Couples Therapy with Narcissistically Vulnerable Individuals: Contributions from Self Psychology

A relational understanding of narcissism begins with Balint (1968), who defines narcissism as self-focus, which is secondary to the failure of object love. This latter definition is relevant to understanding couples whose experience of responsive failures from primary caregivers predisposes them to a narcissistic preoccupation with their own needs to the exclusion of the other

In discussing the couple relationship, Soloman (1985, 1988a, 1988b, 1989, 1996) suggests that narcissism may be explained as a self-focus because of the urgency of the self's needs as a result of repeated non-optimal responses and traumatic failures from primary objects throughout development. One or both partners in a couple may present with exquisite vulnerability to the failure of specific responsiveness from the other, which manifests in interactions dominated by defensive organization and vulnerability to criticism or confrontation by the other. These manifestations of narcissistic vulnerability become a therapeutic challenge in couples therapy, generating questions about which metapsychological model(s) and/or techniques are likely to be most helpful in treatment

This paper will explore the theoretical strengths and technical implications of self psychology for the treatment of narcissistic vulnerability in couples, with special emphasis on three areas (1) The conceptualization of transference, (2) the conceptualization of defence, and (3) the nature of the therapeutic relationship and listening perspective. In addition, the progression of theoretical development will be extended to include the redefinition of the optimal therapeutic relationship