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¶ … self-psychology approach to narcissistic personality disorder: A nursing reflection.
Donna M. Czuchta Romano
JOURNAL: Perspectives in Psychiatric Care, Year 2004, Volume 40, Page 20-28.
APA CITATION: Romano, D.M.C (2004). A self-psychology approach to narcissistic personality disorder: A nursing reflection. Perspectives in Psychiatric Care 40(1): 20-28.
What was the major purpose or problem described in this article?
To describe how nurses can use the self-psychology perspective to help people with narcissistic personality disorder, and to help nurses work more effectively with people with narcissistic personality disorder.
What, if any, were the hypotheses or research questions?
The research question is which psychotherapeutic interventions are most useful for nurses working with patients who have narcissistic personality disorder or similar traits. The hypothesis is that Kohut's self-psychology perspective can be effectively applied to narcissism in a nursing context.
2. What sample was used in this research?
Only one case study was used in this research, a 25-year-old university student who had been admitted to an inpatient psychiatric unit.
3. What types of methods of data collection were used?
The author does not clarify the method of data collection or even whether data was collected using systematic qualitative...
What were the results and conclusions of this research?
The author claims that applying the self-psychology framework to the case study of James, her own understanding of narcissistic personality disorder improved, allowing her to have greater empathy with the patient. Unresolved issues of self can lead to outbursts and depression, which are symptoms of underlying feelings of insecurity and vulnerability. Because narcissistic personality disorder patients can be challenging for untrained staff, it is important to help nurses understand how narcissistic personalities function and to have greater empathy in order to help the client to improve.
5. What is your opinion or reaction to this research?
The research questions the efficacy of narcissistic personality disorder as a general psychiatric condition or diagnosis. For example, the author claims that James "insisted on knowing my academic preparation" and was also "not impressed with the . . . years of academic preparation needed to work on the unit," (Romano, 2004, p. 25) as if these concerns were not legitimate or in some way indicative of narcissism. The author also fails to clarify whether the diagnosis of narcissistic personality disorder was an assumption her own, or how that diagnosis was made otherwise. Also, the research shows that there is in fact an ironic level of narcissism among nurses who dislike their…
The author claims that applying the self-psychology framework to the case study of James, her own understanding of narcissistic personality disorder improved, allowing her to have greater empathy with the patient. Unresolved issues of self can lead to outbursts and depression, which are symptoms of underlying feelings of insecurity and vulnerability. Because narcissistic personality disorder patients can be challenging for untrained staff, it is important to help nurses understand how narcissistic personalities function and to have greater empathy in order to help the client to improve.
5. What is your opinion or reaction to this research?
The research questions the efficacy of narcissistic personality disorder as a general psychiatric condition or diagnosis. For example, the author claims that James "insisted on knowing my academic preparation" and was also "not impressed with the . . . years of academic preparation needed to work on the unit," (Romano, 2004, p. 25) as if these concerns were not legitimate or in some way indicative of narcissism. The author also fails to clarify whether the diagnosis of narcissistic personality disorder was an assumption her own, or how that diagnosis was made otherwise. Also, the research shows that there is in fact an ironic level of narcissism among nurses who dislike their credentials being challenged or questioned by clients who have a right and a responsibility to do so.
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