Narcissism and Its Discontents

NPD is a difficult entity to diagnose and treat. Even defining narcissism can be a daunting task, given its many “faces,” its continuity with healthy self-interest and confidence, and its changing nature both throughout development and in the same patient faced with different environmental stressors. Thus, the authors’ ability to cover all these topics and to create a multifaceted image of a narcissistic patient in only 150 pages is truly impressive. Most importantly, the book teaches how to think about NPD conceptually, taking into account each patient’s unique character traits and circumstances. With that said, it would be impossible to cover everything related to NPD in a short book, and interested readers may want to look elsewhere to deepen their understanding of the topics this book covers. The authors provide plentiful references to encourage further exploration. It is important to note that, however broad, the focus is still primarily on psychoanalytically-oriented theories. While the role of other treatment modalities, such as group and couple therapies, is briefly discussed, other therapeutic techniques, including CBT and DBT, appear to be beyond the scope of this book. However, this is a comprehensive overview of NPD from multiple vantage points that is short, easy to read, and full of memorable examples that most clinicians can relate to.

This is a very timely and helpful contribution for clinicians and psychotherapists independent of the stage of their careers. It is also a most instructive and needed educational guide on the range of narcissistic pathology and its treatment.

Glen O. Gabbard, M.D., is Clinical Professor of Psychiatry at Baylor College of Medicine in Houston, Texas. He is also Training and Supervising Analyst at the Center for Psychoanalytic Studies in Houston. He is in the full-time private practice of psychiatry, psychoanalysis, and psychotherapy.Holly Crisp, M.D., is Clinical Associate Professor at Baylor College of Medicine in Houston, Texas. She is on the faculty at the Center for Psychoanalytic Studies in Houston. She is in the full-time private practice of psychiatry, psychoanalysis, and psychotherapy.