Clinician Emotional Response Toward Narcissistic Patients: A Preliminary Report
Clinician Emotional Response Toward Narcissistic Patients: A Preliminary Report
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DOI：
10.7411/rp.2014.023
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发表时间：
2015-01-01
影响因子：
2.7
通讯作者：
Lingiardi, Vittorio
中科院分区：
文献类型：
--
作者：
Tanzilli, Annalisa;Colli, Antonello;Lingiardi, Vittorio
自恋型人格障碍（NPD）患者是治疗中最难治疗的患者之一，特别是由于他们对治疗的强烈抵抗，以及在建立以亲密、安全和信任为特征的治疗关系方面存在其他困难。尤其是治疗师。正如临床文献中经常报道的那样，对这些患者的情绪反应可能特别强烈和令人沮丧；然而，他们很少进行实证调查。这项初步研究的目的是1)检查患者之间的关联。NPD和治疗师。不同的反移情模式，以及2)验证这些临床医生是否。情绪反应受理论取向、性别和年龄的影响。全国范围内的精神科医生和临床心理学家样本（N = 250）完成了治疗师反应问卷（TRQ），以确定治疗师情绪反应的模式，并完成了谢勒-韦斯顿评估程序-200 (SWAP-200)，以评估他们目前所照顾的患者的人格障碍和心理功能水平，这些患者至少工作了8次，最多工作了6个月（每周一次）。从整个治疗师样本中，我们确定了一个亚组（N = 35） NPD患者。结果表明，NPD与被批评/虐待的反移情和脱离反移情呈正相关，与积极的治疗师反应呈负相关。此外，患者之间的关系。NPD和治疗师。情绪反应不依赖于临床医生。理论方法（而不是他们的年龄和性别）。这些发现与临床观察以及一些经验贡献一致，对患有这种具有挑战性的病理的患者的临床实践具有重要意义。
Patients with narcissistic personality disorder (NPD) are among the most difficult to treat in therapy, especially due to their strong resistance to treatment and other difficulties in establishing a therapeutic relationship characterized by intimacy, safety, and trust. In particular, therapists. emotional responses to these patients can be particularly intense and frustrating, as often reported in the clinical literature; however, they have rarely been investigated empirically. The aims of this preliminary study were 1) to examine the associations between patients. NPD and therapists. distinct countertransference patterns, and 2) to verify whether these clinicians. emotional reactions were influenced by theoretical orientation, gender, and age. A national sample of psychiatrists and clinical psychologists (N = 250) completed the Therapist Response Questionnaire (TRQ) to identify patterns of therapist emotional response, and the Shedler-Westen Assessment Procedure-200 (SWAP-200) to assess personality disorder and level of psychological functioning in patients currently in their care with whom they had worked for a minimum of eight sessions and a maximum of six months (one session per week). From the whole therapist sample, we identified a subgroup (N = 35) of patients with NPD. Results showed that NPD was positively associated with criticized/mistreated and disengaged countertransference, and negatively associated with positive therapist response. Moreover, the relationship between patients. NPD and therapists. emotional responses was not dependent on clinicians. theoretical approach (nor on their age and gender). These findings are consistent with clinical observations, as well as some empirical contributions, and have meaningful implications for clinical practice of patients suffering from this challenging pathology.