Schema therapy: reparenting for an NPD patient.

Schema therapy was developed by Dr. Jeffrey Young for treating personality disorders, which are deeply ingrained patterns of behavior that are not receptive to traditional therapies used for depression, anxiety, neurotic disorders, etc.
(You can read more about how Schema therapy is used for NPD patients here.)

NPD is one of the most difficult of the personality disorders to treat, and it’s rare a patient will present themselves for treatment, unless they have suffered a narcissistic crisis that led to them becoming depressed.

These three videos are part of a graduate school practicum, showing schema therapy in action on a narcissistic patient (non-pathological narcissism/low spectrum NPD).* In the first video (session 1) the patient, “Sam,” has come to therapy because he is having problems relating to his wife and feels rejected by his coworkers. He is easily irritated and shows a number of narcissistic traits, including entitlement and grandiosity. He doesn’t understand or have empathy for his wife’s complaints about feeling hurt by his “brutal honesty.”

In the second video (session 8), Sam begins to talk about himself at five years old, when he broke his arm and felt rejected because his immediate physical and emotional needs were dismissed by his mother, who took him to the babysitter instead of showing the empathy and concern she should have. Then he is asked to relate how “little Sam” feels and begins to explore the emotions he shut himself off from feeling because of his mother’s rejection.

In the third video (session 16), Sam begins to show emotional discomfort as the therapist has “little Sam” (his true self) talk to “Detached Sam” (his narcissistic mask). He admits he wants to be able to show his wife how much he loves her.

Session 1:

Session 8:

Session 16:

Schema therapy is also commonly used to treat people with Borderline Personality Disorder.

* The patient is an actor but this is still an interesting look at how this method of therapy works.


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