Fragile Selves: Working with Narcissistic and Borderline States of Mind

The Challenge of Working with Narcissistic Patients

Referencing a detailed case study Jay Greenberg explains Freud and Winnicott’s differing attitudes to the viability of working with and overcoming narcissistic defenses. Greenberg outlines his encounters with a particular patient whose responses showed her need to remain unaffected by his interpretations. He suggests that whilst narcissistic patients are severely provoked by a therapist who can withstand their aggression, only therapists who are unafraid to differentiate from these patients really have anything to give them.