Narcissistic personality disorder: the dominant rewarding roles and their effect on the healing relationship.

The term “narcissistic personality disorder” comes from Narcissus (mythical face), who, known for his beauty, enjoyed admiring mirroring a lake where he eventually drowned trying to reach his idol. The person’s constant need for self-admiration is typical of people suffering from this disorder. In particular, the basic features of a person suffering from narcissistic personality disorder are the intense sense of greatness and greatness and the devaluation of others’ abilities. It also dominates the belief that the individual is exceptional and unique and therefore should be associated with high-level people. This belief leads to the search for particular rights and more favorable treatment than others (Kaplan, 1996). These people are also very concerned about their appearance, they make sure they are successful and prestigious. However, all these activities they have no other goal than the admiration of others. Ryle reports that people with a narcissistic personality structure move between the ends of two opposing poles. Whether they will be admired by wondrous people, or they will underestimate others in an effort to avoid their own devaluation. Admiration and devaluation as typical behaviors of these individuals in their relationships with others will most likely be adopted in the healing relationship as well. As Ryle says, in the cognitive analytical treatment, the way we behave in our relationships, or better, the roles we adopt in them are an example of a more general “relativity” model that has its roots in childhood. In narcissistic personality disorder, it appears that the dominant contributing roles 1 with which the person has learned to relate are: admirer, adorable, undervalued, undervalued (Kerr, 2002). Nevertheless, one’s desire is to associate it only in roles of admiration or admiration, while devaluation is the opposite pole to which, through admiration, he tries to fail to reach. Otherwise, behind the need for admiration, there seems to be a fundamental need of the individual to avoid devaluation. The difficulty of making a healing alliance with people suffering from this disorder is evident. The tendency of the therapists to seek admiration from the therapist but also to admire him often frustrate the therapist, who attempts to create a realistic, de-motivated relationship with the healer. Respectively, treating the healer as a devaluation of the fact that his therapist does not admire him, he ends up underestimating this therapist. Particularly useful here, according to Ryle, is the use of accurate patient descriptions when recording roles but also when creating chart 2. In this way the healer does not feel that someone else “knows more than that” or, even worse, that he is being criticized. Ryle and Kerr also argue that in order to create a good therapeutic relationship, the therapist should process his countertotal 3 (probably negative due to the devaluation he receives from the treated), recognizing Deeply need to help the patient. Nehmad (1997), studying the counter-transference to narcissistic personality disorder, raises the question: “Is difficulty with narcissistic sufferers due to the personal difficulty of the therapists to reconcile with their narcissistic characteristics?” Indeed, the trend of therapists seeing themselves as “caregivers” or “wound healers” can disorient them from the awareness of their need for acceptance and recognition by the healers. He also points out that such a difficulty would exclude the therapist from seeing the patient’s healthy “piece”, the part that despite the arrogant behavior is “there” to ask for help. As Jacques Lacan says, the therapist should not forget the patient’s “le demand”. To seek treatment, the person certainly suffers. Obviously, for the “narcissists”, the desperate attempt to avoid devaluation is not a pleasant process. In B. Joseph, the central aim of each treatment is to find out where the vital contact is, emotional and immediate, between the therapist and the patient, because this is an essential precondition for true understanding. This contact can not occur without the therapist’s empathy4, which presupposes his ability to find common human points with the healer so that he can be associated with him. Indeed, many therapists (Ryle, Kerr, Nehmad, Freeman) admit that empathy, as a healer’s characteristic, can lay the foundations for a healthy treatment relationship with those who suffer from

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