Cold Therapy and Narcissistic Disorders of the Self

Abstract

Sam Vaknin

For well over a century, since the publication of Freud’s seminal “On Narcissism” in 1914, pathological narcissism was widely considered to be a disorder of the “character” or the personality. This culminated in the 1980s and 1990s with the inclusion of Narcissistic Personality Disorder (NPD) in the third, fourth and text revision editions of the Diagnostic and statistical Manual (DSM). Cold Therapy is based on two premises: (1) That narcissistic disorders are actually forms of complex post-traumatic conditions and not disorders of the personality; and (2) That narcissists are the outcomes of arrested development and attachment dysfunctions. Consequently, Cold Therapy borrows techniques from child psychology and from treatment modalities used to deal with PTSD. Cold Therapy consists of the re-traumatization of the narcissistic client in a hostile, non-holding environment which resembles the ambience of the original trauma. The adult patient successfully tackles this second round of hurt and thus resolves early childhood conflicts and achieves closure rendering his now maladaptive narcissistic defenses redundant, unnecessary, and obsolete. In the process, both transference and countertransference are encouraged in order to most closely recreate the roles of the original “perpetrator” of abuse (abuser) and his or her victim (the patient or client). Cold Therapy makes use of proprietary techniques such as erasure (suppressing the client’s speech and free expression and gaining clinical information and insights from his reactions to being so stifled). Other techniques include: grandiosity reframing, guided imagery, negative iteration, other-scoring, happiness map, mirroring, escalation, role play, assimilative confabulation, hyper vigilant referencing, and re-parenting

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