One of the difficulties of working with highly narcissistic individuals is their extreme sensitivity to even the mildest negative feedback. Helpful suggestions can be experienced as such devastating criticisms that the clients either fall into self-hating depressions or angrily defend themselves by devaluing the therapist. Greenberg attributes this sensitivity to the inherent instability of narcissistic self-esteem, one of the themes touched on by Bentley in his article, “Working with Narcissism in Organizations.” Using Gestalt therapy field theory, Greenberg redefines narcissism as two alternating and mutually contradictory ways of organizing the organism/environment field that narrowly focus on self-esteem issues: The inflated organization makes figural only those cues that enhance the person's sense of being special and perfect, and the deflated organization makes figural only those cues that confirm the person's sense of being inherently worthless and inadequate. She explains three ways a therapist can use Gestalt therapy field theory to help narcissistic clients stabilize their mood and form a realistic and integrated sense of their own worth.

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