Understanding and Counseling Narcissistic Clients

This article is intended to provide counselors with an overview of narcissism and its treatment. In the first section, dysfunctional narcissism is described, drawing on the diagnostic indicators presented in the DSM-III and the contemporary object relations theories of Heinz Kohut and Otto Kernberg. The second section focuses on counseling narcissistic clients.     

Assertiveness and cognitive processing in interpersonal situations

This study examined social skills components that precede the delivery of a skilled overt interpersonal response. Using a cognitive-behavioral systems approach to assertiveness, a task analysis of how women receive and process information in interpersonal situations requiring an assertive response to men was performed. Forty women were assigned to high- or low-assertive groups based on their Rathus Assertiveness Schedule scores. In small group sessions, each woman viewed four videotaped problem situations requiring an assertive response to both pleasant and angry males. After viewing each scene, each woman completed three questionnaires: (a) receiving information, (b) processing-generation of alternatives and decision making, and (c) processing-generation of consequences. High- and low-assertive participants were found to differ in their evaluation of consequences, for response options, particularly how a male would likely to behave to them. High-assertive participants were judged to evaluate more correctly than low-assertive participants the likely behavior of males if response options were implemented. All participants generated more complex alternatives and more assertive responses to situations involving an angry male as compared to a pleasant male. No differences were found between groups in their ability to receive information accurately. Correlational results were supportive of a cognitive-behavioral systems approach of assertion, that is, the emission of a skilled response depends on a chain of preceding responses.Thanks are due to Vida Dyson and Lenard Jason for their comments on an early draft of this paper.     

Perceived variability and symbol use: a common language-cognition interface in children and chimpanzees (Pan troglodytes)

Analysis of two chimpanzees' conversations with their teacher during a tool-use training task demonstrated that chimps use lexigrams, a humanly devised visual symbol system, selectively to encode perceived variability; that is, they generally used their symbols to differentiate alternative possibilities or to represent change or novelty in a situation. In contrast, they tended to leave unsaid what was unchanging, repetitive, or the unique possibility in a situation. Perceived variability influenced not only which symbols were selected but also utterance length: A single dimension of variability in a situation leads to single-lexigram utterances; multiple dimensions are associated with multi-lexigram utterances. This pattern of results indicates that the absence of formal grammatical structure in chimp language does not imply that utterances beyond one word in length are either rote strings or imitations. The chimps' tendency to mention the variable while leaving the constant or redundant unsaid is, moreover, strong support for the position that their use of a humanly devised symbol system is more than a series of conditioned responses.     

Scaling of output regularities in free recall: A review

Problems involved in scaling the output regularities observed in free recall are outlined, and assumptions underlying attempted solutions for both categorized and “unrelated” lists are discussed. Several studies that make claims for the superiority of particular measures have indeed demonstrated that it matters which index is selected, but they are shown to provide no justification for preferring one to another. Evidence from simulation studies, however, suggests that a number of measures have “built-in” correlations with theoretically relevant variables such as recall. Some of these biases have proved elusive because their appearance is confined to nonrandom output sequences. The relation between theoretical assumptions and simulation studies is discussed.     

The importance of assessing treatment integrity: An example in the anxiety disorders

One purpose of this investigation was to examine the importance of assessing treatment integrity in a study evaluating a treatment for specific anxiety disorders. Three subjects, two social phobics and one simple phobic, received self-instruction training (Phase I) followed by exposure and self-instruction training (Phase II) in a multiple baseline across subjects design. All subjects were assessed during a pretreatment baseline and throughout treatment using measures of treatment integrity and measures of change in phobic severity. Improvement took place at different times for different subjects. Measures of treatment integrity, which consisted of monitoring of self-statements as well as practice outside the session, indicated that treatment was not always received as intended and that improvement was correlated with practice. The usefulness of measures of treatment integrity in both clinical and research settings is highlighted.     

Reactivity and unreliability of husbands as participant observers

This study examined the reliability and reactivity of participant observation. Twelve couples engaged in two discussions in a laboratory, one on a conflict topic and one on a consensus topic. For the eight couples in the experimental sequences, a baseline discussion was followed by participant observation in which the husband recorded his wife's use of I while continuing to converse. The four couples in the control sequences conversed without participant observation. Compared to observations made by a trained observer, the husbands were unreliable observers, underestimating their wives' use of I. Participant observation was reactive (P<.01), with more wives decreasing their use of I in the experimental sequences than in the control sequences (p<.094). The topic of discussion did not differentially influence reliability or reactivity.This research was conducted as the first author's independent doctoral research project. We extend gratitude to the Research Council of the University of North Carolina at Greensboro for Grant 0-2-110-218-XXXXX-7548; the Statistical Consulting Center of the University of North Carolina at Greensboro; two anonymous reviewers; and our research assistants, Suzanne Brannon, Ben Hardie, Kathy Lindamood, Amy Mitchem, Regina Pierce, and Elga Wulfert. Portions of this paper were presented at the meeting of the Association for Advancement of Behavior Therapy, Washington, D.C., December 1983.