Understanding Closet Narcissism: The Challenges of Integrating Psychoanalytic Perspectives into Protocolized Treatments

Abstract

As trauma-processing modalities such as CPT and EMDR have been refined and perfected in the twenty first century, little attention has been given to psychoanalysis as a viable treatment option for victims of trauma—perhaps due to the time constraints of social workers and therapists that are being implemented in different treatment settings outside of private practice. While there are many trainings available for CPT and EMDR (both of which are very effective in treating trauma, and are easily reimbursable from insurance companies), psychoanalytic approaches in trauma treatment are not often discussed in graduate programs and different clinical trainings for therapists, and have unfortunately become a secondary consideration in trauma treatment. The present case study offers a cautionary example of how overlooking psychodynamic perspectives can lead to incomplete trauma treatment outcomes, and is a call for therapists to creatively increase their utilization of psychoanalytic concepts within the limitations of non-private practice settings.

Keywords:

• Closet narcissism
• childhood trauma
• compulsion to repeat
• idealized object

Disclosure Statement

The views expressed in this article are those of the author, and do not necessarily reflect the official policy of the Department of the Navy, Department of Defense, Defense Health Agency, or the U.S. Government. Neither the Department of the Navy nor any other component of the Department of Defense has approved, endorsed, or authorized this product.