In This Issue

New Pragmatic Case Studies in Psychotherapy now available

Case studies in narcissism concretize and provide a "bottom up" understanding to narcissistic dynamics and behaviors
Announcing the publication of our third 2012 issue of Pragmatic Case Studies in Psychotherapy (PCSP) (Vol. 8, Module 3) a peer-reviewed, multi-theoretical, freely available e-journal of systematic case studies & case study method articles. The PCSP is available free of charge.

Case studies

The Management of Narcissistic Vulnerability: Three Case Studies
Guided by Stephen Mitchell's Integrated Treatment Model by Robert Riordan, Rutgers University.
With commentaries by: Nancy McWilliams, Rutgers Univerity; Kenneth Levy, Pennsylvania State University

Editor's note: Nancy McWilliams, in her commentary on Riordan's article, notes that "narcissistic drivenness is a clinical phenomenon so pervasive, so painful to its sufferers, and ultimately so consequential to everyone involved with narcissistic others that it needs to be taken seriously and addressed from many angles of vision. ... [In fact,] until clinicians protested en masse (see, e.g., Widiger, 2011), Narcissistic Personality Disorder was threatened with exclusion from the proposed DSM-5 on grounds that included the assumption that its features were common enough to be considered normal" (p. 204).

There is a considerable literature, especially in the field of psychoanalysis, on theories of treatment for individuals with narcissistic personality disturbance. However, more examples of systematic case studies detailing the clinical process of treating such patients are needed to help concretize and provide a "bottom up" understanding to narcissistic dynamics and behaviors. Robert Riordan makes such a contribution by presenting the long-term-therapy case studies of "Alex," "Brian" and "Candace," each of whom showed during treatment important personality growth in the context of their narcissistic vulnerabilities. Each was treated using Stephen Mitchell's model, which integrates two of the other major approaches in the field: Otto Kernberg's view of narcissism as a defensive phenomenon and Heinz Kohut's view of narcissism as a growth-enhancing opportunity.

Nancy McWilliams and Kenneth Levy, two prominent experts in the field of narcissistic personality disturbance, comment on the process and implications of Riordan's case studies-McWilliams from a perspective on the "less specifiable, more artistic elements," and Levy, from a contrasting conceptual, methodological and empirical perspective. Riordan closes with a more personal view on his treatment of Alex, Brian and Candace.

Table of contents

  • "The Management of Narcissistic Vulnerability: Three Case Studies Guided by Stephen Mitchell's Integrated Treatment Model" by Robert W. Riordan, pp. 150-203

  • "On Tone, Play, and Healing: Commentary on Riordan's Case Studies" by Nancy McWilliams, pp. 204-215

  • "The Many Complexities in Treating and Studying Narcissism" by Kenneth N. Levy, pp. 216-235

  • "A Personal Perspective on the Treatment of Three Cases of Narcissistic Vulnerability" by Robert W. Riordan, pp. 336-244