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Treatment of Alec: “History does not have to repeat itself”
  • Igor Weinberg
Igor Weinberg
McLean Hospital Gunderson Personality Disorders Institute

Corresponding Author:[email protected]

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Treatment of patients with pathological narcissism presents several challenges and there is paucity of published case reports that document meaningful and durable change in patients suffering from this condition. Using descriptive and atheoretical language, this paper presents a treatment of a young adult in his transition from young adulthood to middle adulthood while he was negotiating complex residues of his experiences of growing up along with developmental challenges related to work and love. Against the backdrop of these transitions, the patient was working through various aspects of functioning related to pathological narcissism. Initially, given academic pressures and past romantic disappointments, he was confronting issues related to perfectionism, self-criticism, and avoidance. While he was able to move past some of these dynamics and function academically, later challenges related to becoming an independent adult led to a retreat into an avoidant state of futility and pessimism. Working through painful family dynamics related to not being seen and controlled, along with a deepening attachment in therapy as well as confrontation with realities of his life, led him to take steps towards greater independence. Thereafter, his treatment focused on learning from life experiences such as a newly developed career and romantic life, accepting the complexity of self and others, and tolerating disillusionments.
08 Aug 2023Submitted to Journal of Clinical Psychology
09 Aug 2023Submission Checks Completed
09 Aug 2023Assigned to Editor
09 Aug 2023Review(s) Completed, Editorial Evaluation Pending
10 Aug 2023Reviewer(s) Assigned
15 Sep 2023Editorial Decision: Revise Minor
04 Oct 20231st Revision Received
05 Oct 2023Submission Checks Completed
05 Oct 2023Assigned to Editor
05 Oct 2023Review(s) Completed, Editorial Evaluation Pending
06 Oct 2023Editorial Decision: Accept