Treating the Narcissistic Client


How to Maintain Compassion While Achieving Leverage

Discover how to effectively treat narcissistic clients with Wendy Behary by learning how to use tactical confrontation, cognitive restructuring, behavioral therapy and skills training, experiential psychotherapy, and more. In this clip from our upcoming streaming-video webcast series, "The 6 Most Challenging Issues in Therapy ...And How Therapists Can Overcome Them," she describes what it’s like to work with a typical narcissistic client in the first session, and the process she undergoes to successfully relate to these kinds of clients.

Wendy Behary, L.C.S.W., the founder and director of The Cognitive Therapy Center of New Jersey and of The New Jersey Institute for Schema Therapy, is the author of Disarming the Narcissist: Surviving and Thriving with the Self-Absorbed.

The 6 Most Challenging Issues in Therapy
...And How Therapists Can Overcome Them

Starts Thursday, June 21st

Click here for full course details.

06.06.2012   Posted In: NETWORKER EXCHANGE   By Psychotherapy Networker
You must login to leave comment. Why?

  • Not available avatar Chris 06.06.2012 12:36
    Great intervention in dealing with narcissistic presentations. Interesting to note that the approach is decidedly here-now relational/interpersonal yet coming from a practitioner of Cognitive and Schema therapy, according to the bottom header anyway.
  • Not available avatar Lynn 06.06.2012 12:53
    Different than the Masterson approach which focuses on the narcissist's feelings when experiencing "injury". In this demonstration,the therapist shares what it may feel like for the person on the other end of interactions with a narcissist. I'm curious if the client, in the latter intervention, responds with anger over the confrontation, not having their feelings heard and understood, and being "made" to hear about the other's feelings so soon in the therapeutic relationship.
  • Not available avatar Roberta 06.06.2012 13:07
    I had a similar reaction to Lynn. I also wondered how this person would react to being asked to look at his own contribution in the initial session. It might account for why the hypothetical client reacted by disparaging the therapist. I think it's clearly an intervention that many therapists would agree would need to be used eventually but maybe not immediately, although I understand the impulse to shake-up the client. These are very difficult people to work with who often have little or no insight into their own behavior and the way it makes other people feel.
  • Not available avatar paul 06.06.2012 13:10
    My experience with this type of intervention is that the client will ignore what I said and go back to their rant. So, I usually follow with something like, "could you repeat back to me what I just said to you". The narcissistic client can be great at deflecting! I mean by definition, narcissistic people are probably not good listeners and may not even care how they make the therapist feel so I think almost having to "stick their nose in it" (I don't mean to be disrespectful). Of course, before I do this type of intervention I have spent a lot of time building up some trust with them! I think otherwise, they may just walk out the door.
  • Not available avatar Mark 06.07.2012 17:02
    I agree with a lot of these comments in that it seems more disarming with these kind of clients to respond with empathy pretty much across the board. It's the one big thing they never got and what they need to become more human and feeling based. I think of it in terms of ignoring the content and focusing on the feelings they are trying to express. This is a humanizing approach I think.
  • Not available avatar Lorrie 06.08.2012 03:37
    My curiosity is about ultimate success for the client utilizing the empathic approaches identified by the commenters above and the ultimate success for the client utilizing Wendy's style. I have to think she has some level of success or would not be offered as a teacher by Networker. While the judgment of her clinical effectiveness cannot be limited by this, neither do I think it should be ignored; all of us commenting have enough respect for Networker to have taken a bit of time here. Beyond that, there is the comfort level of the therapist using whatever approach. It may take the willingness to lose the client immediately to offer this particular intervention. That places responsibility on the client to engage and remain. My best guess is some narcissistic clients feel relief that they are being challenged, that here is someone who is neither intimidated nor rejecting.
You must login to leave comment. Why?
I do blog this IDoBlog Community