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Couple Therapy with Narcissistically Vulnerable Clients: Using the Relationship Enhancement Model

The term "narcissistically vulnerable" is used in the literature to describe clients who are particularly reactive to experienced criticism or blame, minimally able to empathize, and prone to both idealization and abandonment rage. Models of couple therapy that effectively integrate the psychodynamic and the psycho-educational can provide a structured and facilitating environment in which both partners can gradually learn to express feelings with less risk of shaming the other and to empathize more deeply with the feelings of the other that have previously evoked defensive reactions. Relationship Enhancement therapy is described as one such model, and a case example is given to illustrate how the model can be used to address the particularfeatures of narcissistic vulnerability.