Dedicated to the Study and Treatment of Personality Disorders

The Center for Transference-Focused Psychotherapy

Treating Pathological Narcissism with Transference-Focused Psychotherapy

Diana Diamond, Frank E. Yeomans, Barry L. Stern, and Otto F. Kernberg
Guilford Press, 2021

Filling a crucial gap in the clinical literature, this book provides a contemporary view of pathological narcissism and presents an innovative treatment approach. The preeminent authors explore the special challenges of treating patients—with narcissistic traits or narcissistic personality disorder—who retreat from reality into narcissistic grandiosity, thereby compromising their lives and relationships. Assessment procedures and therapeutic strategies have been adapted from transference-focused psychotherapy (TFP), a manualized, evidence-based treatment for borderline personality disorder. Rich case material illustrates how TFP-N enables the clinician to engage patients more deeply in therapy and help them overcome relationship and behavioral problems at different levels of severity. The volume integrates psychodynamic theory and research with findings from social cognition, attachment, and neurobiology.

“This book provides the most integrated view of assessment and treatment of pathological narcissism to date. Detailed clinical strategies are furthered by many informative case vignettes. Connecting object relations and attachment theory with findings from neuroscience and social cognition, the book offers a much-needed, comprehensive understanding of the complex range of narcissistic personality functioning. The authors are especially attentive to systematic diagnostic assessment, nuances in relatedness between therapist and patient, and flexibility in treatment interventions. This is an outstanding guide for psychotherapists.”

—Elsa Ronningstam, PhD, Associate Professor (part-time), Harvard Medical School; Clinical Psychologist, McLean Hospital

“This extraordinary book is a landmark in our understanding of the development, diagnosis, and treatment of narcissistic pathology. Brilliantly lucid, it presents multiple perspectives and comprehensively reviews the relevant literature. Based on the pioneering work of Kernberg and his associates on transference-based psychotherapy (TFP), the book includes a variety of case material. Normal narcissism—healthy self-esteem, self-confidence, and ethical values—is contrasted with increasingly severe narcissistic psychopathology, characterized by grandiosity, psychopathy, entitlement, and lack of empathy. An invaluable resource for experienced clinicians, this book also merits inclusion in all curricula for training in psychoanalytic psychotherapy.”

—Harold P. Blum, MD, training and supervising analyst, Psychoanalytic Association of New York, affiliated with NYU Langone Health

“A masterpiece! Building on a wealth of prior work establishing TFP as an evidence-based treatment for borderline personality disorder, the authors have developed TFP-N, which they deliver in depth in this welcome volume. The object relations theoretical basis for TFP-N is well covered, but the home run of the book is the privilege to listen in, step by step, as therapists and patients navigate all stages of treatment. Narcissism abounds these days, but pathological narcissism can be especially devastating and hard to reach. Here’s a wise, much-needed guidebook for clinicians of all stripes and all levels of experience.”

—John M. Oldham, MD, MS, Distinguished Emeritus Professor, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine


2021 in press • 462 pages • ISBN 9781462546688
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