Therapy with survivors of narcissistic Abuse: Part 6 Five steps to case formulation
Now we’re ready to put it all together. In this post I’m going to explain how to answer 5 questions about your client to know how you can best help them reach their goals. First, I will show you a diagram that you can use in your own clinical work and apply it to the case of Sarah that I introduced in part 1 of this series.
This post is the last in a series on CMT and how you can learn to apply this theory in your own clinical work. It’s a 6-part series that covers these topics:
Part 1 Overview of Control-Mastery Theory
Part 2 The Client’s Goals
Part 3 The Client’s Pathogenic Beliefs
Part 4 The Client’s Key Traumas
Part 5 How Clients may Test Pathogenic Beliefs
Part 6 Five steps to case formulation
My name is Jay Reid and I’m a licensed psychotherapist in California who specializes in the treatment of survivors of narcissistic abuse. I work from a form of therapy called Control-Mastery Theory which prizes the client’s efforts to overcome the trauma of narcissistic abuse and realize a fuller and richer quality of life for themselves. If this topic interests you then I encourage you to learn more by getting my free e-book on ‘Effective Therapy with Survivors of Narcissistic Abuse: The basics of Control-Mastery Theory’
| What are this client’s goals for therapy? | What pathogenic beliefs – conscious or unconscious – stand in the way? | Key traumas that gave rise to PB’s? | How might the client test the PB’s out with the therapist? | What kinds of therapist interventions/attitudes would be helpful to them? |
| To engage in an activity (e.g. swimming) that client enjoys on a regular basis | “If I don’t take responsibility for other’s emotional wellbeing then they will fall apart.” | Father prone to sullen depressive episodes and would only feel better when Sarah was at home and working hard to cheer him up. | See whether therapist agrees/disagrees with her practice of putting others’ needs ahead of hers. | Challenging Sarah’s assumption of responsibility for others’ emotional health in her life. |
| See whether therapist requires Sarah to take care of the therapist’s emotional needs. | Demonstrating in attitude and presence that you are capable of caring for your own needs (e.g. end sessions on time, address issues of payment as needed). | |||
| See whether therapist will support her efforts to prioritize her own emotional wellbeing ahead of others. | Affirm Sarah’s displays of self-care. |
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Jay Reid is a Licensed Professional Clinical Counselor (LPCC). If you are considering therapy for overcoming a childhood with one or more narcissistic parents please contact me for a free 15-minute phone consultation.
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