Psychotherapeutic Treatment of Depressive Symptoms in Patients with Narcissistic Disturbances: A Review

Jane Fjermestad-Noll; Elsa Ronningstam; Bo Bach; Ole Jacob Storebø; Bent Rosenbaum; Erik Simonsen

doi:10.1007/s10879-019-09437-4

Psychotherapeutic Treatment of Depressive Symptoms in Patients with Narcissistic Disturbances: A Review

Jane Fjermestad-Noll^*, Elsa Ronningstam, Bo Bach, Ole Jacob Storebø, Bent Rosenbaum, Erik Simonsen

^*Corresponding author for this work

Department of Clinical Medicine

2 Citations (Scopus)

Abstract

This review sought to outline the common complicating and facilitating factors during treatment of depressive symptoms in patients with narcissistic pathology, including various specific treatment approaches. A systematic literature search was performed to identify literature describing the co-occurrence of depressive symptoms and narcissistic pathology along with psychotherapeutic considerations and methods used to treat depressive symptoms in such patients. Theory and research suggest that depressive symptoms often co-occur with narcissistic disturbances because depression may emerge when narcissistic defenses fail. Narcissistic disturbances are thought to oscillate between grandiose and vulnerable features, and patients often seek treatment when they are in the vulnerable state. Psychological factors that are frequently dysregulated in these patients are shame, perfectionism and aggression. These factors must therefore be recognized as a part of the narcissistic pathology, and should particularly be considered in order to build a psychotherapeutic alliance with the patient, to avoid premature termination of treatment, and to achieve a positive treatment response. Psychotherapy must primarily target the underlying narcissistic disturbance, and not the depressive symptoms per se. The review aims at outlining treatment approaches that may be useful for clinicians.

Original language	English
Journal	Journal of Contemporary Psychotherapy
ISSN	0022-0116
DOIs	https://doi.org/10.1007/s10879-019-09437-4
Publication status	Published - 1 Mar 2020

Keywords

Depression
Depressive symptoms
Narcissistic disturbances
Narcissistic pathology
Psychotherapeutic treatment
Therapeutic treatment

Access to Document

10.1007/s10879-019-09437-4

Cite this

@article{de427d30332f4f6ab3f5c72e8f127843,

title = "Psychotherapeutic Treatment of Depressive Symptoms in Patients with Narcissistic Disturbances: A Review",

abstract = "This review sought to outline the common complicating and facilitating factors during treatment of depressive symptoms in patients with narcissistic pathology, including various specific treatment approaches. A systematic literature search was performed to identify literature describing the co-occurrence of depressive symptoms and narcissistic pathology along with psychotherapeutic considerations and methods used to treat depressive symptoms in such patients. Theory and research suggest that depressive symptoms often co-occur with narcissistic disturbances because depression may emerge when narcissistic defenses fail. Narcissistic disturbances are thought to oscillate between grandiose and vulnerable features, and patients often seek treatment when they are in the vulnerable state. Psychological factors that are frequently dysregulated in these patients are shame, perfectionism and aggression. These factors must therefore be recognized as a part of the narcissistic pathology, and should particularly be considered in order to build a psychotherapeutic alliance with the patient, to avoid premature termination of treatment, and to achieve a positive treatment response. Psychotherapy must primarily target the underlying narcissistic disturbance, and not the depressive symptoms per se. The review aims at outlining treatment approaches that may be useful for clinicians.",

keywords = "Depression, Depressive symptoms, Narcissistic disturbances, Narcissistic pathology, Psychotherapeutic treatment, Therapeutic treatment",

author = "Jane Fjermestad-Noll and Elsa Ronningstam and Bo Bach and Storeb{\o}, {Ole Jacob} and Bent Rosenbaum and Erik Simonsen",

year = "2020",

month = mar,

day = "1",

doi = "10.1007/s10879-019-09437-4",

language = "English",

journal = "Journal of Contemporary Psychotherapy",

issn = "0022-0116",

publisher = "Springer",

}

TY - JOUR

T1 - Psychotherapeutic Treatment of Depressive Symptoms in Patients with Narcissistic Disturbances

T2 - A Review

AU - Fjermestad-Noll, Jane

AU - Ronningstam, Elsa

AU - Bach, Bo

AU - Storebø, Ole Jacob

AU - Rosenbaum, Bent

AU - Simonsen, Erik

PY - 2020/3/1

Y1 - 2020/3/1

N2 - This review sought to outline the common complicating and facilitating factors during treatment of depressive symptoms in patients with narcissistic pathology, including various specific treatment approaches. A systematic literature search was performed to identify literature describing the co-occurrence of depressive symptoms and narcissistic pathology along with psychotherapeutic considerations and methods used to treat depressive symptoms in such patients. Theory and research suggest that depressive symptoms often co-occur with narcissistic disturbances because depression may emerge when narcissistic defenses fail. Narcissistic disturbances are thought to oscillate between grandiose and vulnerable features, and patients often seek treatment when they are in the vulnerable state. Psychological factors that are frequently dysregulated in these patients are shame, perfectionism and aggression. These factors must therefore be recognized as a part of the narcissistic pathology, and should particularly be considered in order to build a psychotherapeutic alliance with the patient, to avoid premature termination of treatment, and to achieve a positive treatment response. Psychotherapy must primarily target the underlying narcissistic disturbance, and not the depressive symptoms per se. The review aims at outlining treatment approaches that may be useful for clinicians.

AB - This review sought to outline the common complicating and facilitating factors during treatment of depressive symptoms in patients with narcissistic pathology, including various specific treatment approaches. A systematic literature search was performed to identify literature describing the co-occurrence of depressive symptoms and narcissistic pathology along with psychotherapeutic considerations and methods used to treat depressive symptoms in such patients. Theory and research suggest that depressive symptoms often co-occur with narcissistic disturbances because depression may emerge when narcissistic defenses fail. Narcissistic disturbances are thought to oscillate between grandiose and vulnerable features, and patients often seek treatment when they are in the vulnerable state. Psychological factors that are frequently dysregulated in these patients are shame, perfectionism and aggression. These factors must therefore be recognized as a part of the narcissistic pathology, and should particularly be considered in order to build a psychotherapeutic alliance with the patient, to avoid premature termination of treatment, and to achieve a positive treatment response. Psychotherapy must primarily target the underlying narcissistic disturbance, and not the depressive symptoms per se. The review aims at outlining treatment approaches that may be useful for clinicians.

KW - Depression

KW - Depressive symptoms

KW - Narcissistic disturbances

KW - Narcissistic pathology

KW - Psychotherapeutic treatment

KW - Therapeutic treatment

UR - http://www.scopus.com/inward/record.url?scp=85068863462&partnerID=8YFLogxK

U2 - 10.1007/s10879-019-09437-4

DO - 10.1007/s10879-019-09437-4

M3 - Journal article

AN - SCOPUS:85068863462

SN - 0022-0116

JO - Journal of Contemporary Psychotherapy

JF - Journal of Contemporary Psychotherapy

ER -

Psychotherapeutic Treatment of Depressive Symptoms in Patients with Narcissistic Disturbances: A Review

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this