Clinical Practice SWES Practice Exam

In working with a client who has narcissistic personality disorder, how might the social worker become involved in the client's perceptions?

1. As an object of the client's anger

2. As an idealized figure fulfilling unmet needs

3. As a target for the client's defensive reactions

4. As someone to provoke feelings of inadequacy

The correct answer is: As an idealized figure fulfilling unmet needs

The choice of becoming an idealized figure fulfilling unmet needs reflects a nuanced understanding of how individuals with narcissistic personality disorder may perceive relationships. Clients with this disorder often possess a fragile self-esteem and might idealize certain individuals whom they perceive as capable of meeting their emotional needs or enhancing their self-worth. This can be a reflection of the client’s internal struggles and their desire for validation and admiration. In this dynamic, the social worker may unintentionally become a source of idealization as the client projects their desires and unmet needs onto them. Such idealization can lead to the social worker being placed on a pedestal, seen as all good, which can temporarily enhance the client's self-esteem. However, this idealized perception can also shift if the social worker's actions or comments do not align with the client's expectations, revealing the dependency and volatility often present in these relationships. The understanding of this dynamic is crucial for effective intervention, as it can help the social worker navigate the complexities of the relationship and establish healthy boundaries while being aware of the potential for idealization and subsequent devaluation. This insight fosters a therapeutic environment that encourages self-awareness and growth for the client.