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Transference focused psychotherapy

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Re: Transference focused psychotherapy

Postby ViniStonemoss » Sun Oct 06, 2019 7:36 pm

I thought I'd answer you here since it's your thread:

covertunsure wrote:Because I don't want to have pathological narcissism--that idea is very painful to me and I want to deny it.


Most Cluster B have a narcissistic core. There is no reason to fixate on the worst possible outcome.

"Solving something else?" Like what? Pathological narcissism is my biggest problem and what prevents me from having happiness and romantic and career success.


Yes, that's exactly what I meant. Moving on from wondering about your narcissism, to start doing something about it.

covertunsure wrote:Yes, exactly. I wish I were a straightforward borderline who could just be cured or at least helped a lot. I'm this ######6 mess of a human being with pathological narcissism, which is supposedly almost intractable and hard to treat, AND borderline (perhaps) traits or at least what he calls "identity disturbance."

How did this even happen. Life's pretty unfair.


Another cognitive distortion/dark thought. Narcissism may have worst press but no defense mechanism is actually worst than the others, or harder to treat. As long as you put in the work, there is steady progress.

In fact, I would argue that both your openness and analytical attitude regarding your emotional experiences constitute an advantage.
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Re: Transference focused psychotherapy

Postby covertunsure » Mon Oct 07, 2019 4:57 am

ViniStonemoss wrote:I thought I'd answer you here since it's your thread:

covertunsure wrote:Because I don't want to have pathological narcissism--that idea is very painful to me and I want to deny it.


Most Cluster B have a narcissistic core. There is no reason to fixate on the worst possible outcome.


I hear so much conflicting information about narcissism, borderline, etc. It's all very confusing. There's also psychoanalytical takes and more neurobiological takes on all this, too, which muddles the waters even more. They've apparently done brain scans on and found differences in many with NPD and BPD.

"Solving something else?" Like what? Pathological narcissism is my biggest problem and what prevents me from having happiness and romantic and career success.


Yes, that's exactly what I meant. Moving on from wondering about your narcissism, to start doing something about it.


Doing something about it means accepting I have it. I guess I'll wait to be formally diagnosed with pathological narcissism or at least told I have significant issues with it. First of all, I don't know where to start in terms of doing something about it. It's like a cancer that's metastasized throughout your brain. I'd argue it is part of your brain, since it constitutes your personality, even a dysfunctional personality.

covertunsure wrote:
Yes, exactly. I wish I were a straightforward borderline who could just be cured or at least helped a lot. I'm this ######6 mess of a human being with pathological narcissism, which is supposedly almost intractable and hard to treat, AND borderline (perhaps) traits or at least what he calls "identity disturbance."

How did this even happen. Life's pretty unfair.


Another cognitive distortion/dark thought. Narcissism may have worst press but no defense mechanism is actually worst than the others, or harder to treat. As long as you put in the work, there is steady progress.

In fact, I would argue that both your openness and analytical attitude regarding your emotional experiences constitute an advantage.


I wanted to think that and did for a while--that "insight" and introspective ability are a positive prognostic factor for personality disorders. Now I'm not so sure. I'd actually argue that it could make it harder since you see what you're doing and you know why you do it, and it makes you hate yourself even more.

For example, I'm staying at a hotel for business. I went to the hotel bar; bartender tells me they're closed. A guy starts chatting with me and eventually persuades the manager to get us a drink. He says next time I'm in this city to hit him up and he'll take me out. I wondered what he wants, I look down on him because he's drunk and because that's what I do to anyone who's interested in me, and I'm extremely cynical about everyone and their motives and everything in life, in general. The overt narcissist in me was just begging to come out and say "I have no interest in ever seeing you again and get the ###$ away from me." But the "nice" covert part was in its typical full pretending force, putting on an act of self-effacement and being the nice, unassuming, shy guy.

The constant conflict between "empathy" and pathological narcissism is just so draining.

I hate it, I hate myself, I hate how fake I am when in reality I'm mostly a pretty #######5 person inside.
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Re: Transference focused psychotherapy

Postby Akuma » Mon Oct 07, 2019 5:44 am

Usually after a few sessions a therapist will be able to give a general idea about prognosis. So I'd talk with him about that.
From my experience with you I would dare to say your biggest negative prognostic indicator is not at all if you have NPD or BPD, but that your actual obsessive symptoms seem to not be very ego-alien to you and that you seem to have relatively little interest in looking at them as symptoms and / or figuring out why they are there. As I said in another thread this might be a "good" thing depending on what they are defending against, but in all sorts of analytic therapies, having a certain curiosity about the coping strategies is a must.
This is kind of the sad essence of all cyberchondriacs, that they are so obsessed with illnesses that they dont get that the obsession is their illness - and they waste a lot of their lifes time in the process.
dx: dissociative disorder + npd
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Re: Transference focused psychotherapy

Postby covertunsure » Wed Oct 09, 2019 3:46 am

Akuma wrote:Usually after a few sessions a therapist will be able to give a general idea about prognosis. So I'd talk with him about that.
From my experience with you I would dare to say your biggest negative prognostic indicator is not at all if you have NPD or BPD, but that your actual obsessive symptoms seem to not be very ego-alien to you and that you seem to have relatively little interest in looking at them as symptoms and / or figuring out why they are there. As I said in another thread this might be a "good" thing depending on what they are defending against, but in all sorts of analytic therapies, having a certain curiosity about the coping strategies is a must.
This is kind of the sad essence of all cyberchondriacs, that they are so obsessed with illnesses that they dont get that the obsession is their illness - and they waste a lot of their lifes time in the process.


Hey Akuma. From my understanding, OCD is by definition ego-dystonic/ego-alien. I think with OCD or OCD spectrum disorders/traits, it's actually quite easy to begin "living" your obsessions. Some OCD is also characterized as "poor insight" or may even have psychotic features. With some "obsessions," I think I may have poor insight, but in most cases I think it's fairly decent (guess I wouldn't know if it wasn't, though).

Some intrusive thoughts are definitely ego-dystonic. For example, I'll get a sudden intrusive thought, "I'm gorgeous," and it'll literally make me cringe just as much as the homicidal OCD I used to have, because I don't believe it and it makes me even more vulnerable if I act the part and get shot down.

Regardless, I definitely have traits of NPD (more so) and perhaps BPD (less so). And/or maybe Aspergers-related emotional dysregulation; I have traits of Aspergers but probably don't quite meet the official diagnostic criteria.
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Re: Transference focused psychotherapy

Postby ViniStonemoss » Wed Oct 09, 2019 10:52 pm

covertunsure wrote:I hate it, I hate myself, I hate how fake I am when in reality I'm mostly a pretty #######5 person inside.


Most people are super lovely inside, but disorderness make it difficult to communicate that properly.

covertunsure wrote: First of all, I don't know where to start in terms of doing something about it. It's like a cancer that's metastasized throughout your brain. I'd argue it is part of your brain, since it constitutes your personality, even a dysfunctional personality.


I experience "disorderness" as a fog of war. You clear a path, but the fog remains thick. It feels like you are not clearing anything.
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Re: Transference focused psychotherapy

Postby covertunsure » Thu Oct 10, 2019 5:01 pm

ViniStonemoss wrote:
covertunsure wrote:I hate it, I hate myself, I hate how fake I am when in reality I'm mostly a pretty #######5 person inside.


Most people are super lovely inside, but disorderness make it difficult to communicate that properly.

covertunsure wrote: First of all, I don't know where to start in terms of doing something about it. It's like a cancer that's metastasized throughout your brain. I'd argue it is part of your brain, since it constitutes your personality, even a dysfunctional personality.


I experience "disorderness" as a fog of war. You clear a path, but the fog remains thick. It feels like you are not clearing anything.


Sorry if you told me this before, but are you diagnosed with NPD or any other PD?

Update on new therapist:

At our second consultation yesterday, my new psychologist says he's still quite convinced identity disturbance is my main issue or at least one of my main issues. He says I likely have a borderline personality organization. But he would lean more toward NPD than BPD if he had to give a DSM-V diagnosis, which I believe he says I don't seem to fit.

He says he hasn't seen significant grandiosity yet, but I know he will, because I know myself and that it's there. He says he waits to see it rather than the patient telling them they have something. He's really nice and seems pretty good at his craft. He trained with Otto Kernberg or at least one of his disciples. I'm still not sure about TFP, as it doesn't seem as "scientific" as CBT or DBT, but he specializes in DPs, so hopefully he (and Otto Kernberg) is doing something right.

He also says narcissists generally have a more stable self-esteem than mine, which goes up every other minute based on feedback I get--even if it does fluctuate in NPD/narcissism. That is, my identity also seems less stable.
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Re: Transference focused psychotherapy

Postby ZeroZ » Thu Oct 10, 2019 6:11 pm

@covert;

Are you going in for an evaluation? It usually takes a few sessions they like to get background information, connect past trauma to current behaviors in order for them to understand what really drives them. I’ve had a 2 hour evaluation and I don’t think the results were to be trusted in my opinion
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Re: Transference focused psychotherapy

Postby covertunsure » Thu Oct 10, 2019 6:32 pm

ZeroZ wrote:@covert;

Are you going in for an evaluation? It usually takes a few sessions they like to get background information, connect past trauma to current behaviors in order for them to understand what really drives them. I’ve had a 2 hour evaluation and I don’t think the results were to be trusted in my opinion


He didn't call it an evaluation, but a consultation. Not sure if they're the same thing. He hasn't administered any formal diagnostic tests or questionnaires.

Like I said, though, I think he trained with Otto Kernberg or at least someone who's familiar with Kernberg's work, and he specializes in PDs. So he's quite familiar with how borderline personality organization, NPD, BPD, etc. I hope he's right cuz I'd rather not have NPD, but clearly I have pathologically narcissistic traits.
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Re: Transference focused psychotherapy

Postby SomeDude007 » Fri Oct 11, 2019 12:33 am

I've been reading a little up on transference focused psychotherapy so I'm curious. Let us know how it goes if you're comfortable with that.

Sounds like the guy is really knowledgable. I would suggest that you really allow him to figure you out; be truthful, but don't push the NPD diagnosis too hard. Just talk and see what he has to say.

Good luck!
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Re: Transference focused psychotherapy

Postby covertunsure » Sat Oct 12, 2019 2:44 am

SomeDude007 wrote:I've been reading a little up on transference focused psychotherapy so I'm curious. Let us know how it goes if you're comfortable with that.

Sounds like the guy is really knowledgable. I would suggest that you really allow him to figure you out; be truthful, but don't push the NPD diagnosis too hard. Just talk and see what he has to say.

Good luck!


Thank you. Yes, I'll certainly keep everyone updated; as a narcissist, that's not a chore. :lol:

I don't think I quite qualify for DSM NPD, but that doesn't mean I don't have pathological narcissism, which I'm quite certain I do have, as part of borderline personality organization.
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