Narcissism Key Target Areas for Treatment
Clients on the narcissistic spectrum typically lack awareness of the boundaries and perspectives of others, and this foundational deficit is rooted in several core factors, which are delineated by Benjamin:
• Need for control
• Need to blame
• Tendency to attack
• Tendency to ignore the needs of others
• Intense love for self
• Tendency to neglect what is best for himself or herself
• Self-blame at imperfection or lack of adulation
These core factors are sure to bring about one or several of the common narcissistic defenses listed below (Millon, et al. 2004; Thomas, 2010):
| Repression | Unconscious mechanism to keep disturbing or threatening thoughts from becoming conscious. |
| Distortion | Reshaping external reality to suit inner needs, such as beliefs, hallucinations, and delusions. Sustains feelings of superiority, entitlement. |
| Recruitment | Enlisting the help of others who will support his or her distorted view. |
| Projection | Attributing own unacceptable thoughts, feelings, and motives to another person. |
| Denial | Blocking information from awareness to avoid seeing painful aspect of reality. |
Next Steps
Managing defenses can be difficult and in some cases bring up countertransference reactions. (See the transference and countertransference exercises and Countertransference Scale in Part II, “Antisocial Personality Disorder Spectrum” for more information.) The best way to manage defense mechanisms and focus on core content is to be aware of which defense mechanism your client uses most often when confronted with the core issues listed previously. The following worksheet is designed to help you do that. After your client has completed the worksheet, ask yourself which defense mechanisms are being used most often and under what conditions?
Narcissism Key Target Areas for Treatment
Directions: Below is a list of common defense mechanisms or reactions in which one may engage when confronting important life issues. Circle which defense mechanism you would be most likely to use when you encounter each issue listed. This is a great opportunity to learn about yourself and how you see the world. This increases your personal power by increasing your self-awareness.
| Repression | Unconscious mechanism to keep disturbing or threatening thoughts from becoming conscious. |
| Distortion | Reshapes external reality to suit inner needs, such as beliefs, hallucinations, and delusions. Sustains feelings of superiority, entitlement. |
| Recruitment Projection | Enlisting the help of others who will support his or her distorted view. Attributing own unacceptable thoughts, feelings, and motives to another person. |
| Denial | Blocking information from awareness to avoid seeing painful aspect of reality. |
1. Feel in control
Repression Distortion Recruitment Projection Denial
2. Tendency to blame others
Repression Distortion Recruitment Projection Denial
3. Tendency to attack others when disagreed with
Repression Distortion Recruitment Projection Denial
4. Lessen others' needs
Repression Distortion Recruitment Projection Denial
5. Love for self
Repression Distortion Recruitment Projection Denial
6. Neglect what is best for me?
Repression Distortion Recruitment Projection Denial
7. Self-blame when things are not perfect
Repression Distortion Recruitment Projection Denial
8. Self-blame when I do not get attention I deserve
Repression Distortion Recruitment Projection Denial