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Fortifying the Therapy Relationship when Dealing with Narcissism, Enmeshment, and Other Challenging Patients 

by Jeffrey Conway and Wendy Behary

            


Abstract:

This pre-conference workshop will be grounded in an understanding, both conceptually and practically, of the essential value of the therapy relationship in schema therapy; not only as a means for creating a safe refuge for connection, empathy, trust, and openness, but also as a context in which schemas and schema modes can become triggered and expeditiously addressed.

Activated events in the therapy relationship can serve as microcosmic representations of the patient’s real-life experiences outside the treatment room; interactions that occur with significant and important others, as well as with self.  This dynamic, which calls upon us to maintain a sturdy narrator and a healthy adult posture, can serve as a powerful opportunity for schema investigation and schema healing; providing a gateway to real-time awareness of the underlying pain and suffering that prompts mode shifts.

The therapy relationship, chock full of dual activations for both patient and therapist, allows for opportunities for the therapist to appreciate and report on the resonant “as if” experience they imagine others may feel; those engaged in various forms of relationship with our patient. The use of transparency and self-disclosure can act as a helpful guide for our patients to sense, see, feel, and ultimately, transform their critical, demanding, punitive, and maladaptive modes into healthy and adaptive ones. 

In our many years of experience, we find this phenomenon is especially true when dealing with some of our most challenging patients, for example, those with rigid narcissistic modes and/or deeply ingrained core schemas like enmeshment and mistrust/abuse. 

As we empathically (and courageously) attend to what is happening between us in the therapy relationship, schemas and modes can be identified and tracked, imagery can be bridged from this stance, and a trusting attachment can be solidified. In so doing, we build a sturdier foundation by which we might better utilize the many robust schema therapy experiential exercises, improve collaboration and fortify a better limited reparenting bond… leading to effective treatment outcomes.

About the Presenters:

Jeff Conway

Jeff Conway, LCSW is the Chair of the ISST Committee on Supervisor Skills Training responsible for developing the required workshop to be certified as an ISST Supervisor Trainer. He is a founding member of ISST, a Certified Advanced Level Trainer-Supervisor since 2008, and on the ISST Committee for Training and Education. Jeff is the Chair of the ISST Committee on Supervisor Skills Training responsible for developing the required workshop to be certified as an ISST Supervisor Trainer. He is a founding member of ISST and a Certified Advanced Level Trainer-Supervisor since 2008. 

Wendy Behary: 

With 25 years post-graduate training and advanced level certifications, Wendy Behary is the founder and director of The Cognitive Therapy Center of New Jersey and co-director (with Dr. Jeffrey Young) of The New Jersey-New York City Schema Therapy Institutes. She has been treating clients, training professionals and supervising psychotherapists for more than 20 years. Wendy was on the faculty of the Cognitive Therapy Center and Schema Therapy Institute of New York (until merging in 2012 with the NJ Institute), where she trained and worked with Dr. Jeffrey Young since 1989. She is a Founding Fellow and consulting supervisor for The Academy of Cognitive Therapy (Aaron T. Beck Institute).  Wendy served as the President of the Executive Board of the International Society of Schema Therapy (ISST) from 2010-2014.

Wendy Behary has co-authored several chapters and articles on Schema Therapy and Cognitive Therapy. She is the author of"Disarming theNarcissist...”  (New Harbinger, 2013) translated in 10 languages. Wendy has a specialty in treating narcissists and the people who live with and deal with them. As an author and an expert on the subject of narcissism, she is a contributing chapter author of several chapters on schema therapy for narcissism for professional readers. She lectures both nationally and internationally to professional and general audiences on schema therapy, and the subject of narcissism, relationships, anger, and dealing with difficult people.  Her private practice is primarily devoted to treating narcissists, partners/people dealing with them, parenting issues, and couples experiencing relationship problems.


Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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