Working with Narcissism

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Narcissism is one of the most misunderstood yet also challenging states to understand and work with. This three-part course provides the practical basics for understanding it, successfully working with it therapeutically as well as managing its effects on you and others in everyday life.

Issues addressed include:

• Narcissism vs Narcissistic Personality Disorder
• Why all narcissists don’t behave like Donald Trump (Extravert, Introvert and Communal Narcissism)
• The motivation issue or how narcissists never come for help with their “Narcissism”
• Early signs of narcissism in the therapy room and in relationships – 5 key indicators
• The dangers of echoistic and narcissistic co-dependency – who’s your client?
• The research on how narcissism is changeable and its practical implications for therapy work

Key strategies for change:

• What's the therapeutic goal?
• Empathy prompts, connection contracts and establishing hurt boundaries
• Establishing cognitive boundaries for responsibility and self blame
• Helping victims of narcissism- including escaping excitement and rescuing traps

Part 1: Recognising and Diagnosing Narcissism.

• Narcissism vs Narcissistic Personality Disorder (DSM V) vs Personality slur
• The demographics of narcissism – age, gender, ethnicity and work
• Assessment: Narcissistic Personality Inventory (NPI)
• Why all narcissists don’t behave like Donald Trump - Extravert, Introvert and Communal Narcissism
• Narcissism as a spectrum – from healthy high self esteem to pathological or abusive Narcissism

Part 2: Working with Narcissistic Clients and/or colleagues.

• Principles For the Foundations Of Therapy
• Why “narcissism” is rarely a client’s presenting problem and how easy it is to miss
• The challenges of engagement and motivation and boundary setting
• The therapeutic relationship and client attitudes as a focus for the content of therapeutic work
• The need for a different therapeutic style – or the dangers of empathy
• A CBT Approach to Narcissism
• Narcissism as a cognitive and behavioural reaction to threat perception Nook et al (2022) CBT Model of Narcissism
• A programme of therapeutic intervention
• Additional therapeutic targets: Sensitivity to negative perceptions of self (feeling blamed or treated unfairly) and poor affect tolerance (anger and anxiety)
• Common Challenges: premature drop out, therapy shopping, therapist pleasing and secondary gain

Part 3: Living with Narcissism as applied to clients or yourself.

• Echoism and narcissism as a co-dependency problem
• Addressing echoistic beliefs and behaviours
• Gaslighting and manipulation – recognition and management
• Limits to working with – rather than exiting relationships with narcissists
• The above issues plus others whilst working as a therapist

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