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SKILL CLASS 18 | DAY 2: 4.15 PM - 5.45 PM 

Emotion-Focused Work with Vulnerable-Narcissistic Patients: Focus on "Covert" Overcompensatory Modes

by David Hoehn and Samy Egli


Traditionally, there has been a strong focus on the grandiose subtype of narcissism (also called „overt“). Increasingly, the existence of a vulnerable subtype of narcissism (also referred to as „hypersensitive“ or „covert“ narcissism) is being recognized. While both subtypes share pronounced self-centeredness, vulnerable narcissistic patients clinically differ quite strongly from grandiose narcissistic patients, appearing introverted, defensive and avoidant, often to the degree of resembling avoidant personality disorder. On the level of social interaction, these patients can appear antagonistic or „passive-aggressive “. From a schematherapy perspective, they exhibit modes that can be conceptualized as „covert“ or „hidden“ overcompensatory modes, which are often suppressed in their outward manifestation. We will demonstrate an approach to these covert overcompensatory modes utilizing the safe space of therapy to access the modes experientially through chair work or imagery exercises. These are ways to gain access to the underlying child modes, particularly the angry child mode and redirect the anger against punitive parent modes. These interventions will be demonstrated, and participants will practice in small groups, and the challenges and pitfalls will be discussed.

Level of Experience Required for Participants: 

Intermediate (Participants have had basic Schema Therapy Training)

About the Presenters:

David Hoehn

Born in Seattle, lives in Munich, attended Medical School in Regensburg, Munich and Lille, MD from the Technical University Munich, BA in Philosophy from the Munich School of Philosophy, working as a clinical and research psychiatrist at the Max-Planck Institute of Psychiatry in Munich. Research interests include neuroimaging and imaging genetics, evolutionary psychiatry, psychotherapy research. Current clinical focus: inpatient and outpatient psychotherapy in psychiatry, with a special focus on schema therapy (applied in an individual as well as in a transdiagnostic group setting).

Samy Egli

M.Sc. in Applied Cognitive Psychology at the University of Zurich in 2004, after a year in research at Harvard Medical School affiliated McLean Hospital, Boston, USA in 2001. Ph.D. in cognitive psychology and psychopathology, with a research stay at the Ludwig-Maximilians-University in Munich in 2008. Master of Advanced Studies and Certification in psychotherapy with a cognitive behavioral and interpersonal focus at the Klaus-Grawe-Institute for Psychological Therapy, Zurich and the University of Basel in 2012. After six years as a clinical psychotherapist and deputy Head of Psychology at the Schloessli-Clinic near Zurich until 2014, starting in 2015 as Head of Psychology at the Max-Planck-Institute of Psychiatry, Munich, Germany. Currently working in the continuous establishment of a method-integrative psychotherapy in clinical psychiatry, research and teaching with a focus in and passion for Schema Therapy in invidivual and group- in- and outpatient settings.

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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