<p>It is known that common (a.k.a. overt, flamboyant) narcissists rarely seek therapy on their own. However, there is an atypycal type of narcissism called “shy”, “covert” or “vulnerable“. They behave quite the contrary to the common overt type (<a href="http://www.sakkyndig.com/psykologi/artvit/akhtar2000.pdf" rel="nofollow noreferrer">Sandler et al., 2000</a>). </p>

<p>I wonder if it is common for this type to seek long term psychotherapy (presumably psychoanalysis) to treat NPD specifically, not the comorbid symptoms like anxiety and depression. </p>

<p>Wouldn't high motivation to treatment be in direct contrast with the diagnosis of severe NPD of covert type?</p>

<p><sub>
Sandler J., Michels R., Fonagy, P. (Eds.). (2000). <a href="http://www.sakkyndig.com/psykologi/artvit/akhtar2000.pdf" rel="nofollow noreferrer">Changing Ideas in a Changing World: The Revolution in Psychoanalysis</a>-Essays in Honour of Arnold Cooper. Karnac Books.
</sub></p>

CC BY-SA 4.0
2018-11-26T18:24:23.527Z
Firstly, it's important to note that the DSM 5 doesn't directly divide NPD into "overt narcissists" and "covert narcissists" although it does state that one particular symptom (feelings of entitlement) might be either overt or covert. I don't know if the psychoanalytical perspective views NPD differently.
anonymous
CC BY-SA 4.0
2018-11-27T08:24:31.713Z
The book you provided seems to be based in psychoanalysis. Is this the perspective you are expecting an answer from? You added a lot of tags, and it does not seem all of them are relevant. +1 regardless for a well-researched question!
Steven Jeuris
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2018-11-28T17:48:14.193Z
@StevenJeuris The idea of "perspective" is weird to me. It seems there are two main - DSM and psychoanalytical. I guess I have the "psychoanalytical" perspective then.
Slazer
CC BY-SA 4.0
2018-11-28T17:49:28.050Z
@anonymous I think DSM's taxonomy is seriously flawed and I thus use this taxonomy instead.

   
Lingiardi, V., & In McWilliams, N. (2017). Psychodynamic diagnostic manual: PDM-2.
Slazer
CC BY-SA 4.0
2018-11-28T18:05:37.480Z
It might be they are just patching anxiety, depression from relationship deprivation. Then they would cease the therapy in longer periods of well-being or during compensatory grandiousity. Or with meds.

Or they might be trying to become "better" than other narcissists. Then they would probably cease therapy once they become "healed".

Just thinking.
Slazer
CC BY-SA 4.0
2019-03-17T23:52:11.613Z
This may be difficult to answer because the DSM [mostly caters](https://www.ncbi.nlm.nih.gov/pubmed/18029072) to the grandiose type, so the vulnerable type doesn't get its own billable code etc., which makes gathering stats like how many of each kind seek treatment really difficult. My guess is that the vulnerable type being more co-morbid with depression is more likely to seek help, but I don't have any stats for that.
got trolled too much this week
<personality><abnormal-psychology><developmental-psychology><personality-disorder>
Do vulnerable/covert/shy narcissists seek therapy for NPD?
Slazer
# Do vulnerable/covert/shy narcissists seek therapy for NPD?

(Asked by: username_0 on 2018-11-25)

It is known that common (a.k.a. overt, flamboyant) narcissists rarely seek therapy on their own. However, there is an atypycal type of narcissism called “shy”, “covert” or “vulnerable“. They behave quite the contrary to the common overt type ([Sandler et al., 2000](http://www.sakkyndig.com/psykologi/artvit/akhtar2000.pdf)).

I wonder if it is common for this type to seek long term psychotherapy (presumably psychoanalysis) to treat NPD specifically, not the comorbid symptoms like anxiety and depression.

Wouldn't high motivation to treatment be in direct contrast with the diagnosis of severe NPD of covert type?

Sandler J., Michels R., Fonagy, P. (Eds.). (2000). [Changing Ideas in a Changing World: The Revolution in Psychoanalysis](http://www.sakkyndig.com/psykologi/artvit/akhtar2000.pdf)-Essays in Honour of Arnold Cooper. Karnac Books.

**Tags:** personality, abnormal-psychology, developmental-psychology, personality-disorder

> **Comments:**
> **username_1**: Firstly, it's important to note that the DSM 5 doesn't directly divide NPD into "overt narcissists" and "covert narcissists" although it does state that one particular symptom (feelings of entitlement) might be either overt or covert. I don't know if the psychoanalytical perspective views NPD differently.  
> **username_2**: The book you provided seems to be based in psychoanalysis. Is this the perspective you are expecting an answer from? You added a lot of tags, and it does not seem all of them are relevant. +1 regardless for a well-researched question!  
> **username_0**: @StevenJeuris The idea of "perspective" is weird to me. It seems there are two main - DSM and psychoanalytical. I guess I have the "psychoanalytical" perspective then.  
> **username_0**: @username_1 I think DSM's taxonomy is seriously flawed and I thus use this taxonomy instead.      Lingiardi, V., & In McWilliams, N. (2017). Psychodynamic diagnostic manual: PDM-2.  
> **username_0**: It might be they are just patching anxiety, depression from relationship deprivation. Then they would cease the therapy in longer periods of well-being or during compensatory grandiousity. Or with meds.  Or they might be trying to become "better" than other narcissists. Then they would probably cease therapy once they become "healed".  Just thinking.  
> **username_3**: This may be difficult to answer because the DSM [mostly caters](https://www.ncbi.nlm.nih.gov/pubmed/18029072) to the grandiose type, so the vulnerable type doesn't get its own billable code etc., which makes gathering stats like how many of each kind seek treatment really difficult. My guess is that the vulnerable type being more co-morbid with depression is more likely to seek help, but I don't have any stats for that.  

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## 0 answers

