Treating Pathological Narcissism with Transference-Focused Psychotherapy

491 Pages·4.71 MB·English

by  Diana Diamond, Frank E. Yeomans, Barry L. Stern, Otto F. Kernberg

TREATING PATHOLOGICAL NARCISSISM
WITH TRANSFERENCE-FOCUSED PSYCHOTHERAPY
Psychoanalysis and Psychological Science
Elliot Jurist, Series Editor
Books in this series aim to bridge the work of researchers
and the work of clinicians. They reflect the current empiri-
cal findings and state of the art in psychoanalysis and psy-
chodynamic treatment. They are written to be practical and
relevant to clinicians.
Attachment and Psychoanalysis:
Theory, Research, and Clinical Implications
Morris N. Eagle
Minding Emotions:
Cultivating Mentalization in Psychotherapy
Elliot Jurist
The Unconscious:
Theory, Research, and Clinical Implications
Joel Weinberger and Valentina Stoycheva
Treating Pathological Narcissism
with Transference-Focused Psychotherapy
Diana Diamond, Frank E. Yeomans,
Barry L. Stern, and Otto F. Kernberg
Treating
Pathological Narcissism
with Transference-Focused
Psychotherapy
Diana Diamond, Frank E. Yeomans,
Barry L. Stern, and Otto F. Kernberg
Series Editor’s Note by Elliot Jurist
THE GUILFORD PRESS
New York London
Copyright © 2022 The Guilford Press
A Division of Guilford Publications, Inc.
370 Seventh Avenue, Suite 1200, New York, NY 10001
www.guilford.com
All rights reserved
No part of this book may be reproduced, translated, stored in a retrieval
system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, microfilming, recording, or otherwise, without written permission
from the publisher.
Printed in the United States of America
This book is printed on acid-free paper.
Last digit is print number: 9 8 7 6 5 4 3 2 1
The authors have checked with sources believed to be reliable in their efforts to
provide information that is complete and generally in accord with the standards
of practice that are accepted at the time of publication. However, in view of the
possibility of human error or changes in behavioral, mental health, or medical
sciences, neither the authors, nor the editor and publisher, nor any other party
who has been involved in the preparation or publication of this work warrants
that the information contained herein is in every respect accurate or complete,
and they are not responsible for any errors or omissions or the results obtained
from the use of such information. Readers are encouraged to confirm the
information contained in this book with other sources.
Library of Congress Cataloging-in-Publication Data is available from
the publisher.
ISBN 978-1-4625-4668-8 (hardcover)
About the Authors
Diana Diamond, PhD, is Professor Emerita in the Doctoral Program
in Clinical Psychology at the City University of New York and Senior
Fellow at the Personality Disorders Institute at New York Presbyterian
Hospital– Weill Cornell Medical College. She is also Adjunct Professor at
the New School for Social Research and in New York University’s Post-
doctoral Program in Psychotherapy and Psychoanalysis. Dr. Diamond’s
primary interests are in psychodynamic psychotherapy for patients with
personality disorders; the etiology, pathology, and treatment of narcis-
sism; and clinical applications of attachment theory and research. Author
or coauthor of numerous papers and several books, she is a recipient of
the Research Award from Division 39 (Psychoanalysis) of the American
Psychological Association and the Stern Distinguished Visiting Profes-
sorship Lecture award from Weill Cornell Medicine for contributions to
furthering the understanding of narcissism. She serves on the editorial
boards of Psychoanalytic Psychology and Psychoanalytic Inquiry, is Co-
Vice President of the Margaret S. Mahler Foundation, and has a private
practice in New York City.
Frank E. Yeomans, MD, PhD, is Clinical Associate Professor of Psy-
chiatry at Weill Cornell Medical College, Director of Training at the
Personality Disorders Institute at New York Presbyterian Hospital– Weill
Cornell Medical College, and Adjunct Associate Clinical Professor of
Psychiatry at the Columbia University Vagelos College of Physicians
and Surgeons. Dr. Yeomans is an Honorary Member of the American
Psychoanalytic Association, President of the International Society for
v
vi About the Authors
Transference- Focused Psychotherapy, and Chair of the Committee on
Psychotherapy of the Group for the Advancement of Psychiatry. His pri-
mary interests are the development, investigation, teaching, and prac-
tice of psychotherapy for personality disorders. He has helped estab-
lish training programs in many countries and has published numerous
articles and books.
Barry L. Stern, PhD, is Clinical Associate Professor of Psychology in
Psychiatry at the Columbia University Vagelos College of Physicians
and Surgeons and a faculty member at the Columbia University Cen-
ter for Psychoanalytic Training and Research. Dr. Stern’s work centers
on the study of personality and mental health and the application of
transference- focused psychotherapy with patients across the spectrum of
personality functioning and with couples. He has been a lead investiga-
tor in the validation studies of the Structured Interview of Personality
Organization (STIPO) and its revision (STIPO-R). His published empiri-
cal work focuses on the STIPO and the structural assessment of person-
ality. He has a private practice in New York City.
Otto F. Kernberg, MD, is Professor of Psychiatry and Director of the
Personality Disorders Institute at New York Presbyterian Hospital–
Weill Cornell Medical College, Training and Supervising Analyst at the
Columbia University Center for Psychoanalytic Training and Research,
and Distinguished Visiting Professor of Psychiatry at the Albert Einstein
College of Medicine. Dr. Kernberg is an Honorary Member of many
international psychoanalytic institutes, past president of the Interna-
tional Psychoanalytical Association, and Distinguished Life Fellow of
the American Psychiatric Association (APA). He is a recipient of the Dis-
tinguished Service Award from the APA, the first Sigourney Award for
Distinguished Contributions to the Field of Psychoanalysis, the Edward
A. Strecker Award from the Institute of Pennsylvania Hospital, and the
Heinz Hartmann Award from the New York Psychoanalytic Society and
Institute, among other honors. Dr. Kernberg has conducted research and
published seminal books and articles on psychoanalytic psychotherapy,
psychoanalytic object relations theory, and severe personality disorders.
Series Editor’s Note
N
o one needs convincing that our society currently is facing the chal-
lenge of finding new ways to understand and to treat narcissistic pathol-
ogy. Given its prevalence, it is imperative for mental health professionals
to feel equipped to handle the range of disorders that fall under this
category.
Transference- focused psychotherapy (TFP) was first developed
as a treatment for borderline personality disorder by Otto Kernberg’s
group at the Personality Disorders Institute at New York Presbyterian
Hospital– Weill Cornell Medical College. With this book, the TFP
group, led by Diana Diamond and colleagues, applies TFP to the diag-
nosis and treatment of narcissistic pathology. Diamond and colleagues
ground their approach in a contemporary version of object relations
theory, which is influenced by recent work in social cognition, attach-
ment theory, and mentalization theory. It is important to emphasize that
their focus includes, but is not restricted to, the narrow, DSM definition
of narcissistic personality disorder. Narcissistic pathology connotes the
varying clinical manifestations of narcissism, from individuals who are
high functioning to those functioning on a borderline level to those with
malignant narcissism. Clinicians from all orientations need to be able to
identify narcissistic pathology and to learn how to work effectively with
this range of patients.
The most audacious aspect of Diamond and colleagues’ book is to
argue that it is possible to modify TFP and apply its principles, regard-
less of the clinicians’ training and identifications, in encountering narcis-
sistic patients. Extending TFP is especially valuable, as we have come to
vii