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Motive-Oriented Psychotherapeutic Relationship Facing a Patient Presenting with Narcissistic Personality Disorder: A Case Study

Journal of Contemporary Psychotherapy volume 44, pages 71–82 (2014)Cite this article

An Erratum to this article was published on 12 October 2013

Abstract

Motive-oriented therapeutic relationship (MOTHER), a prescriptive concept based on an integrative form of case formulation, the Plan Analysis (PA) method (Caspar, in: Eells (ed.), Handbook of psychotherapy case formulations, 2007), has shown to be of particular relevance for the treatment of patients presenting with personality disorders, in particular contributing to better therapeutic outcome and to a more constructive development of the therapeutic alliance over time (Kramer et al., J Nerv Ment Dis 199:244–250, 2011). Several therapy models refer to MOTHER as intervention principle with regard to borderline and Narcissistic Personality Disorder (NPD) (Sachse et al., Clarification-oriented psychotherapy of narcissistic personality disorder, 2011; Caspar and Berger, in: Dulz et al. (eds.), Handbuch der Borderline-Störungen, 2011). The present case study discusses the case of Mark, a 40-year-old patient presenting with NPD, along with anxious, depressive and anger problems. This patient underwent a seven-session long pre-therapy process, based on psychiatric and psychotherapeutic principles complemented with PA and MOTHER, in preparation for further treatment. MOTHER will be illustrated with patient–therapist verbatim from session 4 and the links between MOTHER and confrontation techniques will be discussed in the context of process-outcome hypotheses, in particular the effect of MOTHER on symptom reduction.

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Authors and Affiliations

  1. Department of Psychiatry-CHUV, Institute of Psychotherapy, University of Lausanne, Av. D’Echallens 9, 1004, Lausanne, Switzerland

    Ueli Kramer, Laurent Berthoud & Sabine Keller

  2. Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland

    Laurent Berthoud & Franz Caspar

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  1. Ueli Kramer
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  2. Laurent Berthoud
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  3. Sabine Keller
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  4. Franz Caspar
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Correspondence to Ueli Kramer.

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Kramer, U., Berthoud, L., Keller, S. et al. Motive-Oriented Psychotherapeutic Relationship Facing a Patient Presenting with Narcissistic Personality Disorder: A Case Study. J Contemp Psychother 44, 71–82 (2014). https://doi.org/10.1007/s10879-013-9249-5

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Keywords

  • Narcissistic Personality Disorder
  • Motive-oriented therapeutic relationship
  • Plan analysis
  • Confrontation
  • Case study