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Ed Schwartzreich's avatar

Interesting viewpoint. Since when I did psychotherapy I did not use attachment concepts or the idea of codependency -- I found them descriptive yes, but without much therapeutic leverage -- I never approached this issue this way.

I would try to look at internalized object relations, yes boundaries, labeling what I thought was going on dyadically. I did relate things to the childhoods of my patients, of course too.

Melissa Kalt, M.D.'s avatar

Thanks, Ed. I’m not a therapist and don’t do therapy, so it doesn’t surprise me our approaches would be different.

I identify and decode toxic patterns, then help people rewrite them. There is a lot of misinformation out there that says NPD and codependency are opposites that cannot coexist. This myth does a lot of harm to the person trying to make sense of the pattern they’re experiencing.

Ed Schwartzreich's avatar

For me, the cardinal realizations of victim of an pwNPD are: “I am being abused”, and “S/he is an abuser”. There are many toxic patterns where no one is “an abuser” actually. Abuserdom is for persons with NPD, some of the other cluster B personality disorders, and a few nasties who don’t merit any particular diagnosis.

Labeling someone “an abuser” draws a line in the sand, regardless of attachment, codependency, or whatever.