, United States
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