Experiential techniques and therapeutic relationship in the treatment of narcissistic personality disorder: The case of Laura

J Clin Psychol. 2023 Jul;79(7):1656-1669. doi: 10.1002/jclp.23514. Epub 2023 Mar 27.

Abstract

Experiential techniques can be used to address maladaptive interpersonal patterns in patients with personality disorders (PDs) as long as they are delivered minding about the therapeutic relationship. We present the case study of Laura, a 38-year-old woman presenting with covert narcissism, generalized anxiety disorder, depression, and complicated grief treated with metacognitive interpersonal therapy. Laura initially refused to engage in any experiential work out of fear of being judged and abandoned by her therapist. To navigate this therapeutic obstacle, the therapist focused on exploring and eventually repairing early alliance ruptures. Thereafter, Laura engaged in experiential work, which helped her address her narcissistic interpersonal patterns. After 2 years, Laura's symptoms and narcissistic problematic behaviors decreased. This case study can help us understand how experiential techniques can be successfully used in PD psychotherapy as long as attention to the therapy relationship is paid.

Keywords: alliance/therapeutic alliance; grief; mental imagery; narcissistic personality disorder; personality disorders.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Grief
  • Humans
  • Narcissism
  • Personality Disorders* / psychology
  • Psychotherapy* / methods