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Readers address needs of narcissistic patients.

I loved the thought-provoking article on treating narcissistic executives (Spring 2018 issue). I wonder if an appeal to the ego that identifies the patients ultimate success would open a door to escape the trappings.

Perhaps this might be an approach: telling them how successful they have been, with the wealth they have accumulated, the celebrity status, the extra-worldly lifestyle they live, and then asking if they feel they have "won" the game now and can return to being the "nice guy" who they felt "finished last." One could point out people such as Bill Gates, Warren Buffett, etc., who are respected for their business acumen but also loved for their philanthropy.

So, just as the woman who spared nothing to appear as perfectly beautiful as possible at all times could be asked, "Does that ever get exhausting?", a successful businessperson so caught up in pursuing the next golden ring could be asked the same. Do they have enough success that they can finally relax and enjoy life?

Philip D. Osborne

Patient advocate

Hurst, Texas

Connection to the article on working with narcissistic patients was easy to establish, from my experience as their therapist. Paul Hokemeyer's words echo those of the late Paul Russell, MD, whose paper on "The Theory of the Crunch" sat by my bedside for reassurance and to facilitate rest over the years that it took to collaborate with such troubled, emotionally impoverished folks.

Often, my clients were financially poor as well, as distinct from Dr. Hokemeyer's high net worth patients, as their lack of intimacy and their superficial overconfidence was hard for colleagues or co-workers to tolerate.

Shirley Jacobson, LICSW

Wayland, Mass.

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Title Annotation:LETTERS
Author:Osborne, Philip D.; Jacobson, Shirley
Publication:Addiction Professional
Article Type:Letter to the editor
Date:Sep 22, 2018
Words:275
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