ABSTRACT
Narcissistic personality disorder (NPD) has become increasingly recognizable as a diagnostic entity in the Western world. At the same time, the definition and determinants of this disorder have been carefully articulated. For instance, Masterson (1993), among others, differentiated two versions of the disorder: the “exhibitionistic” narcissistic personality disorder and the “closet” narcissistic personality disorder. The more common version, the exhibitionistic or grandiose form of this disorder, is specified in DSM-IV. The treatment of both versions of this disorder involves a number of unique therapeutic challenges. Nevertheless, individuals with NPD can be effectively treated. This chapter describes specific engagement, pattern analysis, pattern change, pattern maintenance, and termination strategies for effectively managing and treating the grandiose form of this disorder. In addition to individual psychotherapeutic strategies and tactics, group, marital, family, medication, and integrative and combined treatment strategies are detailed. An extensive case example illustrates the treatment process. Before turning to treatment strategies, the DSM-IV description and criteria are briefly presented.
