PMID- 37847856
OWN - NLM
STAT- MEDLINE
DCOM- 20240308
LR  - 20240308
IS  - 1097-4679 (Electronic)
IS  - 0021-9762 (Linking)
VI  - 80
IP  - 4
DP  - 2024 Apr
TI  - Homework assignments in relational psychoanalytic treatment of personality 
      disorders: A case study of a patient with narcissistic personality disorder.
PG  - 871-883
LID - 10.1002/jclp.23600 [doi]
AB  - Homework assignments, or specific tasks patients are asked to engage in or 
      complete between sessions, are a controversial topic among psychoanalysts. While 
      many argue these interventions contradict psychoanalytic principles, others 
      believe they can help address problems and promote coping skills. We propose that 
      homework can be a legitimate aspect of relational psychoanalysis when used in a 
      way that is attuned to the patient's experience and that homework may be an 
      important component of treating personality disorders (PD). We present the case 
      of a man diagnosed with narcissistic PD. He often felt superior to and reported 
      that he despised others, though the core self-image was of fragile. He embraced 
      the role of the omnipotent caregiver, which came with boredom and anger and lack 
      of satisfaction in his social life. The patient tried to control therapy, 
      asserting that he could psychoanalyze himself. As a result, therapy was stalled 
      and progress was limited. At this point, the therapist asked him to complete 
      homework assignments that encouraged him to refrain from his compulsive 
      caregiving to better understand what motivated this behavior. Through this 
      process, the patient came to realize he acted out of avoidance, as he did not 
      want to disclose his own vulnerabilities and flaws. At that point he was able to 
      experience relationships while adopting different stances and finding new 
      meanings. We argue that homework can be fully integrated into the relational 
      psychoanalytic repertoire to improve self-reflection and foster change in 
      patients with PD.
CI  - (c) 2023 Wiley Periodicals LLC.
FAU - Magistrale, Giuseppe
AU  - Magistrale G
AUID- ORCID: 0000-0002-4471-7877
AD  - Centro DCA, Bari, Italy.
AD  - ISIPSe Via Col Di Lana, Rome, Italy.
FAU - Hasson-Ohayon, Ilanit
AU  - Hasson-Ohayon I
AUID- ORCID: 0000-0002-5618-019X
AD  - Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
FAU - Lysaker, Paul H
AU  - Lysaker PH
AUID- ORCID: 0000-0002-6617-9387
AD  - Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indianapolis, 
      Indiana, USA.
AD  - Department of Psychiatry, Indiana Univeristy School of Medicine, Indianapolis, 
      Indiana, USA.
FAU - Dimaggio, Giancarlo
AU  - Dimaggio G
AUID- ORCID: 0000-0002-9289-8756
AD  - Centro di Terapia Metacognitiva Interpersonale, Piazza dei Martiri di Belfiore 4, 
      Rome, Italy.
LA  - eng
PT  - Case Reports
DEP - 20231017
PL  - United States
TA  - J Clin Psychol
JT  - Journal of clinical psychology
JID - 0217132
SB  - IM
MH  - Male
MH  - Humans
MH  - Narcissistic Personality Disorder
MH  - *Psychoanalysis
MH  - Personality Disorders/therapy
MH  - Self Concept
MH  - *Psychoanalytic Therapy
OTO - NOTNLM
OT  - homeworks
OT  - psychotherapy integration
OT  - relational psychoanalysis
EDAT- 2023/10/17 18:43
MHDA- 2024/03/08 06:43
CRDT- 2023/10/17 14:53
PHST- 2023/08/30 00:00 [revised]
PHST- 2023/05/13 00:00 [received]
PHST- 2023/09/23 00:00 [accepted]
PHST- 2024/03/08 06:43 [medline]
PHST- 2023/10/17 18:43 [pubmed]
PHST- 2023/10/17 14:53 [entrez]
AID - 10.1002/jclp.23600 [doi]
PST - ppublish
SO  - J Clin Psychol. 2024 Apr;80(4):871-883. doi: 10.1002/jclp.23600. Epub 2023 Oct 
      17.