The role of shame and self‐compassion in psychotherapy for narcissistic personality disorder: An exploratory study

• DOI: 10.1002/cpp.2160
• Publication Date: 2017-12-19T09:46:36Z
• Authors: Ueli Kramer; Antonio Pascual‐L...; Kristina B. Rohde; Rainer Sachse
• Keywords: Adult; Male; 05 social sciences; Adult; Empathy; Female; Humans; Male; Middle Aged; Personality Disorders/psychology; Personality Disorders/therapy; Psychotherapy/methods; Self Concept; Shame; Young Adult; clarification-oriented psychotherapy; emotion processing; interaction process; narcissistic personality disorder; self-compassion; shame; Middle Aged; Shame; Personality Disorders; Self Concept; Psychotherapy; Young Adult; Humans; Female; 0501 psychology and cognitive sciences; Empathy

AbstractThis process‐outcome study aims at exploring the role of shame, self‐compassion, and specific therapeutic interventions in psychotherapy for patients with narcissistic personality disorder (NPD). This exploratory study included a total of N = 17 patients with NPD undergoing long‐term clarification‐oriented psychotherapy. Their mean age was 39 years, and 10 were male. On average, treatments were 64 sessions long (range between 45 and 99). Sessions 25 and 36 were rated using the Classification of Affective Meaning States and the Process‐Content‐Relationship Scale. Outcome was assessed using the Symptom Check List‐90 and Beck Depression Inventory‐II. Between Sessions 25 and 36, a small decrease in the frequency of shame was found (d = .30). In Session 36, the presence of self‐compassion was linked with a set of specific therapist interventions (process‐guidance and treatment of behaviour‐underlying assumptions; 51% of variance explained and adjusted). This study points to the possible central role of shame in the therapeutic process of patients with NPD. Hypothetically, one way of resolving shame is, for the patient, to access underlying self‐compassion.