Effectiveness of Schema Mode Therapy on Ambivalence in Emotional Expression and Defense Styles in Individuals with Narcissistic Personality Disorder

Abstract

Objective: This study aimed to investigate the effectiveness of schema mode therapy on ambivalence in emotional expression and defense styles in individuals with narcissistic personality disorder.

Methodology: This semi-experimental study employed a pretest-posttest design with a control group and follow-up. The statistical population consisted of individuals with narcissistic personality disorder who referred to counseling centers in Shiraz during 2023-2024. A total of 60 participants were selected through convenience sampling and randomly assigned to an experimental group (30) and a control group (30). The research instruments included the Emotional Expressivity Questionnaire (EEQ), the Defense Style Questionnaire (DSQ-40), and structured clinical interviews. The experimental group underwent 12 weekly 90-minute sessions of schema mode therapy, while the control group received no intervention. Data were analyzed using covariance analysis and Bonferroni post hoc tests.

Findings: The results indicated that schema mode therapy significantly increased positive emotional expression and intimacy while decreasing negative emotional expression in the experimental group (P<0.01). Additionally, a significant increase in mature defense styles and a reduction in neurotic and immature defense styles were observed in the experimental group (P<0.01).

Conclusion: Schema mode therapy is an effective approach for improving emotional expression ambivalence and transitioning from maladaptive to adaptive defense styles. This therapeutic method can be considered a suitable clinical intervention for individuals with narcissistic personality disorder.