SLopez Week 15 Case Study PDF

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Sussan Lopez Case Study Narcissistic Personality Disorder Client Profile: Brad 1. The nurse is confirming appropriate roles in the nurse-client relationship and prioritizing the client’s insight and perception of reality during the working phase of relationship development. Brad shows grandiosity, arrogance and concentrates on his money as success and needs admiration when he sends the gift basket or suggests a trip to the nurse. These characteristics are common in clients with Narcissistic Personality Disorder. 2. The hallmarks of Narcissistic Personality Disorder (NPD) are grandiosity, a lack of empathy for other people, and a need for admiration. People with this condition are frequently described as arrogant, self-centered, manipulative, and demanding. They may also concentrate on grandiose fantasies (e.g. their own success, beauty, brilliance) and may be convinced that they deserve special treatment. These characteristics typically begin in early adulthood and must be consistently evident in multiple contexts, such as at work and in relationships. Brads meets almost all criteria regarding this behavior. 3. The majority of this diagnosis are male, 50-75%. Hospitalization of clients with narcissistic personality disorder usually happens when they have additional symptoms from a co-existing mental disorder. 4. According to Kohut’s self-psychology model, narcissistic psychopathology is a result of parental lack of empathy during development. Consequently, the individual does not develop full capacity to regulate self-esteem. The narcissistic adult, according to Kohut's concepts, vacillates between an irrational overestimation of the self and irrational feelings of inferiority, and relies on others to regulate his self-esteem and give him a sense of value. 5. Brad relies on Mary to give him that sense of value and superiority over her. Mary needs empathy and to be considered a priority in his life rather than looked down upon.

6. It would feel like being the current president of the United States. Grandiose and overestimation of self and superior to all those around him. Aging can be a problem with a client with NPD. In America, it is more common for society to disregard the elderly. In NPD, the client craves approval and admiration of others. As they age, they lose their beauty which in turn loses their social standing. 7. Some techniques to engage a narcissist in exploring his more empathic side are to start with what he already does well and build on that. Many narcissists are great with their children (particularly when the children are too young to reject the parent or his values) and their pets, because they enjoy dynamics where others look up to them. Children often function as an extension of the narcissist’s self. If a narcissist has any capacity for empathy, it will manifest itself here. A narcissist, although he can change and learn to be more empathic, will generally always have limitations. He rarely will turn into a person

who is comfortable with sharing his vulnerabilities and with asking for emotional support. However, if he can learn to provide some emotional support, the marriage will improve and grow closer. 8. This is a very difficult couple to treat, but successful therapy hinges on cultivating empathy in the narcissist for his wife’s perspective and feelings. If there is even a small move in the direction of understanding his spouse’s point of view, the marriage has the capacity to improve. On the other side, there needs to be an increase in the spouse’s feelings of self-esteem and self-efficacy. If she can learn to value herself and find sustenance and support in other people, her career, or other outlets, then she will not be as dependent on the narcissist for validation. 9. The nurse should tell Brad that it is more appropriate to discuss this with both the Dr. and Mary present, so they can explore any feelings that may arise regarding Mary’s feelings about Brad. 10. Since a narcissist often wishes to impress others, I would praise him for any efforts toward getting better, but the care would remain the same as with any other client....