It then needs to be matched with sensitive and supportive psychotherapeutic work.

Honest and caring confrontation is different from confrontations driven by the wish to retaliate, punish, or humiliate the narcissistic member.

We believe that it is crucially important that a group assume such an honest and direct stance toward these vulnerable clients.

respond by rejecting her. As she came to understand that we were sticking by her, she calmed enormously and became more able to take in our care.

The group members were aware that Sal was highly vulnerable and tolerated criticism poorly. Yet they did not hesitate to challenge him directly and compassionately.

This deepened our understanding and we signaled that we were not going to

Her rejection of us was a window into how she felt with her mother.

It was only after reflecting on my (ML) fantasy of how the group would be better if Rona were to leave that my awareness crystallized. This was projective identification in action.

Recognize your own countertransference and use it to interrupt negative interpersonal cycles.