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Treating Narcissists with Chair Work and the Mode Model

by Matias Valente


Schema Therapy is a highly developed psychotherapy system with a strong focus on understanding interpersonal problems and relating these to lifelong patterns. Working with narcissists and their self-aggrandizing modes can nonetheless be very challenging and unfold quite different reactions in us, depending on our own schemas and modes. The dynamic-dimensional perspective connects coping modes (“front stage”) to inner critic and child modes (“backstage”), allowing us to quickly access underlying conflicts, schemas and biographical scenes “behind the curtains” – both in patients and ourselves. Exercises with multiple chairs can very effectively bring this dynamic to life, making it accessible for change.

Teaching Methods:

After an introduction to the dynamic-dimensional perspective on the mode model in general, a typical case conceptualization for a narcissistic patient will be analyzed using the dynamic-dimensional mode map. Different approaches to exercises with multiple chairs will be explained, one of them demonstrated in role play. This specific technique allows the therapist to empathically confront narcissistic patients with feelings of shame and emotional pain their self-aggrandizing or bully modes inflict on other people, inducing healthy guilt and activating their core need for connection, this being a key to self-control. Participants will replicate in small working groups under supervision.

Learning Objectives:

1) Learn to conceptualize narcissistic patients and our own reactions using the dynamic-dimensional mode model.

2) Learn to use chair work to do empathic confrontation and at the same time create “space” for remorse and empathy, accessing child modes “behind” coping modes and training the healthy adult mode to self-control, balancing himself between core needs for connection and assertiveness and avoiding overcompensation while coping with challenging interpersonal conflicts.

Workshop Intended For:


Relevant Background Readings on Topic:

Contextual Schema Therapy: An Integrative Approach to Personality Disorders, Emotional Dysregulation, and Interpersonal Functioning (Roediger, Stevens)

Level of Experience Required for Participants: 


About the Presenter:

Matias Valente

(PhD), born 1979, clinical psychologist and psychotherapist. Trained in psychodynamic and cognitive-behavioral therapy (ACT, DBT, BA). Trained in Schema Therapy by Eckhard Roediger 2005-2009. Advanced schema therapist and trainer since 2010. Since 2014 director of the Schema Therapy Training Center in Stuttgart (GER), formerly head psychologist at the psychosomatic department of the psychiatric hospital in Weinsberg (GER). Research-Area: ST with inpatients. Since 2018 working in private practice. Specialized in treating severe personality disorders and trauma-associated disorders in both inpatients and outpatient settings, working with ST, DBT, CBT and ACT. 

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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