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Smolen, A.G. (2006). An Analysis with a Latency-Age Girl with Posttraumatic Stress Disorder Resulting in a Secondary Narcissistic Personality Disorder. J. Infant Child Adolesc. Psychother., 5(2):175-195.

(2006). Journal of Infant, Child & Adolescent Psychotherapy, 5(2):175-195

An Analysis with a Latency-Age Girl with Posttraumatic Stress Disorder Resulting in a Secondary Narcissistic Personality Disorder

Ann G. Smolen, MSS, LCSW

I have always felt uncomfortable making use of Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnoses in my work. I never felt that such labels were useful in helping me to understand and subsequently help my patient. However, when I began to see 7-year-old Karen, it quickly became evident that she fit the criteria for the diagnosis of posttraumatic stress disorder (PTSD) and a secondary narcissistic personality disorder. With the guidance of my supervisor, I began to better understand how a young child can present with such a complex diagnosis. As I came to comprehend and empathize with Karen's inner life and her problematical dynamics, I was able to attempt to reach behind her defense of grandiosity and her mean, nasty exterior to the traumatized child within. This article explores how psychoanalysis with a latency-age child who presented with PTSD and a narcissistic personality disorder was successful and how Karen's pathological narcissistic structure slowly receded in favor of a more age-appropriate narcissism, which in turn, allowed her to get back on track developmentally.


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