Psychodynamic theory and narcissistically related personality problems: Support from case study research.
An introductory overview of central psychodynamic theories relevant to narcissistically related personality problems and disorders of the self is provided, focusing on the central role of the child's relationship with primary care givers in the development of the self. A psychodynamic formulation is described for a 45-year-old woman experiencing depression, anxiety and despair following a severe rift in her previously enmeshed/merged relationship with her teenage daughter. The subsequent two and a half years of therapy were monitored using the Brief Symptom Inventory (BSI), the Dysfunctional Attitudes Scale (DAS) and the Object Relations Technique (ORT), producing data supportive of psychodynamic theory and therapy. A pattern of depression emerged during therapy which was in keeping with the concept of abandonment depression, as the client came to experience herself as more separate from her daughter and others. Changes in the functioning of primitive defences were also illustrated, plus the expression of previously denied anger, and increased abilities to be assertive, set limits and take care of herself.
Hingley
Susan M.
SM
Psychology Service, Lobley Hill Clinic, Gateshead, UK.