“…Overall, all patients tend to actualize in the therapeutic relationship the repetitive and dysfunctional interpersonal patterns that are ubiquitous in their real-life relationships. Narcissistically grandiose individuals-both adults and adolescents-tend to be aggressive towards the clinician, making contemptuous comments, devaluing or ignoring the clinician's interventions, or exerting omnipotent control to affirm their self-centeredness and grandiose illusion of self-sufficiency (e.g., P. F. Kernberg et al, 2000;Tanzilli, Colli, Gualco, & Lingiardi, 2018;Westen, DeFife, Malone, & DiLallo, 2014). Vulnerable patients tend to be interpersonally detached and aloof in therapy, disavowing the need for closeness; at the same time, they have to receive attention and admiration from their clinicians (Ogrodniczuk & Kealy, 2013).…”